Building & Safety Division 100 Civic Plaza, Dublin, CA Ph: (925)

Transcription

1 Community Development Department Building & Safety Division 100 Civic Plaza, Dublin, CA Ph: (925) Special Inspection and Testing Agreement Project: Address: Plan Check No.: (To applicants of projects requiring Special Inspection or Testing per Chapter 17 of the California Building Code) BEFORE A PERMIT CAN BE ISSUED: The owner or his/her representative, on the advice of the responsible Project Engineer or Architect, shall complete, sign and submit two (2) copies of the Special Inspection Agreement and Structural Tests Schedule to the Building Division for review and approval. ORIGINAL SIGNATURES are required on both pages; photocopied or faxed signatures are not acceptable. The owner and his/her general contractor, where applicable, shall also acknowledge the following conditions applicable to Special Inspection and/or Testing: 1. Contractor is responsible for proper notification to the Inspection or Testing agency for items listed. 2. Only the testing laboratory should take samples and transport them to their laboratory. 3. Copies of all laboratory reports and inspections are to be sent directly to this Division by the Testing agency on a weekly basis. 4. Inspection agency to submit names and qualifications of on-site special inspectors to this Division for approval. This will not be required when the agency provides each special inspector with an identification badge that indicates the following: a. Name of inspector. b. Photo of inspector. c. The specific areas in which the Inspector is qualified to inspect. d. An authorization signature by the registered Engineer who is a full-time employee of the agency. e. The special inspector shall display his/her badge whenever performing the function of an inspector. 5. The special inspector is responsible to the Chief Building Official for immediate notification of any concerns and/or problems encountered. 6. It is the responsibility of the contractor to review the Building Division approved plans for additional inspection or testing requirements that may be noted. A pre-construction conference at the job site is recommended to review special inspection procedures. 7. The special inspector shall use only Building Division Approved Drawings. 8. BEFORE AN OCCUPANCY PERMIT CAN BE ISSUED: The inspection agency shall submit a statement that all items requiring testing and inspection were fulfilled and reported. Those items not tested and/or inspected shall be noted in this statement. A copy of the statement shall be maintained at the job site for the Building Inspector s review prior to final inspections. 9. Constructor responsible for the construction shall submit a written statement of responsibility to the Chief Building Official and the owner per CBC Section where required. 10. Attach a City approved matrix list for all special inspectors showing inspection areas for which they are qualified by experience and appropriate certifications. (See enclosed) ACKNOWLEDGEMENT: Owner s Name (print) Signature Date Special Inspection Company Name Rep. Signature Date Project Architect / Engineer (print) Signature Date Contractor s Name (print) Signature Date Approved by Chief Building Official Signature Date G:\Forms & Handouts\BUILDING\Special Inspection & Testing Agreement.docx Page 1 of 5 (Rev 5/30/18)

2 STRUCTURAL TESTS AND INSPECTION SCHEDULE (Per CBC Sections 1704, 1705 or 1708) Hereby certifies that the Testing/Inspection Agency named above has been engaged to perform structural tests and inspection during construction, as checked below, to satisfy all applicable portions of the Building Code. Prior to issuance of any occupancy permit, the Inspection Agency shall submit a statement that all items of designated work performed were reported. Any items checked but not tested or inspected will be noted and explained. Whenever any designated items on the list are ready for sampling, testing, or inspection, it shall be the responsibility of the contractor to give timely notice to the Inspection Agency so that the required services may be performed. REINFORCING STEEL: Tensile & Bend, one set per heat per Inspection of Placement Inspection of Welding Dowelling tons MASONRY: Preliminary Acceptance Tests (Masonry Units, Wall Prisms) Subsequent Tests (Mortar, Grout, Field Wall Prisms) Inspection of Grouting Inspection of Placement & Grouting CONCRETE, SHOTCRETE, GROUT & MORTAR: Concrete Shot Grout Mortar Aggregate Tests for Designs Suitability of Aggregates Mix Designs Test Panel Batch Plant Inspection Cement Grab Sample Inspect Placing Compression Tests Cast Specimens Pick-Up Samples Shrinkage Bars Yield Check Air Check Dry Unit Weight PRECAST CONCRETE: Reinforcing Tests Inspection of Reinforcing Placement Tendon Tests Inspection of Tendon Placement Inspection of Concrete Batching Inspection of Panel Attachments & Inserts Compression Tests Inspection of Stressing/Transfer PILING, CAISSONS, CAPS, TIES: Drilled Piers Inspection of Reinforcing Placement Inspection of Concrete Batching Epoxy Holdowns UNDERPINNING: Inspection of Steel Fabrication Inspection of Reinforcing & Forms Inspection of Tiebacks Others: Epoxy Anchors Anchor Bolts Installed in concrete STRUCTURAL STEEL: (list specific members below) Shop Identification & Welding Inspection Shop Ultrasonic Inspection Shop Radiography Field Welding Inspection Field Bolting Inspection Field Ultrasonic Inspection Field Radiography Metal Deck Welding Inspection ASPHALTIC CONCRETE: Mix Designs Inspection of Batch Plant Core/Test Field Inspection Suitability Tests Specific Gravity Asphalt Content Sieve Analysis K Factors Stabilometer Valve Swell INSULATING CONCRETE: Unit Weights FIREPROOFING: Inspection of Placement Density Tests Thickness Tests Inspect Batching Acceptance Tests STRUCTURAL WOOD: Inspection of Fabrication Inspection of Truss Joist Fabrication Components Inspection of Glue Lam Fabrication Nailing and Bolting Anchoring and Other Fastening FILL MATERIAL: Acceptance Tests Moisture-Density Determination Field Density ROOFING: Inspection of placement Seismic Resisting Elements (Periodic Special Inspection is Required UON) Cold-Formed Steel Framing: Bolting Screw Attachment Anchorage of Other Fastening G:\Forms & Handouts\BUILDING\Special Inspection & Testing Agreement.docx Page 2 of 5

3 Storage Racks and Access Floors: Anchorage of Access Floors Anchorage of Storage Racks 8 Feet or Greater in Height Erection and Fastening of Architectural Components: Exterior Cladding Interior and Exterior Nonbearing Walls Interior and Exterior Veneer Fastening of Mechanical and Electrical Components: Electrical Equipment for Emergency or Standby Power Anchorage of other Electrical Equipment in Seismic Design Category E or F Installing of Piping System Specify if other tests, inspections or special instructions are required for the project. G:\Forms & Handouts\BUILDING\Special Inspection & Testing Agreement.docx Page 3 of 5

4 RECOGNIZED SPECIAL INSPECTION & TESTING AGENCIES KEY: RC = Reinforced Concrete PC = Pre-Stressed/Post-Tensioned Concrete SM = Structural Masonry SS = Structural Steel Welding/Bolting FP = Spray-Applied Fireproofing URM = Unreinforced Masonry Push/Torque Tests Only Agency Name HQ Address Phone/Fax No. RC PC SM SS FP URM Exp. Date A1 Inspection Services Advanced Testing & Inspections Achievement Engineering Corp Apex Testing Lab, Applied Material Engineering BAGG Engineers Berlogar Geotechnical Consultants Biggs Cardosa, * B.S.K. Capex Engineering, Consolidated Engineering Labs Construction Materials Testing, Construction Testing Services Construction Testing & Engineering, Earth Systems Pacific ENGEO, Gularte &, HP Inspections Inspection Services, KC Engineering Co. Kleinfelder, Korbmacher Engineering, Krazan and, MatriScope Engineering Laboratories, Moore Twining 1754 Mission St. San Francisco, CA Brunken Ave., Suite B Salinas, CA s 3 rd St., Unit 206 San Jose, CA Third St., Suite 3E San Francisco, CA ST St. Oakland, CA W Maude Ave. Sunnyvale, CA Sunol Blvd. Pleasanton, CA The Alameda, Suite 200 San Jose, CA Quarry Ln., Suite 300 Pleasanton, CA Shanico Common Fremont, CA Crow Canyon Rd., Ste. 100 San Ramon, CA F Pike Ct. Concord, CA Rheem Dr., Suite A Pleasanton, CA West Larch Rd., Suite F Tracy, CA S Hillview Dr. Milpitas, CA Crow Canyon Rd., Ste. 250 San Ramon, CA Nichols Dr. Rocklin CA Sunol St., Bldg. H San Jose, CA Pier 26 The Embarcadero San Francisco, CA Cotting Ln., Suite A Vacaville, CA Willow Rd., Suite 100 Pleasanton, CA Preston Ct., Suite B Livermore, CA Sierra Ct., Suite B Dublin, CA th St., Suite 1429 Oakland, CA Power Inn Rd., Suite C Sacramento, CA (415) (415) X X X X X X 5/15/18 (831) (831) X X X X X X 7/10/18 (800) (408) X X 11/25/18 (415) (415) X X X X X X 12/9/18 (510) (510) X X X X X 5/1/18 (650) (650) X X X X X 5/23/20 (925) (925) X X X X 3/4/18 (408) (408) X X X X X 1/5/18 (925) (925) X X X X X 10/2/15 (510) (510) X X X X X X 9/9/18 (925) (925) X X X X X X 5/27/20 (925) (925) X X 4/8/18 (925) (925) X X X X X X 5/15/20 (800) (209) X X X X X X 6/2/18 (408) (408) X X X X X X 6/3/18 (925) (925) X X X X X X 5/13/18 (916) (916) X IT IT 5/24/18 (408) (408) X X X X X X 11/30/17 (415) (415) X X X X X X 9/24/18 (707) (707) X X X X X 12/6/18 (925) (925) X X X X X X 7/31/18 (925) (925) X X X X X 7/1/18 (925) (925) X X X X X X 3/1/18 (510) (510) X X X X X X 2/3/18 (916) (916) X X X X X X 3/1/18

5 RECOGNIZED SPECIAL INSPECTION & TESTING AGENCIES KEY: RC = Reinforced Concrete PC = Pre-Stressed/Post-Tensioned Concrete SM = Structural Masonry SS = Structural Steel Welding/Bolting FP = Spray-Applied Fireproofing URM = Unreinforced Masonry Push/Torque Tests Only Agency Name HQ Address Phone/Fax No. RC PC SM SS FP URM Exp. Date MPE Mid Pacific Engineering Inc Neil O. Anderson & Nicholas Engineering Consultants* Ninyo & Moore North American Technical Services Purcell, Rhoades & Raney Geotechnical, RES Engineers, RMA Group Signet Testing Laboratories Smith-Emery Company Structure Materials Group Stevens, Ferrone & Bailey Engineering Summit Terracon Consultants, Inc Twining Laboratory Terrasearch, Testing Engineers, Valley Inspection, Wallace-Kuhl & Youngdahl Consulting Group 2915 Innsbruck Dr. Suite A Redding CA 840 Embarcadero Dr Suite 20 West Sacramento, CA Goldenland Ct., Suite 100 Sacramento, CA Dublin Blvd., Suite 15 Dublin, CA Webster St., Suite 400 Oakland, CA Enterprise Way, Suite 4 Modesto, CA Hook Ave. Pleasant Hill, CA Beacon Blvd. West Sacramento, CA Missouri St., Suite 207 San Francisco, CA Wright Brothers Ave. Livermore, CA Breakwater Ct. Hayward, CA PO Box , Hunters Point Shipyard, Building 114 San Francisco, CA Research Dr. Livermore CA Willow Pass Ct. Concord, CA Clayton Rd., Suite 1380 Concord, CA Gold Camp Dr., Suite 170 Rancho Cordova CA Santa Ana Ave. Sacramento, CA Pieren Rd. San Jose, CA Teagarden St. San Leandro, CA Woodrow Ave. Vallejo, CA W Hammer Ln., Suite F Stockton, CA Glenhaven Ct. El Dorado Hills, CA (530) (503) (919) (916) (916) (916) (925) (925) (510) (510) (209) X X X X X 1/30/18 X X X X X 4/17/18 X X X X X X 8/21/18 X X X X X 10/1/16 X X X X X 10/2/18 (925) (925) X X X X X 12/1/18 (916) (916) X X X X X X 1/10/16 (415) (415) X X X X X X 8/14/18 (925) (925) X X X X X X 2/25/20 (510) (510) X X X X X X 12/1/18 (415) (415) X X X X X X 9/28/18 (925) (925) (925) (925) (925) (925) (916) (916) (916) (916) (408) (408) (510) (510) (707) (707) (209) (209) (916) (916) X X IT X X X 8/27/18 X X X X X X 7/5/18 X X X X X 3/6/18 X X X X X 3/13/18 X X X X X X 1/23/18 X X X X X X 12/1/17 X X X X X X 5/3/18 X X 2/7/18 X X X X X X 6/13/18 X X X X X 6/17/18 Agencies have not been evaluated for geotechnical special inspection or for nondestructive testing. Agencies may not be qualified to perform all aspects of special inspection. Agencies may have offices in more than one location. Other agencies may be approved by local jurisdictions. *Agency Sub-Contracts Laboratory Services