HomeMy WebLinkAboutSigned SCI Wynne Ranch - Spec Insp Notice Form_011921 - esignPlanning and Development Services
Building and Code Regulations
2300 Virginia Avenue
Fort Pierce, FL 34982-5652
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Special Inspector Form 2/17/2020
NOTICE TO BUILDING OFFICIAL OF SPECIAL INSPECTOR
I (we) have been retained by _____________________________________________ , Owner,
to perform special inspector services in accordance with the Florida Statutes 471 & 553 and the
Florida Building Code – 6th Edition 2017.
Project Name: ___________________________________ Permit # _____________________
Address: _______________________________________ City _____________ Zip ________
NOTE: ONLY THE MARKED BOXES APPLY
____ SPECIAL INSPECTOR FOR PILINGS
_____ SPECIAL INSPECTOR FOR SOIL COMPACTION AND FOUNDATIONS
_____ SPECIAL INSPECTOR FOR SHORING
_____ SPECIAL INSPECTOR FOR REINFORCING MASONRY AND ALL CONCRETE ELEMENTS
____ SPECIAL INSPECTOR FOR POST-TENSION CABLES AND ACCESSORIES
____ SPECIAL INSPECTOR FOR STEEL AND/OR WELDED CONNECTIONS
____ SPECIAL INSPECTOR FOR FLOOR AND ROOF TRUSSES
____ SPECIAL INSPECTOR FOR PRECAST UNITS, TILT WALL, ATTACHMENTS & REBAR PLACEMENT
____ SPECIAL INSPECTOR FOR CURTAIN WALL AND/OR STRUCTURAL GLAZING
____ SPECIAL INSPECTOR FOR PLYWOOD DECK AND/OR METAL DECK AND ATTACHMENTS
____ SPECIAL INSPECTOR FOR THE FOLLOWING (If not identified above):
___________________________________________________________________________________________
* The following individual(s) employed by this firm are authorized representatives to perform
inspections on the project named herein and are authorized by the signature and seal below
1. ___________________________________ 2. ___________________________________
3. ___________________________________ 4. ___________________________________
* a. Authorized Representatives of an Engineer or an Engineer performing threshold inspections shall
conform to Rule 61G15-30.004 of the F.A.C. & FL Statute Section 553.79(5)(a),(b) and (c), Sections 110.7 & 110.8 of
the Florida Building Code (FBC)
b. Special inspectors performing building department required inspections shall conform to the 6th
Edition (2017) Florida Building Code, comply with Section 110.8, and be licensed under FS 468 Part XII. Permission
to perform these inspections may only be performed under specific authorization of the Building Official
c. The special inspector may not serve as a surrogate in carrying out the responsibilities of the
building official, the architect, or the engineer of record
d. A list of all individuals performing actual inspections with their qualifications, resumes and license
information shall be furnished to the Building Department for approval with this document. Only persons listed on this
document and authorized by the Building Official or his/her representative will be accepted
I, (we) will notify the St. Lucie County Building Department of any changes regarding authorized
personnel performing inspection services.
I, (we) understand that a Special Inspection Log for each building must be displayed in a
convenient location on the site for reference by the St. Lucie County Building Inspector. All
Wynne Ranch Tower SLC - 1910-0086
Orange Avenue St. Lucie
Alberto Rios
Telecommunication compound post construction
SCI Towers
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Special Inspector Form 2/17/2020
mandatory inspections, as required by the Florida Building Code, must be performed by the
County. The St. Lucie County Building Inspector must be called for all mandatory inspections.
Inspections performed by the Special Inspector hired by the Owner are in addition to the
mandatory inspections performed by the Building Department. Upon completion of the work
under each Building Permit, I (we) will submit to the St. Lucie County Building Inspector at the
time of final inspection the completed inspection log form and a signed and sealed statement
indicating that, to the best of my knowledge, belief and professional judgment, those portions of
the project approved for special inspections and permits outlined above and are in substantial
accordance with the approved plans. I (we) hereby certify that if shoring is needed to be
installed on an emergency basis, it will be in compliance with the provisions of the Florida
Building Code and in conformance with generally accepted engineering standards.
Engineer Printed Name: ______________________________________________________
Engineer Signature: __________________________________________________________
Company Name: __________________________________________________________
Address: ___________________________________________________________________
City: ____________ State: ____ Zip: ________+_____ Phone (____) ______-_____________
PE # ________ SI # ________
Signed & Sealed:
Owner/Agent Printed Name: _____________________________________________________
Owner/Agent Signature: ________________________________________________________
For St Lucie County Office Use Only
Date document received: _____/_____/_____ By: ________________________________
Permit # ______________________ Authorization: _____________________________
Date: _____/_____/_____
Hugh O. Reilly
CBVR TELECOM DESIGN GROUP
6505 N Himes Avenue
TAMPA FL 33634 305 439 6266
72410