HomeMy WebLinkAboutNotice to Building Official of Special InspectorPlanning and Development Services
Building and Code Raaulations
A 2300 Virginia Ai enue
Fort Pierce, FL 34 82-5652
NOTICE TO BUILDING OFFICIAL OF SPECIALNSPECTOR
(we) have been retained by C%b AV
�`vt CO ,,7_,6 A414 116, N , Owner,
to perform special inspector services in accordance with the Florid I Statutes 471 & 553 and the
Florida Building Code — 6th Edition 2017.
Project Name:Gwvkpq,64"44� 605
Permit
1 Address: T� A City Zip .
i
NOTE: ONLY THE MARKED BOXES AP LY
SPECIAL INSPECTOR FOR PILINGS
SPECIAL INSPECTOR FOR SOIL COMPACTION AND FOUNDATIONS
SPECIAL INSPECTOR FOR SHORING
SPECIAL INSPECTOR FOR REINFORCING MASONRY AND ALL CONC it TE ELEMENTS
SPECIAL INSPECTOR FOR POST -TENSION CABLES AND ACCESSORI =S
SPECIAL INSPECTOR FOR STEEL AND/ok WELDED CONNECTIONS
SPECIAL INSPECTOR FOR FLOOR AND ROOF TRUSSES
SPECIAL INSPECTOR FOR PRECAST UNITS, TILT WALL, ATTACHMEN^ & REBAR PLACEMENT
SPECIAL INSPECTOR FORCURTAIN WALL AND/OR STRUCTURAL G "ZING
SPECIAL INSPECTOR FOR PLYWOOD`DECK AND/OR METAL DECK AN ATTACHMENTS
SPECIAL INSPECTOFt:FOR THE FOL OWING If not identified above):
i'l.�r:✓ l ra t e
V- JA) �:uiGt �ler �
i
The,foliowing Individual(s) employed by this firm are.authorized rep1 sentatives to perform
in ctions nit" p j Pt: named, herein and are au horied the sr nature,.:and seal below
3. 4.
II.
a. Authorized Representatives.of an Engineer Oran Engineer perform��ing threshold inspections shell
conform to Rule 61 G15-3Cy.004 of the F,A,C. &'FL Statute Section 553.79(5)(a),(b) slid (c), Sections 110.7 & 110.t3 of
the Florida Building, Code (F8C)
b. Special inspectors perrorming building department required inspec ions shall conform to the 6th
Edition (2017) Florida Building'Cade,' comply with Section 110.8, and be licensed u er Ft 468 Part )al. Permission
to perfonn these Inspections may only be. performed under specificauthorization of If 0 Building Official
C. The special .inspector may not serve as a surrogate in carrying o the responsibilities of the
building o�eiai, the. arcl4iect, or the engineer of record
d. A list of all individuals.perli rming actual inspections with their quay cations, resumes and license
information shall be fumistied'to the Building Departn erlt for approval with this docum nL Only persons listed an this
document and authddzed-by the Building Official or hi$lher representative wilrbe acre ted
i, (we) will notify the St. Lucie County B.ullding Department of any changes regarding authorized
personnel performing inspection services.
I, (we) understand that a •Special Inspection Log for each building mus be displayed In
convenient location on the site for reference by the St. Lucie County B'� ilding In lector. All
Page, 1. of 2
Sp®clal Inspector Form 2/47/2020
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: _ 1 SW 11j'W AgQJL)
r
City: State: K. zip: Phone (�,"t, I_I i 3 _
PE # ' tjSi #�
Signed & Sealed:
* • 39539
Owner/en
Owner/Agent
For St Lucie County Office Use Only
Date document received: / / By:
Permit # Authorizatio ,
Date: 11J
Page 2 of 2
Spealal Inspector Form 2/17/20,20 P�y