Special Inspections Owners Acknowledgement

Special Inspections Owners Acknowledgement

IBC Chapter 12 -2015 Edition

OWNERS ACKNOWLEDGEMENT OF SPECIAL INSPECTIONS
I hereby acknowledge that I am the owner of the project referenced below and I have contracted with the design professional listed below to act as my agent in contracting and coordinating the required special inspections for this project.
Permit Number
Project Name
Owner's Name
Owner's Address
Street Address Address Line 2 City State ZIP Code
Owner's telephone contact number(s)
Phone number Type (Cell/Work/Fax)
SC Registered Design Professional in Responsible Charge
First Last
Firm (optional)
License Number
Phone
Email
Address
Street Address Address Line 2 City State ZIP Code
IDENTIFICATIONOF THE DESIGN PROFESSIONAL IN RESPONSIBLE CHARGE
Project
Permit Number
Project Location
Street Address Address Line 2 City State ZIP Code
Project Owner
Project Owner Address
Street Address Address Line 2 City State ZIP Code
SC Registered Design Professional in Responsible Charge
First Last
Firm (optional)
SC License Number
Phone
FAX
Address
Street Address Address Line 2 City State ZIP Code
Architect
First Last
Firm (optional)
SC License Number
Phone
FAX
Address
Street Address Address Line 2 City State ZIP Code
Structural Engineer
First Last
Firm (optional)
SC License Number
Phone
FAX
Address
Street Address Address Line 2 City State ZIP Code
STATEMENT OF SPECIAL INSPECTIONS
Project
Permit Number
Project Location
Street Address Address Line 2 City State ZIP Code
Project Owner
Project Owner Address
Street Address Address Line 2 City State ZIP Code
SC Registered Design Professional in Responsible Charge
First Last
Firm (optional)
SC License Number
Phone
FAX
Address
Street Address Address Line 2 City State ZIP Code
Architect
First Last
Firm (optional)
SC License Number
Phone
FAX
Address
Street Address Address Line 2 City State ZIP Code
Structural Engineer
First Last
Firm (optional)
SC License Number
Phone
FAX
Address
Street Address Address Line 2 City State ZIP Code
CHECKLIST OF REQUIRED SPECIAL INSPECTION REPORTS & FIRMS/INDIVIDUALS PERFORMING INSPECTIONS
Project
Permit No
Project Location
Street Address Address Line 2 City State ZIP Code
Fabricator
ISO 9000 Lead Quality Assurance Auditor. IBC 1704.2.5.1
Firm/Individual Name
SC License No
Metal Building Fabrication
IBC 1704.2.5
Firm/Individual Name
SC License No
Precast Concrete Fabrication
IBC 1704.2.5
Firm/Individual Name
SC License No
Prefabricated Trusses
IBC 1704.2.5
Firm/Individual Name
SC License No
Steel Bar Joist Fabrication
IBC 1705.2.3
Firm/Individual Name
SC License No
Structural Steel Fabrication
IBC 1705.2.1, 1705.12.1
Firm/Individual Name
SC License No
Site Welding
IBC 1705.3.1, 2204.1
Firm/Individual Name
SC License No
Steel Frame
IBC 1705.2
Firm/Individual Name
SC License No
High Strength Bolts
IBC 1705.2, 2204.2
Firm/Individual Name
SC License No
Concrete
IBC 1705.3
Firm/Individual Name
SC License No
Masonry
IBC 1705.4
Firm/Individual Name
SC License No
CHECKLIST OF REQUIRED SPECIAL INSPECTIONREPORTS& FIRMS/INDIVIDUALS PERFORMING INSPECTIONS
Wood Construction
IBC 1705.5 and IBC 2306.3.2
Firm/Individual Name
SC License No
Soils
IBC Sections 1705.6
Firm/Individual Name
SC License No
Fill Placement
IBC 1803.5
Firm/Individual Name
SC License No
Pile Foundations
IBC Section 1705.7
Firm/Individual Name
SC License No
Pier Foundations
IBC Section 1705.8
Firm/Individual Name
SC License No
Sprayed Fire Resistance Materials
IBC Section 1705.14 through 1705.15
Firm/Individual Name
SC License No
Exterior Insulation and Finish Systems (EIFS)
IBC Section 1705.16
Firm/Individual Name
SC License No
Special Cases
IBC Section 1705.1.1
Firm/Individual Name
SC License No
Special Inspection for Smoke Control
IBC Section 1705.18
Firm/Individual Name
SC License No
Special Inspections for Seismic Resistance
IBC Section 1705
Structural Steel
IBC Section 1705.2.1
Firm/Individual Name
SC License No
Structural Wood
IBC Section 1705.5, 1705.12.2
Firm/Individual Name
SC License No
Cold Formed Steel Framing
IBC Section 1705.2.2 through 1705.2.4, 1705.12.3
Firm/Individual Name
SC License No
Storage Racks and Access Floors
IBC Section 1705.12.7
Firm/Individual Name
SC License No
Architectural Components
IBC Section 1705.12.5
Firm/Individual Name
SC License No
Mechanical and Electrical Components
IBC Section 1705.12.6
Firm/Individual Name
SC License No
Structural Observations
IBC Section 1704.6.1
Firm/Individual Name
SC License No
Contractor Statement of Responsibility for Seismic System
IBC Section 1704.4
Firm/Individual Name
SC License No
Contractor Statement of Responsibility
IBC 1704.4 Contractor Responsibility. Each contractor responsible for the construction of a seismic force-resisting system, designated seismic system, wind or seismic resisting component listed in the Statement of Special Inspections.
Permit Number
Project Name
Project Address
Street Address Address Line 2 City State ZIP Code
Contractor's Name
Contractor's License Number
Contractor's Address
Street Address Address Line 2 City State ZIP Code
Contractor's Phone Number
1. I hereby acknowledge that I have read and am aware of the special inspection requirements contained in the Statement of Special Inspections.
2. I hereby acknowledge that control will be exercised to obtain conformance with the construction documents approved by the Building Official.
3. The procedures for exercising control within the contractor’s organization are as follows:
The reports will be put in the jobsite 3 ring binder in reverse chronological order. Additional copies of the reports will be distributed by:
to the individual firms
Submitted on a (explained bellow) Basis
4. Control of this process will be exercised by:
Name
First Last
Qualifications
Position within the organization

Special Inspections Owners Acknowledgement

Special Inspections Owners Acknowledgement

OWNERS ACKNOWLEDGEMENT OF SPECIAL INSPECTIONS

IDENTIFICATIONOF THE DESIGN PROFESSIONAL IN RESPONSIBLE CHARGE

STATEMENT OF SPECIAL INSPECTIONS

CHECKLIST OF REQUIRED SPECIAL INSPECTION REPORTS & FIRMS/INDIVIDUALS PERFORMING INSPECTIONS

CHECKLIST OF REQUIRED SPECIAL INSPECTIONREPORTS& FIRMS/INDIVIDUALS PERFORMING INSPECTIONS

Special Inspections for Seismic Resistance

Contractor Statement of Responsibility

Berkeley County Government

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Phone number	Type (Cell/Work/Fax)