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1998, 07-10 Inspection & Testing: 98-3307 Jul -10-98 02 : 52P Giffc i Consultants 509 42925 P.02 E-1567-02 • SPECIAL INSPECTOR AND TESTING LAB EMPLOYMENT ACKNOWLEDGEMENT FORM Please complete one form for each INDIVIDUAL performing Special Inspection or Testing work on each project. Date July 10, 1998 Project Address 5908 E. Broadway Project Name Lamar Outdoor Advertizinq Project No. 98-3307 Inspection or Lab Firm Name Gifford Consultants, Inc. Address 2020 E. Springfield Ave. , Spokane, Washington 99202 Phone (509) 534-3670; FAX (509) 534-2925 Name of Individual performing work Timothy D. Bather ICBO Number 66513 ( ) Non-Certified Trainee Supervisor (if Trainee) ICBO No (must be Certified Special Inspector) STATEMENT OF UNDERSTANDING Timothy D. Barber ,hereby affirm that l have been employed by Gifford Consultants, Inc. for a duration of as needed (hours,days,weeks)to provide special inspections under Section 306 of the Uniform Building Code of: Welding and high strength bolting as it relates to the above stated project and that I am aware that as special inspector, my duties and responsibilities include: 1)Observation of the work assigned for conformance with the approved design drawings and specifications,2)Furnishing inspection reports to the building official,and the engineer or architect of record, in addition to other designated persons. All discrepancies shall be brought to the immediate attention of the contractor for correction,then,if uncorrected, to the proper design authority and to the building official, and 3) Submitting a final signed report stating whether the work requiring special inspection was, to the best of my knowledge, in conformance with the approved plans and specifications and the applicable workmanship provisions of the Uniform Building Code. I also agree to immediately notify the building official if my employment as it relates to this project is modified in any way or terminated prior to submittal of my final report. Individual's Signature - Supervising Special Inspector's Signature (required if indivual is a Trainee)