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2001, 08-21 Inspection & Testing Agreement 08/21/2001 13:51 GEO ENGINEERS 4 Spokane County NO.227 p002 111 r • 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: August 21,2001 Project Address: 12606 E.Mission Ave. Project Name: Valley Hospital Addition Bid Pacs 4&5 Permit No. not yet issued Inspection or Lab Finn Name: GeoEngineers,Inc. Address: 523 East Second Ave.,Spokes,WA.99202 Phone: 363-3125 Fax: 363-3126 Name of Individual performing work: ; i,V,AziE Tim Barber Gary Panther Dave Lyon Scot Wise Jerry Amann 0855800-88,ACI 62512,ACI AC1 Tech.I ACI Tech I ACI Tech.I wyiM%' 0855800-84 0866959-84 - " _: 0855800-85 5060705-85 77-1:‘..:4 0855800-86 STATEMENT OF UNDERSTANDING 1,Timothy Barber,hereby affirm that GeoEngineers,Inc. has been employed by Valley Hospital and Medical Center for a duration of the project(hours,days,weeks)to provide special inspections wider Section 1701 of the Uniform Building Code of: Concrete.bolts in concrete,concrete reinforcing,structural steel andwelding hielt strength bolting,adhesive anchors special rgra g.excavatio aid �) as it relates to the above stated project and that I am aware that as a special inspector,ray 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 individual is a Trainee) 08/21/2001 13:51 GEO ENGINEERS 4 Spokane County NO.227 D003 • •• SPECIAL INSPECTION AND TESTING NOTICE/AGREEMENT Project Title:Valley Hospital Addition and Remodel Project Address:1,2606 E.Mission.Svokane,W.A. Project Owner:Valley Hospital and Medical Center Permit Number. unknown The above-referenced project requixes special inspection or testing per Section 1701 of the Uniform Building Code. Please acknowledge and return this Agreement to the appropriate department PART 1.GENERAL CONDITIONS 1. The Policy Manual for Special inspection under the Uniform Building Code in the City and County of Spokane sets forth the accepted and recommended practices associated with special inspection. A copy is attached for your reference. 2. The Special Inspector,special inspection agency and testing lab,hereinafter referred to as the • Special Inspector,must be approved by the Spokane County Department of Buildings. 3. The Special Inspector is responsible for immediately notifying the Building Official of any concerns and/or problems encountered. 4. Copies of all routine reports shall be submitted by the Special Inspector directly to the Building Official on a weekly basis. 5. The Special Inspector shall submit the naxties and qualifications of on-site inspectors and lab technicians to the Building Official for approval using the Employment Acknowledgement Form. 6. The Special Inspector shall use only those construction documents which have been approved by the Building Official. • 7. The contractor is responsible for reviewing the approved plans for additional inspection requirements that may be noted. S. The contractor is responsible for notifying the Special Inspector as to when items listed in the Tests and Inspections Schedule will be ready for inspection. PART 2.SPECIFIC REQUIREMENTS • 1. Which must be accomplished prior to issuance of a permit a. The owner or his designated representatives shall,on the advise of the responsible design professional,complete,sign and submit two copies of this Agreement to the Building Official for his approval. b. The Special Inspector shall submit completed Employment Acknowledgement Forms. All areas listed on the Tests and Inspections Schedule must be covered by a qualified Special Inspector 2. Which must be accomplished prior to issuance of a Certificate of Occupancy. a. All Special Inspector reports must have been received by the Building Official. 08/21/2001 13:51 GEO ENGINEERS -) Spokane County NO.227 1)004 1 • • b. The Special Inspector chill submit a final report to the Building Official stating that all items requiring testing and inspections were fiilfilled and reported,and that all work was done in accordance with the approved plans. Items not tested and/or inspected shall be noted in this report A copy of this report must be maintained on the job site until the Certificate of Occupancy has been issued. PART 3.TESTS AND INSPECTIONS SCHEDULE 1. The following checklist has been completed by the Building Official and indicates which tests and inspections are required to be performed by a Special Inspector. ❑ CONCRETE—During the taking of test specimens and placing of reinforced concrete and pneumatically placed concrete. O BOLTS INSTALLED IN'CONCRETE—During installation of bolts and placing of concrete around such bolts when stress increases permitted by Footnote No.5 of Table No.26—G of the Uniform Building Code are utilized. O DUCTILE MOMENT RESISTING FRAME— required in Section 2625(j)of the Unifoma Building Code. O REINFORCING STEEL AND PRESTRESSING STEEL—During all stressing and grouting of prestressed concrete and during placing of reinforcing steel,placing of tendons and prestressing steel for all concrete required to have special inspection. ❑ WELDING—Ductile moment-resisting steel frames as required by Section 2722(1)of the Uniform Building Code and all structural welding,including welding of reinforcing steel, ❑ HIGH-STRENGTH BOLTING—During all bolt installations and tightening operations. Q STRUCTURAL MASONRY—During preparations of masonry wall prisms,sampling and placing of all masonry units,placements of reinforcement,inspection of grout space,immediately prior to closing of cleanouts,and during all grouting operations. O REINFORCED GYPSUM CONCRETE—When cast-in-place Class B gypsum concrete is being mixed and placed ❑ INSULATING CONCRETE FILL—During the application of insulating concrete fill when used as part of a structural system. ❑ SPRAY-APPLIED FIREPROOFING—As required by Uniform Building Code Standard No.43-8, ❑ PILING,DRILLED PIERS AND CAISSONS—During driving and testing of piles and construction of cast- in-place drilled piles or caissons. O SHOTCRETE—During the taking of test specimens and placing of all shotcrete and as required by Section 2621(j)and(k)of the Uniform Building Code. O SPECIAL GRADING,EXCAVATION AND FILLING-During earthwork excavations,grading and filling operations inspection. O SPECIAL CASES—Work which,in the opinion of the Building Official,involves unusual hazards or conditions. 2. The owner hereby certifies that the special inspector(s)named in this Agreement have been engaged to perform tests and inspections,as indicated in the checklist below,during construction to satisfy all applicable portions of the Uniform Building Code. 08/21/2001 13:51 GEO ENGINEERS -4 Spokane County NO.227 D005 r I • PART 4.DESIGNATION 0)'SPECIAL INSPECTOR(S) List special inspector(s)intended to be employed by the owner. Include mac,address and phone nwmber for all individuals who will be doing on-site or lab work relating to the required tests and inspection& Tim Barber,GeoEngineers-Gifford,523 East Second,Spokane,WA 99205 (509)363-3125 Jen!Ani.GeQEngineers-Gifford,523 East Second.Spokane.WA 99205(509)363-3125 Gary Panther. GeoEngineers-Gifford,523 East Second, Spokane,WA 99205(509)363-3125 Scot Wise.GeoEngineets-QiJ ord,523 East Second.Spokane.WA 99205(509)363-3125 Dave Lyon,GeoEngineers-Gifford,523 East SecondLSpokane,WA 99205 (509)363-3125 FART 5. ACKNOWLEDGEMENT I have read and agree to comply with the terms and conditions of this Agreement OWNER: BY: DATE: CONTRACTOR: BY: DATE: ARCHITECT: BY: DATE: ENGINEER: BY: DATE: PART 6. ACCEPTANCE BY BUILDING OFFICIAL • I accept the special inspector(s)listed in part 4 for the purposes of performing required tests and inspections • listed in Part 3. )3111WING OFFICIAL: BY: DATE: 08/21/2001 13:51 GEO ENGINEERS + Spokane County NO.227 E001 ,y , Geo Engineers 523 Fast Second Avenue FAX TRANSMITTAL Spokane,WA 93lephone: (509)363-31125 Tel25 Fax: (509)363-3126 To: Spokane County Dept of Date: August 21,2001 Building&Planning File: 8675-001-04 Fax Number: 477-4703 Attention: Jun Mascardo Regarding: Special Inspection Form-Valley Hospital • Pages Date Description 1 8/21/01 Fax Txansouittal 4 8/21/01 Special Inspection Employment Acknowledgement Form Total Pages: 5 Comments: Signed: Tim Barber tbarber@geoengineers.coat DISCLAIMER This facsimile and any attachments are confidential and intended solely for the use of the individual or entity to whom they are addressed.