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Project Name:
Address:
Responsibility under Section 109 of the International Building Code (IBC) for selection of a testing
laboratory lies with the owner or his agent (architect or structural engineer of record).
The following have been or will be contracted with to perform all SPECIAL INSPECTIONS required
per Chapter 17, IBC and the Renton Building Department.
o Structural Considerations
Testing Agency:
Telephone:
Address: City/State/Zip:
o Geotechnical Considerations Per Soils Report
Geotechnical Engineer of Record:
Testing Agency:
Telephone:
Address: City/State/Zip:
We understand that these assignments cannot be changed (transferred) once the building permit
has been issued without the approval of the Building Official.
The completed form must be returned to the City of Renton Plans Examiner prior to issuance of
the Building Permit.
Print Name
Signature of Owner/Authorized Agent Date
AUTHORIZATION
FOR SPECIAL
INSPECTION
ACTIVITIES
Development Services Division
1055 South Grady Way – Renton, WA 98057
Phone: 425-430-7200
www.rentonwa.gov www.MyBuildingPermit.com
Weatherly Inn Renton
4500 Talbot Rd S, Renton WA 98055
Materials Testing & Consulting, Inc.
(360) 534-9777
2118 Black Lake Boulevard SW Olympia, WA 98512
Earth Solutions NW, LLC
Earth Solutions NW, LLC
(425) 449-4704
1805 136th Pl NE Bellevue, WA 98005
Frank Durocher
August 14, 2019
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