HomeMy WebLinkAboutSpecial Inspection FormDEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
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AUTHORIZATION FOR SPECIAL INSPECTION ACTIVITIES
Development Services Division
1055 S Grady Way – Renton, WA 98057
Phone: (425) 430-7200 | Fax: (425) 430-7231
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:
Telephone:
Testing Agency:
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