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rentonwa.gov/permitcenter | permittech@rentonwa.gov | 425-430-7215 2/12/2024 Page 1 of 1
CITY OF RENTON Ι PERMIT CENTER
AUTHORIZATION FOR SPECIAL INSPECTION
ACTIVITIES
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.
STRUCTURAL CONSIDERATIONS
Testing Agency:___________________________________________________________________________________________________________________________________________________________________________________
Phone:___________________________________________________________________________________________________________________________________________________________________________________________________
Address:________________________________________________________________________________________________________________________________________________________________________________________________
GEOTECHNICAL CONSIDERATIONS PER SOILS REPORT
Geotechnical Engineer of Record:_________________________________________________________________________________________________________________________________________________
Testing Agency:_____________________________________________________________________________________________________________________________________________________________________________________
Phone:____________________________________________________________________________________________________________________________________________________________________________________________________
Address:_________________________________________________________________________________________________________________________________________________________________________________________________
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