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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
Print Name
Si at of O /Aut
Mindy's Place (Estates) lot 1
16000 SE 140th Place Renton WA 98059
Alex Poblete
Robinson Nobel (As required for structural fill only)
(253) 475-7711
3011 S. Huson St. Suit A Tacoma WA 98409
David Detzler
October 15, 2018
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PR13000037
B19003029
V1
RECEIVED
06/06/2019
aalexander
BUILDING DIVISIONAPPROVEDBUILDING DIVISION
THIS SET OF APPROVED PLANS MUST BE ON THE JOB AT ALLTIMES DURING CONSTRUCTION. THIS BUILDING IS NOT TO BEOCCUPIED UNTIL AFTER FINAL INSPECTION BY THE RENTONBUILDING DIVISION AND RECEIPT OF CERTIFICATE OFOCCUPANCY.
APPROVAL SHALL NOT BE CONSTRUED AS THE AUTHORITY TOVIOLATE OR CANCEL ANY PROVISIONS OF CODES, ORDINANCES,OR OTHER REGULATIONS ENFORCED BY THIS CITY.
DATE: 07/16/2019