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HomeMy WebLinkAboutSpecial Inspection Formrentonwa.gov/permitcenter | permittech@rentonwa.gov | 425-430-7215 3/15/2023 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