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---PAGE BREAK--- General. Where application is made for construction as described in this section, the owner or the registered design professional in responsible charge acting as the owner’s agent shall employ one or more special inspectors to provide inspections during construction on the types of work listed under the International Building Code® (IBC), 2003 edition, Section 1704. The special inspector shall be a qualified person who shall demonstrate competence, to the satisfaction of the building official, for inspection of the particular type of construction or operation requiring special inspection. These inspections are in addition to the inspections specified in IBC Section 109. Exceptions: 1. Special inspections are not required for work of a minor nature or as warranted by conditions in the jurisdiction as approved by the building official. 2. Special inspections are not required for building components unless the design involves the practice of professional engineering or architecture as defined by applicable state statutes and regulations governing the professional registration and certification of engineers or architects. 3. Unless otherwise required by the building official, special inspections are not required for occupancies in Group R-3 as applicable in IBC Section 101.2 and occupancies in Group U that are accessory to a residential occupancy including, but not limited to, those listed in IBC Section 312.1. Building permit requirement. The permit applicant shall submit a statement of special inspections prepared by the registered design professional in responsible charge in accordance with IBC Section 106.1 as a condition for permit issuance. This statement shall include a complete list of materials and work requiring special inspections by this section, the inspections to be per formed and a list of the individuals, approved agencies or firms in tended to be retained for con ducting such inspections. Report requirement. Special inspectors shall keep records of inspections. The special inspector shall furnish inspection reports to the building official, and to the registered design professional in responsible charge. Reports shall indicate that work inspected was done in conformance to approved construction documents. Discrepancies shall be brought to the immediate attention of the contractor for correction. If the discrepancies are not corrected, the discrepancies shall be brought to the attention of the building official and to the registered design professional in responsible charge prior to the completion of that phase of the work. A final report documenting required special inspections and correction of any discrepancies noted in the inspections shall be submitted at a point in time agreed upon by the permit applicant and the building official prior to the start of work. ---PAGE BREAK--- PLEASE PRINT CLEARLY USING PERMANENT BLUE OR BLACK INK. APPLICANT’S NAME: ROLE: CONTRACTOR DESIGN PROFESSIONAL OTHER: COMPANY: ADDRESS: BUILDING OR SUITE NO.: CITY: STATE: ZIP CODE: APPLICANT’S INFO.: PHONE NO.: CELL NO.: FAX NO.: PROJECT NAME: ASSESSOR PARCEL NO. (APN): PROJECT ADDRESS: BUILDING OR SUITE NO.: PROJECT INFO.: CITY: FERNLEY STATE: NV ZIP CODE: 89408 CHECK SPECIAL INSPECTION CATEGORIES REQUIRED FOR THIS PROJECT FABRICATOR STEEL CONSTRUCTION WELDING HIGH-STRENGTH BOLTING CONCRETE MASONRY WOOD CONSTRUCTION SOILS PILE FOUNDATIONS PIER FOUNDATIONS WALL PANELS & VENEERS EIFS SPRAYED FIRE-RESISTANT MATERIALS SPECIAL CASES AND/OR OTHER: SPECIAL INSPECTOR: COMPLETED STATEMENT OF UNDERSTANDING ATTACHED (REQUIRED) FIRM/EMPLOYED BY: ADDRESS: BUILDING OR SUITE NO.: CITY: STATE: ZIP CODE: PHONE NO.: CELL NO.: FAX NO.: ICC CERTIFICATE CATEGORY: ICC CERTIFICATE NO.: EXP.: ICC CERTIFICATE CATEGORY: ICC CERTIFICATE NO.: EXP.: ICC CERTIFICATE CATEGORY: ICC CERTIFICATE NO.: EXP.: ICC CERTIFICATE CATEGORY: ICC CERTIFICATE NO.: EXP.: SPECIAL INSPECTOR: COMPLETED STATEMENT OF UNDERSTANDING ATTACHED (REQUIRED) FIRM/EMPLOYED BY: ADDRESS: BUILDING OR SUITE NO.: CITY: STATE: ZIP CODE: PHONE NO.: CELL NO.: FAX NO.: ICC CERTIFICATE CATEGORY: ICC CERTIFICATE NO.: EXP.: ICC CERTIFICATE CATEGORY: ICC CERTIFICATE NO.: EXP.: ICC CERTIFICATE CATEGORY: ICC CERTIFICATE NO.: EXP.: SPECIAL INSPECTION INFORMATION ICC CERTIFICATE CATEGORY: ICC CERTIFICATE NO.: EXP.: FOR BUILDING DIVISION USE ONLY BUILDING PERMIT NO.: BP PLAN NO.: APPROVED BY: DATE: Community Development Department 595 Silver Lace Blvd., Fernley, NV 89408 * [PHONE REDACTED] ---PAGE BREAK--- FOR BUILDING DIVISION USE ONLY BUILDING PERMIT NO.: BP ARCHITECT: ADDRESS: BUILDING OR SUITE NO.: CITY: STATE: ZIP CODE: PHONE NO.: CELL NO.: FAX NO.: ENGINEER OF RECORD: ADDRESS: BUILDING OR SUITE NO.: CITY: STATE: ZIP CODE: DESIGN PROFESSIONAL’S INFO.: PHONE NO.: CELL NO.: FAX NO.: I certify that I have read and understand this application and state that the above information is correct. Special inspections shall meet the minimum requirements of the International Building Code® (IBC), 2003 edition, Chapter 17. I further understand that special inspection services shall be made at no expense to the City of Fernley. The contract for special inspection services with the designated firm/inspector shall not be terminated for this project until a new Special Inspection Application & Agreement is submitted and approved by the Building Official. I certify that I am licensed contractor pursuant to NRS 624. (Initial) I certify that I am registered design professional pursuant to NRS 625. (Initial) Signature Date Print Name Title (engineer, contractor, etc.) Project Address (address numbers and street name only) ---PAGE BREAK--- PLEASE PRINT CLEARLY USING PERMANENT BLUE OR BLACK INK. PROJECT NAME: ASSESSOR PARCEL NO. (APN): PROJECT ADDRESS: BUILDING OR SUITE NO.: PROJECT INFO.: CITY: FERNLEY STATE: NV ZIP CODE: 89408 CHECK SPECIAL INSPECTION CATEGORIES REQUIRED FOR THIS PROJECT SPECIAL INSPECTION FABRICATOR STEEL CONSTRUCTION WELDING HIGH-STRENGTH BOLTING CONCRETE MASONRY WOOD CONSTRUCTION SOILS PILE FOUNDATIONS PIER FOUNDATIONS WALL PANELS & VENEERS EIFS SPRAYED FIRE-RESISTANT MATERIALS SPECIAL CASES AND/OR OTHER: STATEMENT OF UNDERSTANDING I, , herby affirm that I have been (print name of registered design professional) employed by: (Name of Firm) (Address) (City, State and Zip Code) to supervise the performance of special inspection at the above stated project and that I am aware that in supervising this inspection, I am acting as an agent for the City of Fernley and responsible to the Building Official. I am further aware that my duties include assurance of compliance with the approved plans, specifications, the 2003 International Building Code®, local ordinances, state law and recognized construction practices which do not conflict with any of the aforementioned documents. Special inspectors shall keep records of inspections. The special inspector shall furnish inspection reports to the Building Official, and to the registered design professional in responsible charge. Reports shall indicate that work inspected was done in conformance to approved construction documents. Discrepancies shall be brought to the immediate attention of the contractor for correction. If the discrepancies are not corrected, the discrepancies shall be brought to the attention of the Building Official and to the registered design professional in responsible charge prior to the completion of that phase of the work. A final report documenting required special inspections and correction of any discrepancies noted in the inspections shall be submitted prior to the final building inspection and subsequent Certificate of Occupancy. (Sign and affix professional wet seal and date) Community Development Department 595 Silver Lace Blvd., Fernley, NV 89408 * [PHONE REDACTED]