***BE ADVISED THIS DOES NOT PRECLUDE YOU FROM OTHER MANDATORY INSPECTIONS IN THE CODE***
This uniform document is being provided by Broward County Board of Rules and Appeals for use by Broward County Municipalities
C:\Users\mguerasio\Desktop\6th edition 2017 FBC Special Bldg Insp Form.doc
Effective: January 1st, 2018
FORM FOR “SPECIAL BUILDING INSPECTOR”
SECTION 110.10 – BROWARD COUNTY ADMINISTRATIVE CODE
AND THE FLORIDA BUILDING CODE, 6
th
Edition (2017)
NOTICE TO PROPERTY OWNER:
You are hereby directed in accordance with Section 110.10.1 or 110.10.2 of the Broward County Administrative Code and the Florida
Building Code to retain a Special Structural Inspector (A Florida Registered Architect or Licensed Engineer) to perform the following
mandatory or discretionary inspections, as outlined in Section 110.10 of the Florida Building Code and submit progress reports,
inspections reports, and a Certificate of Compliance to the Building Official as per Sections 110.10.6 and 110.10.7 of the Florida
Building Code.
Note: The Building Official determines which discretionary inspections are to be delegated.
DATE: ___________________________________ IDENTIFICATION, CONTROL OR BUILDING PERMIT # ___________________________
PROJECT NAME: ___________________________________________________________________________________________________
JOB ADDRESS __________________________________________________________________________ ZIP _______________________
LEGAL DESCRIPTION: _________________________________________________________________ FOLIO # _____________________
A. MANDATORY INSPECTIONS TYPE BY CODE:
1) Precast Concrete Units – Section 110.10.2.1 ..................................................................................................................................................................... Yes □ No □
2) Reinforced Unit Masonry – Section 110.10.2.2 (per ACI 530.1-13-Level B Quality Assurance)*
*unless noted otherwise on plan ........................................................................................................................................................................................... Yes □ No □
3) Connections – 110.10.2.3........................................................................................................................................................................................................ Yes □ No □
4) Metal System Buildings – Section 110.10.2.4 ....................................................................................................................................................................... Yes □ No □
5) Smoke Control Systems – Section 110.10.2.5 .................................................................................................................................................................... Yes □ No □
B. DISCRETIONARY INSPECTION TYPE BY BUILDING OFFICIAL:
1) Building Structures or part thereof of Unusual Size, Height, Design or Method of Construction and
Critical Structural Connections – Section 110.10.1.1 ....................................................................................................................................................... Yes □ No □
2) Windows, Glass Doors and Curtain Walls on buildings over two (2) stories – Section 110.10.1.1 ....................................................................... Yes □ No □
3) Pile Driving Only – Section 110.10.1.1 ................................................................................................................................................................................. Yes □ No □
4) Precast Concrete Units – Section 110.10.2.1 ..................................................................................................................................................................... Yes □ No □
5) Reinforced Unit masonry – Sections 110.10.2.2 ................................................................................................................................................................. Yes □ No □
6) Other ........................................................................................................................................................................................................................................... Yes □ No □
C. MANDATORY DOCUMENTATION
1) Inspection schedule stating the specific inspection that will be made and at what phase of construction must be submitted with this application.
2) Progress Report/Inspection reports during construction in accordance with Section 110.10.6.
3) Certificate of Compliance must be submitted prior to the scheduling of the final building inspection, Section 110.10.7.
ACKNOWLEDGMENT
Owner’s Signature: _________________________________ Permit Holder’s Signature: ________________________________________________
Printed Name: _________________________________ Printed Name: ________________________________________________
License # (if applicable) ________________________________________________
SPECIAL BUILDING INSPECTOR: _______________________________________________________________________________________
Registered Architect and/or □ Licensed Engineer
Signature of Special Building Inspector, Embossed Seal AND Date
Printed Name of Special Building Inspector ________________________________________________________________
Address of Special Building Inspector ________________________________________________________________
________________________________________________________________
State of Florida Registration # ___________________________ Fax # _________________________ Telephone # _____________________________
________________________________________________________________________________ Date: __________________________________
Building Official (or designated representative)
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