Fillable Residential Special Inspection Agreement Form (City of Beaverton)

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Residential Special Inspection Agreement Form (City of Beaverton)

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Form B70-1013 REV 1/15 Page 1 of 2
Permit Number: ___________________ Date: ________________________
Project Name: ____________________________________________________________________
Project Address: _________________________________________________________________
Name of Architect or Designer (Firm): ________________________ Phone: _______________
Name of Engineer of Record (Firm): __________________________ Phone: _______________
This agreement presents the requirements for special inspection, testing and structural
observation for residential construction designed following the 2014 Oregon Structural
Specialty Code (the 2012 International Building Code with 2014 Oregon amendments)
In accordance with OSSC Sections 107.1, 1704.2, 1704.3, and 1704.5, special inspections
and testing are required for the types of construction shown in the approved project drawings.
These tests and inspections shall be determined and performed following the provisions in
these Code sections.
Special Inspector Duties
The special inspector shall comply with the duties and responsibilities presented in Sections
II and V of the OBOA Special Inspection Program and shall observe and document the work
for conformance with the approved plans and specifications. All written results of these
inspections or tests, including noncompliance lists and final summary letters, shall be
provided to the Building Official and the registered design professional in responsible charge.
Sequencing
Special inspections are in addition to, and do not replace, inspections required to be
performed by City inspectors. Before proceeding with the project, City inspectors
must approve all work after a report by the special inspector has been provided.
Example: Prior to placing concrete in a footing/foundation, approval by BOTH the special
inspector and City inspector must be obtained.
The final special inspection report shall be submitted to the Building Services Division a
minimum of two days prior to requesting a final inspection. A final inspection request
will not be granted until the final special inspection report has been deemed acceptable by
the Building Services Division.
Based upon the work shown in the project drawings, and the provisions in Chapter 17 of
the 2014 Oregon Structural Specialty Code (OSSC), the inspections listed in Part A below
are required for this project.
To address these required inspections, this Agreement must be completed and approved in
order to issue a permit for this project. Please review this form and have the owner, or
owner’s authorized agent, complete parts B and C below.
CITY OF BEAVERTON
Community Development Department
Building Division
12725 SW Millikan Way / PO Box 4755, Beaverton, OR 97076
Phone: (503) 526-2493 Fax: (503) 526-2550
General Information (503) 526-2222 V/TDD
BeavertonOregon.gov
RESIDENTIAL SPECIAL INSPECTION AGREEMENT
WAIVER
Form B70-1013 REV 1/15 Page 2 of 2
A. REQUIRED SPECIAL INSPECTIONS (To be completed by plans examiner)
In accordance with OSSC Section 1704 the following inspections are required for this project:
Steel Construction (OSSC 1705.2) Helical Pile Foundations (OSSC 1705.9)
Concrete Construction (OSSC 1705.3) Soils (OSSC 1705.6)
Masonry Construction (OSSC 1705.4) Wood Construction (OSSC 1705.5)
Post-Installed Anchors (OSSC 1705.1.1(3))
In accordance with OSSC Section 1705.1.1, the building official has determined that the
following Special Case inspections are required:
B. SELECTION OF THE INSPECTION AGENCY OR SPECIAL INSPECTOR
(To be completed by applicant)
A special inspection agency may be chosen from any of the approved inspector lists accepted by the
Building Services Division. The Building Services Division recognizes the agency lists published by
the Oregon Building Officials Association (OBOA), and the Washington Association of Building
Officials (WABO).
Please indicate the approved special inspection agency that will perform the required special
inspections as noted in Part A above. The OBOA registered agency list is provided below for your
convenience.
ACS Testing Inc. (503) 443-3799 Krazan & Associates, Inc. (425) 485-5519
Carlson Testing Inc. (503) 684-3460 Mayes Testing Engineers, Inc. (503) 281-7515
Clair Company, Inc. (800) 383-8855 Northwest Geotechnical Inc. (503) 682-1880
Kleinfelder, Inc. (503) 644-9447 Professional Service Industries, Inc. (503) 289-1778
FEI Testing and Inspections, Inc. (541) 757-4698 KPFF (503) 227-3251 – Inspections Only
If the agency you desire to employ is not included within the list above, use the “Other” box to indicate
the agency or inspector you intend to use. A written request to use this agency, or individual, must
also be submitted for the Building Official’s review and approval. Include with this request the
agency’s qualifications, national certifications, and validations demonstrating competence to perform
inspections for the type of construction in question.
Other: ________________________________ Phone Number: ______________
C. SIGNATURE (To be completed by applicant)
The owner/authorized agent has reviewed the Special Inspection requirements presented in this
Agreement and agrees to comply with the terms and conditions of the program, and to employ a
special inspector or special inspection agency to perform the above-noted special inspections in
conformance with the guidelines presented in Chapter 17 of the 2014 OSSC.
Owner/Authorized Agent: _____________________________ Date: ______________
D. ACCEPTED FOR THE BUILDING DIVISION
Plans Examiner: ____________________________________ Date: ______________
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Residential Special Inspection Agreement Form (City of Beaverton)

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Completed 2 August 2020

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