Permits and Planning
23335 NE Halsey Street | Wood Village, Oregon 97060
(503) 667-6211
Permit Number: ________________________
Project Name: ________________________
Project Address: ________________________
________________________
Inspection of Fabricators (OSSC 1704.2.5)
Steel Construction (OSSC 1705.2)
Concrete Construction (OSSC 1705.3)
Masonry Construction (OSSC 1705.4)
Wood Construction
(OSSC 1705.5)
Soils (OSSC 1705.6)
Driven Deep Foundations (OSSC 1705.7)
Cast-in-place Deep Foundations (OSSC 1705.8)
Helical Pile Foundations (OSSC 1705.9)
Sprayed Fire-resistant Materials (OSSC 1705.13)
Mastic and Intumescent Fire-rest. Coatings (OSSC 1705.14)
EIFS (OSSC 1705.15)
Fire-Resist Penetrations
and Joints (OSSC 1705.16)
Anchors Expansion / Adhesive (OSSC 1705.1.1)
Special Case (OSSC 1705.1.1) _______________________________________________________________________________
Seismic Resistance – Risk Category III and IV
Structural Steel (OSSC 1705.11.1)
Structural Wood (OSSC 1705.11.2)
Cold-formed Steel Light-frame Construction (OSSC 1705.11.3)
Designated Seismic System Verifications (OSSC 1705.11.4)
Architectural Components (OSSC 1705.11.5)
Mechanical and Electrical Components (OSSC 1705.11.6)
Storage Racks and Access Floors (OSSC 1705.11.7
)
Seismic Isolation Systems (OSSC 1705.11.8)
2 - STRUCTURAL OBSERVATION (OSSC 1704.5):
Per Structural Observation Program noted on the Structural Drawings
Indicate stages at which structural observation is to occur:___________________________________________________________
____________________________________________________________________________________________________________
______________________________________________ ________________________________________ _________________________________________________
Owner Owner’s Representative Email
______________________________________________ ________________________________________ _________________________________________________
General Contractor Contractor Representative Email
______________________________________________ ________________________________________ _________________________________________________
Engineering or Architecture Firm Engineer or Architect Representative Email
______________________________________________ _________________________________________ _________________________________________________
OBOA Registered Agency Name Special Inspection Agency Representative Email
ACCEPTED BY THE BUILDING DEPARTMENT: ___________________________________ __________________________________________
Building Official or Designee Email
SPECIAL INSPECTION AND TESTING AGREEMENT
In accordance with the Oregon Specialty Structural Code (OSSC) 107.1, the Registered Design Professional (RDP) shall
prepare and submit a special inspection and structural observation program. The RDP shall confirm that the special
inspection and structural observations noted below are indicated on the approved plans. This agreement is meant to denote
general areas of construction requiring special inspection. Reference the approved plans for more specific requirements related to
each respective area.
Per OSSC 1704.2, the Building Official may accept all special inspectors registered with the Oregon Building Officials Association
(OBOA) Special Inspection Program for the type of work for which they are certified/qualified to inspect.
The Special Inspector shall observe and document the work for conformance with the building department approved
plans and specifications and applicable workmanship provisions of the OSSC. Additionally, the special inspector(s), general
contractor, owner and RDP shall comply with the duties and responsibilities outlined in Appendix D of the OBOA Special
Inspection Program. Appendix D is available upon request or can be viewed at www.oregonbuildingofficials.com/specialinspection.
The following special inspections, material testing and structural observations shall be performed according to OSSC Chapter 17
unless a separate program of inspection is submitted by the RDP and approved by the Building Official.
BEFORE A PERMIT CAN BE ISSUED: The RDP shall complete Part 2 of this agreement and verify all non-
jurisdictional acknowledgements in Part 3 are completed.
PRIOR TO RECEIVING FINAL INSPECTION: The Special Inspector or Inspection Agency and the RDP shall submit a
final summary report to the Building Official. The summary shall include a statement that all items requiring special
inspection, testing or structural observations were fulfilled, reported and, to the best of their knowledge, in conformance with
the building department approved plans, specifications, approved change orders and applicable workmanship provisions of the
OSSC.
1 - SPECIAL INSPECTION AND TESTING:
3 - ACKNOWLEDGEMENTS: (I have read and agree to comply with the terms and conditions of this agreement)*
