PRINCE WILLIAM COUNTY Department of Development …

1 Statement of special Inspections Page 1 of 10 Version 2015-12-31 Building Development Division. 5 COUNTY Complex Court, PRINCE WILLIAM , VA, 22192. 703-792-6930. PRINCE WILLIAM COUNTY Department of Development Services Building Development Division STATEMENT OF special INSPECTIONS (Building/Other Structures other than Retaining Walls) Version 2015-12-31 Building Permit Number:BLD20 - VUSBC Edition: Project Name: Group: Construction Type: Project Address: Building Owner s Name: Owner s Address: Architect of Record: Name & LicenseCompanyStructural Engineer of Record: Name & LicenseCompanyGeotechnical Engineer of Record: Name & LicenseCompanyMechanical Engineer of Record.

2 (Smoke Control Systems Only)Name & LicenseCompanySpecial Inspections Engineer of Record: Name & LicenseCompanyInspection and testing Agency: CompanyAddressGeneral Contractor: Name & LicenseCompanyOthers: Responsible PartyName & LicenseCompanyThis Statement of special Inspections is submitted as a condition for permit issuance in accordance with the Virginia Uniform Statewide Building Code. The special Inspections Schedule is an integral part of the Statement of special Inspections. The special Inspections Engineer of Record shall keep records of specified special inspections and testing and shall furnish copies of inspection and testing reports to the PRINCE WILLIAM COUNTY special Inspections Section (PWCSIS) and to the appropriate Registered Design Professional(s) of Record (RDPR), ( the SER for building structural elements, MER for smoke control system, AR for EIFS and SFRM).

3 Discrepancies from the approved plans and specifications and code violations observed during the conduct of special inspections services shall be brought to the immediate attention of the Contractor for correction, to the attention of PWCSIS, and to the RDPR. A Final Report of special Inspections, documenting completion of specified special inspections, correction of any discrepancies and observed code violations shall be submitted to and approved by PWCSIS prior to the building concealment inspection by the Building Construction Inspections Branch. Prepared by: Signature & Date Reviewed and Approved by:Structural Engineer of Record: Signature & Date Architect of Record (EIFS, SFRM, Mastic & Intumescent applications Only) Signature & Date Mechanical Engineer of Record (Smoke Control Systems Only) Signature & Date Building Owner s Authorization:Signature & Date Building Official s Acceptance.

4 Building Plan Reviewer special Inspections ReviewerStatement of special Inspections Page 2 of 10 Version 2015-12-31 Building Development Division. 5 COUNTY Complex Court, PRINCE WILLIAM , VA, 22192. 703-792-6930. special INSPECTIONS SCHEDULE Building Permit Number: BLD20_____- _____ REQUIRED VERIFICATION AND INSPECTIONI nspections By Start Date of inspection Completion Date of inspection Task, Verification and InspectionFrequency Of InspectionsReference CriteriaContinuous Periodic Ref.

5 Std. IBC Ref. A. SOILS SIER fill placed under Site Permit(Submit Building Pad Certification inaccordance with Building DevelopmentDivision s Policy , Building PadCertification) fill placed under this BuildingPermitX materials below shallowfoundations are adequate to achieve thedesign bearing capacity. excavations are extended to properdepth and have reached proper material. classification and testing ofcompacted fill materials. use of proper materials, densitiesand lift thicknesses during placement andcompaction of compacted to placement of compacted fill,observe subgrade and verify that site hasbeen prepared properly. installation of Drain tile (Gravity/Mechanical) XB.

6 CONCRETE SIER of reinforcing steel andplacement, including prestressingtendons. XACI 318 , of reinforcing steel welding inaccordance with Table , Item 2b ofthis schedule of inspections. AWS ACI 318: of anchors cast in concretewhere allowable loads have been increasedor where strength design is ACI 318: , of anchors post-installed inhardened concrete members. X ACI 318: , , use of required design mix. X ACI 318: Ch. 4, , , Statement of special Inspections Page 3 of 10 Version 2015 -12-31 Building Development Division.

7 5 COUNTY Complex Court, PRINCE WILLIAM , VA, 22192. 703-792-6930. special INSPECTIONS SCHEDULE Building Permit Number: BLD20_____- _____ REQUIRED VERIFICATION AND INSPECTIONI nspections By Start Date of inspection Completion Date of inspection Task, Verification and InspectionFrequency Of Inspections Reference Criteria Continuous Periodic Ref. Std. IBC Ref. B. CONCRETE CONSTRUCTION Continued. SIER the time fresh concrete is sampled tofabricate specimens for strength tests, perform slump, air content tests, and determine the temperature of the concrete.

8 X ASTM C 172 ASTM C 31 ACI 318: , of concrete and shotcreteplacement for proper ACI 318: , , , for maintenance of specifiedcuring temperature and techniques. X ACI 318: of prestressed concrete:9a. Application of prestressing ACI 318: 9b. Grouting of bonded prestressing tendons in the seismic-force-resisting system. X ACI 318: of in-situ concrete strength,prior to stressing of tendons in post-tensioned concrete and prior to removal of shores and forms from beams and structural slabs. X ACI 318: formwork for shape, location anddimensions of the concrete member being formed, shoring and reshoring.

9 X ACI 318: Concrete Panel elements12a. Erection of precast concrete members X ACI 318: Chap. 16 12b. Verify that manufacturer of precast structural elements is under the supervision of a registered design professional and plant maintains detailed quality control procedures. X ACI 318: Chap. 16 12c. Manufacturer is PCI/NPCA Fabrication of Tilt-Up Concrete Panel members X12e. Erection of Tilt-Up Concrete Panel members X Others 13. 14. of special Inspections Page 4 of 10 Version 2015-12-31 Building Development Division.

10 5 COUNTY Complex Court, PRINCE WILLIAM , VA, 22192. 703-792-6930. special INSPECTIONS SCHEDULE Building Permit Number: BLD20_____- _____ REQUIRED VERIFICATION AND INSPECTIONI nspections By Start Date of inspection Completion Date of inspection Task, Verification and InspectionFrequency Of InspectionsReference CriteriaContinuous Periodic IBC RefTMS 402/ACI 530/ASCE 5 TMS 602/ACI 6C. MASONRY CONSTRUCTION - LEVEL 1 compliance with the approvedsubmittals X Art. of f'm and f'AAC prior toconstruction except where specificallyexempted by the code. X Art. of slump flow and VSI asdelivered to the site for Art.