HomeMy WebLinkAboutCBPR-8-11-12112 Special Inspections Paperwork.tif Appendix A Blank Form
Page 1 of 3 CATAWBA COUNTY, NORTH CAROLINA
SPECIAL INSPECTIONS PROGRAM
Statement of Special Inspections
BLDC -8 -11 -20692
TPI Permit #1: TPI Permit #2: TPI Permit #3
(TPI Permit Numbers to be furnished by CCBSD)
PROJECT: CarMax Auction Expansion NCBC Edition: 2009
Address: 1935 15th Avenue Place Occupancy: A -3 (Assembly)
Hickory, NC 28601 Construction Type: II -B
Building Owner: R Smith CarMax
Name Comnun r.
Owner's Address: 12800 Tuckahoe Cre Parkway, Richmond, VA 23238
Architect of Record: Charles J. O'Brien, III (NC #5096) - Pieper O'Brien Herr Architects
Name License Company
Structural Engineer of Record: Randall W. Gipson GA #16638 Haines, Gipson & Associates, Inc.
Name ct License Compali
Geotechnical Engineer of Record: Jeffrey Holchin (NC #20450) - ECS Carolina
?fame & License Compam
Special Inspections Engineer of Record 1 : TBD
Vamc & License Con:panv
Special Inspections Engineer of Record 2: TBD
Nance S License Compan,i
Special Inspections Engineer of Record 3: TBD
lVaine & License Cumpam
General Contractor: TBD
Name & beense Compani'
This Statement of Special Inspections is submitted as a condition for permit issuance in accordance with the North Carolina Statewide
Building Code.
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 Catawba County Building Services Division and to the appropriate registered design professionals
of record. 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 the Catawba County
Building Services Division, and to the appropriate registered design professionals of record. A final report of special inspections
documenting completion of specified special inspections and correction of any discrepancies and observed code violations noted in the
inspection and testing reports shall be submitted to the Catawba County Building Services Division prior to the request for final building
inspection and building inspection approval by County staff.
Prepared by Registered Design Professional in Responsible Charge:
_ G_
Charles J. O'Brien, III 9/6/2011
fTtPC orprintt k , time — Sc,�nanae All"
Building Owner's Authorization:
L i;uarrr & 7,
Building Official's Acceptance:
Catavvbr County Building Services Samar r, A Dx,
llaue 1
Appendix A Blank Forms
Page 2 of 3 STATEMENT OF SPECIAL INSPECTIONS Date: 9/1/11
PROJECT: CarMax Auction Expansion Prepared By: P. Fenn
ACTIVITY /SYSTEMS Y/N AGENT ` Continuous or Periodic Inspection ref. below
Steel Construction, Fabrication & Y 1 NC Building Code 1704.2, 1704.3, 1707,
Seismic Resistance 1708.4 & SICC Chapter 6
Concrete Construction, Fabrication & Y 1 NC Building Code 1704.2, 1704.4, 1708.3
Seismic Resistance SICC Chapter 7 & 8
Masonry Construction, Fabrication & Y 1 NC Building Code 1704.2, 1704.5, 1708.1 &
Seismic Resistance SICC Chapter 9
Wood Construction, Fabrication & N NC Building Code 1704.2, 1704.6, 1707.3
Seismic Resistance & SICC Chapter 10
Soils Y 1 NC Building Code 1704.7 & SICC Ch. 11
Pile Foundations & Fabricators NC Building Code 1704.2, 1704.8, 1808,
N 1809, 1810, 1811 & SICC Section 1104.2
Pier Foundations N NC Building Code 1704.9, 1808, 1812 &
SICC Section 1104.2
Earth Retention Systems Y 1 NC Building Code 1806.2 & SICC Ch. 12
Sprayed Fire Resistance Materials N NC Building Code 1704.10 & SICC Ch. 13
Mastic & Intumescent fire- resistant'coatings N NC Building Code 1704,11 & SICC Ch. 13
EIFS N NC Building Code 1704.12 & SICC Ch. 14
Smoke Control N NC Building Code 1704.14 & SICC Ch. 15
Seismic Resistance Architectural, N NC Building Code 1705.3 para 42, 4.3, 4.4,
Components 4,5, &1707.7 & SICC Ch.16
Seismic Resistance Mechanical N NC Building Code 1705.3 para 2- 5, 1707.8,
Com onents 1707.9, 1707.10, & 1708.5 & SICC Ch. 16
Seismic Resistance Electrical N NC Building Code 1705.3 para 2- 5, 1707.8,
Components 1707.9, 1707.10, & 1708. 5 & SICC Ch. 16
Structural Observations required in seR NC Building Code 1702 & 1709 To be
Occupancy Category III or IV per Table N conducted by the Structural Engineer of
1604.5 Record
Special Cases N NC Building Code 1704.13
. INSPECTION AGENTS Name, Company, Address
1. Special Inspections Engineer of Record 1:
TBD
2. Inspection and Testing Agency 1 A:
TBD
3. Special Inspections Engineer of Record 2:
TBD
4. In peec ct tion and Testing Agency 2 A:
TB
5. Special Inspections Engineer of Record 3:
TBD
6. Inspection L and Testing Agency 3 A:
Note: The inspectors and testing agencies shall be engaged by the Owner or the Owner's Agent, and not by the Contractor or Subcontractor whose
,work is to be inspected or tested. Any conflict of interest must be disclosed to the Building Official, prior to commencing work.
f'a -e 2
• Appendix A Mank Forms
Page 3 of 3 CATAWBA COUNTY, NORTH CAROLINA
STATEMENT OF SPECIAL INSPECTIONS
Identification of Seismic Systems NCBC 9705.3
Seismic Design Category D
Identification of Seismic Systems Required I N
NCBC 1705.3 para 1 & 1705.3.1 Description of seismic force resisting system requiring special inspections
(Review Section 1705.3, 1707 and 1708 of the NCBC to prepare this section):
N/A
NCBC 1705.3 para 2 & 1705.3.1 Description of designated seismic systems requiring special inspections
(Review Section 1705, 1707 and 1708 of the NCBC and ASCE 7 to prepare this section):
N/A
NCBC 1705.3 para 3, -4, 5 & 1705.3.1 Description of additional seismic systems requiring special
inspections (Review Section 1705, 1707 and 1708 of the NCBC and ASCE 7 to prepare this section):
N/A
Identification of Wind Force Resisting System 1705.4
Basic Wind Speed 3 second gust) 90 mph
Wind Exposure Category C
Identification of MWFR Systems Required (Y/N) N
Description of wind force resisting system and designated wind resisting components requiring special
inspections (Review Section 1705.4 of the NCBC to prepare this section):
N/A
Statement of Responsibility
List each contractor responsible for the construction or fabrication of a system or component designated above. Each
contractor listed must submit a Statement of Responsibility.
Name Company System or Component
TBD
I
C'a,�e