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CITY OF PHILADELPHIA DEPARTMENT OF LICENSES INSPECTIONS Special Inspections Program International Building Code In accordance with the provisions of Chapter 17 of the 2009 International Building Code this form is to list the Special Inspections as required for the proposed construction located at PROPERTY ADDRESS print Application Owner s Name print Owner s Phone Owner s Address print Street City State Zip Code The design professional of record shall indicate by a checkmark which of the special inspections listed below are required for the above mentioned construction site VERIFICATION INSPECTION ITEM REQUIRED Fabrication of structural load-bearing members and assemblies. 1704. 2 Steel 1704. 3 Welding Weld Filler Materials Steel Frame Joint Details High Strength Bolts Nuts Washers Reinforcing Steel Concrete 1704. 4 Materials Pre-Cast Concrete Shotcrete Application Pre-stressed Concrete In-situ Concrete Strength Masonry 1704. 5 Fabrication process of prefabricated wood structural elements and assemblies. 1704. 6 Existing Site Soil Conditions Fill Placement Load Bearing Requirements 1704. 7 Driven deep/Cast-in-place deep/Helical pile/Vertical masonry foundations 1704. 8 1704. 9 1704. 10 1704. 11 Spray Fire-Resistant Materials Mastic Intumescent Coatings 1704. 12 1704. 13 Exterior Insulation and Finish Systems form EIFS 1704. 14 Special Cases Attach separate sheet if necessary 1704. 15 Underpinning Smoke Control Systems 1704. 16 Seismic Resistance 1707 NOTE All inspection reports must be submitted directly to the Building Inspector. VERIFIED Design Professional of Record Professional Engineer Registered Architect Responsible for maintaining records of all inspections furnishing reports to the Building Inspector and verifying that the special inspector for each required item above is qualified to perform that inspection* Name print Phone Address print. 1704. 2 Steel 1704. 3 Welding Weld Filler Materials Steel Frame Joint Details High Strength Bolts Nuts Washers Reinforcing Steel Concrete 1704. 4 Materials Pre-Cast Concrete Shotcrete Application Pre-stressed Concrete In-situ Concrete Strength Masonry 1704. 4 Materials Pre-Cast Concrete Shotcrete Application Pre-stressed Concrete In-situ Concrete Strength Masonry 1704. 5 Fabrication process of prefabricated wood structural elements and assemblies. 1704. 6 Existing Site Soil Conditions Fill Placement Load Bearing Requirements 1704. 5 Fabrication process of prefabricated wood structural elements and assemblies. 1704. 6 Existing Site Soil Conditions Fill Placement Load Bearing Requirements 1704. 7 Driven deep/Cast-in-place deep/Helical pile/Vertical masonry foundations 1704. 8 1704. 9 1704. 10 1704. 7 Driven deep/Cast-in-place deep/Helical pile/Vertical masonry foundations 1704. 8 1704. 9 1704. 10 1704. 11 Spray Fire-Resistant Materials Mastic Intumescent Coatings 1704. 12 1704. 13 Exterior Insulation and Finish Systems form EIFS 1704. 11 Spray Fire-Resistant Materials Mastic Intumescent Coatings 1704. 12 1704. 13 Exterior Insulation and Finish Systems form EIFS 1704. 14 Special Cases Attach separate sheet if necessary 1704. 15 Underpinning Smoke Control Systems 1704. .

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