13-452-001The City of So uth Miami
Building DJ6Second Floor
6130 Sunset Drive
South Miarri', FL 3;3143
_ 305 -663 -6355
Fax 305 - 666 -4591
NOTICE TO CITY OF SOUTH MIAMI BUILDING DEPARTMENT OF EMPLOYMENT AS SPECIAL
INSPECTOR UNDER THE FLORIDA BUILDING CODE.
I (We) have been retained by
inspector services under the Florida Building Code 2010 at the
project on the below listed structure as of
arch itect/professional engineer licensed in the State of Florida.
Process Number:
to perform special
(date). I am a registered
Special Inspector for Piling, FBC 1822.1.20 (R4404.6.1.20)
XSpecial Inspector for Trusses > 35 ft. long or 6 ft. high, FBC 2319.17.2.4.2 (R4409.6.17.2.4.2)
t, - Special Inspector for Reinforced Masonry, FBC 2122.4 (R4407.5.4)
Special hlspector for Steel Framing, FBC 2218.2 (R4408.5.2)
11 peeial Inspector for Soil Compaction, FBC 1820.3.1 (R4404.4.3.1)
Special Inspector for Precast Attachments, FBC 1927.12.2 (R4405.9.12)
Special Inspector for Roofing Applications, Lt.Weight. Insul.Cone. FBC 1917.2 (R4405.12.2)
_ Other
Note: Only the marked boxes apply.
The following individual(s) employed by this firm or me is authorized representative to perform
inspection*
1. 2.
11
*Special inspectors utilizing authorized representatives shall insure the authorized representative is qualified by
education or licensure to perform the duties assign by Special Inspector. The qualifications shall include licensure as a
professional engineer or architect: graduation from an engineering education program in civil or structural engineering;
graduation from an architectural education program; successful completion of the NCEES Fundamentals Examination;
or registration as building inspector or general contractor.
I (we) will notify the City of South Miami Building Department of any changes regarding
authorized personnel performing inspection services.
I (we), understand that a Special Inspector inspection log for each building must be displayed in a
convenient location on the site for reference by the City of South Miami Building Department
Inspector. All mandatory inspections, as required by the Florida Building Code, must be
performed by the City of South Miami Building Department .Inspections performed by the
Special Inspector hired by the owner are in addition to the mandatory inspections performed by
the department. Further, upon completion of work under each Building Permit, I will submit to
the Building Inspector -at the time of the final inspection the completed inspection log forth and a
sealed statement indicate that, to the best of my knowledge, belief and professional judgment
e, r v ty tem. R le
those p6fttot? -,,,O' t ,Vl rpjea i�..titlined above meet the intent of the Florida Building Code and are
in substantial sf cot� ance wiz),thv:,,approval plans.
r En 7ineer /Architect
Name�%
x°
Print _
Signed and Seca ed I I t �t 8) -1 �> / �
Date r r� �? C% Address �/ d f c J
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