NBSIR 73-278 (4 Volumes)

Model Documents for the Evaluation,

Approval, and Inspection of

Manufactured Buildings

VOLUME IV - COMPLIANCE ASSURANCE AND

LOCAL ENFORCEMENT AGENCY DOCUMENTS

CES Project

Office of Building Standards and Codes Services

Center for Building Technology, lAT

National Bureau of Standards

Washington, D. C. 20234

September 1973

Preliminary Report

U.S. DEPARTMENT OF COMMERCE

NATIONAL BUREAU OF STANDARDS

NBSIR 73-278 (4 Volumes)

MODEL DOCUMENTS FOR THE EVALUATION,

APPROVAL, AND INSPECTION OF

MANUFACTURED BUILDINGS

VOLUME IV - COMPLIANCE ASSURANCE AND

LOCAL ENFORCEMENT AGENCY DOCUMENTS

R. D. Dikkers, H. R. Trechsel, P. W. Cooke, H. K. Tejuja, L. P. Zelenka

CES Project

Office of Building Standards and Codes Services

Center for Building Technology, lAT

National Bureau of Standards

Washington, D. C. 20234

September 1973

Preliminary Report

This is a preliminary report issued with the express

intent to solicit comments and suggestions. Accordingly,

results and conclusions contained herein are not necessarily

those that will be included in the final report.

U. S. DEPARTMENT OF COMMERCE, Frederick B. Dent. Secretary

NATIONAL BUREAU OF STANDARDS, Richard W. Roberts. Director
PREFACE

In response to requests from the Executive Office of the President and the

National Conference of States on Building Codes and Standards (NCSBCS), the National

Bureau of Standards has undertaken specific research programs to remove or reduce

barriers created by the building regulatory process, so as to improve productivity

and innovation in building construction. One of these programs is to establish a Coordinated Evaluation System (CES) by developing, in conjunction with the state

governments, model informational documentation for use in the building regulatory

process.

This four-volume report outlines the results of an initial study of documentation

needs, sample forms and checklists pertaining to manufactured buildings and components.

It is a preliminary report issued with the expressed intent to solicit comments and

suggestions so that more comprehensive and more generally applicable model documentation can be developed.

A first draft of this report was reviewed during a 2 1/2 day meeting in April,

1973, by a group of consultants composed of representatives of state and local building officials, design professionals, third party evaluation and inspection agencies,

and industrialized building manufacturers. The review m.eetlng was organized and

chaired by Mr. John Dunlap, Consulting Engineer of Sacramiento, California. The other

consultants were;

Joseph Bartell, City of St. Petersburg

Jack Bono, Underwriters Laboratories, Inc.

< Kern E. Church, State of North Carolina

Jasper Hawkins, Hawkins and Lindsey, Architects

James M. Hicks, State of California

Glendon R. Mayo, Consulting Engineer

J. Dlllard Powell, Continental Homes

Ed Starostovic, Product Fabrication Service

Joseph Stein, City of New York

Steve Wilson, National Homes Corporation

The comments of the consultants were most helpful in developing the miodel docum.ents contained in this report, and their valuable assistance is greatly appreciated

and herewith acknowledged.

ii
CONTENTS - VOLUME I

Page

1. INTRODUCTION .... - 1

2. COORDINATED EVALUATION SYSTEM (CES) PROJECT 3

3. SCOPE OF CES MODEL INFORMATIONAL DOCUMENTATION h

4. REGULATORY PROCESS FOR MANUFACTURED BUILDINGS AND

BUILDING COMPONENTS 5

4.1. Program Administration 5

a. Initiation of Action 7-

4.2. Preparation and Submission 7

a. Building Systems 8

b. Com.pllance Assurance Prograni 8

c. Modifications and Variations 8

4.3. Preliminary Review ^

4.4. Evaluation 10

4.5. Approval and Disapproval 10

a. Notice of Completed Evaluation 10

b. Stamp of Approval 10

c. 'Building System.s Approval Report 11

4.6. Fabrication, Inspection, Certification, Transportation

and Handling, and Installation 11

a. Fabrication 11

b. Inspection and Certification 12

c. Transportation and Handling 12

d. Installation 12

4.7. Local Enforcement Activities 13

4.8. Interstate Acceptance (Reciprocity) 14

5. MODEL INFORMATIONAL DOCUMENTS l4

5.1. Use of Documents l4

5.2. Submission 14

a. Building Systems 15

b. Submission Requirements for Manufactured

Building Components 17

c. Compliance Assurance Program 19

d. Modifications of Approved Systems and Variation of

Certified Units 21

ill
CONTENTS - VOLUME I (Continued)

Page

5-3- Preliminary Review 23

5.4. Evaluation , 24

a. Building System 25

b. Compliance Assurance Program 28

5.5- Approval and Disapproval 30

5.6. Fabrlcationj Inspection, and Certification 31

5.7- Local Enforcement Agency Activities 33

a. Building Permit Application 33

b. Building Permit 3^

c. Local Enforcement Agency Violation Report 3^

d. Certificates of Occupancy 34

5.8. Interstate Acceptance (Reciprocity) 36

a. Introduction 36

b. Prerequisite for Interstate Acceptance 36

c. Process of Interstate Acceptance 37

d. Model Documents 38

6, SUMMARY 40

7. REFERENCES 4l

APPENDIXES 43

Iv
CONTENTS - VOLUMES II, III AND IV

Document

Number VOLUME II - SUBf4ISSI0N DOCUMENTS Page

S-01 Application for Buildi.ng System and Compliance

Program. Approval 1 S-02 General Subm.ission Requirements 5 S-03 Architectural Submission 9 S-04 Structural Submission 13

S-05 Mechanical Submiission 19

S-Od Plum.bing Submission 21

S-C7 Electrical Submiission 23

S-08 Subm.ission Requirem.ents for Building Components 2?

S-09 Compliance Assurance Program. 29

S-10 Appllcaticn for Approval of Minor Modification

to an Approved Building System and/or Compliance

Assurance Program 63

S-11 Application for Approval of Vai'iation to a Certified Manufactured Building or Component 65

VOLUME III - EVALUATION AND APPROVAL DOCUMENTS

E-01 Processing Record 1 E-02 . Preliminary Revlev; Checklist 3 E-O3 Subm;ittal Unsuitable for Processing 7 E-04 Evaluation Checklist - Architectural 9 E-05 Evaluation Checklisr. - Structural 17 E-O6 Evaluation Checklist - Mechanical 21

E-07 Evaluation Checklist - Plumbing 25

E-08 Evaluation Checklist - Electrical 27

E-09 Certification of Products and Test Reports 31

E-10 Evaluation Checklist - Compliance Assurance Manual 33

E-11 Manufacturing Facility Evaluation Report 43

A-01 Notice of Comipleted Evaluation ^9

A-02 Stamps of Approval' 51

A-03 Building Systemi Approval Report 55

V
CONTENTS - VOLUMES II, III AND IV (Continued)

Document VOLUME IV - COMPLIANCE ASSURANCE AND LOCAL

Number ENFORCEMENT AGENCY DOCUMENTS Page

C-01 Manufacturer's Data Plate 1 C-02 In-Plant Inspection Checklist 5 C-03 ^ Inspection Report 75

• C-04 Noncompliance Tag 77

C-05 Prohibited Sales Notice 79

C-06 Notification of Suspended Activities 8l

C-07 Label 83

C-08 Label Control Record 85

L-01 Standard Building Permit Application Form 87

L-02 Manufactured Building Violation Report 89

L-03 Certificate of Occupancy 91

vi
MODEL DOCUMENTS FOR THE EVALUATION, APPROVAL,

AND INSPECTION OF MANUFACTURED BUILDINGS

R. D. Dikkers, H. R. Trechsel, P, W. Cooke,

H. K. Tejuja, L. P. Zelenka

To assist the states In developing their building regulatory activities

and functions, the Coordinated Evaluation System (CES) Project has defined

and developed model Informational documentation pertaining to the functional

areas of data submission, evaluation, approval, compliance assurance, installation data, and owner information.

This is a preliminary report which gives the results of the investigation

to date, and presents discussions of informational needs and sample model

documents pertaining to manufactured buildings and building components. The

model documentation is based on the Model Rules and Regulations for m.anufactured

buildings developed by a Department of Commerce sponsored working task group,

and the results of a comprehensive state-of-the-art study of most of the existing

state building regulatory programs. The documentation presented in this report

covers all functional areas except owner information which is not usually subject

to regulation and will be covered by a separate report. Emphasis was placed on developing documentation , applicable primarily to one and two family detached

dwellings

.

Based on the comments received on this preliminary report, the documentation presented herein will be revised and a final report Issued.

Key words: Building codes; certification; compliance assurance; evaluation;

industrialized building; inspection; model documents; NCSBCS; standards;

state regulation.

vli

CES DOCUMENT NO. C-01 Page 1 of 3

MANUFACTURER'S DATA PLATE

Part IV, Section 3(A) requires that the manufacturer place certain Information

directly or by reference on one or more data plates.

The data plates for manufactured buildings are to be permanently mounted on or In the vicinity of the electrical distribution panel or in some other easily accessible

location approved by the Administrative Agency. Most data plates currently used are metal with the information either printed or embossed. For manufactured building

components the Administrative Agency is given the authority to approve alternate

means of supplying the required Information. In particular, where the size and/or

shape of a component is such that a data plate can not be attached permanently, the

Information can be given on a tag attached to the component or In a manual crated

with the component. Information which is needed by the occupant (user) also should

be contained in a manual which is presented to him upon transfer of possession.

The purpose of the data plate is to provide permanently the information needed to

identify and properly operate the unit. As stated in the Rules and Regulations, the

data plate must contain the following information:

1. Manufacturer's name and address:

2. Serial number of unit;

3. Label serial number;

4. Name and date of applicable nationally recognized codes com.plled with;

5. Model designation and name of manufacturer of major In-plant installed

appliances .•

If required by the adopted code, standard, specification or requirement, the Rules

and Regulations require that the following additional information also be given on the

data plate:

6. Identification of permissible type of gas for appliances and directions for

water and drain connection;

7. Snow, wind, seismic, and other live load criteria;

8. Electrical ratings - instructions and warnings on voltage;

9. Special conditions or limitations on use of the unit, including unsuitability

for areas in which specified environmental conditions prevail;

10. Methods of assembly or joining multiple units;

11. Type of construction, including fire rating, occupancy class, interior finish

flame spread class, and toxicity class;

12. Building height and story limitation;

13. Floor area;

14. Minimum side yard requirements for fire rating.

The Information that should be given on the data plate for a specific unit depends

on the unit's characteristics and its Intended use. Accordingly, some of the above

1
CES DOCUMENT NO. C-01 Page 2 of 3

items may not apply to a given unit, and other information may be needed. In selecting the contents of the data plate, it should be borne in mind that all those items

should be recorded on the permanent plate which need to be known after initial installation of the unit on the site, and possibly a long time thereafter. Accordingly, if

the initial installation is of a permanence similar to that of conventional construction, instructions for this installation need not be given on the data plate (although

it must be furnished by the installer to the erector, builder, or owner in some other

form). However, if the unit is intended and designed for later or periodic reinstallation on new sites (such as for example, relocatable schools), installation instructions should also be contained on the data plate. Similarly, the need for including

items referring to building and story height limitations, occupancy and zoning, climatic conditions, etc., also depend on the likelihood of either later relocation

and/or changes in occupancy and use.

An example of a manufacturer's data plate is shown on page 3 of this document.

In the example shown, all items that the Model Rules and Regulations give as mandatory contents are shown. Additional contents which are dependent on codes and other

state requirements are included based on the state-of-art study of data plate

requirements currently established by the various states.
CES DOCUMENT NO. C-01 Page 3 of 3

MANUFACTURER'S DATA PLATE

Manufactured by:

Date of

Manufacture

Serial Label

No. -

Unit complies with Codes and Standards:

Name Edition Year

Electrical System:

Panel Board

Amps

.

Number

circuits

cycle phase

voltage

capacity

High temperature field service

conductors . °C

Equipment

:

Furnace

Water Heater

Air Conditioner

Capacities Fuel

Potable water system tested at psig.

DWV plumbing system tested at psig.

Design Criteria:

Wind load Ibs/sq. ft.

Roof load Ibs/sq. ft.

Floor load Ibs/sq. ft.

Roof pitch ( / ) at Ibs/sq. ft. total load.

Seismic zone construction.

Design temperatures: Summ.er OF; V/inter

3

CES DOCUMENT NO. C-02 Page 1 of 69

IN-PLANT INSPECTION CHECKLISTS

This document is a production station oriented series of checklists portraying

the essential characteristics of inspection by the Inspection Agency during audit

inspections of the manufacturer. The checklists presented in this report are for a hypothetical wood frame modular unit produced in a main assembly production sequence.

It is not representative of any one manufacturer but is presented in this report to

illustrate the approach and degree of detail that should be checked on the manufacturer's production line.

The essential characteristics of inspection have typical suggested callouts for

the materials of construction and then the individual fabrication steps for each suggested production station in the sequence. For each characteristic of inspection, a reference (source of design Intent) Is indicated by an identifying number where the

actual design data for each characteristic can be found. Provision is made for entering the actual design conditions on the checklists under "Actual Design Requirement"

for each characteristic.

The checklists also contain the suggested methods for determining compliance for

each characteristic, identified by letters.

Individual In-Plant Inspection Checklists with the "Actual Design Requirement"

entries completed should be submitted as part of the compliance assurance manual

submittal for each production model for which approval is sought.

Page 2 of this document contains an index of the separate station checklists.

Pages 68 and 69 of this document give the keys for the Identification of the design

intent reference numbers and compliance determination reference letters.

5
CES DOCUMENT NO. C-02 Page 2 of 69

Index to Station Checklists

Document Volume IV

Station Page Number Page Number

Floor Framing Station 3 7 Floor Insulation Station 5 9 Floor Sheathing Station . . 6 10

Wall Framing and Setting Station 9 13

Wall Insulation Station 12 l6

Interior Wall Covering Station 13 17

Celling/Roof Framing and Setting Station ...... 16 20

Interior Ceiling Covering Station 19 23

Plumbing Station 22 26

Electrical Station 31 35

Mechanical (HVAC) Station 44 48

Ceiling Insulation Station 53 57

Miscellaneous Components (Window, Exit Door,

and Stairway) Installation Station . . . 55 59

Wall Sheathing Station 57 . ., 6l

Exterior Siding Station 59 63

Roof Sheathing Station 62 66

Finish Roofing Station

.

. 65 69

Final Compliance Inspection and Certification

Station 67 71

6
IN-PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAME: mm [S):

FLOOR FRAMING STATION

CES DOCUMENT NO. C-02 Page 3 of 69

PASE_ OF APPLICATION NO: PLANT LOCATION:

STATE: STATION NO.: SYSTEM APPROVAL N0(S1.:

DETERMINATION

OF COMPLIANCE

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

1. MATERIALS: Structural framing

members - joists, beams.

stringers, blocking, bridging.

etc.

(a) Species A, D

(b) Grade A, D

(c) Slze(s)

(d) Moisture Content 1, 2

(e) Preservative Treatment 1, 2 D, F

(f) Condition/Tolerances 2, 3 (e.g.. warp, bow, splits,

twist . etc .

)

2. OPERATIONS:

(a) Measuring and Cutting

(1) Span (joists)

(b) Drilling and Notching

(1) Holes 1, 2, 4

(2) Notches 1, 2, 4

E^, G

D, E^

D. E^

(c) Layout/Spacing

(1) Location and Orientatlor 1, 2 D, E^

(joist setting with

crown up)

7
CES DOCUMENT NO. C-02 Page h of 69

IN-PLANT INSPECTION CHECKLIST (Pontinued) p»GE_OF

STATION NAME: fi^oR fmMiNG station STATION NO.:

CCCCUnil PUl Dl PTCDI CTI PC ftC IIICDCPTinil cdbtNIIAL UHAKALIfcnlolILd Ul' iNdrtUllUN SOURCES

Ur UtoluN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPllANrF UU Ifir Lmn V

L

I 0 I T QT^C CJKlH ^T^n "1 /^OC \c. J J-icipb dXlU. OP-LJ-UCO D, E-L

('^) End Rparinp* D. P

( 4 ) La161^3,1 Suppor^t 1 ? -tj . .& (e.s. . blockinec. bridging)

J.

i J

i (1) Location (per drawing) 1 ^ 1 J (2) Praming (per drawing) 1

1

3. FASTENERS: Nails, bolts/screws. 1

1 joist hangers

1

1

i

1

(a) Size 1. 2 RD, nU, Hz-j^ F ._;

(b) Type/Grade 1, 2, 6

(c) Condition 2

r

(pi) Numhpr (of f^^iRt'Pnpr'^

\o. J i'lwiiu-'cx \ ^x xcioL/\^ii\^x oy ]_ D

(b) Location and Spacing 1, 2 J2^£j

(c) Method (e.g., toenail. 1, 2 end-nail)

[

(d) Bearing of Members 2 JV^^ !

(e) Washers (w. bolts/screws) 1, 2

1 D, P

(f) Workmanship 2 n^.F^s}

8
CES DOCUMENT NO. C-02 Page 5 of 69

IN-PLANT INSPECTION CHECKLIST Of -

APPIICATIOM NO: MANUFACTURER: PLANT LOCATION:

INSPECTION AGENCY: STATE: STATION NAME: floor insulation station STATION NO.: MODEL (S): IZZIZZZZZIIZZIZZ^ SYSTEM APPROVAL NOISl:

ESSENTIAL CHARACTERISTICS OF INSPECTION

^nilRP.FS OUU nuLO

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

. 1. MATERIALS: Moisture barrier.

thermal insulation

(a) Size (e.g., thickness. 1 B, D

weight

)

(b) lype/Grade 1 B. D

(c) Condition (e.g., dry. 2 D, F, G undamaged)

2 . INSTALLATION

:

(a) Moisture Barrier

•

(1) Pla'cement (e.g.. 1, 2 D

continuity)

(2) Attachment 1, 2 D

(b) Thermal Insulation

(1) Placement 1, 2 D, E

_l_

(2) Attachment (method of 1, 2 D, E^ fastening, location and

spacing)

(c) V/orkmanshlp 2 D, P, G

9
IN-PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAMt

MODEL (Sj:

PLOOR SHEATHBJG STATION

CES DOCUMENT NO. C-02

APPLICATION NO: PLANT LOCATION:

STATE: STATION NO.:

Page 6 of 69

PAGE OF

SYSTEM APPROVAL NO(S].:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. MATERIALS : Plywood, proprietary

sheathing types

(a) Size (e.g., thickness)

(b) Type/Grade A, B, D

(c) Condition/Tolerances 2, 5

2. FASTENERS:

(a) Nails, Staples

(1) Size 1, 2 B, D, El

(2) TVpe/Grade 1, 2, 6 B, D

(3) Condition

(b) Adheslves

(1) Type 1, 2 B, D

(2) Age, Shelf Life B, D

(3) Mixing Schedule B, D

(4) Coupon Tests D, H

3. INSTALLATION:

(a) Measuring and Cutting

(b) Layout

10
CES DOCUMENT NO. C-02 Page 7 of 69

iN PLANT INSPECTION CHECKLIST (CfiNTiNUED) P*fiE_OF_

STATION NAME: floor sheathing station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION OUUnbLO

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DFTFBHINtTION

OF COMPLIANCE

(1) Dimensions 1 D, F^

(2) Location and Orientation 1 D

(3) Laps and Splices 1 D

(c) Nails, Staples

(I) Number 1 D

(2) Location and Spacing 1 D, E^

(3) Workmanship 2 D, F, G

(d) Adhesives

(1) Application 1, 2 D

(2) Pressure 1, 2 D

(3) Terrperature-or special 1, 2 D handling conditions —

1

(4) Curing (drying time 1, 2 D i

1 before next operation) <

i

(5) Workmanship 2 D, F, G

(e) Methods

(1) Face grain orientation 2 D

with respect to joists

11
CES DOCUMENT NO. C-02 Page 8 of 69

IN PLANT INSPECTION CHECKLIST (CONTINUED) PAGE_OF_

'^TATION NAME: fi^or sheathtog station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

lUTCUT

INItNT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(2) Joints centered over 2 D

joists, rafters

r

V 9 1 WorT^mnriRlTi'n J / fKWX l\l (itZll lOl .1—1-^ 2 T) 17 n

1

12
CES DOCUMENT NO. C-02 Page 9 of 69

IN PLANT INSPECTION CHECKLIST

APPLICATION NO: MANUFACTURER: PLANT LOCATION:

INSPECTION AGENCY: STATE: STATION NAMt wall FRAf^iG and setting station STATION NO.: ma (S): ZZZIZIZZZ^ZIZZZZI system approval noisi:

CCCCUTIll PU 1 Dl PTTDICTIPC (IT lUCDCPTinil SOURCES

or DESIGN INTFNT In 1 L n 1

ACTUAL DESIGN REQUIREMENT

DETERMINATION

Ur COMPLIANCE

1. MATERIALS: Structural framing

members—studs, plates, lintels,

etc

.

(a) Species 1 A, D

(b) Grade 1 A, r

(c) Size(s) 1 F-,

(d) Moisture Content 1, 2 D, Ep

(e) Condition/Tolerances (e.g.. 2, 3 D, E-,

2 . OPERATIONS

:

j (a) r''easuring and Cutting 1 i'

j

'-

1 (h) Drillinp* and Nntchine" 1 2 P. Ft

( c ) Lsyout/Spacing^ 1, 2 P,'1Fn

\\J. J -1 CUlLLl 1^ J. wl l^JdJ L W^CTl l/^o ]_

]_ ' ^1

(2) Framing (per dravjlng) 1 n, ^

13
IN PLAKT INSPECTION CHECKLIST (CONTINUED)

CES DOCUMENT NO. C-02 Page 10 of 69

PAGE OF

STATION NAME: wall framing and setting station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

3. FASTENERS: Nails, bolts/screws,

staples

(a) Size 1, 2 B, D, El

(b) 'Type/Grade 1, 2, 6 B, D

(c) Condition 2 D, F, G

4 . CONNECTIONS

:

(a) Number (of fasteners) 1 D

(b) Location and Spacing D, Fl

[c) Metnod (.e.g., toenail. -^i^ D, F

end-nail)

:

'

:

;

: (d) Bearing of Members 2 D, F

(e) Plumb and Square 2

! D, F

1

1

! (f) Workmanship 2 D, P, G

if

5. ERECTION/SETTING OF WALLS:

(a) Connections/Fasteners

(1) Number (of fasteners) 1 D

(2) Location and Spacing D, Fl

i 14
CES DOCUMENT NO. C-02 Page 11 of 69

IN-PLANT INSPECTION CHECKLIST (rnmiNUEDi i'AGE_OF

lATION NAME: wall framimg aj^id setting station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

t

DETERMiNAIiON

OF COMPLIANCE

(3) T'fethod 1, 2

1 D, F

- - i

(b) Bearing of Members 2

(c) Vforlonansbjip 2

-

j

!

i

1

'

I

,

i

i

1

1 15
CES DOCUMENT NO. C-02 Page 12 of 69

IN PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAMt wall insulation station

MSflEL (S):

PA6E OF APPLICATION NO: _ PLANT LOCATION: _ STATE: _ STATION NO.: SYSTEM APPROVAL NO|S].:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. MATERIALS : Moisture barrier.

thermal Insulation

(a) Size (e.g., thickness. B, D

weight

)

(b) TVpe/Grade B, D

(c) Condition (e.g., dry, un- damaged)

D. F, G,

2. INSTALLATION:

(a) Moisture Barrier

(1) Placement (e.g..

continuity)

1, 2

(2) Attachment 1, 2

(b) Thermal Insulation

(1) Placement 1, 2 ^, Fl

(2) Attachment (method of 1, 2 fastening, location, and

spacing)

(3) Vtorkmanship

16
CES DOCUMENT NO. C-02

IM PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAME: intepior vjall covering station

ma iS]:

Page 13 of 6S

PAGE OF APPLICATION NO: _ PLANT LOCATION:

STATE: _ STATION NO .: SYSTEM APPROVAL NOfSl:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF OESIGN INTENT

ACTUAL OESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1-. MATERIALS : Gypsum wallboard

(a) Size (thickness) ^> ^> ^1

(b) TVpe/Grade

(c) Condition

2 . FASTENERS

:

(a) Nails J screws, wallboard

clips

(1) Size 1. 2 R,

(2) TVpe/Grade 1, 2, 6

(3) Condition

(b) Adhesives

(1) Type 1, 2

(2) A^e, Shelf Life P. P

17
CES DOCUMENT NO, C-02 Page ih of 69

N PLANT INSPECTION CHECKLIST (pomtinued) page^OF _

TfATION NAME: interior wall covering station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION OUUnuLO

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

nFTFRMINATinN UL 1 Lnini nn 1 lun OF COMPLIANCE

(3) Mixing Schedule 2 B, D

(4) Coupon Tests 2 D, H

1

'

3. INSTALLATION:

(a) Nails, screws

(1) Number (of fasteners) 1 D

(2) Location and Spacing 1 ""'.^h

(3) Workmanship 2

„

D, F, G

(b) Adhesives

(1) Application 1, 2 D

(2) Pressure I, 2

(3) Temperature-or special 1, 2 _A

handling conditions

-

(4) Curing (drying time I, 2 D

before next operation)

(5) Workmanship 2 D, F, G

(c) Method

i

(1) Joints centered over 2 D

supports

(2) Tape and spackle joints 2 D

18
CES DOCUMENT NO. C-02 Page 15 of 69

iN-PLANT INSPECTION CHECKLIST (rnmiNUEO) l>AGE__OF

NATION NAME: interior wall coverujg station STATION NO.:

^:SSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

i

DETERMINATION

OF COMPLIANCE

C3) V/orkmanshlp 2 D. F. G

1

1

... .

r

.

....

i

i -

i

... — . .. -

19
IN-PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAMt ceiling/roop framing and setting station

ma (S): ZZZZIZIZZIIIIZZZ^ir"

CES DOCUMENT NO. C-02 Page l6 of 69

PAGE_ OF _

APPLICATION NO: __

PLANT LOCATION:

STATE: STATION NO.: SYSTEM APPROVAL NOfSl:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. MATERIALS : Structural framing

members-rafters, joists, roof

trusses, etc.

(a) Species

A. D

(b) Grade

(c) Slze(s)

(d) Moisture Content 1, 2

(e) Condition/Tolerances (e.g.. 2, 3 warp, bow, splits, tvast,

etc.

)

[2. OPERATIONS:

(a) Measuring and Cutting

(1) Span (joists)

(b) Drilling and Notching 1, 2, H

(c) Layout/Spacing 1, 2

(d) Laps and Splices 1, 2 D, E

20
CES DOCUMENT NO. C-02 Page 17 of 69

IN-PLANT INSPECTION CHECKLIST (pohtinued) PAGE__0F_

iTATlON NAME: ceiling/roof framing and setting station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(e) End Bearing 1, 2 D, F

(f) Framing for Openings

(1) Location (per drawing) 1 D, F]_

.

^ (2) Framing (per dravdng) 1 n TP

3. FASTENERS: Nails, bolts/screws.

i trussplates, etc.

......

- - - B, D, El

r~

B, D

(a) Size 1, 2

(b) TVpe/Grade 1, 2, 6

(c) Condition 2 ! D, F, G

4 . CONNECTIONS

:

!

(a) Number (of fasteners) 1

(b) Location and Spacing 1, 2 D, Et_

(c) Method (e.g., toe-nail, D, F

end-nail)

1

! 21
CES DOCUMENT NO, C-02 Page l8 of 69

IN PLANT INSPECTION CHECKLIST (CONTINUED) PAGE_Of_

JATION NAME: ceiling/roof framing and setting station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(d) Bearing of Members 2 D, F

(e) Plumb and Square 2 D, P

i (f) Workmanship D, P, G

1

1

•

(

i

j _ 1 —

!

f 5. EPECTION/SKLTING OF CEILINfiS/ ROOFS:

i

i

(a) Connections/Fasteners

:

(1) Number (of fasteners) 1

; D

(2) Location and Spacing ij 2

(3) Method D, P

. (b) Bearing of Members D, F

(c) Workmanship 2 D, P, G

—

-

\-

:

22
IM PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAMt INTERIOR CEILING COVERING STATION

MGOEL (S):

CES DOCUMENT NO. C-02 Page 19 of 69

PAGE OF APPLICATION NO: _ PLANT LOCATION: _ STATE: _ STATION NO.: SYSTEM APPROVAL NO(S].:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. MATERIALS: Gypsum wallboard

(a) Size (thickness) B. D, Er

(b) Type/Grade A, B, D

(c) Condition D, F, G .

2. FASTENERS:

(a) Nails, screws, wallboard

clips

(1) Size 1. 2 B, D,

-U) Type/Grade 1, 2. 6 B, D

( 3) Condition

(b) Adheslves

-XI.) lype -1^2_ B. D

(2) Age, Shelf Life

(3) Mixing Schedule B, D

23
CES DOCUMENT NO. C-02 Page 20 of 69

iN PLANT INSPECTION CHECKLIST (CONTINUED) PAGE__OF___

STATION NAME: interior ceiling covering station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

IIITCIIT in icNi ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF mUD 1 1 1 UP c LUMPLIANuE

(H) Coupon Tests 2 D, H

^ TM^TflT T ATTDM

» 1

1 H 1 il iH 1 1 k .

!

i — -1

i

1

i —

i

i

\ J- J i JLUiii '"1 \j± 1 cLo u trl itrl 0 / _L n i

1

]_

\ / ^-i- r\l

I

ICU. 101 I'M 2 LI, b, h ,

t

i

\ 1_J y rti—U. ICJO-L V CO

-i

J J

V J / J-trllipt:! d.UU_L tr—UI bpcCJ-d-L 1 2 --J '- D ;

handling conditions

W Curing (drying time 1, 2 _D

1 before next operation)

1

1

___?. j£.?_r: , \ _J J W^L J:\iliclJ iol U.p 2

(c) rfethod: 1

,

(1) Joints centered over 2 D

... J

1 supports

i 24
CES DOCUMENT NO. C-02 Page 21 of 69

IN PLANT INSPECTION CHECKLIST (continued) p»ge_OF__

iTATION NAME: interior ceiling covering station STATION NO.:

tSSENHAL CHARACTERISTICS OF INSPECTION SOURCES

nr n rcip

u

Or DESIGN

INTFNT In 1 en 1 ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF rnuDi iturr UUMrLIAnLt

(2) Tape and spackle Joints 2 D

( 3 ) Workmanship 2 D, F, G

1

! -\

1

(

1

1

1

i

•

i

i

j

1

i

]

\

- - - \

-!

:

!

rl

-

.

- -

-

- -i

!

25
CES DOCUMENT NO. C-02

IN-PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAML

MOOEL (S):

Page 22 of 69

PAGE OF

PLUMBING STATION

APPLICATION NO: _ PLANT LOCATION: _ STATE: _ STATION NO.: SYSTEM APPROVAL NO(Sl:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. MATERIALS:

(a) Pipe - D.W.V.

(1) Slze(s)

(2) TVpe/Grade

(3) Condition

P.,

A, B. D

(b) Pipe - water supply and

distribution

A, B, D

D, F, G

(1) Size

(2) TVpe/Grade

(3) - Condition

(c) Pipe - gas fuel supply

piping

(1) Size

(2) TVpe/Grade

D, E,

A, B, D

(3) Condition

(d) Plumbing fixtures/drains

(1) Type/Size

(2) Label/marking A, B, D

26
CES DOCUMENT NO. C-02 Page 23 of 69

iN PLANT INSPECTION CHECKLIST (rnvTiHUED) PAIiE_OF__

STATION NAME: p^riG station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES w w u n u L w OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(e) Valves

(1) TN-pe/Size 1 D, E^

(7) Tflhpl /rprkirg 1 A, B, D

(f) Appliances and equiprsnt

(1) T!»-pe/Size 1

!

(2) Lacel/rarldng 1 A, 3, D !

-.

1

1

(g) Miscellanecos - air gaps,

j pipe ccarir^gs, ccnxcunds,

solder, ez2. i

1

I

(1) I^xe 1 A, 3, D !

(2) Lacel/naridj-g 1 A, 5, D

2. ZZ.'STAII. rR.AlZLn.jZ S'iS_r^'.:

1

(2: Meas-urir^ ar.d luTti.-^ — i -

1. 3 - Hsarring — > -

(-} 3rade ar.d -ztzzr. _ 1, Z-

— > -

— y -
CES DOCUMENT NO. C-02 Page 24 of 69

iN PLANT INSPECTION CHECKLIST (mNTiNUED) PAGE_OF_

STATION NAME: pluivbing station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION

u U U nuL

J

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

RFTFRMINlTinN Ul 1 Lnini nR 1 lUn OF COMPLIANCE

(8) Direction 1. 2 D

(9) Cleanouts

- Size 1 D, E^

- Location 1 D

- Accessibility 1 D, G

(10) Flashing and 1, 2 D

WeatherproofIng

(11) Workmanship 2 D, F, G

i

3. INSTALL VENTING SYSTEM: 1

i

1 (a) Installation -

1

(1) Connections and 1 D 1 Fittings

i

(2) Terminations 1

i (3) Location 1

(4) Offset 1 D. E^ 1

(5) Height 1 D, E^

(6) Reaming 1, 2 D

(7) Flashing and 1. 2 ^ "1

Weatherproofing 1

28
CES DOCUMENT NO. C-02 Page 25 of 69

iN PLANT INSPECTION CHECKLIST (romiNUEOi PAGE__OF_

iTATIOH NAME: plumbing station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

lUTCUT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(8) Workmanship 2 D, F, G

4. INSTALL TRAPS AND TRAP AfiMS:

i

- •

i (a) Installation -

i

(1) Fixtures serviced 1

( D j

i

1 (2) Location 1 D

(3) Length 1 D, E-^

!

i (^) Vertical Location 1 D, E^

1 (5) Horizontal Location 1 __JD^Ej_ _:

(6) Slope and Pitch 1 D, E^

( 7 ) Workmanship 2 D, F, G i

;

j 5. INSTALL JOINTS AND CONNECTIONS:

(a) Installation -

(1) Location 1 D

(2) Reaming 1, 2 D

(3) Pipe .1oint compound 1, 2 !

29
CES DOCUMENT NO. C-02 Page 26 of 69

iN PLANT INSPECTION CHECKLIST (mmiNUEO) PAGE__OF_

STATION NAME: plumbing station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION

SOURCES

OF DESIGN

lUTrUT

INIENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(4) Cleanout pIuks

- Size 1 D

- T.nhr'l nation 1 D

(5) Caulklnff 1, 2 D

(6) Solder and Flux 1, 2

!

I

(7) Flaring 1, 2 D

j

(8) Adaptors 1 ° i

i (9) Solvent welding 1, 2 n ! •L'

!

j

i (10) Soldering and bronzing Ij 2 n i ^ 1

i

j

(11) Conpresslon Fittings 1, 2 U 1

i

(12) Slip joints 1 u

(13) •Accessibility 1

; (14) Unions :

- Location 1

Ti

JJ

- Accessibility 1

(15) Waterproofing and 1, 2 counter flashing

(16) Reducers - Increasers --

- Size 1 —D

1

- Adaptors 1 D

(17) Workmanship 1, 2 D, F, G

30
CES DOCUMENT NO. C-02 Page 2? of 69

IN PLANT INSPECTION CHECKLIST (phntinued) PAGE_Of__

iTATIOH NAME: plumbing station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

6. raSTALL INDIRECT WASTE

PIPING, WET VENTED SYSTEMS

flWn SPRCTAT, WASTF,S:

(a) Installation -

(1) Size 1 D> h

4 (2) Location 1 D i

i

1

(3) Separate discharge 1

j

vent

J

(4) Length 1

i

(5) Pressure Connections 1 D

- (6) Discharge 1 D :

- (7) Height 1 D, E^

1

: (8) Workmanship 1, 2 D, F, G ;

- 7. INSTALL PLUMBING FIXTURES:

;

(a) Installation -

(1) Location 1 D :

(2) Connections 1 -5 1

(3) Access 1

(H) Joints and water D

tightness

31
CES DOCUMENT NO. C-02 Page 28 of 69

iN PLANT INSPECTION CHECKLIST (Phntinued) PAGE_0F_

STATION NAME: plumbing station STATION NO.:

F^^FNTlAi rHARArTFRKTin^ flF IN^PFrTlflN

cniiDprc oUUKlcS

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

nc

Ur COMPLIANCE

( 5 ) Secupinp^ 1. 2

(6) Setting!; 1 D

(f) Support ] D

(8) Cross connection I D

(9) Workmanship 1, 2 D, P, G

8. INSTALL WATER DISTRIBUTION

SYSTEM:

!

(a) Installation -

1

(1) Length 1 D, E-, ; >—1 1

i

(2) Support 1, 2 D -J

(3) Location ! 1 D

•

(4) Connections 1 D !

(5) Reaming 1, 2 D :

i

-4 (6) Fittings and 1, 2 D

i Connections

!

(7) Valves

- Pressure 1 D

- Pressure Relief 1 D

(8) Testing 2 D

1

1

32
CES DOCUMENT NO. C-02 Page 29 of 69

IN-PLANT INSPECTION CHECKLIST (pomtinued) P»GE_0F__

NATION NAME: plumbing station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(9) Workmanship 2 D

9. ' INSTALL FUEL GAS PIPING:

:

(a) Installation -

i

(1) Location 1 D

(2) Length 1 D, E.,

(3) Support 1, 2 D

1 (4) Connectors 1 D i

(5) Testing 2

i

!

(6) Workmanship 2 ^ i -A

!

i 10. INSTALL WATER HEATER AND

VENTS:

j

i

i

i

(a) Installation -

i

1

1

i (1) Location 1 D !

1

(2) Enclosures 1 n -\

(3) Combustion Air 1 D

(4) Controls - location 1 D

(5) Clearances D, E^

33
CES DOCUMENT NO. C-02 Page 30 of 69

IN PLANT INSPECTION CHECKLIST (ronTiNUED) PAfiE_OF_

HATION NAME: plumbing station STATION NO.:

CCCrUTIll PUl Dl PTC Dl CTI PC OC lUPDrPTinU

cSScNIIAL LHAKALitnlbllLo Or INSrtCilDN SOURCES

nr ncciPH

Ur UtMuN

INTFNT In 1 Ln 1

HTiiii nroiAki n r n III n r Ki r fti T ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF

UUfflrLIANUt

(6) Protection 1 D

(7) Access 1 D

(8) Venting

— ijUL/d-L'-LUI 1

"1 nu

— nex^Qu -L LI,

- Openings -1± U

- Connectors L iJ

— oUPPO"L -L, nJ-/

1

J.

j

( — 1 eiiiLLi id. u ±urI 1X

^ D ;

— LO/al u nOOQ 1. D !

} woj/Kinansmp D F G '

'

:

1

1

1

34
CES DOCUMENT NO. C-02

IN-PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY- STATION NAML

MODEL (S):

Page 31 of 69

PAGE OF

FTKnTOTHflT, STATION

APPLICATION NO: _ PLANT LOCATION: _ STATE: _ STATION NO- SYSTEM APPROVAL NOISl:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF OESIGN INTENT

ACTUAL OESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. MATERIALS:

(a) Service Equipment

(1) Service Enclosure

- Type

- Size

- Capacity & Rating

A, B, D

A, B, D, E,

A, B, D

- Switches & Breakers

Main Switch & Breaker rating

Sub-switches & Breakers - rating

- Condition

A , B, D

A, B, D

(2) Service Entrance

- Conduit:

overhead & underground

Identification A, B, D — B, D — Size B, D>

- Conductors

35
CES DOCUMENT NO. C-02 Page 32 of 69

iN PLANT INSPECTION CHECKLIST (roNiiHUED) PAfiE_OF_

STATION NAME: electrical station STATION NO.:

ri^cru Till A II sniATrniOTi no at lucnrnTiAu

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

nr n r PIA &I OF DESIGN

in 1 cN 1 ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE — Type and 1, 2 A, B, D

Insulation

— Size 1 B, D, E^

— uonaition <L n T? p D, F, G

( 3 ) Grounding

- Grounding conductor 1 A, B, D, E,|

- Ground clamp 1 A, B, D

- Bonding ,1urnper size 1 A, B, D, E,|

(.4; Electrical Gutter

- Type 1 A3 rJ, u

— oize L R TT D, JJ, Ji^

-'Fittings & Couplings ij 9 u

— Bonding Jumper Size 1 D, hj^

- Grounding Conductor 1 A, B, D, E^

(5) Service Disconnects

- Type 1 A, B

- Size & Rating 1 A, B

- Switch 8c Breaker 1 A, D

1 Q D F

& Locknuts

- Grounding Conductor 1 A, B, D, E^

36
CES DOCUMENT NO. C-02 Page 33 of 69

IN PLANT INSPECTION CHECKLIST (rnNilNUED) PAfiE_OF__

^.TATION NAME: el^ctoical station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION

cniiQrr^ ouunuLo

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

ui 1 tnninA Mun

OF COMPLIANCE

(b) Distribution Panel & Load Center

(X) Panel Board

- Type 1 A, B

- Size 1 D

- Capacity & Rating 1, 15 A, B, D

i = ]

- Circuit Breakers & 1 A, B, D 1 Fuses

j

—I - Separate eroundlnp; \ conductor

— Type 1 A, B, D — Size 1 B, D ;

i

- Condition 2 D, F, G

(c) Feeder Circuits

(1) Type

- Cable 1 A, B, D

- Individual conductors 1 B, D

(2) Size

- Cable 1 B, D, E^

- Individual conductors 1 B, D, E^

37
CES DOCUMENT NO. C-02 Page 3^ of 69

IN PLANT INSPECTION CHECKLIST (pntinued) page__OF_

ilTATION NAME: electrical station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

iiiTriiT in 1 tn 1 ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF mUD 1 1 A no

r

COMPLIANCE

(3) Racevjays

- Type 1 A, B, D

- Size 1 B. D, E^

- Connectors ii 9

(d) Branch Circuits

(1) TVpe

- Cable 1 A, a, U

- ![ndlvldual conductors 1 D, U

(2) Size

- Cable 1 n Fi T? r), u, tjj-^

- Individual conductors 1 R n TT 1 iS, U, til

(3) Raceways

- Type 1 n

1

- Size 1 \ j

- Connectors 1> 9

\ (e) Fixed Appliances:

Ranges, Water Heaters, etc.

(1) Make & Model

- MarklnK & nameplate A, B, D

- Marking of elements 1, 10 B, D

-

38
CES DOCUMENT NO, C-02 Page 35 of 69

IN PLANT INSPECTION CHECKLIST [rnnTiNUEO) PAGE_flF__

iTATION NAME: eiectoical station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(f) Outlet Boxes, Switches,

Junction Boxes, Fittings,

etc.

C 1 'I Trienti fi cati nn

- Label & markins 1, 9 D

(2) Metallic, Non-metallic i1

- Type 1, 9 D

- Size 1 D

j - Use - wet location - 1 D, G

1 dry I

1

1

(g) Lighting Fixtures, Lanpholders & Lamps i

;

!

(1) Type 1 A, B, D j

i

(2) Listed & labeling 1 A, B, D ;

(3) Fixture studs 1 A, B, D

(4) Outlet boxes 1 A, B, D j

(5) Rosettes 1 A, B, D

1

(6) Condition 2 D, F, G i

i

2. INSTALL ELECTRICAL SERVICE: j

11

(a) Identification 1, 2 A, B, D

39
CES DOCUMENT NO. C-02 Page 36 of 69

IN PLANT INSPECTION CHECKLIST (Pontinued) page__OF_

STATION NAME: electoical station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(b) Mounting cabinet

(1) Backing 1 D

(2) HelKht 1

(3) Location 1 D

(c) Service entrance

(1) Service conduit 1 A, B

- Connection to meter 1 D

base

- Supports 1, 2 D

- Reaming & bushing 1, 2 D

- Height & clearance 2, 11 D, E,

J from roof i

! 1

i (2) Service entrance !

1 conductors

:

overhead & underground !

- Identification 1, 2 A, B, D

- Length & drlploop 1 ^' El.. J

- Servlcehead location 1, 2, 12 D, E^

- Connections to bus 1, 2 D

- Connection to 1, 2 D

neutral bus

...

Ho
CES DOCUMENT NO. C-02 Page 37 of 69

IN PLANT INSPECTION CHECKLIST (roNTiNUED) PAGE_OF__

iTATION NAME: eiectoical station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

lUTrtlT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF luMPLIANCE

(d) Grounding Continuity

(1) Grounding conductor

- Connection to bus 1) 2 D

(2) Bondins ,iumper at service

- Connection 1, 2

i D, F i

i (e) Gutter at service

1

(1) Identification 1 0 A R n ! A, tS, U J

\c.) oize anu iixj. ± n n P ' tl, u, b-i

( 3 ) Location ±

ri

'

j — : (5) Service entrance

.

(5) Connection to service

i

;

cllUX dJiCc LUlILlU 1 U

— Couplings & nipples 1, IJ JJ

i — Bonding & grounding JJ !

I — Reaming/bushing

\i J oervice jjisconnecu

i

(1) Identification 1, 2 A, B, D

1\

(2) Location 1 D

41
CES DOCUMENT NO. C-02 Page 38 of 69

IN PLANT INSPECTION CHECKLIST (roNTiNUED) PAGE_OF__

NATION NAME: electrical station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES W V V 11 V L w OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DFTFRMINATinN

OF COMPLIANCE

(3) Mounting 1, 2 D

(4) Connections to gutter

- Coupling & nipples 1, 2 D

- Bonding and grounding 1, 13 D

(5) Meter Base

- Bonding and grounding 1, 2 D

- Height 1 D, E^

(g) Workmanship 2 D, F, G

3. INSTALL DISTRIBUTION PANEL AND LOAD CENTER:

(a) Identification

(1) Label 1 A, B, D

(b) Mounting

(1) Location 1 D

(2) Accessablllty 1, 2 D

(c) Over current protection

(1) Circuit breakers and 1, 2 A, B, D

fuses

42
CES DOCUMENT NO. C-02 Page 39 of 69

iN-PLANT INSPECTION CHECKLIST (rnNTiNUEO) PAGE_Of _

HATION NAME: ei^ctoical station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(d) Grounding and bonding

(1) To main service 1, 2 D

(2) Connections 1, 2 D

(e) Workmanship 2 D, F, G

4. INSTALL feeder CIRCUITS: i

1

i

(a) Identification 1, 2 D

i (b) DrillinK. boririK-studs/ 1, 2, 16 D, E^, G i .iolsts i

!

!

i

(c) Mechanical protection 1, 2, 16 G

(d) Mechanical continuity

(1) Metal raceway 1, 2 D, G

i

(2) Cable armor 1, 2 D, G \

1 (e) Installation j

(1) Attachment & support 1, 17 D, G

(2) Radius of bend 1, 2 .

i - Non metallic 1, 18 sheathed cable

-i - Conduit 1, 19 D, E^

(f) Workmanship 2 D, F, G

43
CES DOCUMENT NO. C-02 Page 40 of 69

IN-PLANT INSPECTION CHECKLIST (roHTiNUED) PAGE_flF_

iTATION NAME: electrical station STATION NO.:

rccruTiii PUiDiPTrDiCTirc nt lucDrrTiny tootniiHL i<nAnAUicnioiiio Ur inortuiiun

0 All nn r

o

SOURCES

ur ucoian

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

At

OF COMPLIANCE

(a) Identification 1 D

(b) Drilling, boring studs 1, 2, 16 D, G

.iolsts

(c) Mechanical protection 1, 2, 16 D, G

(d) Mechanical continuity

(1) Metal raceway 1 D, G

(2) Cable armor 1 D, G

(e) Installation

1 (1) Attachment & support ^ i

!

-•Type and spacing 1, 17 D, E,

(2) Radius of bend

- Non-metallic sheathed 1, 18 D, E

1 cable

— Conduit D, E,

(f) Workmanship 2 D, F, G

6. INSTALL FIXED APPLIANCES: RANGES, WATERHEATERS, ETC.

(a) Marking

44
CES DOCUMENT NO. C-02 Page ^Jl of 69

IN PLANT INSPECTION CHECKLIST (rovTlNUED) PAGE_Of_

iTATIOH NAME: electoical station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(1) Nameplate 1, 10 D

(2) Elements 1, 10 D

(b) Supply circuits

(1) Size of branch circuits 1, 2 D

(2) Identity, branch 1, 2 D

circuits

-i

i

!

i (c) Location 1

1

-i (1) Spacing 1, 2 -^^-^1 J

-J. (2) Protection from damage 1, 2 D, G 1

(d) Grounding 1, 2 D

!

(e) Over current protection

1

(1) Circuit breakers 1, 2

- J

(2) Controllers and 1, 2 D ' disconnects

(f) Workmanship 2 D, F, G

^

j 7. INSTALL OUTLET, SWITCH AM)

JUNCTION BOXES AND FITTINGS:

(a) Identification -i

(1) Label and marking 1, 2 A, B, D

45
CES DOCUMENT NO. C-02 Page 42 of 69

IN-PLANT INSPECTION CHECKLIST (roNTiNUEO) P*8E_0F_

STATION NAME: eiectoical station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(b) Mounting and Installations

(1) Supports 1, 20 D

(2) Flush mounttos 1, 2, 21 D

(3) Unused openings 1, 2. 22 D

(c) Size and shape

(1) Depth and dimensions 1 D, E^

(2) Fill and area 1 D, E^

(d) Covers and Canopies 1, 2 D

(e) Conductors

(1) Entering of boxes 1, 2 F

(2) Securing to boxes. 1, 2 D, F temlnals and switches

(3) Bushings 1 D, F

(f) Accessibility 1, 23 D

(g) Grounding, bonding and 1, 2 D, F

insulation from supports

(h) Workmanship 2 D, F, G

8. LIGHTING FIXTURES, LAMPHOLDERS,

LAMPS, ROSETTES, OUTLET BOXES:

(a) Identification 1, 2 A, B, D

1 46
CES DOCUMENT NO. C-02 Page ^13 of 69

IN PLANT INSPECTION CHECKLIST (Pontinued) page_OF__

STATION NAME: eiectoical station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(b) Installation 1, 2 D

(1) Location & Mounting 1, 2 D

(2) Shades, guards 1, 2 D

(3) Clearances 1, 2 D, E^

. (4) Supports 1, 2 D

1

(5) Conductors - movable 1, 2 D ; part

1

i

! (6) Protection-conductors 1, 2 D, G i

(7) Connections, splices. 1, 2 tops i

- - -

(8) Wet Locations 1, 2 D

! (9) Height and mounting 1, 2 D, E^, G

1

1

1

(10) Grounding and bonding 1, 2 D i

i

!

9. TESTING OF SYSTEM:

:

(1) Continuity Test 2

J

- - - (2) Dielectric test 2

!

47
CES DOCUMENT NO. C-02

IN PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAML

MODEL (S):

Page 44 of 69

PAGE OF

MECHAMCAL (HVAC) STATION

APPLICATION NO: _ PLANT LOCATION: _ STATE: _ STATION NO.: SYSTEM APPROVAL NOjSI.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. MATERIAI^:

(a) Heating: Equipment, furnaces room heaters, etc.

(1) Type

(2) Rating

(3) Ducts: metallic, nonmetallic

- Size

- Label

-' Connectors

A. B. D

A, B, D

A, B

A, B, D

(4) Vents

Size

- Type

- Material

(5) Condition

(b) Ventilation systems

D, P, G

(1) Ducts, hoods

Size

- Type

48
CES DOCUMENT NO. C-02 Page 45 of 69

IN PLANT INSPECTION CHECKLIST (rnNTiNUED) PAGE_OF_

5TATI0N NAME: mechanical (hvac) station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

- Material 1 D

- Label 1 A, B, D

(?) Condition 2 D, F, G

(c) Air Condltlonijig Equipment

(1) Type 1 A. B, D

(2) Label and nameplate 1 A, B, D

(3) Rattag 1 A, B, D

(4) Ducts

- size 1 D

- - -i - Non-metallic 1 A, B, D j

!

1 - Connectors 1 A, B, D ! >—>

1

t

, (5) Condition 2 D, F, G

j

(d) Miscellaneous heat produc- -J

ing appliances - ranges.

i

dryers, etc.

i

(1) TVpe 1 A, B, D

(2) Label and nameplate 1 __Aj_B, JD

(3) RatijiK 1 A, B, D —

i

(4) Condition 2 D, F, G ^

49
CES DOCUMENT NO. C-02 Page 46 of 69

IN PLANT INSPECTION CHECKLIST (roNTiNUED) PAGE_OF

iTATION NAME: mechanical (hvac) station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

or DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

or COMPLIANCE

2. INSTALL WARM AIR FURNACES:

(a) Identification

(1) Label and nameplate 1 A, B, D

(2) Rating 1 A, B, D

(3) Type of fuel/controls 1 A, B, D

(b) Installation

(1) Location 1 D, E^, F

(2) Clearance from 1, 2 D, E^, G combustibles

(3) Shut-off valve/ 1, 2 D

location

(4) Electrical connectors 1, 2 D

(5) Access 1, 2 D

(c) Circulating Air supply

(1) Source 1 D

(2) Ducts 1 D

(3) Separation 1, 2 D

(4) Air requirements 1, 2 D

(5) Return air 1, 2 D

50
CES DOCUMENT NO, C-02 Page 1,7 of 69

:N-PLANT INSPECTION CHECKLIST (^""iiNUEDl PAGE OF

lATlON NAME: mechanical (kvac) station STATION NO.

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINsIK'f*

OF COMPLIANCE

(d) Conditioned air supply

(1) Ducts and connectors

- Size

- Location

- Registers and grills 1, 2

(e) Combustion air

(1) Air supply

(2) Space

(3) Location of air

openings

(4) Outside supply/interior

(5) Under floor supply

(6) Ducts/connectors

(f) Workmanship

3. VENTS/CHIMNEYS:

(a) Identification

1, 2

1, 2

1, 2

1, 2

(b) Type - System

(c) Size/area

(d) Location/support 1, 2

D

D

D, E.1

! D

D, E,

51
CES DOCUMENT NO. C-02 Page 48 of 69

IN PLANT INSPECTION CHECKLIST (rnviiNUED) PAGE__OF___

'lATlON NAME: mechanical (hvac) station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(e) Lenfffch/pltch/clearance 1, 2 D, E^

(f) Termination 1, 2 D

(g) Connectors 1, 2 D

(h) Unused openings 1, 2

(1) Workmanship 2 D, F, G

4. DUCTS:

(a) Identification 1, 2 D

(b) Fastening/support 1, 2 D

'

(c) Location 1 D

(d) Plenum

(1) Material 1 D

(2) Location 1 D

(3) Access 1, 2 D

(4) Support 1, 2 D

(e) Workmanship 2 D, F, G

i

5. INSTALL FLOOR FUFMACES, ROOM

HEATERS, ETC.:

52
CES DOCUMENT NO. C-02 Page ^9 of 69

N PLANT INSPECTION CHECKLIST rv\Hm] PAGE OF

'lATlON NAME: mechanical (hvac) station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

OEIERMINf

OF COMPLIAN

(a) Identlfication/labeiyilsting 1, 2 A, B, D

(b) Type/system 1 A, B

(c) Location/Access 1 D,

(d) Combustion air supply 1, 2 D

(e) Grilles/Registers

(1) Location 1 D

(f) Support 1, 2 D

(g) Protection from damage 1, 2

-

D

(h) Controls-manual/auto 1

(1) Electrical connectors 1, 2 D

(j) Workmanship 2 i D, F, G

i

! i 6. INSTALL VENTILATION SYSTEM:

(a) Ducts ...

(1) Size 1

(2) Capacity 1 D

(3) Dampers 1 D

(4) Location 1 D

(5) Separation 1, 2 D, F

(6) Clearance from 1, 2

1 combustible

53
iN PLANT INSPECTION CHECKLIST (roNTiNUED)

CES DOCUMENT NO. C-02

rrATION NAME: mechanical (hvac) station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE 1

(7) Tightness 1, 2 D, G

(8) Support 1, 2 D

((^) Cleanouts 1 D

(10) Exhaust outlets

.. .J - Termination 1, 2 D ,

^

-j

- Clearance above roofs 1, 2

S

(

( (b) Hoods

6

\

i

(1) Material 1 D i

(2) Fastening/support 1, 2 ^ - -I

(3) Size/location 1 _ _D^_E^

(4) Clearance 1, 2 D, E^

(c) Workmanship 2 D, P, G ,

7, INSTALL AIR CONDITIONING

EQUIPMENT:

(a) Identification

(1) Label/nameplate 1 A, B, D

J

1

(2) Ratijie 1 A, B, D

(b) Location 1 P_

(c) Support 1, 2

54
CES DOCUMENT NO. C-02 Page 51 of 69

IN PLANT INSPECTION CHECKLIST (pnNTiHOEy) M«_Of__

oTATION NAME: mechanical (hvac) station STATIIN H:.

cccruTiii pu 1 Di PTroi CTi PC nc iiicDFOTinii ESSENTIAL lHARACIcRISIICS Or INSPECTION SOURCES

Ur DtSliN

INTFNT in 1 tn 1 ACTUAL DESIfiN REIiREiENT

lETERMINATION

BF UOMrLIRRbt

(d) Access 1, 2 D, F, G

(e) Circulating Air Supply

(1) Source 1 ^ u

\£- J

LJLLL, 0 oJ O OCIU 1 D

D i

1 _ 1 (4) Clearances n J —

( 5 ) SciTBsns

\1 J riferL/UlIl ci. 1 1 J_JJIJ_L 00.0X011 D !

( g ) Workmsnship 0c. D P G

I

1

1

1 "1

i

i U • 1

1 ^ 1 il 1 1*1 1 tTt.,niJ II iHi\\irxJ\ XlLjii. J.

-

PROT^TTPTKm APPTTAMPFS RANOF.S

i

jjriirxio

.

!

;

i

j

-i

1

(a) Identification

i

''

X A, B, D

{d) naming ± A, B, D

i (b ) Location X D '

1 (c ) Clearances D E F

(d^ T~)i]pf,s

(1) Fastening 1, 2 D

(2) Fire resistant 1, 2 D

enclosure

55
CES DOCUMENT NO. C-02 Page 52 of 69

iN PLANT INSPECTION CHECKLIST (cnNTiNUED) PAGE_OF__

iTATION NAME: mechanical (hvac) station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(3) Connection/fastenings 1> 2 D

(4) Termination/exhaust 1, 2 D, F, G

(e) Workmanship 2 D, F. G

56
IN-PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAME: MOOEL (Sj:

CEILING INSULATION STATION

CES DOCUMENT NO. C-02 Page 53 of 69

PAGE_OF_

APPLICATION NO: PLANT LOCATION:

STATE: STATION NO.: SYSTEM APPROVAL NO|S).

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. MATERIAI^ : Moisture barrier.

thermal insulation

(a) Size (e.g., thickness , weight B, P

(b) Type/Grade

(c) Condition (e.g., dry, undamaged)

2. INSTALLATION:

(a) Moisture Barrier

(1) Placement (e.g., I5 2 D

continuity)

(2) Attachment 1, 2 p

(b) Thermal Insulation

(1) Placement 1. 2 y), F-^

(2) Attachment (method of 1, 2 D, E. fastening, location and

spacing)

57
CES DOCUMENT NO. C-02 Page 5^ of 69

IM PLANT INSPECTION CHECKLIST (continued) page_OF__

STATION NAME: ceiltog insulation station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES W W W 11 W b W OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION UL 1 Lfiifiinn nun

OF COMPLIANCE

(3) Workmanship 2 D. P. G

58
CES DOCUMENT NO. C-02

IN-PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAMt

MODEL [Sj:

Page 55 of 69

PAGE OF

MISCELLAl'^OUS COMPOI'JEI'JTS (WJTOW, EXIT DOOR, AND

STATRWAY) mSTATLATTON .STATTON .

APPLICATION NO: PLANT LOCATION:

STATE: STATION NO.: SYSTEM APPROVAL NO|S].

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. MATERIALS:

(a) Doors and Windows

(1) Size

(2) Type and Grade

(3) Hardware

(4) Weather Stripping and

flashing

(5) Condition

B, D, E.

^^

A, B, D

D, G

D. G

D, F, G

(b) Stairways

(1) Size 1, 2, 7

(2) Material Type & Grade A, B, D

(3) Condition D, F, G

2. INSTALLATION:

(a) Doors and Windows

59
CES DOCUMENT NO. C-02 Page 56 of 69

IN-PLANT INSPECTION CHECKLIST (continued) pa6E_0F

' MISCELLANEOUS COMPONENTS (WINDOW, EXIT DOOR AND

iTATION NAME: staih^/ay) installation station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(1) Location 1 D, E^

(2) Weather Stripping/ 1, 2 D Plashing

(3) Hardware 1, 2 D, G

(4) Workmanship 2 D, F, G

(b) Stairways

(1) Layout (e.g., clear 1, 2, 7 D, E^

vadth, headroom)

(2) Bearing w/r Stmictural D, G

Members

(3) Handrails and Guardrails 1, 2, 8 D,

(4) Worlonanshlp 2 D, F, G

————

.

60
CES DOCUMENT NO. C-02

IN PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAME: wall sheathing station

MDOEL (S): ZZZZ^^ZZ!

Page 57 of 69

PAGE OF APPLICATION NO: _ PLANT LOCATION: _ STATE: _ STATION NO- SYSTEM APPROVAL NOISl:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF OESIGN INTENT

ACTUAL OESIGN REQUIREMENT

OETERMINATION

OF COMPLIANCE

1. _ MATERIALS: Plywood, fiberboard,

proprietary sheathing types

(a) Size (e.g., thickness) i, D, E.

(b) TVpe/Grade A, P, D

(c) CondltlonA'olerances 2, 5

2 . FASTENERS

:

(a) Nails, Staples

(1) Size 1, 2 B, D, F;^

(2) IVpe/Grade

(3) Condition

(b) Adhesives

1, 2, 6 B, D

D, F, G

(1) Type 1, 2 P, P

(2) Age, Shelf Life B, D

(3) Mixing Schedule B, r

(^) Coupon Tests D, H

61
CES DOCUMENT NO. C-02 Page 58 of 69

iN PLANT INSPECTIOK CHECKLIST (continued) page_of_

NATION NAME: waix sheathing station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

3. INSTALLATION:

-

(a) Measuring and Cutting 1 D, El

{D) Layout

(1) Loca:tlGns 1 D, P

(2) Coverage 1 D, F

- . (c) Nails J Staples

( 1 ) Number 1 D

(2) Location and Spacing 1

-

-

( 3 ) Workmanship d D, P, G

(d) Adhesives

. .

. .._ (1) Application 1, 2 D

(2) Pressure 1, 2 D

(3) Temperature-or special 1, 2 D handling conditions

-

(4) CLiring (drying time 1, 2 D

before next operation) D

(5) Workmanship 2 D, P, G

62
CES DOCUMENT NO. C-02

IN-PLANT INSPECTION CHECKLIST

MANUFACTURER:

INSPECTION AGENCY: STATION NAME: MOOEL (Sj:

Page 59 of 69

PAGE OF

EXTERIOR SIDING STATION

APPLICATION NO: _ PLANT LOCATION: _ STATE: _ STATION NO.: SYSTEM APPROVAL NOfSl:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. MATERIALS:

(a) Exterior wall siding

B, D, E^

A, B, D

(1) Size

(2) Type/Grade

(3) Condition

(b) Weather Flashing

(1) Material

(2) Type/Size

(3) Condition

(c) Caulking Conpounds/Mastlcs

(1) TVpe/Grade

(2) Condition

B, D

B, D, E^

B, D

2. FASTENERS:

(a) Nails, Staples

(1) Size 1, 2 B, D, E^

(2) TVpe/Grade 1, 2, 6 B, D

(3) Condition D, F, G

63
CES DOCUMENT NO. C-02 Page 60 of 69

IN PLANT INSPECTION CHECKLIST (mNTiNUED) PAGE_OF__

STATION NAME: exterior siding station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES U V V It W k u OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(b) Adheslves

(1) Type B. D

(?) AgR, ShPlf T.ifP ? R, n

(3) Mixing Schedule 2 B, D

(4) Coupon Tests 2 D, H

3. INSTALLATION:

(a) Plashing!; 1, 2 D, G

(b) Layout 1 D, F

(c) Weather Tightness 1, 2 D, G

(d) Nails; Staples

(1) Number 1 D

(2) Location and Spacing 1 D, E^

(3) Penetration 1, 2 D, P

(4) Workmanship 2 D, F. G

(e) Adheslves

(1) Application 1, 2 D

(2) Pressure 1, 2 D

(3) Temperature - or 1, 2 D

special handling

conditions

64
CES DOCUMENT NO. C-02 Page 6l of 69

IN-PLANT INSPECTION CHECKLIST (pnvTiNUED) P*GE_OF__

HATION NAME: exterior siding station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(4) Curing (drylne time 1, 2 D

before next operation)

Workmanship 2 D, F, G

(f ) CauHdjiK Application 1, 2 D, G

(g) Comer Treatment 1, 2 D, G

1

.

i

t

1

!

I

1

, _

,

;

'

-

,

. ..... .. . . , -H

- - '

^

65
CES DOCUMENT NO. C-02 Page 62 of 69

IN PLANT INSPECTION CHECKLIST

IPPUCATIOH NO

MANUFACTURER: PLANT LOCATION:

INSPECTION AGENCY: STATE: STATION NAML roof sheateeng station STATION NO.: MOOEL (S): SYSTEM APPROVAL N0(S1.:

ESSENTIAL CHARACTERISTICS OF INSPECTION

cniiDPCC

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

nFTrniiiNiTinN OF COMPLIANCE

1. MATEFOJU^: Plywood,

proprietary sheathing types

(a) Size (e.g. J thickness) 1 B, D, E-j_

(b) Type/Grade 1 A, B, D

(c) CondltlonA'olerances 2, 5 D, E3, G

2. FASTENERS:

(a) Nails, Staples, Plyclips

(1) Size 1, 2 B, D,

(2) Type/Grade 1, 2, 6 B, D

(3) Condition 2 D. F, G

(b) Adheslves

(1) Type 1, 2 B, D

(2) Age, Shelf Life 2 B, D

(3) Mixing Schedule 2 B, D

(4) Coupon Tests 2 D, H

66

PAGE OF
CES DOCUMENT NO. C-02 Page 63 of 69

iN-PLANT INSPECTION CHECKLIST (poitinueoi PAGE _0P

ITATION NAME: roof sheading station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

3. INSTALLATION:

t

(a) Measuring and Cutting 1

1

(b) Layout

1

1

(1) Blockixig/Plycllps 1, 2 D, F 2 ?

(c) Nails, Staples ;

i (1) Number 1 D !

i (2) Location and Spacing 1

•

(3) Penetration 1, 2 D, F

(4) Workmanship 2 D, F, G

- (d) Adheslves -

- - (1) Application 1, 2 D

(2) Pressure 1, 2 D

(3) Tenperature - or 1, 2 D

special handling .... _.. conditions

(4) Curing (drying time 1, 2 D

before next operation)

(5) Workmanship 2 D, F, G

(e) Methods

(1) Face grain orientation 2 with respect to rafters

67
CES DOCUMENT NO. C-02 Page 64 of 69

IN PLANT INSPECTION CHECKLIST (fONTiNUED) P»fiE__OF_

STATION NAME: roof sheathing station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

(2) Joints centered over 2 D, E^

rafters

(^) Workmanship 2 D. F, G

-i

j

1

68
CES DOCUMENT NO. C-02 Page 65 of 69

IN PLANT INSPECTION CHECKLIST Of _

APPLICATION HO: MANUFACTURER: PLANT LOCATION:

INSPECTION AGENCY: STATE: STATION NAME pinish pooping station STATION NO.: MCOEL (S): ZZZZIZZIZZZZ^ SYSTEM APPROVAL NOISl:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. MTERIALS:

-

(a) Underlayment

(1) Type/Grade 1 A, B, D

(2) Weight, Thickness I B, D

(3) Condition 2 P, P, G

(b) Roofing

(1) Type/Grade 1 A, B, D

(2) Weight 1 B, D

(3) Condition 2 D, P, G

(c) Weather Plashing

(1) Material 1 B, P

(2) TVpe/SlzeAfelght 1 B, D, Pi

(3) Condition 2 D, P, G

(d) Nails

(1) Size 1, 2 P, D, Fi

(2) TVpe/Grade 1, 2, 6 B, D

(3) Condition 2 P, F, G

69
CES DOCUMENT NO. C-02 Page 66 of 69

iN PLANT INSPECTION CHECKLIST (CONTINUED) PAGE_OF_

iTATION NAME: finish roofing station STATION NO.:

ESSENTIAL CHARACTERISTICS OF INSPECTION

cniiDrr^ oUUnbCo

OF DESIGN

INTENT ACTUAL DESIGN REQUIREMENT

ncTrDiiiuiTiny uc 1 tnfflinA IIUN OF COMPLIANCE

2. INSTALLATION:

(a) Uhderlayment I3 2 D, G

(b) Flashing 1, 2 D, G

(c) I^out 1 D, F

(d) Nails

(1) Number 1 D

(2) Location and Spacing 1 D, El

(3) Penetration 1, 2 D, F

(e) Exposure I D, El

(f) Workmanship 2 D, F, G

70
CES DOCUMENT NO. C-02 Page 6? of 69

IN-PLANT INSPECTION CHECKLIST "GE- Of _

APPLICATION HO: MANUFACTURER: PLANT LOCATION:

INSPECTION AGENCY: STATE: STATION NAML final cqT'Ipliance inspection and cKKi'ib'icATioN STATION STATION NO.: MCOEL (S): ZZZIIZZZZIIIZ^ SYSTEM APPROVAL NOfSl:

ESSENTIAL CHARACTERISTICS OF INSPECTION SOURCES

OF DESIGN INTENT

ACTUAL DESIGN REQUIREMENT

DETERMINATION

OF COMPLIANCE

1. CCX'TKLANCE PZ\?IE1'': 2

2 . LAEEL

:

(a) Contents 2 D

(b) Location 1, 2 D

(c) A-ttachraent (method of 1, 2 D

fastening)

3. U-3zL CCITI^DL FZCOPD: 2 D

4. MANUFACTURER'S DATA PLATE:

(a) Contents 2 D

(b) Location 1, 2 D

(c) Attachment (method of 1, 2 D

fastenJjTg)

71
CES DOCUMENT NO. C-02 Page 68 of 69

Notes to the Inspection Checklists

Sources of Design Intent - References

1. Approved Building System (I.e., drawings and specifications).

2. Manufacturer's Approved Compliance Assurance Manual.

3. Standard Grading Rules for Western Lumber (1970), Western Wood Products

Association, Section 752.

4. One and Two Family Dwelling Code, 1971 Edition, Section R-602.6.

5. Plywood Product Standard Handbook (1970), American Plywood Association,

Sections 3-9, 3-10, 3-11 and 3-12.

6. Federal Specification FF-N-105B (March 17, 1971).

7. One and Two Family Dwelling Code, 1971 Edition, Section R-214.

8. One and Two Family Dwelling Code, 1971 Edition, Section R-215.

9. Underwriters Laboratories Construction Materials List.

10. Underwriters Laboratories Appliance Utilization List.

11. National Electric Code (NEC) (1971), Section 230-24.

12. NEC, (1971), Section 230-51.

13. NEC, (1971), Section 250-72.

14. NEC, (1971), Section 230-71.

15. NEC, (1971), Section 384-13.

16. NEC, (1971), Section 300-8.

17. NEC, (1971), Section 336-5.

(Non-metallic sheathed cable). No. 348-12 (Electrical metallic tubing) or other sections as applicable for other types of circuits or conductors.

18. NEC, (1971), Section 336-10.

72
CES DOCUMENT NO. C-02 Page 69 of 69

19. NEC, (1971), Section 3^8-9 for electrical metallic tubing and other

sections as applicable.

20. NEC, (1971), Section 370-13.

21. NEC, (I97I), Section 370-10.

22. NEC, (1971), Section 370-8.

23. NEC, (1971)5 Section 370-19-

Determination of Compliance

A - Listing Agency Label

B - Manufacturer's Label

C - Test Reports

D - Visual Inspection

E - Physical Measurement or Test (In accordance with the following

technique, as appropriate)

E-|^ - Measurement with pocket tape or scale.

- Measurement of lumber moisture content - Electrical

resistance type moisture meter.

E^ - Measurement of plywood moisture content - Oven, scales,

thermometer, timepiece, core saw.

Ei^ - Measurement with a wire gage.

E^ - Measurement with a continuity tester.

Eg - Measurement with a megometer or equivalent dielectric

testing equipment.

F - Inspector Knowledge

G - Inspector Judgement

H - Sampling by Inspector

73

CES DOCUMENT NO. C-03 Page 1 of 2

INSPECTION REPORT

The suggested Inspection Report form Is for use by the Inspection Agency

inspector to report in summary form the results of his audit Inspections of a manufacturer. Copies of the Inspection Report should be made available to the manufacturer

and, as appropriate, the Administrative Agency. All Noncompliance Tags (CES Document

No. C-0^) and Prohibited Sales Notices (CES Document No. C-05) issued should be sum- marized by unit serial number on the Inspection Report. The frequency of occurrence

for each defect should be so indicated in the column marked "Frequency" for each

Individual entry. Each individual report should be signed at the bottom by both the

Inspection Agency inspector and the manufacturer's compliance control representative.

75
CES DOCUMENT NO. C-03 Page 2 of 2

Mm& and addA.(m OjJ Tmpe.cXA.on Ag&ncy

INSPECTION REPORT

NAME OF MANUFACTURER:

PLANT LOCATION:

DATE OF REPORT: REPORT NO:

Unit

Serial

No

.

Noncompliance

Tag No. Description of Defect Frequency

Agency Inspector Mfgr. Inspector

(Signature) (Signature)

" Page

76
CES DOCUMENT NO. Page 1 of 2

NONCOMPLIANCE TAG

Deficiencies in construction found by the Inspection Agency inspector that can

not be corrected immediately in his presence should be tagged with a Noncompliance

Tag (red tag). It is suggested that the tag be pre-prlnted on both sides on heavy

red paper stock material and be attached by a string in the area of the noncompliance;

yet the tag should be prominently visible. The tags are individually serialized for

reference and control purposes. The Inspector fills out the tag noting the deficiency

on both the portion of the tag attached to the unit and the detachable end which he

keeps. A red tag may be attached to individual deficiencies or may apply to several

deficiencies depending on the items involved and the judgement of the inspector.

Only the Inspection Agency inspector or authorized manufacturer personnel should remove Noncompliance Tags. Completed tags should show the action taken to correct

deficiencies and should be retained as part of the compliance assurance records.

Units of construction should not be labeled when bearing a Noncompliance Tag. The

status of Noncompliance Tags issued should be summarised on the Inspection Report,

CES Document No. C-03.

The manufacturer may also utilize Noncompliance Tags or may use some other device,

such as production travellers to identify construction deficiencies.

77
CES DOCUMENT NO. C-04 Page 2 of 2

®

TAG NO. XXXX

NQNCQMPLIANCE TAG

[ Woffie 0(5 Iyu>pzction Agzncy ] Mfgr : Plant

:

Unit Serial No. Inspector : Date Issued:

Noncompliance Tag to be removed

only by AUTHORIZED PERSONNEL

after noncompliance is corrected.

Unit should not be labeled when

bearing a Noncompliance Tag.

(Noncon^jliance noted on other side)

TAG NO. XXXX

[ Wcune of, Ivuspzction Agmcy ] Mfgr : Plant : Unit Serial No: Inspector: Date

Date Corrected;

By:_

(Noncompliance noted on other side)

Perforate

tag

i—here

®

Description of noncompliance:

Description of noncompliance:

Front of Tag Back of Tag

78
CES DOCUMENT NO. C-05 Page 1 of 2

PROHIBITED SALES NOTICE

For the more serious unit violations which affect public health and safety and

which can not be readily repaired as provided by a Noncompliance Tag, a Prohibited

Sales Notice should be applied to the individual unit of production until such time

as corrective measures have been implemented by the manufacturer. The Prohibited

Sales Notice should be an official state notice with reference to appropriate laws

and rules and regulations of the state and should be affixed when noncompliances

would result in a hazard to health and safety and where major repair or rework is

required by the manufacturer to bring the completed unit into code compliance. The

notices should be on adhesive backed paper and should each be Individually serialized

and controlled by the Inspection Agency. Only Inspection Agency or Administrative

Agency personnel should be authorized to remove a Prohibited Sales Notice.

Like the Noncompliance Tag, the Prohibited Sales Notice should be referenced on the Inspection Report, CES Document No. C-O3.

.1
CES DOCUMENT NO. C-05 Page 2 of 2

PROHIBITED

SALE - INSTALLATION - OCCUPANCY

NOTICE IS HEREBY GIVEN THAT THE SALE, OFFERING FOR SALE, INSTALLA-

{Jd6.nti^y e.nabting Izg-iiiaJxon and KzgaiatixiyL& 0)j itatz]

THE [Name, kppnopfuMjtz Agency) SHALL BE NOTIFIED PRIOR

TO MOVING THIS STRUCTURE OR UPON CORRECTION OF THE LISTED DEFICIENCIES

THE REMOVAL, DESTRUCTION OR CONCEALMENT OF THIS NOTICE

BY ANY UNAUTHORIZED PERSON IS UNLAWFUL.

REFERENCE - IDENTIFY INSPECTION REPORT DESCRIBING

TION OR OCCUPANCY OF THIS STRUCTURE IN IS PROHIBITED.

STATE OF

I Wcune, addxeAi and teJLzphono, no. OjJ i i_ appfiopfUaX-Z agmcy _l

DEFICIENCIES

DATE

NOTICE

POSTED BY

AGENCY

INSPECTOR MFGR.

NAME

UNIT

SERIAL NO.

SERIAL NO. OF

THIS NOTICE

80
CES DOCUMENT NO. C-06 Page 1 of 2

NOTIFICATION OF SUSPENDED ACTIVITIES

If a manufacturer Is repeatedly conducting operations in direct violation with

the Act or the Rules and Regulations, then an official Notification of Suspended

Activities as suggested by this document should be Issued. This document, which Is

a form letter, may be Issued by the Administrative Agency, the Evaluation Agency or the Inspection Agency, In accordance with Part IV, Section 3(C) of the Model Rules

and Regulations.

The suggested letter form requires the initiating agency to cite the applicable

manufacturer violations and to direct the party at fault to surrender any certification labels in their possession to the issuing agency.

When the manufacturer has taken corrective action to remedy the condition which

led to the suspension, the manufacturer should so notify the Administrative Agency

in writing. At that time the conditions of the violation and the remedy proposed

should be reassessed. If all conditions are satisfactory to the Administrative

Agency, the suspension should be lifted and Inspection Agency monitoring reinstated

at the 100% level.

The same type of form letter notification could be utilized to suspend or revoke

the approval of Evaluation or Inspection Agencies as provided for by Part IV, Section 3 of the Model Rules and Regulations.

81
CES DOCUMENT NO. C-06 Page 2 of 2

STATE OP

Namz and addn.(U>i> AdminiitAcutivt Agency,

Evdtucution Agency, oA. Inipzation Agmcy

Date:

TO : (Mome and Add/t.e64 0|{ Hanuf^acXu/LeA]

SUBJECT: Notification of Suspended Activities

As prescribed In [PoAt It/, S&ction 3(C), "SuijpznAlon and Rzvocailon" - CeAti{,-lajitlon]

of the Model Rules and Regulations for the Manufactured Building Act, any manufacturer

who violates or falls to comply with the Act and the Rules and Regulations shall be

notified in writing describing the reasons for suspension or revocation along with

the specific violations and to instruct the manufacturer to deliver all labels in

their possession, or under their control, to the issuing agency.

SPECIFIC VIOLATIONS:

INSTRUCTIONS FOR RETURNING LABELS TO ISSUING AGENCY:

I hereby certify that the violations noted on this form are true and correct.

[S-LgnatuKe. and Titlz]

cc: Appropriate Administrative, Evaluation, Inspection or Local Enforcement

Agencies Involved

Administrative Agency in states having granted reciprocity

82
CES DOCUMENT NO. C-07 Page 1 of 2

LABEL

The suggested label shown on page 2 of this document contains the information

and wording as required in Part IV, Section 3(B) of the Model Rules and Regulations.

However, this wording does appear to Imply a liability by the Inspection Agency

which is not otherwise implied by the Rules and Regulations. Accordingly, it is

recommended that the question of liability be investigated with regard to any particular state program before the wording of the label is adopted in that specific state.

The label should be made of a material which can be permanently imprinted or embossed with the necessary Information and which cannot be removed after being

attached to the unit of construction without being destroyed.

Labels should only be attached to manufactured buildings or building components

which comply with all applicable codes, standards, and Rules and Regulations. Attachment of labels should be done by the Inspection Agency, or, if delegated in accordance with the Rules and Regulations, by the manufacturer's employees charged with

controlling the use of labels. Records of label usage should be maintained as suggested in the Label Control Record (CES Document No. C-08). Reference is also made

to CES Document S-09, pages 7 and 25 "Compliance Records" and "Final Inspection and

Certification" In which record keeping and final inspections are discussed.

At the discretion of the Administrative Agency [Part IV, Section 3(B)(1)],

labels may be limited in size and content for building components whose size or shape do not permit the full Information to be placed thereon. In such cases, the

alternate label must be approved by the Administrative Agency. For high production

components, alternate labeling methods may be approved, such as simple markings or identifications stamped, etched, embossed, or otherwise permanently affixed to the

component during, or as part of the fabrication process.

83
CES DOCUMENT NO. C-07 Page 2 of 2

STATE OF

DEPARTMENT OF

This label certifies that this building [or

building component] has been manufactured

in accordance with an approved building

system and compliance assurance program

approved by {Mame. Evaluuition A.qene^l

and inspected by {Maim of, lyvkpzcAyion kgrncij]

under the auspices and approval of

[Home, oj State.) LABEL SERIAL NO:

MANUFACTURER'S SERIAL NO:

APPROVAL BUILDING SYSTEM:

NUMBERS p-, COMPLIANCE

LI ASSURANCE PROGRAM:

SEE DATA PLATE

LOCATED ON:

AGENCY ISSUING

THIS LABEL:

8^1
CES DOCUMENT NO. C-08 Page 1 of 2

LABEL CONTROL RECORD

This document suggests a means of formally controlling the usage of certification

labels. Control over Issuance of labels is required by Part IV, Section 3(B)(2) of

the Model Rules and Regulations and permanent records of the handling of labels is

required by Part IV, Section 3(E)(3).

The suggested form provides a record of label usage and direct traceability

between the manufacturer's production unit serial number and the label serial number

as well as the date the label was affixed (Date of Manufacture). Other information

required is the destination of the individual unit, the building system approval

number, and name of the labeling person.

As each page of the form is completed, it should be signed and dated by the

respective manufacturer and Inspection Agency inspection personnel. The original

copy of the form should be retained in the compliance assurance record of the

Inspection Agency; duplicate copies should also be provided to the manufacturer and

to the Administrative Agency for record keeping purposes.

Subject to approval by the Administrative Agency, for small high production

manufactured building com.ponents v;hich do not require to carry the full label with

a label serial number, the Label Control Records may be based on lot or batch

numbers

.

85
CES DOCUMENT NO. C-08 Page 2 of 2

Wome and adcheM |

I Inipe.ation Agzncy _J

LABEL CONTROL RECORD

NAME OF MANUFACTURER:

PLANT LOCATION:

Manufacturer '

s

Serial

Mn1^ u •

Label

Serial

Date

of

ini g . Destination

Building

System

Approval

No

.

Labeled

by

( Name

)

Agency Inspector Mfgr. Inspector

(Signature & Date) (Signature & Date) l'af:;e of

86
CES DOCUMENT NO. L-01 Page 1 of 2

STANDARD PERMIT APPLICATION FORM

The concept of a national uniform building permit application form was originally

Introduced by the Bureau of the Census, U, S. Department of Commerce, in I966. The

purpose was to provide a document which could be adopted by building permit offices

for local use and at the same time contain basic information which would improve

data reported to and collected by the Bureau of the Census in its monthly surveys.

Prom the outset, the major building codes organizations have been kept informed of

whatever progress has been made and have approved of the idea of a uniform form. Two

of them recommended adoption of earlier versions of the form to their members.

The original document was modified by a number of users and the form presented is a "third generation" version. Prom what reactions thus far received, the contents, with

local modifications, are satisfactory for many jurisdictions. However, the form and

its contents should not be considered mandatory. The form is a viable document which

should and must be modified to meet local requirements and changing data needs. It is not meant to be unchanging and sterile.

It would be self-defeating to recommend a single form for adoption by all jurisdictions - large and small, metropolitan and rural. As presented, the form and its

contents should be considered as a core which can be accepted as is, which can be

rearranged or which can be Implemented as necessary. Some of the items - Type of

Sewage Disposal, Type of Water Supply, Type of Roof - may not be applicable in many

jurisdictions and there Is nothing sacred about retaining them. However, a review

will indicate that most of the data listed are basic Information items.

If a single uniform application form is not applicable for an entire State, the

proposed form can be modified for adoption within a metropolitan area in which most

informational requirements among jurisdictions are similar. Adoption would enable a local organization - a State or local university, a regional planning commission,

etc. - to keep track of new construction: where and what is going on.

Since the inception of the undertaking In 1966, the Bureau of the Census has volunteered its aid to any State or metropolitan area-wide agency in preparing a modified

version of the form which meets its particular requirements. This offer still stands.

87
CES DOCUMENT NO. L-01 Page 2 of 2

/ Name of Permit Issuing Jurisdiction \ \Name of Department Issuing Building Permits ) BUILDING PERMIT APPLICATION

IMPORTANT - Complete ALL Hems. Mark boxes where applicable.

I.LOCATION OF

BUILDING

Number and street Subdi' I Block Census tract

N S E W Side of_ . feet

N S E W from intersection of. (Other local geographic, political, or legal subdivision identification)

II. TYPE AND COST OF BUILDING - Ail applicants complete Parts A ~0

TYPE in

2[Z] an

en

7n

OF IMPROVEMENT

New building Addition (If residential, enter number

of new housing units added, if any,

in Part D. 13) Alteration (See 2 above)

Repair, replacement Wrecking (U multifamily residential, enter number of units in building in Part D, 13) Moving (relocation) Foundation only

B. OWNERSHIP

8 I 1 Private (individual, corporation, nonprofit institution, etc.) 9 I ] Public (Federal, State, or local government)

PROPOSED USE - For "Wrecking"

Res idential 12 I I One family

13 I" ] Two or more family — Enter number of units p~ 14 [ I Transient hotel, motel.

or dormitory — Enter number

of units p~ 15 I 1 Garage

16 Carport

17 Other - Specify

mosf recent use

Nonresidonriol

18 j__ J Amusement, recreational

19 [ I Church, other religious 20 |_ ] Industrial

21 Q Parking garage

22 I" [ Service station, repair garage

23 [ I Hospital, institutional 24 [

I Office, bank, professional Public utility 26 1 _ J School, library, other educatioiial 27 r 1 Stores, mercantile

28 I J Tanks, towers

29 Q Other - Specify ^

C. COST

10. Cost of improvement To be installed but not included

in the above cost

a. Electrical

b. Plumbing

c. Heating, air conditioning

d. Other (elevator, etc.)

11. TOTAL COST OF IMPROVEMENT

(Omit cents) Nonresidential — Describe in detail proposed use of buildings, e.g., food processing plant, machine shop, laundry building at hospital, elementary

school, secondary school, college, parochial school, parking garage for department store, rental office buildtng, office building at industrial plant.

If use of existing building is being changed, enter proposed use.

III. SELECTED CHARACTERISTICS OF BUILDING For new huHdtngs and additions, complete Parts E — L;

for wrecking, complete only Part J, for all others skip to IV.

E. PRINCIPAL TYPE OF FRAME

30 [ 1 Masonry (wall bearing)

31 n ^°°<i frame

32 I I Structural steel 33 I [ Reinforced concrete 34 n Ottier - Specify

F. PRINCIPAL TYPE OF HEATING FUEL

35 Gas sen Oil 37 Electricity 38 Coal

39 [ I Other — Specify

G. TYPE OF SEWAGE DISPOSAL

40 [

'

I Public or private company

41 [___ 1 Individual (septic tank, etc.)

H. TYPE OF WATER SUPPLY

42 I _ I Public or private company

43 I

"

1 individual (well, cistern)

TYPE OF MECHANICAL

Will there be centra! air conditioning?

44 [ 1 Yes 45 No

Will there be an elevator?

46 Yes 47 No

. DIMENSIONS

48. Number of stories

49. Total square feet of floor area,

all floors, based on exterior dimensions

50. Total land area, sq. ft.

. NUMBER OF OFF-STREET

PARKING SPACES

51. Enclosed

52. Outdoors

. RESIDENTIAL BUILDINGS ONLY

53. Number of bedrooms

54. Number of bathrooms

(

Partii

IV. IDENTIFICATION - To be completed by all applicants

Mailing address — Number, street, city, and State

Owner

Contractor

3.Architect

The owner of this building and the undersigned agree to conform to all applicable laws of (name of permit jurisdiction). Signature of applicant Application dale

DO NOT miTE IN THIS SPACE - FOR OFFICE USE

Approved by Permit fee

$

Date permit issued Permit number

Recommended by: U.S. Department of Commerce Bureau of the Census July 1, 1968
CES DOCUMENT NO. L-02 Page 1 of 1 STATE OF

Name and AddAe^i Oj$ Admirii&t/uitLvz Ag&ncy

MANUFACTURED BUILDING VIOLATION REPORT

GENERAL INFORMATION

Name of Local Enforcement Agency

Address

Name of Inspection AgencyAddress

Name of Builder or Owner

Address

Location of Unit

UNIT IDENTIFICATION

Manufacturer

Model Designation and Serial No. Unit Label No. Building System Approval No. C.A. Program Approval No. Building Permit No. VIOLATIONS :

(Date of Inspection) (Name of Inspector) (Signature of Inspector)

ACTIONS TAKEN EH Occupancy Permit Withheld CH Provisional Occupancy Permit Issued

Other

(Name of Local Building Official) (Title) (Signature) (Date)

ADMINISTRATIVE AGENCY USE ONLY

Report Received (Date)

Actions Taken

89

CES DOCUMENT NO. L-03 Page 1 of 1

Namz and AddAeM OjJ Local En^o^cmznt Agency

No,

CERTIFICATE OF OCCUPANCY

Date

CO. Appl. No._

Location

Map No,

Proposed Use. No. of Stories

Building Permit No, Date Issued

Section Block Lot

No. of units

I I This certifies that the building located at premises indicated above complies

with all applicable local ordinances.

j j This certificate Is Issued pursuant to the requirements of {Jd^nt-i^y enabt-Lng

itatz Izg-Litat^on and Ke.gutat-ioni ) and compiles with applicable local ordinances.

Approval Report No. Label No.

This certificate Issued to: Name:

(Ovmer, lessee or tenant) Address;

(Seal or Stamp) (Signature of Local Enforcement Agency Official)

Any change in the type of occupancy, or part of premises thereof, will render this

certificate VOID and a NEW certificate must be obtained.

91