Miami_Shores_Village_Special_Inspector_Form_FBC 6th Edition (2017)Miami Shores Village
Building Department
10050 NE 2nd Ave.
Miami Shores, FL 33138
305-795-2204 / Fax 305-756-8972
NOTICE TO MIAMI SHORES BUILDING DEPARTMENT OF EMPLOYMENT AS SPECIAL
INSPECTOR UNDER THE FLORIDA BUILDING CODE.
I (We) have been retained by to perform special inspector services under the Florida
Building Code 6th Edition (2017) and Miami Dade County Administrative Code at the
project on the below listed structure as of (date). I am a registered
architect/professional engineer licensed in the State of Florida.
Process Number:
__ Special Inspector for Reinforced Masonry, Section 2122.4 of the FBC 6th Edition (2017)
__ Miami Dade County Administrative Code, Article II Section 8-22 Special Inspector for
__ Trusses > 35 ft. long or 6 ft. high
__ Steel Framing and Connections welded or bolted
__ Soil Compaction
__ Precast Attachments
__ Roofing Applications, Lt. Weight. Insul.Conc.
__ Other
Note: Only the marked boxes apply.
The following individual(s) employed by this firm or me is authorized re presentative to perform
inspection*
1. _____________________________ 2. ________________________________
3. _____________________________ 4._________________________________
*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 Miami Shores 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 Miami Shores Building Department Inspector. All
mandatory inspections, as required by the Florida Building Code, must be performed by the Miami Shores
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 form and a sealed statement indicating that, to the best of my knowledge, belief and
professional judgment those portions of the project outlined above meet the intent of the Florida Building
Code and are in substantial accordance with the approval plans.
Engineer/Architect
______________________________ Name ______________________________
Signed and Sealed Print
Date: _____________________ Address ________________________