Design Professional Inspection Form (Print)
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10 JOHNSTON COUNTY INSPECTIONS DEPARTMENT 309 EAST MARKET STREET , SMITHFIELD , NC 27577 phone 919 - 989 - 5060 fax 919 - 989 - 5431 email inspections @ johnstonnccom D ESIGN P ROFESSIONAL I NSPECTION F ORM R ECORD OF THE I NSPECTION OF A C OMPONENT OR E LEMENT BY A NC L ICENSED A RCHITECT OR E NGINEER Project Information Date Submitted Received Permit No Residential Single - Family Project Y N Commercial Project Y N Project Name Owner Project Address Contractor Name Suite No Date Inspected Component Inspected Responsible Licensed NC Architect or NC Engine er Name Firm Name Phone Numbers Office Mobile Email Address Mailing Address A PPLICABLE C ODE __ _______ ____________________________________________________ _ _ 201 8 NC BC 201 8 NC Building Code ; 201 8 NC RC 201 8 NC Residential Code Describe Element Component Type of Inspection subgrade form letter may also be required Attestation Signature By signing below , I certify that the component and or element of the building as identified on this form has been inspected by me or someone under my direct supervision per subsection b2 of NC GS 153 A - 352 and is in compliance with the Code or other proposal of the archit ect or engineer for the project T his inspection is in compliance with all of the requirements of the above referenced C ode Attach any additional documents if needed S EAL _________________________________________________ Licensed Architect or Engineer Inspection Department disclaimer Upon the receipt of a signed written document as required under subsection a of Article 160A - 4135 , Code Enforcement shall be discharged and released from any liabilities , duties and responsibilities imp osed by this article or in common law from any claim arising out of or attributed to the component or element in the construction of the building for which the signed written document was submitted Be aware that this inspection will be noted in all inspection records including the Certificate of Occupancy or Certificate of Compliance This inspection does not address any local ordinances or zoning requirements 12 2019Page