Title Page

  • Concealed Space Inspection:

  • Document No.

  • Client / Site

  • Job Number:

  • Conducted on

  • Prepared by

  • Location/Area of Inspection
  • Attendees

Structure

  • Structure

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Prime Paint Touch-Up

  • Bolt/Weld Inspection

  • Weld Painted

  • Roof Drains Supported

  • Bolts Tight

  • Opening Steel in Place

Fireproofing

  • Fireproofing

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Gaps Patched

  • Overspray Removed

  • Coverage Complete

Deck Bottom

  • Deck Bottom

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Clean

  • Hangers Correct

  • Electric Cells ID

  • Communication/Data Cells ID

Fire stopping

  • Fire Stopping

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Top Of Walls

  • Pipe Penetrations

  • Decking Flutes Filled In

  • Conduit Penetrations

  • Duct Penetrations

  • Exterior Wall

  • Floor Expansion/Contraction Joints

  • Wall Expansion/Contraction Joints

Piping

  • Piping

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Sprinkler

  • Sprinkler Heads

  • Domestic Water

  • Hot Water

  • Chilled Water

  • Condensate

  • Steam

  • Valve Tags

  • ID/Flow Labels

  • Valve Access

  • Valve Chain Operators

  • Hangers

  • Hangers Saddles & Nuts

  • Roof Drains & Supports

  • Insulation

  • Insulation Termination

  • Vibration Isolation

  • Clean

Walls

  • Walls

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Finish

  • Anchors

  • Supports/Bracing

  • Seals

  • Expansion/Contraction Joints

  • Fire Stops

Duct Work

  • Duct Work

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Supports/Hangers

  • Insulation (pin/glue)

  • Isolation at Unit

  • Dampers/Operators

  • Access Panels

  • Clean (Interor/Exterior)

Ceiling

  • Ceiling

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Grid Supports/Hangers

  • Grid Configuration

  • Grid Color

  • Hard Ceiling Supports

  • Light Fixture Supports

  • Access Panels

  • Grid Clean

  • Top of Tile Clean

  • Seismic Supports

Electrical

  • Electrical

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Conduit Supports

  • Junction Box Covers

  • Identification

  • Light Fixture Drops

  • Exit Signs

  • No Grid Supports

Com/Data

  • Communication/Data

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Conduit

  • Cable Support

  • Junction Box Covers

  • Devices

  • Power Drops

Fire Alarm

  • Fire Alarm

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Conduit Supports

  • Identification

  • Alarm Indicators

  • Alarm Boxes

  • Junction Box Covers

  • No Grid Support

Cleanliness

  • Cleanliness

  • Comments:

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Cleaned Pre-Closure

Additional Items

  • Additional Items

  • Status Codes;

    A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean

    WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL)

  • Comments:(add item here in a numeric list and select response that coincides with that response below)

  • 1.

  • 2.

  • 3.

  • 4.

  • 5.

  • 6.

Acceptance

  • Does the work conform to the Contract Documents?

  • If not is re-inspection by PAC acceptable?

  • Comments:

  • Acceptance Signatures:

  • Add signature

  • Add signature

  • Add signature

  • Add signature

  • Add signature

  • Add signature

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