Certified Compliance Program (CCP) - Woodwork Institute

Woodwork Institute PROJECT # _______________________OFFICE USE ONLYDate _________________Project specifications require the items to be inspected to conform to the Architectural Woodwork Standards, orProject specifications require the items to be inspected to conform to (indicate standard and grade): _______________________________________________________________________________________________________________________We hereby request the Woodwork Institute to inspect the millwork product types indicated belowby an “X” in the appropriatebox(s), or we have indicated such by a “C” in the box if it is required to be WI Certified. Exterior Millwork Interior Millwork Doors Casework Plastic Laminate Tops Laboratory Tops Shop Drawings Installation Finishing Other____________________Person requesting Inspection (print): ______________________________ Firm: ______________________________________1. Project Name: ________________________________________________________________________________________Address: _____________________________________________________________________________________________2. Date contract signed: ___________Date of delivery, if jobsite inspection: __________ AWS/Amend. dates:____________3. Architect: ______________________________________________________________ Phone: _______________________Address: _______________________________________________________________ FAX: ________________________4. Inspector of Record: _____________________________________________________ Phone: _______________________Address: _______________________________________________________________ FAX: _________________________5. General Contractor: _____________________________________________________ Phone: _______________________Address: _______________________________________________________________ FAX: _________________________6. Int/Ext Woodwork Supplier: ______________________________________________ Phone: _______________________Address: _______________________________________________________________ FAX: _________________________7. Casework Manufacturer: ________________________________________________ Phone: _______________________Address: _______________________________________________________________ FAX: _________________________8. Door Supplier: _________________________________________________________ Phone: _______________________Address: _______________________________________________________________ FAX: _________________________9. Door Manufacturer: _____________________________________________________ Phone: _______________________Address: _______________________________________________________________ FAX: _________________________10. Countertop Manufacturer: _______________________________________________ Phone: _______________________Address: _______________________________________________________________ FAX: _________________________11. Finisher: : ______________________________________________________________ Phone: _______________________Address: _______________________________________________________________ FAX: _________________________12. Installer: : _____________________________________________________________ Phone: _______________________Address: _______________________________________________________________ FAX: _________________________13. ATTACH COPY OF SPECIFICATIONS - PLANS & SHOP DRAWINGS MUST BE AVAILABLE AT INSPECTION SITE.14. ATTACH ANY APPROVED MODIFICATIONS TO THE PLANS AND/OR SPECIFICATIONS, AND INDICATESUCH BELOW.15. There are no approved modifications, or The approved modifications are attached herewithThe Woodwork Institute is hereby authorized to inspect the millwork products indicated above. As applicable: a) we attestthat said products and/or installation meet the minimum requirements for the Woodwork Institute grade specified, except asmay have been modified by the plans and/or specification, b) we agree to pay all the appropriate inspection fees, and c) weshall defend and hold the Institute harmless from all claims and demands arising out of any failure or claimed failure to meetthose requirements.(This Request and Authorization to Inspect is subject to the Institute’s established inspection Policies and Procedures contained withinThe WI Programs & Services Manual, and generally reviewed on the reverse side of this form.)Firm Name: __________________________________________ Telephone ___________________ FAX ___________________Address: ________________________________________________________________________________________________Signature _________________________________________________________ Title _________________________________Print Name ________________________________________________________ Date _________________________________WI-127-0811Request and Authorization to Inspect(Please print and complete all the information.)(Page 2 of 2)