HomeMy WebLinkAboutCOM2020-00026 - COM Inspections - 5/18/2020 Mason County Community Services
s Building Division
SPECIAL INSPECTION & 615 WAlderStreet
Shelton, WA 98584
TESTING AGREEMENT 360.427.967;O ext.3s2
www.co.mdson.wo.us
(All references are per the 2%A&C-
nternationalBuildin CodeProject Name: "` G 06LtvLi
Project Address: Q/4 . �J
Building Permit Number: QiOM2W (,o Date Issued:
BEFORE A PERMIT CAN BE ISSUED: The registered design professional in responsible charge shall fill out the Agreement and
Include the name of each inspector as well as their appropriate licenselcertification number. Two(2)copies of this form
are to be submitted to the County prior to the Issuance of a building permit. If changes are made as to who*111 perform
the special inspections a new form shall be submitted and turned Into the Building Permits & inspections Division for
approval.
STATEMENT OF SPECIAL INSPECTIONS: In addition to this Agreement, a "Statement of Special Inspections" shall be
provided per IBC 1704.3. This Statement shall be made as part of the approved plans, and be placed In a conspicuous
location,such as the first page of the construction plans or the first page of the structural sheets.
SPECIAL INSPECTORS: All special inspectors shall be approved by the Building Division prior to performing any duties. The
special inspector shall provide proof of certification as a special Inspector for each Inspection Item and be licensed by the
State of Washington.
SPECIAL INPSECTION REPORTS: Special inspection reports are to meet the requirements of IBC 1704.2.4. Coo.les of each
report are to be sent to the address listed in the letterhead noting the Project Address and Permit Number. Alfinal report
shall be submitted stating that all special inspection and structural testing items were completed and are In conformance
with the approved design drawings and specifications. Items not in conformance,unresolved items,or any discrepancies in
inspection coverage(i.e. missing Inspections,periodic inspections when continuous was required,etc.)shall be,specifically
Itemized in the final report.
GENERAL SPECIAL INSPECTION ITEMS(per IBC Chapter 17)
Onlir checked lAwma are ufrtd
Areas requiring special inspection: Name of Agency: Name of inspector: Ucense/Cert.No.
❑ unapproved Fabricators(IBC 1704.2.5)
Other than Structural Steel(IBC Table 1705.2.2)
❑ Steel floor&roof decks
❑ welding of reinforcement
❑ Cold-formed steel
Structural Steel
6"t:
❑ Welding(Per NSA of AISC 360-10) ,� .1;�)l/
❑ Details(Per NS.7 of AISC 360-10) Ids -t
❑ High-strength bolts(Per N5.6 of AISC 350-10)
Concrete Construction(per iBCTable 1705.3)
Reinforcement,embeds,anchors AC—
X Formwork r
Materials �bs)Nvl I
❑ Shotcrete
❑ Post-tensioned/Pre-stressed Concrete
❑ Erection of precast concrete L't „
Pagd 1 of 3
Mason County Community Services
Building Division
SPECIAL INSPECTION & '615 WAiderStreet
Shelton, WA 98584
TESTING AGREEMENT 36a 427.9570 ext.352
www.co.mrson.wa.us
GENERAL SPECIAL INSPECTION ITEMS(per IBC Chapter 17)-continued
(only checked hems are required)
Areas requiring special inspection: Name of Agency: Name of Inspector. Ucense/Cert.No.
Masonry Construction(IBC 1705.4)
❑ Prior to Construction(Article 1.15,7MS-602)
❑As Construction Begins(Article 1.19.2,TMS402)
❑ Prior to Grouting(Table 1.19.2,TMS-402)
❑ During Construction(Per TMS-402&TMS-602)
Wood Construction
❑ High-Load Diaphragms(IBC 1705.5.1)
❑Wood Trusses>60ft{IBC 1705.5.2)
❑Solis(IBC Table 1705.6)
❑ Driven Deep Foundations(IBC Table 1705.7)
❑ Cast-in-place Deep foundations(IBC Table 1705.8)
❑ Helical Pile Foundations(IBC 1705.9)
❑Sprayed Fire-Resistant Materials(18C 1705.13)
❑ Mastic&Inturnescent Coatings(18C 170S.14)
❑ E1FS(IBC 1705.1S)
❑ Fire-Resistant Penetrations(IBC 1705.16)
❑ Smoke Control(IBC 1705.17)
❑ Other (IBC 170S.1.1)
❑Other (IBC 1705.1.1)
SPECIAL INSPECTIONS FOR SEISMIC RESISTANCE(IBC Section 2705.11)
(Only checked hems are required)
Areas requiring special Inspection: Name of Agency: Name of Inspector: License/Cent.No.
❑ Structural Steel(IBC 1705.11.1&AISC 341-10)
❑ Structural Wood(iBC 170S-11.2)
❑ Cold-formed Steel(IBC 1705.11.3)
❑ Mechanical&Electrical Components(1705.11.4)
❑ Architectural Components(IBC 1705.11.5)
❑ Storage Racks(IBC 1705.11.7)
Page 2 of 3
Mason County Community Services
Building Division
515 W Alder Street
SPECIAL INSPECTION & Shelton, WA98584
• TESTING AGREEMENT 350.427.9s7,Aext 352
wrvw cv.ma5on.wa.us
Declaration by Architect/Engineer '
1,the design professional in responsible charge for this project,declare that the r +�SIIIANSj-
above ' ci inspe ion and structural testing items are required for this
pr ' ct crnr nce h IBC Chapter 17. ti ,
LIU
Si luredate .�� 7•�8
Declaration by Owner
1, the Owner of the project, declare that the above listed firm(s) or individual(s) are hired by me to perform
special inspections and structural testing for the project pursuant to IBC 1704.2.
"4
Aw� a., -,-/17
T+OL'
,100'
Signature e
CONTRACTOR RESPONSIBILITY: Each contractor involved with the construction of wind or seismic force-resisting
systems shall comply with the requirements of IBC 1704.4. The contractor is responsible for providing the
special inspector access to approved plans and contract documents at the job site. All special inspection records
shall be retained at the job site by the contractor and shall be made available to the Building Department upon
request.
Declaration by General Contractor
I, the General Contractor of the project, agree to comply with the "Contractor Responsibility" items noted
above.
Signature Date
Page 3 of 3