HomeMy WebLinkAboutBLD2019-00930 Special Inspection - BLD Inspections - 10/4/2019 -� Mason County Community Services
Building Division
SPECIAL INSPECTION & 615 WAlderStreet
- . Shelton, WA 98584
r TESTING AGREEMENT 360.427,9670ext 352
�.. www.co.mason.wo.us
(All references are per the 2015 international Building Code)
Project Name: HVAC Relocation
Project Address: 6999 E State Route 106,Union
Building Permit Number: BLD2019-00930 Date issued:
BEFORE A PERMIT CAN BE ISSUED: The registered Design Professional in responsible charge shall fill out the Agreement
and include the name and address of the company or inspector. 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 will 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 INSPECTION REPORTS: Special inspection reports are to meet the requirements of IBC 1704.2.4. Copies of each
report are to be sent to the address listed in the letterhead noting the Project Address and Permit Number. A final 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.
Areas requiring special inspection: Name of Agency: Address&Contact Information
❑ Unapproved Fabricators(IBC 1704.2.5)
Other than Structural Steel(IBC Table 1705.2.2)
❑ Steel floor&roof decks
❑ Welding of reinforcement
_..... .... . _..............
Cold=fiorrriedst
Structural Steel
❑ Welding(Per N5.4 of AISC 360-10)
❑ Details(Per N5.7 of AISC 360-10)
❑ High-strength bolts(Per NS.6 of AISC 360-10)
Krazan&Associates, 1230 NW Fin Hill Rd,
Concrete Construction(per IBC Table 1705.3) Inc. Poulsbo,WA 98370
X Reinforcement,embeds,anchors (360)598-2126
X Formwork
X Materials
❑ Shotcrete
❑ Post-tensioned/Pre-stressed Concrete
❑ Erection of precast concrete
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i 1 A
Mason County Community services
Building Division
SPECIAL INSPECTION & 615 w Alder Street
Shelton, wA 98584
TESTING AGREEMENT 36o.4z 97n eats
www.co.mason.wa.us
Areas requiring special inspection: Name of Agency: Address&Contact Information
Masonry Construction(IBC 1705.4)
❑Prior to Construction(Article 1.15,TMS-602)
❑As Construction Begins(Article 1.19.2,TMS-402)
❑ 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)
Krazan&Associates, 1230 NW Fin Hill Rd,
X Soils(IBC Table 17fl5.Gj Inc. Poulsbo,WA 98370
(360)598-2126
❑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(IBC 1705.13)
❑ Mastic&intumescent Coatings(IBC 1705.14)
❑ ElFS(IBC 1705.15)
❑ Fire-Resistant Penetrations(IBC 1705.16)
❑Smoke Control(IBC 1705.17)
❑Structural Steel(IBC 1705.12.1&AISC 341-10)
❑Structural Wood(IBC 1705.12.2)
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Mason County Community Services
- Building Division
SPECIAL INSPECTION $c 625 WA/derSrreet
Shelton, WA 98584
364co6Qo ; usTESTING AGREEMENT A ° mn
❑ Cold-formed Steel(IBC 1705.12.3)
❑ Mechanical&Electrical Components(1705.12.4)
❑ Architectural Components(IBC 1705.12.5)
❑ Storage Racks(IBC 1705.12.7)
❑ Other (IBC 1705.1.1)
❑ Other (IBC 1705.1.1)
Declaration by Architect/Engineer
1, the design professional in responsible charge for this project,declare that the
above listed special inspection and structural testing Items are required for this
project in accordance with IBC Chapter 17.
Signature Date
Declaration by Owner
I,the fawner of the project,declare that the above listed firm(s)or individual(s)are hired by me to perform
special inspection and structural testing for the project pursuant to IBC 1704.2.
AW
Signature Date
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 Can ractor
1, the General Con ra f the project, agree to comply with the "Contractor Responsibility" items noted
above.
10 �g
Signature V oate
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