HomeMy WebLinkAboutCOM2010-00027 Final Shell Tenant Improvements and Special Inspection Authorization - COM Permit / Conditions - 9/22/2010 O
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o CONCRETE — MECHANICAL MANUFACTURED HOME _ O
o Footings/Setbacks Gas Pip g�-�B By Ribbons N
o Interior Date By Interior-Date By Date BY 0
Z
Exterior Date L3 BY Exterior-Date � - gset.� --•__
Point goad/Isolated Footings INSULATION Date By y
�
BG 1 SLAB INSULATION
Date By Data By FIRE DEPARTMENT _ Y
Foundation Wails Floors Date By
Date. By Data By DECKS ------------
F RAM ING Walls Date B y
Date By Data _g'—/o By PROPANE TANKS
PLUMBING vault � Date try
Date JBy OTHER
Groundwork Attic
Date ey Date By Type.Dale By
I
o.w.v �DRYWALL Type o
I Int.Brace Wall Date By
Date -LC—/p BY ic
Date 8y N
FINAL INSPECTION
Water Line Fire Separation O?
Date By
Date By Date �_Z 2 '-�U 13y O
O
Pass or Request Inspect. o
Type of Insp. Fail Date Date Done By Comments
OW
v�vc-
2SdC�Tloiv lj� - L
9-277 9-� a
14'-0"
W-0"or greater L.O.b`rr taaf rmyy1-
ea To exist System between 15'-40 AFFrocess
4"0 SW
------------------ ------- ---- —I I'mW?avply and drmn
ofpcnq w/mfr ed.msvlaree ap
ab net accessory mamt
req'd knee<koran<es
[. I
Verify toilet RI.setout from Wall
,3 I as
Future Toilet Room B 1
e I -
-t-I
3/0 4otsk _ e
R �
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co I I I
I Ele ati oRS 7'-6' Wdk shall have o ron-abwrbeer fnah ro o hnghr of 49•
2'-6• 5'-Cr clr. and shall be mm Wm kcoted wahm 24•0 arty side of rook,
I I Torkr Clear— or ar nal as md,W,d by dashed bro
1'-4• R Fkors shall have anon-absorbent finch
I extendmq 6•mn�p @all wall(aces
-- - E,<cep,as ro,ed above
Adjust position of exterior door
1.1/2•0 Grab bar Wait 1-1/2'from wall.
wldkd w/top*33•-36•AFF
Twkr w/open tote.ear
wtdl seat @ 17'-IT AFF
I I
I A Atom Iwnr lavm w/2T h "IT drs
� P arY �9h P
knee apace anger flxrvx.
I I / Faocer conrrd.ra be wdhn IT of f--r.n
I �
I ory Lkmonce /0 w -
I
1 /
I
Wheekha turn.y
Accessible Toilet Room Schematic
—
I I 1 Scale:112"=1'-0" Refer to ICC-ANSI 117.1
I I
I ( Note:Pro,ade air chamber/mech.de.ice for water hammer mail quick acting whys. c�
__e e
Schematic Partial Main Floor Plan
Scale: 1/4"= 1'-0"
��&Langemackl`d
hmy k..uplwn
Job. 2009-222 7-9-10
Request To Revise An'Appro ed Pla
Corn 2.010 - CzO21 1 wa_-�
Permit Number:BED200 - Name t AC,IL y h n so Y-)
Parcel Number z P, -Sd - MOO
Phone Number daytime
Project Address Mailing Address
Please provide a complete, detailed description of the1�posed revisions to the approved plans:
� Id
Are two sets of the revised plans or addendum indicating the changes included? 9/es ❑ No
Are the approved site plans included? ❑ Yes "o
Are the revisions clearly and accurately identified on the plans or addendum? w'Yes ❑ No
Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes
If Yes, Has the engineer or architect approved this revision? ❑ Yes ❑ No
Is a stamped and signed approval included with this request? ❑ Yes ❑ No
(Note:No structural changes to a"desi ed"plan will be approved without the written consent of the engineer and/or architect of record.
Does the proposed revision modify the footprint or location of the structure? ❑ Yes UA
If Yes, Is a revised site plan, with all new setback dimensions included with this request?
❑ Yes ❑ No
Additional Information:
Applicant's signature Date: 7 12-2— Z 010 -
Office Use Only Received by: _
Date Sent Assigned To Approved By Tate
"7 Original Valuation: $
22 �— a(p ) Additional Valuation: $
Sq.Ft. x$ $
Sq. Ft. x$ $
Total New Valuation $
Additional Fees:
Additional Planning Dept. $
Additional Conditions/Comments: Additional Plan Review $_ Additional Building Permit $
Additional Plumbing $�,4 t
Additional Mechanical le-5-0
Additional E.H. Dept. $
Other $
Total Amount Due: $
Amount To Be Paid Up-Front$
��n.v%rotech �wgt,weer�wg
ceotechw%cal Ewv%rov�w�ewtal Dra�wage °Roadway
September 15, 2010
Sweetwater Creek Properties, LLC
PO Box 1119
Belfair, Washington 98528
Reference: Special Inspection for New Habitat for Humanity Building Located at
22671 State Route 3 in Belfair, Washington, 98528
Dear Mr. Johnson:
Envirotech Engineering and Krazan & Associates, Inc. have completed a special
inspection of the referenced project. Krazan was limited to curing and testing the
concrete specimens. The quality assurance program completed for the site consisted of
the following:
• Inspection of reinforcing steel for the foundation;
• Sampling and testing concrete for the foundation; and,
• Inspection of high strength bolts.
Enclosed are the concrete test results.
Based on our observations and testing, it is our opinion that work within our scope of
services were completed in compliance with the specifications. Specifications were
obtained from the building plans by Web Steel Buildings, dated March 12, 2010.
Thank you for the opportunity to work on this project. If you have any questions or need
any further assistance, please contact Michael Staten at 360-275-9374.
Sincerely,
Envirotech Engineering
PEti CLYpp ST
WASyj 9T�
9/I sho
P0" Q SO V5
FSS/ONAI,
Michael Staten, P.E.
Project Director
j 4 N� F+urd Road
gelfaCr, wash% Otovt,9gs2g
Gff. 360-275_9374
Cell.: 360-689-604.5
Fax: 360-275-47?9
ewvC rote rk@pecteak Air nU fo.con&
4 .
e0wLroteak ev%,O�Men% o
Geotechv%cal EwvLrowvi&ewtal nraLwage °R.oadwa�
Concrete Sampling for New Habitat for Humanity Building Foundation
Date: July 27, 2010
Supplier: Hard Rock, Inc.
Material: 3000 psi blend
Sample 1
6:40am
Slump —4.5"
Ambient temp: 56 degrees
Concrete temp: 65 degrees
Cylinders: (4)4"x 8"
Sample 2
7:30am
Slump—5"
Ambient temp: 56 degrees
Concrete temp: 63 degrees
Cylinders: (4)4"x 8"
74 NE Hurd Road
gef-fa%r, washi.v,atow9gs28
Off: 360-2�5-93�4
Cell.: 360-689-604.5
FOX: 360-27.5-4789
ewv�rotech@aeotechvu,cali,v,fo.cow.
i
Krazan &Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370,(360)598 2126
Project No. 106-10 f3Q Cyl.Code P18191 Pour Date 7/27/2010 Report No. 47770
weather CLEAR Jurisdiction MASON COUNTY Permit No. N/A
Project SWEETWATER PROP Engineer N/A
Location BELFAIR Architect -
Client ENVIROTECH ENGINEERING Contractor ENVIROTECH ENGINEERING
Field Data CYLINDER REPORT Reported Batch Data _
Concrete X Other Design Actual
Weights Weights
Supplier HARD ROCK Plant No. N/A Site Mix Mix No. - -
Cem.lbs. - -
Mix Air Unit F.Ash lbs. - -
Slump Temp. Temp. Wt. C.agg.lbs.1 - -
Time Truck# Ticket# %Air (in.) (F) (F) (pcf) C.agg.lbs.2 - -
_ - - - - - C.agg.lbs.3 - -
Sand lbs. - -
Water lbs. - -
Placement Area Air Ent.(oz) - -
Location 5.0.6 & FOOTING MONOLITHIC PLACEMENT Other(oz) - -
98 yd3 Other(oz) - -
SAMPE 1 OF 2 Other(oz) - -
Other(oz) - -
Water Added on Job(gals.) -
Field Test Methods
Remarks SAMPLED AND DELIVERED BY CLIENT ASTM C143 ASTM C138
ASTM C1064 ASTM C173
ASTM C31 Other
Inspector CLIENT
Laboratory Data Design Strength 3,000 @ 28 days Date Specimens Rec'd. 7/28/2010
Cyl. Test Field Max. Comp. Tested Break Laboratory
Code Date Cure Age Dim. Area C.F. Load Str.(psi) Set# By Type Test Methods
P18191 8/3/2010 7 4X8 12.56 55925 4,450 AT 5 X ASTM C39
P18191 ASTM C109
P18191 ASTM C617
P18191 X ASTM C1231
P18191 ASTM C780
P18191 Other
P18191
P18191 Test Results
Remarks Conforming
Results Reviewed By P Date Reviewed'E IV Non-Conforming
Codes for Break Types: 1: Cone 2: Cone&Split 3: Cone&Shear 4: Shear 5: Columnar(Split)
Measurement Uncertainties: ASTM C-39+/-8%
Form 03101
R—h 2
Effective Date 121OM2
The h1ormaton provided on this report is prepared for the exdusiva use of the caent.TN.report mey not be reproduced in any format wihoit the written pern4 i 1 of the Client and Krazan 6 Asti—atee.
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Krazan &Associates, Inc. 1230 FINN HILL RD. POULSBO WA 98370,(360)598 2126
Project No. 106-10 J� Cyl.Code P18190 Pour Date 7/27/2010 Report No. 47769 ^
weather CLEAR Jurisdiction MASON COUNTY Permit No. N/A
Project SWEETWATER PROP Engineer N/A
Location BELFAIR Architect N/A
Client ENVIROTECH ENGINEERING contractor ENVIROTECH ENGINEERING
Field Data CYLINDER REPORT Reported Batch Data _
Concrete X Other Design Actual
Weights Weights
Supplier HARD ROCK Plant No. N/A site Mix Mix No. - -
Cem.lbs. - -
Mix Air Unit F.Ash lbs. - -
Slump Temp. Temp. Wt. C.agg.lbs.1 - -
Time Truck# Ticket# %Air (in.) (F) (F) (pcf) C.agg.lbs.2 - -
- - - - C.agg.lbs.3 - -
Sand lbs. - - --
Water lbs. - -
Placement Area Air Ent.(oz) - -
Location 506 & FOOTING MONOLITHIC PLACEMENT other(oz) - -
98 yd3 other(oz) - -
sample 2 of 2 Other(oz) - -
Other(oz) - -
Water Added on Job(gals.) -
Field Test Methods
Remarks SAMPLED & DELIVERED BY CLIENT ASTM C143 ASTM C138
ASTM C1064 ASTM C173
ASTM C31 Other
Inspector CLIENT
Laboratory Data Design Strength 3,000 @ 28 days Date Specimens Rec'd. 7/28/2010
Cyl. Test Field Max. Comp. Tested Break Laboratory
Code Date Cure Age Dim. Area C.F. Load Str.(psi) Set# By Type Test Methods
P18190 8/3/2010 7 4X8 12.56 40505 3,220 AT 3 X ASTM C39
P18190 ASTM C109
P18190 ASTM C617
P18190 X ASTM C1231
P18190 ASTM C780
P18190 Other
P18190
P18190 Test Results
Remarks Conforming
Results Reviewed Bye. Date Reviewed� I,It, Non-Conforming
Codes for Break Types: 1: Cone 2: Cone& Split 3:Cone&Shear 4: Shear 5: Columnar(Split)
Measurement Uncertainties: ASTM C-39+/-8%
Form.03101
Revlon 2
Effective Date 12JO21➢2
Th.i founetien provided on the report Is prepared for the excluawe uee of the ceent.The feport may not be reproduced In any formal without the written perme inn of the client and K—an 3 A—etea.
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FORME MUST BE COMPLETED IN INK MASON COUNTY PERMIT v
PLEASE PRESS HARD BUILDING PERMIT APPLICATION
426 W. Cedar•P.O_ Box 186,Shelton,WA 98584
Shelton (360)427-9670•Belfair(360)275-4467• Elma(360)482-5269
On the web www_co.mason.wa_us
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner -T w Company Name J o ff
Mailing Ad ess Qo /3 a y l t l Mai Address
•' teILL�ZipCode 5;) i Cihr ? --7 other Code -
Phone 3hn �z 1 -�r o I Other Ph / n z�S 5`MD Phone'R An nl / / Z i
Lien)Title Holder Contractor Reg. AA I Xp. to - R-o r
E mail address— IAA I� _ e sn.A I-MadAddress c
Drivers Lic 13 ' DOB /o - _ i Drivers Lic.>x F B l o- 6 -/5 E S
SEPTIC/WATER SYSTEM INFORMATION -Conned to New ptic g Septic
Connect to Water Sy
stem ystem��Name of Water
Well Sewer System Name of Sewer Sys
PARCEL INFORMATION - 12 Digit Parcel No. Z - Fieistricta
Legal Description BIAC
Site Address(Plea; include street name, street number and city)
Directions to site v O
Will timber be cut and sold in parcel preparation?Ye sun- 5� b``II e 1'D R /u P
Is property within 200'of Saltwater Lake __River) CreeK ornd
Wetland < Seasonal Runoff Stream__Z_ _Slopes or Bluffs >> 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement "on?YeAO
TYPE OF JOB- New �A d Alt Repair Othero ePRI Y RESIDENCE ❑ SEASONAL ❑
Use of Building�'a i7 tribe Wark F
No.of Bedrooms N . of Bathrooms Square Footage- 1st Floor-4 nd r
3rd Floor Basement Deck Covered Deck Other . R
Garage Attached Detached Carport Attached tached
MANUFACTURED HOME INFORMATION -Make Model Year_
Length—Width--Serial No. No. of Bedrooms No.of Ba Irooms —T
Type of Heat Purchase Price$ Replacement Unit? Yes/No
Installer Name Certification No.
OWNER/BUILDER Admow(edges submission of inacauate information may result in a stop work order or permit
of such is by signature below. 1 declare that I am the owner,owners legal representative.or the contn clor. I further declare
that I am enUUed to receive this permit and to do the work as proposed in the application.I declare that I have obtained ie pemessbon from all
the necessary parties.If pemnission is regwred from arry easement holder or any Other party in interest regarding this a p5catiDn or the work
proposed rn the application.I have obtained pen nission from thern to apply for this pent and conduct the work propos d. The owner or
agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County a ness to the above
d bed property and structure for review and inspection.This penrit/application becomes null 8 void if work or aW xized construction is
not commenced within 180 days or if construction wok is suspended for a period of 180 days.PROOF OF CONTINUA ON OF WORK IS BY
OFAP jWpECTION.INA' OF THIS PERMrrAPPLICATION OF 18o DAYS WILL INVALIDATE APPLICATION.
X t7t w�2v rn c v Date: 4- O 6 - ad) 0
Owrrer Representative/Contra (indicate which one) .
FOR OFFICIAL USE BEYOND THIS POINT Accepted b t& D to
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Planning Department
Environmental Health Department
Fire Marshal
FEES
Building Permit Fee SiteinsDection
Plan Review Fee EH Review Fee
Plumbing 8 Base Fee Planninq Review Fee
Mechanical 8 Base fee other
Wood/Gas/Pellet Stove. Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES
FORM MUST BE COMPLETED IN INK MASON COUNTY PERMIT N00a O
PLEASE PRESS HARD BUILDING PERMIT APPLICATION
426 W. Cedar•P.O. Box 186, Shelton,WA 98584
Shelton (360)427-9670•l3elfai[(360)275-4467• Elma(360)482-5269
On the Web www.co.mason.waus
APPLICANT INFORMATION CONTRACTOR INFORMATION
owners LM/%rv� lA,•x{ �n Company Name J o
Mailing Po ii a x l t l '
rr StateA7p Code�l `Ci— Einr- ate 2 ip Code
kao Phone 0 `731 - ro ,_OtherPh 3�0 Z-7S - 5460 Phone_ D -7'31 ---� !6 / Other .-Tk z7S-S4�i�
Lien!Title Holder Contractor Reg. to - a or ✓J
E mad address—� ' 1••dz _ e awe E Mad Address C
Drivers Lic.9 ' DOB (o - - t55 1 Drivers Lie-# ' B /O. 6 -/5 S S
SEPTIC/WATER SYSTEM INFORMATION-Connect Ne; ExiVg Septic
Connect to Water System —Name of Water
WeI Sewer System — Name of Sewer Sys
PARCEL INFORMATION-12 Digit Parcel No. I Z _ Fire E istrict z
Legal Description C
Site Address(Plea include street name, street number and city)
Directions to site a
Will timber be cut and sold in parcel preparation?Y o 1,o a AA
Is property within 200'of Saltwater lake River!CreeK and
Wetland y� Seasonal Runoff Stream_Z _Slopes or Bluffs 15%
is this pennft submittal the result of a Stop Work Notice,Correction Notice or other enforcement a 'on?Y
TYPE OF JOB - New A d Aft Repair_Qtf�er PRI Y RE DENCE ❑ SEASONAL 0
Use of BuitdingC'�A(av6 �aibe Work Z o e
No. of Bedrooms—Ni .of Bathrooms Square Footage-1st Fl 4 r
3rd Floor Basement Deck Covered Deck Other . It
Garage Attached Detached Carport Attached tached
MANUFACTURED HOME INFORMATION -Make Model Year
Length Width Serial No. No_of Bedrooms No. of Ba irooms _T
Type of Heat Purchase Price$ Replacement Unit? Yes!No
Installer Name Certification No.
OWNER/BUILDER AduxWedges subnrission of uracairate information may result in a stop work order or pemut
Acknowledgement of such is by signature below.I declare that I am the owner,owners Wo representative.or the cordr, Aor.I turther dedare
that 1 am entitled to receive this permit and to do the work as proposed inthe application.I declare that I have obWhed n from all
the necessary parties. if permission is required hom any easemenit holler or arty other party in interest regarding this or the work
mrission from them to apply the permit and and conduct the work The owner or
p uposed in fhe application,I have obtained pe
agent on owners behalff,represents that the urfomralion provided is accurate and Wants empbyees of Mason CourdY to the above
described properly and structure for review and inspection.Thus pemWaWb ation becomes null&void if work or - construction is
not commenced within 180 days or if construction work is suspended for a period of 180 days.PROOF OF CONTINUAI ON OF WORK IS BY
OFAP INSPWKINA OFTMSPERWrAPPLICATIONOF180DAYSWILLWVALIDATE APPUCATK*L
t�wn2v Gr G Y Date- 4- 0 6 - 03201
x t7
Owner ECresertative I cmnictor tiriftate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted b I (/l1 D to
DEPARTMENTAL REVIEW APP OVED DENIED NOTES
Building De rtment I
Planning Department Jr O
Environmental Health Department
Fire Marshal
FEES
Building Permit Fee / d• 5 Site InspectionQ •�`
Plan Review Fee 87 5 / EH Review Fee
Plumbing &Base Fee 47°f 1 40 Planning Review Fee nd
Mechanical&Base fee Other eA
Wood/Gas/Pellet Stove.Fee State Fee _
Volation Fee Pre-Paid at Submittal �S18 COG
Valuation $ TOTAL FEES
FORM MUST BE COMPLETED IN INK MASON COUNTY PERM►T N v
PLEASE PRESS HARD BUILDING PERMIT APPLICATION
426 W. Cedar•P.O. Box 186,Shelton,WA 98584
Shelton (360)427-9670•Belfair(360)275-4467• Etma(360)482-5269
On the web Wr V(=).mason.Wa us CC-CL,3
APPLICANT INFORMATION CONTRACTOR INFORMATION
Owner s , E 11 ,GAA 4:: T C ry ;o o
MaifutgAd�s Qo /i a k t l l�j I lad
'� P�eI#�I r state t��7p code 9.Ch�`6-- City , I�'t ,Y state Code
P►tone3 6 n 3l - 7 /D / Otlter Ph.3/D z7S-S4r7i�
Lien/Title Holder Contractor Reg.
E mall address '!yT C,3 14 d:T a'^'x E Marf Address c c
Drivers Lic.4 ' DOB r o - - Drivers Lic.#, e4 F,44,0 1 B /0. 6 -/5 S' S
SEPTIC/WATER SYSTEM INFORMATION -Conned New` ptic Septic
Conned to Water System__Name of Water
Well Sewer System Name of Sewer System—
'
2 - Fire istrict i
PARCEL INFORMATION-12 Digit Parcel No. C
Legal Description
Site Address(Plead include street name, street number and city)
Directions to site e
Will timber be cut and sold in parcel preparation?YasCto b``I'I e i'o R /U r
Is property within 200'of Saltwater Lake River) CreeK and
Wetland )C Seasonal Runoff Stream_Z_ _Sktpes a Bluffs 15%
Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement a
TYPE OF JOB - New A d Aft Repair Qther PRI Y RES DENCE ❑ SEASONAL ❑
Use of Buitdingea hn� tribe Work Z o e ,
No.of Bedrooms N .of Bathrooms Square Footage- 1st Floor4 r
3rd Floor Basement Deck Covered Deck Other q. fL
Garage Attached Detached Carport Attached tacked
MANUFACTURED HOME INFORMATION -Make Model Year—
Length Width Serial No. --.of Bedrooms No.of Bathrooms _T
Type of Heat Purchase Price$ Replacement Unit? Yes/No
Installer Name Certification No.
OWNER/BUILDER Acknowledges submission of inaccurate information may result in a stop work order or permit
AcknNAedgernerd of such is by signature below.I declare that I am the owner,owners Wo representative,or the .I firther declare
dud I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have oblacted ie pemnission from all
the rh ssary parties. If permission s regtnred from arty easement holder or arty other party in interest regar&V this or the work
Proposed fhn a application, I have obtained pemission from Qtern to apply for trus penrnt and trmdt the work The owner or
agent on owners behalf.represents that the nnforrnetion prowkw is accurate and grants enhptoyees of Mason County a ress to the shove
described properly and stnr i re for rewew and inspection.This panniVapPGcation becomes null&vod If work or autt xumd construction is .
not commenced wwUtin 18o days or if constniction work is suspended for a period of 180 days.PROOF OF CONnNUA1 ON OF WORK IS BY
OFAP INSPECTION.INA OF TMPERMrrAPPLICATIONOF180 DAYS WILL WVALIDATE T tEAPPLICATK*L
X A&L GL�v rrc Y Date• 4- 06 - adl Q
ownertowriers Representatm/contra (undtcate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted b w D ite
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Buiding Department
Planning Department G
Environmental Health Department
Fire Marshal
FEES
Build.ing Permit Fee Site Inspection
Plan Review Fee EH Review Fee
Plumbing& Base Fee Plannina Review Fee
Mechanical& Base fee Other
Wood/Gas/Pellet Stove.Fee State Fee
Violation Fee Pre-Paid at Submittal
Valuation $ TOTAL FEES
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l _Mason County Planning Intake Checklist
Owners Name: o V 1 Date:
Project: ( rg xn� Q S� Reviewed By:
Proposed use(s) of structure(s)
Commercial Development: YES PLANNER: GBM TSW PBC R AHB
Site Plan:
fie( North Arrow ❑ Su'rv'eyquir ed ip AIJa7i U o AF# ❑ onuments
Property Dimensions: _��) X (_ __GLJ � 3
-iT Streets and Driveways Shown. Road name:
All Existing Structures shown with setbacks an use
Well Location, Septic and Drain-field Shown with setbacks
t�( Identify all surface water(streams, ponds,shoreline, wetlands, natural or historic drair age, defined
drainage ditches) P—rQ�
Topography(slopes) 1
pl Minimum F /��_R: W(Di /-� m: jiL J3 S2:
�) Utility and Drainage Easements: `FS No (if yes enter condition #5022)
Other Easements
Accessory Appurtenances: Propane / Heatpump .
czDoes site plan show landings at all e)dts?
Variance applied for: Yes / No - parking spaces allotted? Yes / No
o County Access Permit Needed (add condition #0010)
�( State Access Permit Needed (add condition #0020)
Standard Conditions to be added to all Building permits that planning reviews: #5019 and #0700
Site Access: Are there any impediments (dogs/gates)that my restrict access to your site?
Is the site dearly marked? How? Address
❑ Name
Zoning: ❑ Other:
Comp, Plan: Rural Zoning: UGA Zoning:
0 Rural ❑ RR 2.5 5 10 20 0 RT/RTC 0 R-1 ❑ R-5 ❑ HC I BI
❑ RAC ❑ RMF 0 Unknown ❑ R-IP 0 R-10 ❑ LTA I VC
❑ Allyn UGA ❑ RC 1 2 3 ❑ Agricultural 0 R-1R ❑ PD ❑ FR I T
D Belfair UGA 0 RI ❑ In-holding ❑ R-2 ❑ PF D MU i MHP
0 Shelton UGA ❑ RNR ❑ LTCFL ❑ R-3 0 POS ❑ GC I BP
❑ Tribal I GC-CI
Critical Areas: (streams, ponds, shoreline, wetlands, steep slopes)
Shoreline
Designation: 0 N/A 0 Urban ❑ Rural ❑Conservancy ❑ Natural ❑ U ikown
Water Body(type of water if unnamed):
SEPA: Y No known ` Flood Plain: YES w . ap#
Aquifer Recharge: YES Unknow Map#
Tags/Cases --- — - - -
RLC/SPI Case:. 6-Year Dev. Moratorium Y
Eagle Nest Tag: Y Other/North Bay Sewer Y
Revised 01-13-2009
,�✓I�' MASON COUNTY DEPARTMENT OF
ry COMMUNITY DEVELOPMENT
r "
+ a26 W^st Cetus St,,t . po Box 186 • Shelton.WA 985M
tV
(360)427-967D EXT.357 FAX(360)427-7798 HOME PAGE-www.w.rttera:h.vaw
Special Inspection Authorization
Pm)ecl Otlrcr�ll.Jvp:�W-��e"-Y' BuOdirg Permit Number � Di 0 —_,��
Project Address. 726-7 l / c= � . 3 ixz. Engineer/Architect of record
In adcNon to the inspection:required by Inlennatier al Building Code(IBC)Section 109.the evautr or the engmcer
or archiled of record acting as the owners agent shall employ one of more special Inspectors who shill pfo+ide
special ins c tiore.during construction on the tytaes of work listed under IBC Section 1704.
This fora must be completed by the owner or the crgin ' or architect of record,prior to permit issuance,indicting
who will perfom No required special inspections for this particular project The specified special inspeamr(s)shall
perform UT required stemj inspections during cocstnrclfon of Inc project submit nA inspection reports, to the
Building Departrunt and provide a final signed mporl sta ing whether the work requiring special inspection was.to
the best of Oho inspectors knaviedge.in confomxhnce,to the approved plans and speefic5ons and the appicable
workmanship provisions of the IBC. The fdluning checked items require special inspection:
di. Concrete. !luring the,king of test specimens and placing of reinforced concrete-(IBC 1704.4)
02 Bolls Installed in concrete. Prior to and durrvg the placement of carnoete around baits when strr.
increases permitted by Table 19122 and section 1912.5 are utilbeod.(18C 1704.4)
❑ 3. Erection of precast concrete members. Periodic inspection per ACI 318:Ch 16.(IBC 1704.4)
04. Shaterele. Continuous inspeelfon pM ACI 313:5.9,5.10 and IBC Chapter 19.QBC 1704.4)
ff'5. Reinforcing steel and prGtressing sloe!ten dlO na. Inspection of re'vhlocing steel including prestressing
tendOnS.(IBC 1704.4)
6. Welding of reinforcing steal. Inspection of Uhe wading of reinforcing sled according to AWS D1.4.ACI
318:3.5.2.and IBC 1903.52.(IBC 1704.4)
U 7. Structural wolding. Welding inspection shag be It compliance with AWS 01.1.(IBC 1704,3.1)
fit 8. Highstrcngth Bolting. The installation of high-strength bons shall be periodically inspected in accordance
with AISC i-RFD S c5on M2.5.(IBC 17U.3.3)
0 S. Structural Masonry. Masonry construction shag be inspected and evaluated with the requirements of 18C
section 1704.5.
D 10. Sells. Im pecriona for fills 12 itches or greater to be performed in accmdance with IBC Section 17(W.7
❑ 11. Pile foundations. Inspector to be present when pile foundations are being installed hand during tests.(IBC
17M.8)
0 12 Pier foundatiorns. Special inspectioi of per foundations for buildings are required in seismic Zone rl.(IBC
1704.3)
0 13. Spray.appried fire rr✓lstmni mer rehth. lnepecfions Shall be in accordance,with section 1704.11.1
through 1704.11.5.
0 14. Exterior inouladon finish syWam(EIFS). Spociw MspocriOn shall be required for all EIFS systems. (IBC
1704.12)
Condrucd W Mvaraa silo
TO BE KEPT IN T E
ARCEL F11.1.
THE LANS ST B
ON T SITE
FOR PE
D IS., Smoke.control system. Smoke cottaol systems shall be test-ad by a special inspector per IBC Section
1704.14.
Cl 16. Special exec Special inspection chit be fequmd for proposed work that is,in the option of the trilling
omcial,unusual In its nature such us alternative methods and material of mnstructim unusual dr..ign appliwlans.
and rnolerial,and systems required to be i=Wfled in accordance with additional mvurkhclurefs mstructions that
proOca.Lv requirements not conlamcd in the IRC Or referenced standards.
O Instanadon Of structural epowes O Installation of'higMoad shear panels'
C SCUYural 0trsp.waion(IBC1709) COMM:
Special Inspector Selection:
The special inspection agency and special mspector.hall be registered by the Washington Association of euirding
Officials(WASO)roc the part"ular Type of consUuciion or operation requiring special btspepiarc Such jnSpector(s)
slaRl be afected by the owner or the owners agent aid approved by the Building Official prior to i—, oce of the
buadlhg permit. The owlrcrs agent shaft not be:acting as,or employed by the special inspection agent/or tlo
Contractor for thn project.
Name of Special Inspector or Agency: Type of Inspection: RegL^tmtion Number.
of
-n irorec_ G � « �: B�Itt Str,.l ill-£1nCr+ _
i
Authorization: I hereby state that I am the legal owner of ate project property.or that I am the legal owners agent
won ct not employed by a special inspection agency or conaaetor associated with this Project In addition,1 agme
la comply with the spew)ispectorr requirements r•tablished by Chapter 17 of the lntertcdmnal Building Code as
adorte'r htnon County. ff
�t. 5 MrcA�I Ten S1761
Signature Primed Name o Orator B'Agrn Data
PURPOSE OF SPECIAL INSPECTION
Special Inspection c the monitoring of mahYials and workmanship Which are a I to the:Inte7rity of the building
stn=re to a MVm that the appfOYW plans and VCcificatloe am bCaV followed and that relevant codes are being
OhsMued. Special InspectiOru are in acrribbrn to those conducted by the county building kltpector and by the
en9uheer or och'.act of reror0. SPCc'W mspeClgrs fumish hMPeCiom at all lianas that their presence is requrtCd by
the code.the plans and ipeTJrK3f ions.and the enforning jVfizRkdo 1. Goof onvununication between the SpMY.I
Inspector Ord the desigw.contmctor.and bui ding dep to nenl is essential,
DUTIES AND RESPONSIBIL1TfES OF THE SPECIAL INSPECTOR:
Special inspectors are individuals with highly developed•spcaalmed stills Who observe VIOSe Critical building Or
structural features which they are qualified M inspect. Outies of special inspectors and/or irspecda; agencies
mctda the lotowing:
1.General Requiremans
Special Inspodora oncn review approved PLans and apacifcaddol for special inspection mquremene
Special inspectom shall comply w1M the special inspection mquVements of the e,(Orag ImisdlciioO
Z.Signify presence at Job Site
SLCaial inspectom Should notify convaernr personnel and the enforcing jurisdiction of their prcoorce and
mt-pomiNities at the job:ate.
3.Observe All Work for Which They Are Respom ble
Special mupeebm chW Inspect an wok and perform ar observe aft tests requiring Inspection and test rig for
amforn:mne with the buildhhg-dep..m .itzppovW(stamped)drawings.specucalios and apprc_bk
THESE P
ON THE NS MHST BE
JOg S.T_
FAR I�ISPECTIoN
[(5/282010) Debbera Coker- Re: Special Inspection Authorization form for Jack _ Page 1
From: <envirotech@geotechnical info.com>
To: "Debbera Coker' <Dlc@co.mason.wa.us>
CC: <jjc@hctc.com>
Date: 5/28/2010 11:13 AM
Subject: Re: Special Inspection Authorization form for Jack Johnson project
Hi Debbera,
Please see the Special Inspection Authorization form attached.
I listed concrete for inspection, but I see your email below that it may
not be required since the 28-day strength is only 2500 psi.
Also, it appears that all welding will be completed by the manufacturer.
If for any reason, welding will be performed on-site, we will procure an
authorized inspector.
Thank you,
Michael Staten
Envirotech Engineering
360-275-9374
> If field welding is performed a special inspector will need to evaluate.
> I believe the welding will be performed at the fabrication shop in Oregon,
> however there could be some site welding that needs to be done. High
> strength bolts (A325) are specified and will require special inspection.
> Concrete is spec'd out at 2500 psi so a special inspection is NOT required
> for the concrete.
»» <envirotech@geotechnicalinfo.com> 5/26/2010 1:33 PM >>>
> Hi Debbera,
> Yes, I am working with Jack Johnson. I did not quite get the full story,
> but Mr. Langemak indicated that Mason County requires specific
> certification for special inspections. I cannot do welding inspections,
> and I am not equipped to crush concrete cylinders. However, I have been
> doing soil inspections, rebar, bolts, etc.. Do you have any insight
> regarding this, or should I discuss this with Mr. Langemak?
> Thanks,
> Michael Staten
> Envirotech Engineering
> 360-275-9374
> TNr-SF P
oN THE NS
> FAQ I NSP f S/7-, of
>> Hello Michael,
>> According to Mr. Langemak you are coordinating the special inspection
(5/28/2010) Debbera Coker Re Special Inspection Authorization form for Jack Page 1
From: <envirotech@geotechnicalinfo.com>
To: "Debbera Coker' <Dlc@co.mason.wa.us>
CC: <jjc@hctc.com>
Date: 5/28/2010 11:15 AM
Subject: Re: Special Inspection Authorization form for Jack Johnson project
Attachments: Sweetwater Special Inspection.doc
Sorry, The inspection form is attachment this time.
> If field welding is performed a special inspector will need to evaluate.
> I believe the welding will be performed at the fabrication shop in Oregon,
> however there could be some site welding that needs to be done. High
> strength bolts (A325) are specified and will require special inspection.
> Concrete is spec'd out at 2500 psi so a special inspection is NOT required
> for the concrete.
»» <envirotech@geotechnicalinfo.com> 5/26/2010 1:33 PM >>>
> Hi Debbera,
> Yes, I am working with Jack Johnson. I did not quite get the full story,
> but Mr. Langemak indicated that Mason County requires specific
> certification for special inspections. I cannot do welding inspections,
> and I am not equipped to crush concrete cylinders. However, I have been
> doing soil inspections, rebar, bolts, etc.. Do you have any insight
> regarding this, or should I discuss this with Mr. Langemak?
> Thanks,
> Michael Staten
> Envirotech Engineering
> 360-275-9374
>> Hello Michael,
>> According to Mr. Langemak you are coordinating the special inspection
>> program for the Jack Johnson project. Have you completed the Special
>> Inspection Authorization form yet? The completed form is necessary to
>> issue the permit.
>> Debbera Coker
>> Mason County Building Department
>> Building Inspector IV/Code Enforcement
>> Phone: (360)427-9670 ext 510
>> FAX: (360)427-7798
>> e-Mail: DLC@co.mason.wa.us
>> PO Box 186
>> 426 West Cedar Street THEE PLANS h�>> Shelton, WA 98584 ST BE
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