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CL L � �) CO (°n LZncc -° -0Oa U .` a) Lt ° oa) (na) C � Q `� � � mQ� cCLa720pW 0) a) a) c: a) � � 0w0H o C � E � �cr"' o � � pQaaW L a) a) � U :5 O m N Q C S- «. > — U a) (Ln — ca � M p c '` � � � `� EE � J °O O E O Q 0 -0 -0 co to O O �i 0 ,2 Q Oo > U Q C O '" C — Z Q� L � Q a) O i C p .c O - cn a) cn v> a) . a J O _ C N Q C .� E cn O 'cn C 0 0U) mac, -0 E co: `— C a) � u � a) L Q L(7 cn � a0 0) Nam-' C)"N' N �1 C a cCucN C: in cniE -aa) cQn `' Y a) a) - ,� � O N C a) .0 O a) U 'p) a) N a) 3 - a) a C U) mm (6 O C E a) C a) ° N U m LO p) L .0 U N > a) .O N Q N t°)o U a) pp mOD o 0' 1`1 O >� a) O U Q m O O a'_..h p O W ++ cU L +/ L C +�•' Z Co a) (n C (� _ 04 C)Z �_ _ 0 w 3 O N °U a W n. 0 0 X _ 9 CONCRETE MECHANICAL MANUFACTURED HOME rn N) 0 � .. Footings if Setbacks By Setbacks Ribbons b Gas Piping 0 o interior Gate By interior-Date By gate By o w 00 Exterior Date By Exterior-Gate 13v Set-up Paint Load r Isolated Feelings INSULATION Date By BG I SLAB INSULATION Date By Date By FIRE.DEPARTMENT Foundatlrsn Wails Floors Date By Date By Data BY DECKS F'RAM I NG Walls Date By Date By Data By PROPANE TANKS PLUMBING vault [hate By Date By OTHER Groundwork Attic Date By 'Typo: Date By Dale By D.iii DRYWALL `typo O Int Brace Wall Date By 3 Date By By FINAL INSPECTION N Water Line Fire Sepe ration Date By Dale By Date �Z Zp By J�GC C Pass or Request Inspect. CD � Type 41 Ins i. Fail Gate Date done By Comments ►raWt O�'t d'S Stet h V 77 -23-( ro `�^Z't- J?z c� r_ �� 5 �. 9/1174 orb o.Fk� aw•� o s 0-17-t 'to-rsr-r6 �- ..a ., hC:7 r G,x,rZol6 -6/Z"7 -/ GSA 4),k 4.115� ".3 Y Ell. .fry F,v.�� .ass /a z•//� �z 6 Sc.c— .4,i Or v 0 (31 rr rgo cot, MASON COUNTY (360)427-9670 Shelton ext.352 DEPARTMENT OF COMMUNITY DEVELOPMENT (360)275-4467 Belfair ext. 352 BUILDING•PLANNING•FIRE MARSHAL (360)482-5269 Elma ext. 352 Inspection Hotline (360)427-7262 -� Mason County Bldg. 8, 615 West Alder Street 854 Shelton, WA 98584 www.co.mason.wa.us CORRECTION/INSPECTION REPORT PERMIT/CASE NUMBER: /' �-r Z�%j7 -- c� e t ADDRESS/LOCATION: z;3 Q _ k--tj Ztr� - FINDINGS: ry Items listed above must be corrected to gain compliance. ❑ THIS IS NOT A COMPLETE INSPECTION ❑ This structure has been inspected by Mason County Building Department and the items listed above are in VIOLATION of Mason County laws and/or ordinances. ❑ Call for re-inspection when corrections are made before proceeding with any further work. ❑ Make corrections, items will be checked on the next inspection. to Date: '7 �.� ❑ Please contact our office regarding possible Department: structural damage incurred by recent b "natural/man made"disasters.This is NOT a Inspector: CORRECTION NOTICE. DO NOT REMOVE THIS TAG MCC14.12 Office MAYES � ��R°� TESTING ENGINEERS, INC. Sude110 LWrwood WA98036 ph 425.7429360 fax425.745.1737 Tacom Olfice December 8, 2016 10029S.Tw maWay Suibe E-2 Taxrna,WA 98499 ph 253.584.3720 Mason County Building Department tX2535843707 615 West Alder Street PotgaW Otte Shelton, WA 98584 7911 NE33rdDrive Sute 190 Pa and,OR97211 ph 503.281.7515 Attn: Building Official fax503.2817579 FINAL LETTER Re: Rite Aid Belfair#6455 Permit# COM2016-00081 23940 NE State Route 3 Belfair, WA Project No. T16244 This is to inform you that special inspections have been completed for this project as per our reports, copies of which have been sent to you. Special inspection was provided for: • Proprietary Anchors 1. Expansion Anchors To the best of our knowledge, all work inspected was either performed in accordance with, or corrected to conform to, the city approved drawings, or engineer approved drawings. We trust that this provides you with the information, which you require. Should you have any questions give us a call (253) 584-3720. Sincerely, Mayes Testing Engineers, Inc. Dennis Sanborn Senior Project Manager /� Lynnwood Office MAYES TESTING ENGINEERS, INC 20225 Cedar Valley Road Suite 110 ph 425.742.9360 fax 425.745.1737 Tacoma Office New Project Set Up Questionnaire 10029 S.Ta=m Way SOL=Please fill in the followingfields completely so that we can ensure our project is set u Taoo 2 p Y Y P 1 p Tacoma,WA seas correctly. Please contact us with any questions. ph253.5M.3720 fax 253.584.3707 Project Name: Belfair, WA Rite Aid PoreandOfice 7911 NE 23840 DE Slate Route 3:Belfair,W suib A 88528 33rd Drive Site Address: u�e 190 Site Contact & Podand,OR 97211 ph Robert Grover-James E. John Construction Co Inc fax503.2B1.7 7 15 Company: fax 503.291.7579 Site Phone No: 503-740-6304 Site Email: rgrover@jejohn.com Building Dept: Permit No.: What will we be inspecting? (ie: concrete, masonry, steel, epoxy, etc.) Fixture Anchoring Who are we billing? Company: James E. John Construction Contact: Jason Burgard Address: 1701 SE Columbia River Drive Phone: 503-867-3061 Email: jburgard@jejohn.com PO'No: Job No.: 716050 Would you like to receive your invoice via? email ❑✓ or mail ❑ Who needs to receive emailed copies of reports? If building department is specified above we will email reports so they do not need to be listed below. Company: Contact: Role: ❑Owner ❑Arch ❑ Eng ❑ Cont ❑Other Phone: Email: Company: Contact: Role: ❑Owner ❑Arch ❑ Eng ❑Cont ❑Other Phone: Email: Company: Contact: Role: ❑Owner ❑Arch ❑ Eng ❑ Cont ❑Other Phone: Email: Company: Contact: Role: ❑Owner ❑Arch ❑ Eng ❑Cont ❑ Other Phone: Email: MTE 3673-2C,Rev 3,01/20/14 �eati COU,tr Mason County Community Services Building Division SPECIAL INSPECTION & 615 WAIderStreet Shelton, WA 98584 18 S4 TESTING AGREEMENT 360.427.9670 ext.352 www.co.mason.wa.us (All references are per the 2012 International Building Code) Project Name: —Z' J Project Address: �Mq6 Building Permit Number; C`c>—%Z of cs 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 license/certification 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 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 INPSECTION 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. GENERAL SPECIAL INSPECTION ITEMS(per IBC Chapter 17) [Only checked items are required] Areas requiring special inspection: Name of Agency: Name of Inspector: License/Cent.No. ❑ Unapproved Fabricators(IBC 1704.2.5) Other than Structural Steel(IBC Table 1705.2.2) D Steel floor&roof decks ❑ Welding of reinforcement ❑ Cold-formed steel Structural Steel ❑ Welding(Per N5.4 of AISC 360-10) ❑ Details(Per N5J of AISC 360-10) ❑ High-strength bolts(Per N5.6 of AISC 360-10) .................-- Concrete Construction(per IBC Table 1705.3) ❑ Reinforcement,embeds,anchors ❑ Formwork ❑ Materials ❑ Shotcrete ❑ Post-tensioned/Pre-stressed Concrete ❑ Erection of precast concrete Page 1 of 3 OoN coU�rA Mason County Community Services Building Division SPECIAL. INSPECTION & 515 WAIderStreet Shelton, WA 98584 I .5d TESTING AGREEMENT 360.427.9570ext. 352 www.co.mason.wa.us GENERAL SPECIAL INSPECTION ITEMS(per IBC Chapter 17)-continued [Only checked items ore required] Areas requiring special inspection: Name of Agency: Name of Inspector: License/Cert.No. 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) ❑ Soils(IBC Table 1705.6) ❑ Driven Deep Foundations(IBC Table 1705.7) ❑ CasCin-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) ❑ EIFS(IBC 1705.15) ❑ Fire-Resistant Penetrations(IBC 1705.16) ❑ Smoke Control(IBC 1705.17) ❑ Other (IBC 1705.1.1) ❑ Other (IBC 1705.1,1) SPECIAL INSPECTIONS FOR SEISMIC RESISTANCE(IBC Section 1705.11) [Only checked items are required] Areas requiring special inspection: Name of Agency: Name of Inspector: License/Cert.No. ❑ Structural Steel(IBC 1705.11.1&AISC 341-10) ❑ Structural Wood(IBC 1705.11.2) ❑ Cold-formed Steel(IBC 1705.11.3) ❑ Mechanical&Electrical Components(1705.11.4) El Architectural Components(IBC 1705.11.5) Storage Racks(IBC 1705.11.71 r Page 2 of 3 c0U��A y r Mason County Community Services Building Division SPECIAL. INSPECTION & 615 WAIderStreet _> Shelton, WA 98584 r 54 TESTING AGREEMENT 360.427.9670ext. 3s2 www.co.mason.wa.us 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 (SEAL) Declaration by Owner I, 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. 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 Contractor 1, the General Contractor of the project, agree to comply with the "Contractor Responsibility" items noted above. n Date Page 3 of 3