HomeMy WebLinkAboutCOM2019-00063 Special Inspection and Testing - COM Inspections - 8/8/2019 f �
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Mason County Community Services
_ Building Division
wAId
SPECIAL INSPECTION & Shelton, WA 9er 8584
360.427.9670 ext. 352
TESTING AGREEMENT
www.co.mason.wa.us
(All references are per the 2015 International Building Code)
Project Name: ALTA FOREST PRODUCT—WATER STAIN
Project Address: 780 WEST STATE ROUTE 108 SHELTON WA 98584
Building Permit Number: PAR2019-00002 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) MA,7-CtZI A L-� �� �{MpfA. G.c1l Q
❑ Steel floor&roof decks -ray—,i � (2 w G,10kJ,a L.� C'L,;-
❑ Welding of reinforcement 'Lv tJ S t)L:r/1+JGj �01 5 39
Cold-formed steel t o G • J "G
Structural Steel
Welding(Per N5.4 of RISC 360-10) t /
Details(Per N5.7 of AISC 360-10) �! J
High-strength bolts(Rer N5.6 of AISC 360-10)
Concrete Construction(per IBC Table 1705.3)
19 Reinforcement,embeds, nc ors
❑ Formwork
❑ Materials
❑ Shotcrete
❑ Post-tensioned/Pre-stressed Concrete
❑ Erection of precast concrete
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Mason County Community Services
Building Division
615 W Alder Street
SPECIAL INSPECTION &
Shelton, WA 98584
360.427.9670 ext. 352
TESTING AGREEMENT 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) 1 t 1
❑ Wood Trusses>60ft(IBC 1705.5.2)
❑ Soils(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(IBC 1705.13)
❑ Mastic&Intumescent Coatings(IBC 1705.14)
❑ EIFS(IBC 1705.15)
❑ Fire-Resistant Penetrations(IBC 1705.16)
❑ Smoke Control(IBC 1705.17)
Dd Structural Steel(IBC 1705.12.1&AISC 341-10) 1
YStructural Wood(IBC 1705.12.2) C f r
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• f
Mason County Community Services
Building Division
1515 W Alder Street
SPECIAL INSPECTION & Shelton, WA 98584
t 70 ex t.360.427.96
TESTING AGREEMENT www.co.mason.wa.us
r.C;old-formed Steel(IBC 1705.12.3)
nical&Electrical Components(1705.12.4)
Architectural Components(IBC 1705.12.5) f �I
❑ Storage Racks(IBC 1705.12.7)
❑ other (IBC 1705.1.1)
VE
Structural Observations EC,o
j=I t4A.L_ 11,)C 9J:E-C.T 10 0
Declaration by Architect/Engineer
1, the design professional in responsible charge for this project, declare that the above listed special
inspection and structur testing items are required for this project in accord nce with IBC Chapter 17.
*D.t
Signature(Engineer)
Date
Signatur chitect)
Date
signatur ologist)
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.
Date
Signature
isting
stems
CONTRACTOR RESPONSIBILITY: Each contractor involved
r isorespo s!on of ind or seismic responsible foWproviding the special nsspectoryaccess
shall comply with the requirements of IBC 1704.4. The ontract
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
ree to comply with the"Contractor Responsibility"items noted above.
I,the General Contractor of the project,ag
Date
Signature
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