HomeMy WebLinkAboutCOM2019-00101 Special Inspection and Testing - COM Permit / Conditions - 1/21/2020 r
Mason County Community Services
CGDO Building Division
SPECIAL INSPECTION & 615 WAIderStreet
Shelton, WA 98584
TESTING AGREEMENT 360.427.9670 ext. 352
www.co.mason.wa.us
(All references are per the 2015 International Building Code)
Project Name: 841418 T-Mobile SE05701B Hoodsport
Project Address: 80 E UNION HE,IIGHTS PL SOUTH, UNION, WA 98592
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Building Permit Number: Ce ,,r'10,4q,o to` Date Issued:
BEFORE 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 ofthisformare 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 anew
form shall besubmitted anciturnedinto the Building Permits&Inspections Division forapproval.
STATEMENT OF SPECIAL INSPECTIONS: In addition to this Agreement, a "Statement of Special Inspections"shall be
provideciperlBC1704.3. This Statements hall bemadeaspartoftheapproved plans,and be placed in a conspicuous
location,such as the fi rst page of the construction plans orthe first page of the structural sheets.
SPECIAL INSPECTORS: All special inspectors shall be approved bythe Building Division priorto performing any duties. The
special inspectorshall provide proofof certification as a special inspectorfor each inspection item and be I i censed by th e
State of Washington.
SPECIAL INSPECTION REPORTS: Special inspection reports areto meet the requirements of IBC 1704.2.4. Copiesof each
report are to be sent tothe address listed in the letterhead notingthe Project Address and Permit Number. Afi na I report
shall besubmitted statingthatall special inspectionandstructural testing items were completed and are in conformance
with the approved design drawings andspecifications. Items not i n conformance,unresolved items,or a nydiscrepancies in
inspection coverage(i.e.missingi nspections,periodic inspections when continuous was required,etc.)shall be specifically
itemized inthefinal report.
Areas requiring special inspection: Name of Agency: Address&Contact Information
❑ Unapproved Fabricators(IBC 1704.2.5)
Other tha n Structural Steel (I BC Ta ble 1705.2.2)
❑ Steel floor&roof decks
❑ Welding of reinforcement
❑ Cold-formed steel
Structural Steel
❑ Welding(Per N5.4 of AISC 360-10)
❑ Details(Per N5.7 ofAISC 360-10)
❑ High-strength bolts(Per N5.6 ofAISC 360-10)
Concrete Construction(perlBC Table 1705.3)
❑ Reinforcement,embeds,anchors
❑ Formwork
❑ Materials
❑ Shotcrete
❑ Post-tensioned/Pre-stressed Concrete
❑ Erection of precast concrete
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Mason County Community Services
Building Division
SPECIAL INSPECTION & 615 WAIderStreet
Shelton, WA 98584
TESTING AGREEMENT 360.427.9670 ext. 352
www.co.mason.wa.us
Areas requiring special inspection: Name of Agency: Address&Contact Information
Masonry Construction(I BC1705.4)
❑ Prior to Construction(Article 1.15,TMS-602)
❑ As Construction Begins(Article 1.19.2,TMS-402)
❑ Priorto Grouting(Table 1.19.2,TMS-402)
❑ During Construction(PerTMS-402&TMS-602)
Wood Construction
❑ High-Load Diaphragms(IBC 1705.5.1)
❑ Wood Trusses>60ft(IBC 1705.5.2)
❑ Soils(IBCTable 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)
❑ Structural Steel (IBC 1705.12.1&AISC 341-10)
❑ Structural Wood(I BC 1705.12.2)
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Mason County Community Services
Building Division
SPECIAL INSPECTION & 615 W AlderStreet
Shelton, WA 98584
TESTING AGREEMENT 360.427.9670 ext. 352
www.co.mason,wa.us
❑ Cold-formed Steel (I BC1705.12.3)
❑ Mechanical&Electrical Components(1705.12.4)
❑ Architectural Components(IBC 1705.12.5)
❑ Storage Racks(IBC 1705.12.7)
❑ other______ (IBC 1705.1.1)
❑ StructuraI Observation s Not required N/A N/A
Note:The structural analysis by PJF dated 06/14/19,showed the existing pole to be sufficient for the proposed loading. As such,no modifications to the pole
or its foundation are required. Therefore,there are no construction details within the scope of our services that required special inspection or observation.
Declaration byArchitect/Engineer
I,the des ign professional i n responsible charge for thi s project,declare that the above listed special
inspection and str ctural testing items are required for this project in accordance with I BCChapter 17.
01/21/2020
Signature(Engineer) Date
Signature (Architect) Date
Signature (Geologist) Date
Declaration by Owner
I,the Owner of the project,declare thatthe above I isted firm(s)or individual(s)are hired by me to perform special
inspections and structural testing for the project pursuant to I BC 1704.2.
Signature Date
CONTRACTOR RESPONSIBILITY: Each contractor involved with th e con stru ctio n of wind orseismicforce-resisting systems
shall comply with the requirements ofIBC1704.4. The contractor is responsible for providing the special i nspecto r a cc ess
to approved plans and contract documents atthejob site. All special inspection records shall be retained atthejob site by
the contractor and shall be made available to the Bui I ding Department upon request.
Declaration by General Contractor
I,the General Contractor of the project,agreeto comply with the"Contractor Responsibility'items noted above.
Signature Date
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