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BLD2021-00347 Replace Dock - BLD Inspections - 7/10/2023
615 W.Alder St.Bldg 8,SHELTON,WA 98584 MASON COUNTY SHELTON: 360-427-9670, EXT 352 COMMUNITY SERVICES BELFAIR:360-275-4467,EXT 352 Building.Planning,Environmental Health,Community Ilealth ELMA: 360-482-5269,EXT 352 www.co.mason.wa.us INSPECTION CARD AND CERTIFICATE OF OCCUPANCY** To schedule an inspection call or visit http://www.co.mason.wa.us/community-services/bld-inspectio hp J Permit Number BLD2021-00347 Date Issued 08/23/2022 Issued B Project DOCK REPLACEMENT Site Address 140 N Discovery Dr Applicant PERRY ET UX EDWIN C Contractor Contractor Phone Primary Code UPC IBC, IRC, IFC, IEC,IMC,& Type Permit Type BULKHEAD OR DOCK- Occupancy RESIDENTIAL -APPROVED PLANS MUST BE ONSITE FOR ALL INSPECTIONS. -DO NOT PROCEED BEYOND EACH STAGE OR COVER WORK UNTIL APPROVAL IS GRANTED. -THIS CARD MUST BE POSTED IN A CONSPICUOUS LOCATION, FRONT OF THE PREMISES IS BEST FOR MAKING ENTRY. -ALL PERMITS EXPIRE 180 DAYS AFTER THE PERMIT IS ISSUED OR 180 DAYS AFTER DATE OF LAST INSPECTION. -OWNER/AGENT IS RESPONSIBLE FOR REQUESTING ALL INSPECTIONS THROUGH FINAL INSPECTION. **THIS STRUCTURE MAY NOT BE USED OR OCCUPIED UNTIL ALL APPROVALS ARE GRANTED.** PRIOR TO CALLING FOR FINAL INSPECTION,ALL CONDITIONS OF THE PERMIT MUST BE MET Public Works Access/Driveway Other Health Septic Well Deptartment Planning Site Inspection Department Fire Marshall Fire Apparatus Access Fire Sprinkler Auto Fire Alarm Hood and Duct Other Final Building Department Building Official: Community Services Designee Concrete Setbacks ,S 23 2 a. Slab Footing Perimeter Point load Footing Footing Interior Footing Decks/Porches Foundation Stem Walls Other Rough-In Groundwork Plumbing Framing $ 23 Z Groundwork Mechanical Plumbing Groundwork Gas Pipe Mechanical Gas Piping Shear Wall Nailing Underfloor Other Insulation Slab Ceiling Floor Vaulted Ceiling Walls Vapor Barrier Other Wallboard Interior Wall Brace Panels Fire Walls Nailing Other Final Building 7 11621Z 3 Z-4, Manufactured Setbacks Setup Home Concrete Foot!Runners Final Other �- INSPECTION CARD Mason County N 615 W. Alder St. Building 8, Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov I J uP�Z��4-TE PERMIT# BLD2021-00347 PROJECT ADDRESS 140 N Discovery Dr Hoodsport, WA 98548 PARCEL# 423185000039 PROJECT DESCRIPTION DOCK REPLACEMENT OWNER PERRY ET UX EDWIN c ADDRESS DEBORAH S PETERSON PHONE 1.503.317.2299 CONTRACTOR ADDRESS PHONE CONTRACTOR LICENSE LENDER INSPECTION INSP DATE Comments INSPECTION INSP DATE Comments Setback Inspection Ttll� 5-/rIqz Progress Inspection Framing Inspection -L- I -I- BLD-Final Inspection Ta 7 to 7- F%-rw,l - CbwV,,, a- _ 5-/23/2-3 Sri ►4� Fc,u'6-t� Pc 5s - S/Z3/Z'S 56� t MASON COUNTY 360-427-9670 Shelton ext.352 COMMUNITY SERVICES 36 60-482-52 Belfair ext.352 360-482-5269 Elma ext.352 Building, Planning, Environmental Health,Community Health 615 W.Alder St.Bldg.8 - Shelton,WA 98584 www.masoncountywa.gov CORRECTION/INSPECTION REPORT PERMIT/CASE NUMBER: 3LO 2u 21 —OoSq`1 ADDRESS/LOCATION: Ilio tj FINDINGS: Pl.�.e.s.� rti�1r ?t ,�n.a D�,..c.. Ala�a..,.lt.a" o IbeL- rJ1�e�r JQ 1�aWWS �(yn0—4141 0a. 6 o V 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. © OK to o / ,D�4oS o12 aCon�a .t�sw�.r 44wi..! A �x4. Date: 5/23 I2 Please contact our office regarding possible Department: 3 LD structural damage incurred by recent "natural/man made"disasters.This is NOT a Inspector: �� CORRECTION NOTICE. DO NOT REMOVE THIS TAG MCC14.12 f Mason County Mason County - Division of Community Development 615 W. Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov B DD2021-00347 BULKHEAD OR DOCK- RESIDENTIAL PROJECT DESCRIPTION: DOCK REPLACEMENT ISSUED: 08/23/2022 SITE ADDRESS: 140 N DISCOVERY DR HOODSPORT EXPIRES: 07/30/2023 PARCEL: 423185000039 APPLICANT: PERRY ET UX EDWIN C OWNER: PERRY ET UX EDWIN C DEBORAH S PETERSON DEBORAH S PETERSON PORTLAND,OR 97202 PORTLAND,OR 97202 1.503.317.2299 VALUATIONS: FEES: Paid Due Project Valuation (BID, 25000.00 $25,000.00 Planning Review Fee $240.00 $0.00 ESTIMATION..) Plan Check Fee $269.73 $0.00 Technology Surcharge $13.69 $0.00 State Fee-Residential $6.50 $0.00 Building Permit Fee $414.97 $0.00 Total: $25,000.00 Totals : $944.89 $0.00 REQUIRED INSPECTIONS Setback Inspection Progress Inspection Framing Inspection BLD-Final Inspection CONDITIONS " All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or regulation, must be reviewed and approved by Mason County prior to construction. * All other necessary permits from Mason County, Washington State and/or Federal Agencies that are required for this proposed development and construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. Printed by:Nikita Huckabey on:05/22/2023 04:19 PM Page 1 of 3 Mason County Mason County - Division of Community Development 615 W. Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov BULKHEAD OR DOCK- RESIDENTIAL BLD2021-00347 OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. * Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. * All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may grant a one time extention of 180 days, upon the receipt of a written extension request prior to permit expiration. Letter must indicating that circumstances beyond the control of the permit holder preventing action from being taken. No more than one extension may be granted. * Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28 and 14.17. * Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). * All construction must meet or exceed all local and state ordinances in addition to the International Codes requirements as adopted and amended by Mason County and the State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit revocation. * Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted. * Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your"Approved Site Plan"to ensure these structures are shown and meet the setback conditions listed. * All building permits shall have a final inspection performed and approved by Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason County ordinances and building regulations. * All surface water and potential runoff must be controlled on site and shall not adversely affect any adjacent properties nor increase the velocity flow entering or abutting to any state or county culverting/ditching system or road way. * The foundation/footing must be placed on undisturbed, firm-native soil. * The stamped approved site plan is required to be on-site for inspection purposes. If an inspection is requested and the approved site plan is not on site, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted. * Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material. Printed by:Nikita Huckabey on:05/22/2023 04:19 PM Page 2 of 3 i Mason County Mason County - Division of Community Development 615 W. Alder St. Building 8 Shelton, WA 98584 360-427-9670 ext 352 www.masoncountywa.gov BULKHEAD OR DOCK- RESIDENTIAL BLD2021-00347 * Dock must be located at least 5 feet from side property line * Developers and individuals shall be required to control erosion during construction. Removal of vegetation shall be avoided, and any areas disturbed should be restored to prevent erosion and other environmental impacts. Erosion control methods shall be maintained to avoid fish stranding. * The provisions and recommendations of the Habitat Management Plan shall be enacted. The planting plan listed therein shall be enacted. A monitoring plan shall be enacted whereby a report detailing the condition of the restoration area shall be submitted. This report shall be due on the anniversary date of the issuance of the permits and shall be submitted annually for three years. A survival rate of 80% of plantings is required each year during the three-year monitoring period. If survival falls below 80%, the applicant shall replant to restore the required survival percentage and shall extend the monitoring report the necessary period to address the re-plantings. * A Hydraulic Project Approval from the Washington State Department of Fish and Wildlife must be granted prior to commencing work. wdfw.wa.gov * A Department of the Army permit shall be obtained prior to the performance of any activities waterward of the mean higher high water mark or ordinary high water mark or in wetlands. Please contact the US Army Corps of Engineers, Regulatory Branch, P.O. Box 3755, Seattle, WA 98124. * Must adhere to all conditions within the shoreline permit SHR2021-00007 and adhere to the SMP. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Laws and Ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state/local law regulating construction or the performance of construction. Issued By: Contractor or Authorized Agent: Date: Printed by:Nikita Huckabey on:05/22/2023 04:19 PM Page 3 of 3 r 'P Mason County Mason County - Division of Community Development 615 W. Alder St. Bldg.8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us B DD2021-00347 BULKHEAD OR DOCK- RESIDENTIAL PROJECT DESCRIPTION: DOCK REPLACEMENT ISSUED: 08/23/2022 SITE ADDRESS: 140 N DISCOVERY DR HOODSPORT EXPIRES: 02/19/2023 PARCEL: 423185000039 APPLICANT: PERRY ET UX EDWIN C OWNER: PERRY ET UX EDWIN C DEBORAH S PETERSON DEBORAH S PETERSON PORTLAND, OR 97202 PORTLAND, OR 97202 1.503.317.2299 VALUATIONS: FEES: Paid Due Project Valuation (BID, 25000.00 $25,000.00 Planning Review Fee $240.00 $0.00 ESTIMATION..) Plan Check Fee $269.73 $0.00 Technology Surcharge $13.69 $0.00 State Fee-Residential $6.50 $0.00 Building Permit Fee $414.97 $0.00 Total: $25,000.00 Totals : $944.89 $0.00 REQUIRED INSPECTIONS Setback Inspection Foundation Wall-Pre-Pour Inspection Footing Inspection BLD-Final Inspection CONDITIONS All changes to"approved" building plans that effect compliance with the international codes as amended and adopted, or any other Mason County ordinance or regulation, must be reviewed and approved by Mason County prior to construction. All other necessary permits from Mason County, Washington State and/or Federal Agencies that are required for this proposed development and construction must be obtained PRIOR TO SAME DEVELOPMENT AND CONSTRUCTION. Printed by:Amber Selby on:08/23/2022 01:18 PM Page 1 of 3 Mason County Imo' Mason County - Division of Community Development s 615 W. Alder St. Bldg.8 rr Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us BULKHEAD OR DOCK- RESIDENTIAL BLD2021-00347 OWNER/BUILDER acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner, owners legal representative, or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties, including any easement holder or parties of interest regarding this project. The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null & void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALIDATE THE APPLICATION. * Contractor registration laws are governed under RCW 18.27 and enforced by the WA State Dept of Labor and Industries, Contractor Compliance Division. There are potential risks and monetary liabilities to the homeowner for using an unregistered contractor. Further information can be obtained at 1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. * All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may grant a one time extention of 180 days, upon the receipt of a written extension request prior to permit expiration. Letter must indicating that circumstances beyond the control of the permit holder preventing action from being taken. No more than one extension may be granted. * Owner/Agent is responsible to post the assigned address and/or purchase and post private road signs in accordance with Mason County Title 14.28 and 14.17. * Concrete used for basement walls, foundation walls, exterior walls, porches, carport slabs, steps exposed to the weather, garage floor slabs and other vertical concrete work exposed to the weather shall have a minimum compressive strength of 3000 psi (IRC Table R402.2). * All construction must meet or exceed all local and state ordinances in addition to the International Codes requirements as adopted and amended by Mason County and the State of Washington. Occupancy is limited to the approved and permitted classification. Any non-approved change of use or occupancy would result in permit revocation. * Any changes in proposed construction shall be reviewed by the engineer or architect of record and submitted in writing to the Mason County Building Department prior to construction. All engineering and/or architectural documents are a part of the approved set of plans and shall remain attached thereto. If documents are removed, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted. * Landings and stairs must meet the same setback conditions as any permitted structure; and, must be shown on your site plan. Please check your"Approved Site Plan"to ensure these structures are shown and meet the setback conditions listed. * All building permits shall have a final inspection performed and approved by Mason County Building Department prior to permit expiration. The failure to request a final inspection or to obtain approval will be documented in the legal property records on file with Mason County as being non-compliant with Mason County ordinances and building regulations. * All surface water and potential runoff must be controlled on site and shall not adversely affect any adjacent properties nor increase the velocity flow entering or abutting to any state or county culverting/ditching system or road way. * The foundation/footing must be placed on undisturbed, firm-native soil. * The stamped approved site plan is required to be on-site for inspection purposes. If an inspection is requested and the approved site plan is not on site, approval will not be granted. In addition, a re-inspection fee (refer to current fee schedule, minimum 1 hour)will be charged and shall be collected by the Building Department prior to any further inspections being performed or approvals granted. * Pressure treated wood manufactured after January 1, 2004 may contain high concentrations of copper which could quickly corrode metal fasteners, connectors, and flashing. Install metal connectors approved for contact with the new types of pressure treated material. Printed by:Amber Selby on:08/23/2022 01:18 PM Page 2 of 3 r � Mason County 4 Mason County - Division of Community Development 615 W. Alder St. Bldg.8 Shelton, WA 98584 360-427-9670 ext 352 www.co.mason.wa.us BULKHEAD OR DOCK- RESIDENTIAL BLD2021-00347 • Dock must be located at least 5 feet from side property line • Developers and individuals shall be required to control erosion during construction. Removal of vegetation shall be avoided, and any areas disturbed should be restored to prevent erosion and other environmental impacts. Erosion control methods shall be maintained to avoid fish stranding. " The provisions and recommendations of the Habitat Management Plan shall be enacted. The planting plan listed therein shall be enacted. A monitoring plan shall be enacted whereby a report detailing the condition of the restoration area shall be submitted. This report shall be due on the anniversary date of the issuance of the permits and shall be submitted annually for three years. A survival rate of 80% of plantings is required each year during the three-year monitoring period. If survival falls below 80%, the applicant shall replant to restore the required survival percentage and shall extend the monitoring report the necessary period to address the re-plantings. " A Hydraulic Project Approval from the Washington State Department of Fish and Wildlife must be granted prior to commencing work. wdfw.wa.gov " A Department of the Army permit shall be obtained prior to the performance of any activities waterward of the mean higher high water mark or ordinary high water mark or in wetlands. Please contact the US Army Corps of Engineers, Regulatory Branch, P.O. Box 3755, Seattle, WA 98124. " Must adhere to all conditions within the shoreline permit SHR2021-00007 and adhere to the SMP. I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of Laws nd Ordinances governing this type of work will be complied with whether specified herein no The grantin a permit does not presume to give authority to violate or cancel the provisio of ny ther st /I aw regulating construction or the performance of construction. Issued Contractor or Authorized Agent: Date: O ?3 Printed by:Amber Selby on:08/23/2022 01:18 PM Page 3 of 3 _ ' ��� Pw�s R�v�a 7��e� � gUD?-o21 - 003�`7 4 �e.rY� � C-Dw"VI EASLEY NGINEERING 7135 501h Ave NE Olympia WA 98516 DESIGN MOBILE:(206)423-8907 andrew@easley-engineering.com Perry/Peterson Float May 8, 2023 Replacement Project 140 N Discovery Drive Hoodsport, WA 98548 Subject:Helical Pile Instillation Inspection To Whom it May Concern, This letter is to inform the interested parties that the items listed below were inspected as part of the special inspection requirements per the International Building Code,Chapter 17, in specific, part 1705.9.These items were inspected and confirmed to be incompliance with the contract documents. a. Helical Pile Foundations The contractor supplied the engineer of record with the following information: a. Equipment used for installation b. Test pull data at over 3000 lbs. of force which results in the following when compared to original design values: a. Small floats=factor of safety of 2.4 b. Large float=factor of safety of 2.9 c. Pile dimension, length and auger diameter d. Pile penetration at 48"through backfilling and compacted with additional 12"diameter plate 12" down from the surface (encountered difficult driving conditions) e. Pile installation location relative to permitted foundation plan (no exceptions taken to pile location, see attached pictures). After reviewing the above information with respect to the approved, permitted and designed contract documents,the engineer of record has no exceptions to the pile installation construction. Please see attached for photo references of as built conditions after pile installation. If any questions or concerns arise from the reviewing agencies, please feel free to contact me at any time during normal business hours. Sincerely, OCtc`W PEAS C1�pF W_A3Hi �Fl P -O 53722 2: �Oc,rgG�URAL ENG����\��`V Andrew Easley, P.E.,S.E. �SSIoNALENG Owner, Easley Engineering& Design Engineer of Record (206)423-8907 www.EASLEYENGINEERINGDESIGN.COM - _ i'`�•�r"o--♦�..LL �..li•� i•�'�°art..,�"�['15..i--,J';'.al� f+*2'�j'�`__�F. .if�TY4�FC� i'�d+}.. /F - ..•gl br��_, �•�.,� x,. �..'� � t art a.., e y-`. -} t _ - f *rr- '"' d•,t-tr _ .` -i w `., ' c*,c a i a�04 r_ - a'a f s- >�• + 4y''�1,, a i•, J Cy,, .! - r'J �; �w+rP"=�.^ �m•�JiA ,M�. .� �..r-- p+.M,.' �M+,lM 1rF'�' P P4 � �L.�S + t1f "• _2: ,r,f 7` r LV 7+^�.«. ` , e J,,� _f fy .ep.r r_': �q�yb.�,f 1,pvF+/�_♦� M -01 . *i' ��r�~y �� a� ,�'♦♦~Y ��• �.�.`^,yTf� ��`,'d�r#�{.,/�' ! �' Y'.t 1r J. A �• { ��.� -,r ""Zy�'� _�•t �i..r + -, j X �F y.�. - I/T - �' .LJ_r� f _ mow:��`-.�T" .� '3►•t:'F. �� ¢� �,} g g-, �.�` _ '> . t`''h ��r.,7 ` ♦ '+rid�, ff a`• ♦1` ', �° +,�,r :-dc, • .r ,/(fY y I• +1 s� _ � � -• +�}, r.x` , ' .=X '-t. ,�, 1�. ,,� tig,. .ar- .S Y �g*. F•,. �+ s+. � r. L _i �`• ... r.`. i r.. *� fit_ jrF f _ mayyy.�•1'�`:ar' ti �7J+t St ti�� t �tM► � _, �.- Tk� " ,}EaT •.'s_�i�'�°tir,'t+'.s•2 a�1lIL�at:'� �. �+�c,{t j�',�[r�,�} , '^E '�.y.�a r - 3 , an IL 14 �•' i= '' ♦wm +f y 47 • 0,0 •_„� „ f � t iP� f � � v Y op to- , 1 t' i 6 C6 t Ic, : s.' r�.,r Yam+ r �_ '� `•� t t�~ AA •i w kq`{�. W!0!0 F' n a► O* �� ` - d �, � ♦fir +,-<. ` ,,,�� � � ~ r .ilk'F ii i � ` } "- ,� A .• -.i' '�'�. `/ .+-'�' }`.,. :.«'e'er :. �`` 4y"# t '1-+'� �-fd F�6•�•• l Tt 1'� ,�a.�-m�,*,„���4, 2 L �'ii�rJ ems$�� Y fee ~r_ fi. r ��-°•q t .`�'"' a.�'?ita'"yam, - ♦{t A ;° .� a �'' J�i,,� + f� }1Tr`'y' Zp T ✓1� 3 71 3 ti 4+ Mason County Community Services Building Division . ' SPECIAL INSPECTION & 615 W Alder Street Shelton, WA 98584 TESTING AGREEMENT 36Q.427.9670 ext. 352 www.co.mason.wa.us (All references are per the 2015 International Building Code) Project Name: Perry Dock Project Address: 140 N Discovery Drive, Hoodsport WA 98548 Building Permit Number: 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/Cert.No. ❑ Unapproved Fabricators(IBC 1704.2.5) Other than Structural Steel(IBC Table 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 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 I Mason County Community Services Building Division *� SPECIAL INSPECTION & 615WA/derStreet Shelton, WA 98584 TESTING AGREEMENT 360.427.9670 ext. 352 www,co.mason.wo.us GENERAL SPECIAL INSPECTION ITEMS (per IBC Chapter 17)-continued [Only checked items are 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) ❑ Cast-in-place Deep Foundations(IBC Table 1705.8) �l Helical Pile Foundations(IBC 1705.9) Easley Eng & Dsn Andrew Easley 53722 ❑ Sprayed Fire-Resistant Materials(IBC 1705.13) ❑ Mastic&Intumescent Coatings(IBC 1705.14) Owner can choose other if desired I Materials Testing El in Olympia ❑ 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&Eiectrical Components(1705.11.4) ❑ Architectural Components(IBC 1705.11.5) ❑ Storage Racks(IBC 1705.11.7) Page 2 of 3 Mason County Community Services Building Division SPECIAL INSPECTION & 515 W Alder Street Shelton, WA 98584 A TESTING AGREEMENT 350.427.9570 ext. 352 www.co.mason.wa.us Declaration by Architect/Engineer I, the design professional in responsible charge for this project, declare that the ORS P Eqs< above listed special inspectioi i and structural testing items are required for this Q��0� W� /y �'J_ pro"g accordance with IBC Chapter 17. 1 o 5.20.2021 gnature Date fl S 53722 T � S/ON AL S L 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 inspecti ns ructural testing for the project pursuant to IBC 1704.2. Lrb? Signa 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 I, the General Contractor of the project, agree to comply with the "Contractor Responsibility" items noted above. Signature Date Page 3 of 3 �ce..,�( SrIZSIZs T�. ASLEY NGINEERING 7135 501h Ave NE & Olympia WA 98516 MOBILE:(206)423-8907 DESIGN andrew@easley-engineering.com Perry/Peterson Float May 8,2023 Replacement Project 140 N Discovery Drive Hoodsport,WA 98548 Subject:Helical Pile Instillation Inspection To Whom it May Concern, This letter is to inform the interested parties that the items listed below were inspected as part of the special inspection requirements per the International Building Code,Chapter 17,in specific,part 1705.9.These items were inspected and confirmed to be incompliance with the contract documents. a. Helical Pile Foundations The contractor supplied the engineer of record with the following information: a. Equipment used for installation b. Test pull data at over 3000 lbs.of force which results in the following when compared to original design values: a. Small floats=factor of safety of 2.4 b. Large float=factor of safety of 2.9 c. Pile dimension,length and auger diameter d. Pile penetration at 48"through backfilling and compacted with additional 12"diameter plate 12" down from the surface(encountered difficult driving conditions) e. Pile installation location relative to permitted foundation plan(no exceptions taken to pile location, see attached pictures). After reviewing the above information with respect to the approved,permitted and designed contract documents,the engineer of record has no exceptions to the pile installation construction. Please see attached for photo references of as built conditions after pile installation. If any questions or concerns arise from the reviewing agencies,please feel free to contact me at any time during normal business hours. Sincerely, SEW P E'4S ��OF WA `FL Vim✓" � 2 a 53722 P P Andrew Easley,P.E.,S.E. o�Fs3/0NALENG\� Owner,Easley Engineering&Design Engineer of Record (206)423-8907 www.EASLEYENGIN EERING DESIGN.COM • • 7 + .M„ .. ti '- /art �� •" p�-�' � fr �• :$ ,Y lbp s 01, Or S a,�''��.�,' ^' '. �' ."•�Y _'�-*- '.- �� :f. f •; � � � ^ ' ' ;• ' ►, r. �V it '.,� ��� '� :� .•t+TL�. _ t7 'Y,� Sri w. *� i R • r � ,' k>« 'Y ' ! f rrF rOr��- �NX� +�F'� s�t Y�+R ! i r p � 44 1 r:IK _. Jo Oil- F _ z a 'S y. 1p y �, Ir - a��� ,y� ��"„� �o i�1,l�•. Y aka' {1 • C+ 9 T1 ��-,_ 3. -� .e�f�l`, C�`� �<�tt",�..;,• k�.lf��a d. '� � r.: 4 *� �'��t �7' ���^�' * � ! �� �h � � N �, •wr a �i`.. � R b~ � �r ,N� s�,}.• Y r A .i.T ; j. 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