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HomeMy WebLinkAboutCOM2012-00120 Replace Antenna and Equipment and Special Inspection - COM Permit / Conditions - 11/14/2012 NoMASON COUNTY DEPT. OF COMMUNITY DEVELOPMENT Inspection Line (360)427-7262 Mason County Bldg. 3 426 W. Cedar P.O. Box 186 Phone: (360)427-9670, ext. 352 Shelton, WA 98584 t COMMERCIAL BUILDING PERMIT COM2012-00120 OWNER: SPRINT SPECTRUM RECEIVED: 10/4/2012 CONTRACTOR: LICENSE: EXP: ISSUED: 11/14/2012 SITE ADDRESS: 19941 E STATE ROUTE 3 ALLYN EXPIRES: 5/14/2013 PARCEL NUMBER: 122172200032 LEGAL DESCRIPTION: N 1/2 NW 1/4 EX ST R/W TR B SURVEY 9/137 PROJECT DESCRIPTION: DIRECTIONS TO SITE: ON EXISTING CELL TOWER, REPLACE ANTENNAS, NEW One mile north of Allyn on SR 3 MICROWAVE CONE, AND ASSOCIATE EQUIPMENT CABINETS General Information Construction &Occupancy Information No. of Units: Type of Constr.: Type of Use: Insp. Area: No. of Bathrooms: Occ. Group: Type of Work: ALT Fire Dist.: 5 Valuation: $ 20,000.00 No. of Stories: Exit Design. Load: Building Height: Pre-Manufactured Unit Information Square Footage Information Make: Length: Lot Size: Model: Width: Building: Year: Serial No.: Basement: Parking Spaces: Setback Information Shoreline& Planning Information Front: E 475.00 Ft. Shoreline: Ft. Rear: W 48.00 Ft. Slope: Ft. Water Body: Shoreline Desig.: Side 1. N 182.00 Ft. SEPA?:No Comp. Plan Desig.: Rural Side 2: S 119.00 Ft. Fire Protection System Information Auto Fire Alarm System?: Emergency Key Box?: Standpipe?: Auto Fire Sprinkler System?: Access Road?: Fire Extinguishers?: Fixed Fire Suppression System?: Fire Hydrants?: Fire Lanes?: COM2012-00120 Please refer to the following pages for conditions of this permit. Page 1 of 5 Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee TVN 1nlAl?n19 A?nA R1 C?9n1?nn Planning Review Fee TIN lniAl9nl? 1;'iAn nn g99n19nn Building State Fee I AIN 1n/?R/9n1 _d x;n S17n1?nn Building Permit Fee I AIN 1n/7R/?n1 ?x, C12n17nn Total $864.56 CASE NOTES FOR COM2012-00120 CONDITIONS FOR COM2012-00120 1) 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 1-800-647i'/�-C-- person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 2) 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. X - 3) Approve er dimensions and.-setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 4) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters or properties. Straw matting or silt fencing must be installed and maintained until upland vegetation has become established. X 5) The ro �I shall be in full compliance with the Mason County Cell Tower Ordinance#5-98 (Revised by Ord. No. 53-04). X _ /� a The design of the equipment buildings and related structures shall, to the extent possible, use ma rials, colors, textures, screening and landscaping that will blend the tower facilities to the natural setting and built environment. X 6) All construction and demolition debris must be removed from the shore area after project completion. Proper di�papialconstruction debris must be on land in such a manner that debris cannot enter or cause water quality degradation of State waters. X 7) All approved plans are required to be on-site for inspection purposes. If inspection is called for and plans are not on site, Approval WILL NOT be granted. In addition, a reinspection fee, based on the current fee schedule, minimum one-hour wi I b arged and collected by the Mason County Building Department prior to any further inspections being performed or approvals granted. X COM2012-00120 Page 2 of 5 61 In addition to the inspections required in IBC, Section 109, the owner, the engineer or architect of record acting as the owner's agent shall employ one or more special inspectors who shall provide inspections during construction on the types of work listed under Chapter 17 and as specified by the design professional. The special inspectors duties & responsibilities shall be as specified in Chapter 17. Special inspection reports shall be submitted to the Mason County Building Department, PO Box 186, Shelton WA 98584 and available for inspection. Inspection reports shall be completed and submitted to the dept. in a timely manner and shall be submitted prior to the framing and Xa� pancy inspections. 9) Any changes in construction shall be reviewed by engineer of record and submitted in writing to the Mason County Building Department prior to construction. All engineering documents are a part of the approved set of plans and must remain attached thereto. If engineering documents are removed, approval will not be granted. In addition, a reinspection fee, based on the current fee schedule, minimum one-hour will be charged and col lec y the Mason County Building Department prior to any further inspections being performed or approvals granted. X 10) ALL CONSTRUCTION MUST MEET OR EXCEED ALL LOCAL CODES AND THE INTERNATIONAL CODE REQUIREMENTS AND OCCUPANCY IS LIMITED TO THE PERMITTED AND APPROVED CLASSIFICATION. ANY CHANGE OF USE OR OCCUPANCY WOULD RESULT IN PERMIT REVOCATION. CHANGE OF USE MUST BE APPROVED PRIOR TO CHANGE. x� rC 11) Changes to approved building plans that affect compliance to the current Washington State Energy Code (WSEC), ventilationrequirements), Buildin 2bing/Mechanical Codes and/or Mason County Regulations shall be approved prior to construction. X CC.�. 12) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPTED BUILDING CODE. The construction of the permitted project is subject to inspections by the Mason County Building Department. All construction must be in conformance with the international codes as amended and adopted by Mason County. Any corrections, changes or alterations required by a Mason Coun ilding Inspector shall be made prior to requesting additional inspections. X 13) All property lines shall be clearly identified at the time of foundation inspection. X 14) All building permits shall have a final inspection performed and approved by the 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-com, pliant with Mason County ordinances and building regulations. X _jam:� 15) All permits expire 180 days after permit issuance, or 180 days after the last inspection activity is performed. The Building Official may extend the time for action for a period not exceeding 180 days, upon the receipt of a written extension request indicating that circumstances beyond the control of the per o der have prevented action from being taken. No more than one extension may be granted. X 16) A copy of cial inspection report is required to be provided on site at the time of the final inspection By Mason County. X L� COM2012-00120 Page 3 of 5 This permit becomes null and void if work or construction authorized is not commenced within 180 days, or if construction or work is suspended for a period of 180 days at any time after work is commenced. Evidence of continuation of work is a progress inspection within the 180 day period. Final inspection must be approved before building can be occupied. Proof of continuation of-AQrk is by means of a progress inspection.The owner or the agent on the owners behalf, represents that the information provided is accurate and grants employees WM son County access t above described property and structure for r vie and inspection. OWNER OR A EG NT: DATE: I COM2012-00120 Page 4 of 5 n 0 CA iz CONCRETE MECHANICAL MANUFACTURED HOME Date By Iv Footings I Setbacks Ribbons z Gas Piping C) Interior Date By Interior-Date By Date By C? Exterior Date By Exterior-Date By C) Set-up M Point Load I Isolated Footings INSULATION BG I SLAB INSULATION Date 0 Date By Datij By FIRE DEPARTMENT C: Foundation Walls Floors Date Date By Date By DECKS FRAMING Walls Date B Date By Date y PROPANE TANKS PLUMBING Vault Date Date By OTHER Groundwork AM Uatc By Date b Type: Dale 13 13MV DRYWALL Type- 0 Int.Brace Wall Date By 0 Date y Date S y 9 FINAL INSPECTION 1%j Water Line Fire Soperation Dale D itu By Dale B V Ok IV 6 CD Pass or Request Inspect. Type of Insp. Fail Date Date Done By Comments Ptom✓5 LAO 1C_ (D Cn 0 Cn Permit �� - /40 , MASON COUNTY BUILDING III 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 19�?91 Cr --554 jC�, This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items listed below must be corrected to gain compliance / 6 L r 2 f r You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ please contact our office Make corrections, items will be checked on next inspection regarding possible structural OK to damage incurred by recent "natural/man made" This is not a complete inspection Qn%— �t, disasters.This is NOT Date G,-Q-// Department `✓ CORRECTION NOTICE. Inspector Z2� 1A f1* 4 NOT , iill� V4 ; ' TH/ T 11%X ATC MASON COUNTY DEPARTMENT OF 04I'Y12Di2. COMMUNITY DEVELOPMENT 426 West Cedar Street ♦ PO Box 186 ♦ Shelton,WA 98584 (360) 427-9670 EXT. 352 FAX(360)427-7798 HOME PAGE—www.co.mason.wa.us Special Inspection Authorization Project Owner �22g 4 T Building Permit Number b Project Address 104YI e, 5l+TF ,ATE 3 Engineer/Architect of record i} AZ44/'T'EG73; In addition to the inspections required by International Building Code (IBC) Section 109, the owner or the engineer or architect of record acting as the owner's agent shall employ one or more special inspectors who shall provide special inspections during construction on the types of work listed under IBC Section 1704. This form must be completed by the owner or the engineer or architect of record, prior to permit issuance, indicating who will perform the required special inspections for this particular project. The specified special inspector(s) shall perform the required special inspections during construction of the project, submit all inspection reports to the Building Department and provide a final signed report stating whether the work requiring special inspection was, to the best of the inspector's knowledge, in conformance to the approved plans and specifications and the applicable workmanship provisions of the IBC. The following checked items require special inspection: 1. Concrete. During the taking of test specimens and placing of reinforced concrete. (IBC 1704.4) 2. Bolts installed in concrete. Prior to and during the placement of concrete around bolts when stress increases permitted by Table 1912.2 and section 1912.5 are utilized. (IBC 1704.4) 3. Erection of precast concrete members. Periodic inspection per ACI 318:Ch 16. (IBC 1704.4) 4. Shotcrete. Continuous inspection per ACI 318: 5.9, 5.10 and IBC Chapter 19. (IBC 1704.4) 5. Reinforcing steel and prestressing steel tendons. Inspection of reinforcing steel including prestressing tendons. (IBC 1704.4) 6. Welding of reinforcing steel. Inspection of the welding of reinforcing steel according to AWS D1.4,ACI 318:3.5.2, and IBC 1903.5.2. (IBC 1704.4) 7. Structural welding. Welding inspection shall be in compliance with AWS D1.1. (IBC 1704.3.1) 8. High-strength Bolting. The installation of high-strength bolts shall be periodically inspected in accordance with AISC LRFD Section M2.5. (IBC 1704.3.3) 9. Structural Masonry. Masonry construction shall be inspected and evaluated with the requirements of IBC section 1704.5. 10. Soils. Inspections for fills 12 inches or greater to be performed in accordance with IBC Section 1704.7. 11. Pile foundations. Inspector to be present when pile foundations are being installed and during tests. (IBC 1704.8) 12. Pier foundations. Special inspection of pier foundations for buildings are required in seismic Zone D. (IBC 1704.9) 13. Spray-applied fire resistant materials. Inspections shall be in accordance with sections 1704.11.1 through 1704.11.5. 14. Exterior insulation finish system(EIFS). Special inspection shall be required for all EIFS systems. (IBC 1704.12) Continued on reverse side 15. Smoke-control system. Smoke control systems shall be tested by a special inspector per IBC Section 1704.14, 16. Special cases. Special inspection shall be required for proposed work that is, in the option of the building official, unusual in its nature such as alternative methods and material of construction, unusual design applications, and materials and systems required to be installed in accordance with additional manufacturer's instructions that prescribe requirements not contained in the IBC or referenced standards. Installation of structural epoxies Installation of"high-load shear panels" Structural Observation (IBC1709) Other: Special Inspector Selection: The special inspection agency and special inspector shall be registered by the Washington Association of Building Officials (WABO)for the particular type of construction or operation requiring special inspection. Such inspector(s) shall be selected by the owner or the owner's agent and approved by the Building Official prior to issuance of the building permit. The owner's agent shall not be acting as,or employed by the special inspection agency or the contractor for this project. Name of Special Inspector or Agency: Type of Inspection: Registration Number: Authorization: I hereby state that I am the legal owner of the project property, or that I am the legal owner's agent who is not employed by a special inspection agency or contractor associated with this project. In addition, I agree to comply with the special inspection requirements established by Chapter 17 of the International Building Code as adopted by Mason County. Signature Printed Name Owner Agent Date PURPOSE OF SPECIAL INSPECTION Special inspection is the monitoring of materials and workmanship which are critical to the integrity of the building structure to assure that the approved plans and specifications are being followed and that relevant codes are being observed. Special inspections are in addition to those conducted by the county building inspector and by the engineer or architect of record. Special inspectors furnish inspection at all times that their presence is required by the code,the plans and specifications, and the enforcing jurisdiction. Good communication between the special inspector and the designer, contractor, and building department is essential. DUTIES AND RESPONSIBILITIES OF THE SPECIAL INSPECTOR: Special inspectors are individuals with highly developed, specialized skills who observe those critical building or structural features which they are qualified to inspect. Duties of special inspectors and/or inspection agencies include the following: 1. General Requirements Special inspectors shall review approved plans and specifications for special inspection requirements. Special inspectors shall comply with the special inspection requirements of the enforcing jurisdiction. 2.Signify Presence at Job Site Special inspectors should notify contractor personnel and the enforcing jurisdiction of their presence and responsibilities at the job site. 3.Observe All Work for Which They Are Responsible Special inspectors shall inspect all work and perform or observe all tests requiring inspection and testing for conformance with the building-department-approved(stamped)drawings, specifications and applicable provisions of the code. MASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 426 West Cedar Street ♦ PO Box 186 ♦ Shelton, WA 98584 (360) 427-9670 EXT. 352 FAX (360) 427-7798 HOME PAGE—www.co.masonma.us Special inspection policy Scope: To ensure compliance with all provisions of Local, State and International Building Codes in addition to all jurisdictional policies. Responsible Party: The owner or registered design professional acting as the owners agent is responsible to obtain, and have pre-approved by the jurisdiction, any and all Special Inspection Agencies and/or persons employed by such. Policy: Mason County allows two methods in which compliance may be obtained. Please read the following options carefully when choosing your method of compliance and special inspection agency: JOption I: Registration with WABO (Washington Association of Building Officials) The WABO registration gives the jurisdiction the assurance that the individual and or agency has met certain criteria and that the criteria is maintained. See WWW.WABO.ORG for listing of approved individuals or agencies. 70ption II: Mason County will approve an individual or company,to perform inspections upon demonstration of competence for the particular type of construction or operation requiring special inspection. As proof of competence the individual or company will need to conform to all of the following criteria and provide supporting documentation. A.)Provide the name of the individual that will perform the particular type of inspection along with documents demonstrating competency including copies of all certifications and registration numbers pertinent to the inspection type. Examples: (ICC, ICBO,NICET,AWS) WA. State licensed Structural/Civil Engineers or Architects may also be accepted. B.)When laboratory testing and field inspection equipment will be required provide details of specific tests, the quality of the system,procedures to ensure test are performed properly and all policies for recording,reviewing and performing such test.An equipment log must be maintained and available for review. All calibration maintenance records must be traceable to the National bureau of Standards,calibrations must be performed frequently as set up per the standards. C.)When all required information has been submitted staff will review documentation and approve the acceptability of the special inspection competency or request additional information as deemed necessary. Authorization Form: After selecting option I or II please complete the"Special Inspection Authorization"form and submit it to Mason County for initial review. Approved By: Mark Core Date: 10-02-07 4. Notification of Discrepancies Special inspectors shall bring all nonconforming items to the immediate attention of the contractor. If any such item is not resolved in a timely manner or is about to be incorporated in the work, the engineer or architect of record and the building official should be notified immediately by telephone or in person,and the item noted in the special inspector's written report. The special inspector shall write a separate report to be posted at the job site regarding noted discrepancies which should contain, as a minimum,the following information about each nonconforming item: • Description and exact location, • Reference to applicable detail of approved plans/specifications, • Name and title of each individual notified and method of notification, and • Resolution or corrective action. 5. Reports A. Inspection reports The special inspector should complete written inspection reports for each inspection visit and provide the reports on a timely basis determined by the building official. The special inspector or inspection agency shall furnish these reports directly to the building official, engineer or architect of record, and others as designated. These reports should be organized on a daily format and may be submitted weekly at the option of the building official. In these reports, special inspectors should: • Describe inspections and tests made with applicable locations; • List all nonconforming items; • Indicate how nonconforming items were resolved; • List unresolved items, parties notified, and time and method of notification; and • Itemize changes authorized by the architect/engineer of record and approved by the building department, if not included in the nonconformance items. B. Final reports Special inspectors or inspection agencies shall submit a final,signed report to the building department stating that all items requiring special inspection and testing were fulfilled and reported and,to the best of their knowledge, in conformance with the approved design drawings, specifications, approved change orders and the applicable provisions of the code. Items not in conformance,unresolved items or any discrepancies in inspection coverage(i.e., missed inspections, periodic inspections when continuous was required, etc.)should be specifically itemized in this report. DUTIES AND RESPONSIBILITIES OF THE CONTRACTOR: The contractor's duties include responsibility for notifying the special inspector or agency regarding individual inspections required by the Building Department, or required by the International Building Code, Chapter 17. Adequate notice shall be provided so that the special inspector shall have appropriate access to the approved plans at the job site prior to the required inspection. The contractor shall not perform any work that requires special inspection without the special inspector present. Completion of this form, and the performance of special inspections does not relieve the contractor's responsibility to schedule required inspections by the Mason County Building Department prior to concealing any work. DUTIES AND RESPONSIBILITIES OF THE ENGINEER OR ARCHITECT OF RECORD: The engineer or architect of record is responsible for identifying which special inspections are necessary, developing a schedule of required special inspections, and assisting the owner in the selection of the special inspector. The engineer or architect or record shall review the special inspection reports to determine that all required special inspections have been performed and that all discrepancies (if any) have been resolved. DUTIES AND RESPONSIBILITIES OF THE PROJECT OWNER: The project owner,or the engineer or architect of record acting as the owner's agent,is responsible for the funding of all required special inspection activities in accordance with International Building Code Section 1704. I 15. Smoke-control system. Smoke control systems shall be tested by a special inspector per IBC Section 1704.14. 16. Special cases. Special inspection shall be required for proposed work that is, in the option of the building official, unusual in its nature such as alternative methods and material of construction, unusual design applications, and materials and systems required to be installed in accordance with additional manufacturer's instructions that prescribe requirements not contained in the IBC or referenced standards. Installation of structural epoxies Installation of"high-load shear panels" Structural Observation (IBC1709) Other: Special Inspector Selection: The special inspection agency and special inspector shall be registered by the Washington Association of Building Officials (WABO)for the particular type of construction or operation requiring special inspection. Such inspector(s) shall be selected by the owner or the owner's agent and approved by the Building Official prior to issuance of the building permit. The owner's agent shall not be acting as, or employed by the special inspection agency or the contractor for this project. Name of Special Inspector or Agency: Type of Inspection: Registration Number: Authorization: I hereby state that I am the legal owner of the project property, or that I am the legal owner's agent who is not employed by a special inspection agency or contractor associated with this project. In addition, I agree to comply with the special inspection requirements established by Chapter 17 of the International Building Code as adopted by Mason County. Signature Printed Name Owner Agent Date PURPOSE OF SPECIAL INSPECTION Special inspection is the monitoring of materials and workmanship which are critical to the integrity of the building structure to assure that the approved plans and specifications are being followed and that relevant codes are being observed. Special inspections are in addition to those conducted by the county building inspector and by the engineer or architect of record. Special inspectors furnish inspection at all times that their presence is required by the code,the plans and specifications, and the enforcing jurisdiction. Good communication between the special inspector and the designer, contractor, and building department is essential. DUTIES AND RESPONSIBILITIES OF THE SPECIAL INSPECTOR: Special inspectors are individuals with highly developed, specialized skills who observe those critical building or structural features which they are qualified to inspect. Duties of special inspectors and/or inspection agencies include the following: 1.General Requirements Special inspectors shall review approved plans and specifications for special inspection requirements. Special inspectors shall comply with the special inspection requirements of the enforcing jurisdiction. 2.Signify Presence at Job Site Special inspectors should notify contractor personnel and the enforcing jurisdiction of their presence and responsibilities at the job site. 3.Observe All Work for Which They Are Responsible Special inspectors shall inspect all work and perform or observe all tests requiring inspection and testing for conformance with the building-department-approved (stamped)drawings, specifications and applicable provisions of the code. 4kMASON COUNTY DEPARTMENT OF COMMUNITY DEVELOPMENT 426 West Cedar Street • PO Box 186 • Shelton,WA 98584 (360)427-9670 EXT.352 FAX(360)427-7798 HOME PAGE—www.co.mason.wa.us Special inspection policy Scope: To ensure compliance with all provisions of Local,State and International Building Codes in addition to all jurisdictional policies. Responsible Party: The owner or registered design professional acting as the owners agent is responsible to obtain,and have pre-approved by the jurisdiction,any and all Special Inspection Agencies and/or persons employed by such. Policy: Mason County allows two methods in which compliance may be obtained. Please read the following options carefully when choosing your method of compliance and special inspection agency: UOption I: Registration with WABO (Washington Association of Building Officials) The WABO registration gives the jurisdiction the assurance that the individual and or agency has met certain criteria and that the criteria is maintained. See WWW.WABO.ORG for listing of approved individuals or agencies. FlOption II: Mason County will approve an individual or company,to perform inspections upon demonstration of competence for the particular type of construction or operation requiring special inspection. As proof of competence the individual or company will need to conform to all of the following criteria and provide supporting documentation. A.)Provide the name of the individual that will perform the particular type of inspection along with documents demonstrating competency including copies of all certifications and registration numbers pertinent to the inspection type. Examples: (ICC, ICBO, NICET, AWS) WA. State licensed Structural/Civil Engineers or Architects may also be accepted. B.)When laboratory testing and field inspection equipment will be required provide details of specific tests,the quality of the system,procedures to ensure test are performed properly and all policies for recording,reviewing and performing such test. An equipment log must be maintained and available for review. All calibration maintenance records must be traceable to the National bureau of Standards,calibrations must be performed frequently as set up per the standards. C.)When all required information has been submitted staff will review documentation and approve the acceptability of the special inspection competency or request additional information as deemed necessary. Authorization Form: After selecting option I or II please complete the"Special Inspection Authorization"form and submit it to Mason County for initial review. Approved By: Mack Core Date: 10-02-07 4.Notification of Discrepancies Special inspectors shall bring all nonconforming items to the immediate attention of the contractor. If any such item is not resolved in a timely manner or is about to be incorporated in the work, the engineer or architect of record and the building official should be notified immediately by telephone or in person,and the item noted in the special inspector's written report. The special inspector shall write a separate report to be posted at the job site regarding noted discrepancies which should contain, as a minimum,the following information about each nonconforming item: • Description and exact location, i • Reference to applicable detail of approved plans/specifications, • Name and title of each individual notified and method of notification, and • Resolution or corrective action. 5. Reports A. Inspection reports The special inspector should complete written inspection reports for each inspection visit and provide the reports on a timely basis determined by the building official. The special inspector or inspection agency shall furnish these reports directly to the building official, engineer or architect of record,and others as designated. These reports should be organized on a daily format and may be submitted weekly at the option of the building official. In these reports,special inspectors should: • Describe inspections and tests made with applicable locations; • List all nonconforming items; • Indicate how nonconforming items were resolved; • List unresolved items, parties notified, and time and method of notification;and • Itemize changes authorized by the architect/engineer of record and approved by the building department, if not included in the nonconformance items. B.Final reports Special inspectors or inspection agencies shall submit a final, signed report to the building department stating that all items requiring special inspection and testing were fulfilled and reported and,to the best of their knowledge, in conformance with the approved design drawings, specifications,approved change orders and the applicable provisions of the code. Items not in conformance,unresolved items or any discrepancies in inspection coverage (i.e., missed inspections,periodic inspections when continuous was required, etc.) should be specifically itemized in this report. DUTIES AND RESPONSIBILITIES OF THE CONTRACTOR: The contractor's duties include responsibility for notifying the special inspector or agency regarding individual inspections required by the Building Department, or required by the International Building Code, Chapter 17. Adequate notice shall be provided so that the special inspector shall have appropriate access to the approved plans at the job site prior to the required inspection. The contractor shall not perform any work that requires special inspection without the special inspector present. Completion of this form, and the performance of special inspections does not relieve the contractor's responsibility to schedule required inspections by the Mason County Building Department prior to concealing any work. DUTIES AND RESPONSIBILITIES OF THE ENGINEER OR ARCHITECT OF RECORD: The engineer or architect of record is responsible for identifying which special inspections are necessary, developing a schedule of required special inspections, and assisting the owner in the selection of the special inspector. The engineer or architect or record shall review the special inspection reports to determine that all required special inspections have been performed and that all discrepancies (if any) have been resolved. j DUTIES AND RESPONSIBILITIES OF THE PROJECT OWNER: The project owner,or the engineer or architect of record acting as the owner's agent, is responsible for the funding of all required special Inspection activities in accordance with International Building Code Section 1704. I i AT- SEF 7,7-kC MASON COUNTY DEPARTMENT OF m COMMUNITY DEVELOPMENT 426 West Cedar Street ♦ PO Box 186 ♦ Shelton, WA 98584 (360)427-9670 EXT.352 FAX(360) 427-7798 HOME PAGE—www.co.mason.wa.us Special Inspection Authorization Project Owner �2i rf T Building Permit Number 7-3b Project Address stay/ E- Engineer/Architect of record TEcTS 1411yw-h/64 057,y In addition to the inspections required by International Building Code (IBC) Section 109, the owner or the engineer or architect of record acting as the owner's agent shall employ one or more special inspectors who shall provide special inspections during construction on the types of work listed under IBC Section 1704. This form must be completed by the owner or the engineer or architect of record, prior to permit issuance, indicating who will perform the required special inspections for this particular project. The specified special inspector(s) shall perform the required special inspections during construction of the project, submit all inspection reports to the Building Department and provide a final signed report stating whether the work requiring special inspection was, to the best of the inspector's knowledge, in conformance to the approved plans and specifications and the applicable workmanship provisions of the IBC. The following checked items require special inspection: 1. Concrete. During the taking of test specimens and placing of reinforced concrete. (IBC 1704.4) 2. Bolts installed in concrete. Prior to and during the placement of concrete around bolts when stress increases permitted by Table 1912.2 and section 1912.5 are utilized. (IBC 1704.4) 3. Erection of precast concrete members. Periodic inspection per ACI 318:Ch 16. (IBC 1704.4) 4. Shotcrete. Continuous inspection per ACI 318:5.9, 5.10 and IBC Chapter 19. (IBC 1704.4) 5. Reinforcing steel and prestressing steel tendons. Inspection of reinforcing steel including prestressing tendons. (IBC 1704.4) 6. Welding of reinforcing steel. Inspection of the welding of reinforcing steel according to AWS D1.4, ACI 318:3.5.2, and IBC 1903.5.2. (IBC 1704.4) 7. Structural welding. Welding inspection shall be in compliance with AWS D1.1. (IBC 1704.3.1) 8. High-strength Bolting. The installation of high-strength bolts shall be periodically inspected in accordance with AISC LRFD Section M2.5. (IBC 1704.3.3) 9. Structural Masonry. Masonry construction shall be inspected and evaluated with the requirements of IBC section 1704.5. 10. Soils. Inspections for fills 12 inches or greater to be performed in accordance with IBC Section 1704.7. 11. Pile foundations. Inspector to be present when pile foundations are being installed and during tests. (IBC 1704.8) 12. Pier foundations. Special inspection of pier foundations for buildings are required in seismic Zone D. (IBC 1704.9) 13. Spray-applied fire resistant materials. Inspections shall be in accordance with sections 1704.11.1 through 1704.11.5. 14. Exterior insulation finish system(EIFS). Special inspection shall be required for all EIFS systems. (IBC 1704.12) Continued on reverse side Aw K ra, L ze a-n- & ASSOCIATES , INC . 4E0TE0HN1GAL ENGlNEER1NG • ENVIRONMENTAL EN61NEERlN4 CONSTRUCTION TEST(N4 & INSPECTION December 2,2014 Project No.: 106-14211 Mason County Debbra Coker PO Box 279 Shelton,WA 98584 Permit No.: COM2012 00120 RE: Final Letter Regarding Special Testing&Inspection SE72XCO32 19941 E State Rt.3 Dear Ms Coker: In accordance with our client's request and authorization, we have performed special testing and inspection services for the above referenced project.The special inspections for this project were: Special Inspection Required Performed Expansion/Epoxy Anchor Bolts Structural Steel: Bolting To the best of our knowledge, all work and noted deficiencies have been tested and/or inspected and have been found to be in accordance with the approved plans and specifications. If you have any questions or if we can be of further assistance, please do not hesitate to contact our office at (360)598-2126. Respectfully submitted, K AZAN&ASSOCIATES,INC. Jeff Bowers Construction Services Manager Poulsbo Division JMB/cq cc With Offices Serving The Western United States 1230 Finn Hill Road NW Suite A a Poulsbo,Washington 98370 a(360)598-2126 a Fax:(360)598-2127