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HomeMy WebLinkAboutCOM2004-00151 Replace Communication Tower - COM Permit / Conditions - 10/29/2004 MASON 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 Ir Shelton, WA 98584 pro COMMERCIAL BUILDING PERMIT COM2004-00151 OWNER: WASHINGTON STATE PATROL RECEIVED: 7/8/2004 CONTRACTOR: LICENSE: EXP: ISSUED: 10/29/2004 SITE ADDRESS: 631 W DAYTON-AIRPORT RD SHELTON EXPIRES: 4/29/2005 PARCEL NUMBER: 420023260010 LEGAL DESCRIPTION: TR 1 OF N1/2 SW 631 W DAYTON-AIRPORT RD SHELTON PROJECT DESCRIPTION: DIRECTIONS TO SITE: REPLACE AN EXISTING 100' COMMUNICATION TOWER US HWY 100 NORTHOUND, TURN LEFT ONTO W DAYTO AIRPORT RD, WITH A 155 SELF-SUPPORTING 3-LEG TOWER. ARRIVE AT 631 W DAYTON AIRPORT RD RELOCATE EXISTING MICROWAVE DISHES AND ANTENNAS FROM EXISTING TOWER TO NEW TOWER. General Information Construction &Occupancy Information No. of Units: Type of Constr.: I B Type of Use: Insp. Area:Type of Work: NEW Fire Dist.: 13 No. of Bathrooms: Occ. Group: U-1 Valuation: $ 120,000.00 No. of Stories: Occ. Load: Building Height: 115 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: Ft. Shoreline: Ft. Rear: Ft. Slope: Ft. Water Body: Shoreline Desig.: Side 1: Ft. SEPA?:Yes Comp. Plan Desig.: Urban Growth Area Side 2: 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?: COM2004-00151 Please refer to the following pages for conditions of this permit. 1 of 4 Plumbing Fixtures Mechanical Fixtures FEES Type Qty. Type Qty. Type By Date Amount Receipt Plan Check Fee KC 71Ai9nna P71A 7A g19nnAnn Planning Review Fee KC 7/A/7nna A955 nn g19nnAnn Public Works Review AT 4nn19nna -;4Q?? cwnnAnn Building State Fee NARrr 4ilaivnna U rn C9?nnAnn Building Permit Fee NAPr. Q/1A/9nna 01 1OF 7F C9?nnAnn Total $2,123.21 CASE NOTES FOR COM2004-00151 CONDITIONS FOR COM2004-00151 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 1-800-647-0982. The person signing this condition is either the homeowner, agent for the owner or a registered contractor according to WA state law. X 2) 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*will be charged and collected by the Mason County Building Department prior to any further inspections being performed or approvals granted. X ::� 3) PURSUANT TO INTERNATIONAL CODE, ALL SITES MUST HAVE APPROVED NUMBERS OR ADDRESSES PROVIDED IN SUCH A POSITION AS TO BE PLAINLY VISIBLE AND LEGIBLE FROM THE STREET OR ROAD FRONTING THE PROPERTY. MASON COUNTY BUILDING DEPARTMENT REQUIRES THAT THIS BE COMPLETED PRIOR TO CALLING FOR ANY SITE INSPECTIONS. A REINSPECTION FEE, BASED ON RATES AS ADOPTED BY THE JURISDICTION AND THE INTERNATIONAL CODE WILL BE ASSESSED IF OWNER/CONTRACTOR FAILS TO POST ADDRESS ON SITE PRIOR TO REQUESTING INSPECTIONS. X 4) The approved site plan is required to be on-site for inspection purposes. If inspection is called for and the site plan is not on site, Approval WILL NOT be granted. In addition, a reinspection fee, based on the current fee schedule, minimum one-hour will be charged and collected by the Mason County Building Department prior to any further inspections being performed or approvals granted. X 5) 3000 PSI CONCRETE WILL REQUIRE SPECIAL INSPECTION IF THE QUANTITY EXCEEDS 50 CUBIC YARDS< LESSER AMOUNTS WILL REQUIRE AN APPROVED CONCRETE SUPPLIER TO PROVIDE YOU WITH A BATCH TICKET THAT WILL BE REQUIRED TO BE SUBMITTED TO THE SITE INSPECTOR FOR THE VERIFICATION OF MATERIAL USED. X T COM2004-00151 2 of 4 6) A structural observation, as defined in Chapter 17 of the International Code, shall be provided by the engineer or architect of record responsible for the structural design or another engineer or architect designated by the engineer or architect or record. Prior to the final inspection of the structure the structural observer shall submit written statements to the Mason County Building Department indicating that the site visits have been made and identify any reported deficiencies. X T7 7) International Buildig Code CHAPTER 17: IN ADDITION TO THE INSPECTION REQUIRED IN 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 INSPECTIONS DURING CONSTRUCTION ON THE TYPES OF WORK LISTED UNDER CHAPTER 17. THE SPECIAL INSPECTORS DUTIES & RESPONSIBILITIES SHALL BE AS SPECIFIED IN CHAPTER 17. X - 8) 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 X collected y the Mason County Building Department prior to any further inspections being performed or approvals granted. 9) Changes to approved building plans that affect compliance to the current Washington State Energy Code (WSEC), ventilation and Indoor Air Quality Code (VIAQ), Building/Plumbing/Mechanical Codes and/or Mason County Regulations shall be approved prior to construction. Xj 10) CONSTRUCTION PROCESS TO BE FIELD CORRECTED AS REQUIRED PER MASON COUNTY BUILDING DEPARTMENT AND THE ADOPT D BUILDING CODE. X ` -_ 11) 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- liant with Mason County ordinances and building regulations. X k2___ 12) Project work shall be consistent with conditions of Special Use Permit No. DDR2004-00168. X __ Z_ 13) Prior to final approval, all upland areas disturbed or newLV created by construction activities shall be seeded, vegetated or given an equivalent type of erosion protection (silt fencing or straw matting). X 14) Temporary erosion control measures must be implemented to prevent water quality degradation of adjacent waters or wetlands. Silt fencing must be installed and maintained until upland vegetation has become established. X __�l c ---- 15) ApproZt__ per dimensions and setbacks on submitted site plan. Setbacks are measured from the furthest projection of the structure. X 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 work 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 of Mason County access to the above described structure pro\e � ucture �rreview on. OWNER GENT \ DATE: COM2004-00151 3 of 4 •� MASON COUNTY PERMIT NO. �'J1 BUILDING PERMIT APPLICATION 426 W. Cedar • P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 On the web www.co.mason.wa.us APPLICANT INFORr4ATION CONTRACTOR INFORMATION Owner /a S 1n ° ti S-f-rat t�c. �� ` Company Name Mailing Address 3 '�..,s �� Mailing Address City-->I " 1 tate Zip Code a City State Zip Code Phone o + 40( I Other Ph. Phone Other Ph. Lien/Title Holder Contractor Reg.# Exp. E mail address E Mail Address Drivers Lic.# DOB Drivers Lic.# DOB SEPTIC/WATER SYST�M /V NFORMATION - Connect to New Septic /A Existing Septic Connect to Water System Name of Water System Well �" Water System Name of Water System PARCEL INFORA# TIQN - 1,2 Digit Parcel moo. =' - ' ` ' Fire District Legal Description ' '\ i C, 1l��tt Z Site Address (Please include strwt namr,estrget�number and_cit�yy) Dir ctions to site r`! Will timber be cut and sold in parcel pr�paration?Yes Is property r within 200'of Saltwater ti r Lake River/Creek N-- Pond Wetland Seasonal Runoff Stream — Slopes or Bluffs > 15% Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action?Yes/No TYPE OF JOB_..New Add Alt Repair Other PR RESIDENCE ❑ SEASONAL E]Use of Building Describe Work— 1 1� l No.of Bedrooms No.of Bathrooms Square Footage- 1 st Floor 2nd Floor 3rd Floor Basement Deck Covered Deck Other Sq.ft. Garage Attached Detached Carport Attached Detached MANUFACTURED HOME INFORMATION - Make Model Year Length Width Serial No. No.of Bedrooms No.of Bathrooms Type of Heat Purchase Price $ Replacement Unit? Yes/No Installer Name Certification No. 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 the contractor.I further declare that I am entitled to receive this permit and to do the work as proposed in the application.I declare that I have obtained the permission from all the necessary parties.If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application,I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure for review and inspection. PeQDF-OFCONTIN ATION ORWORK IS BY MEANS OF A PROGRESS INSPECTIOfl. / X ` C ' \ "^" Date: '/ Owner/Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND T OINT /� Accepted by: s Date o DEPARTMENTAL RE I ED DENIED y NOTES Building Department qjpp Planning Department Environmental Health Department Public Works Department Fire Marshal FEES Building Permit Fee Site Ins ection Plan Review Fee EH Review Fee Plumbing & Base Fee Planning Review Fee Mechanical & Base fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal Valuation $ TOTAL FEES I CONCRETE MECHANICAL MANUFACTURED HOME Footings/Setbacks Date By Ribbons Date By Gas Piping Date By Foundation Walls Date By Set-up Date By INSULATION Date By B G / Slab Insulation Floors Final Date By Date FRAMING By Date By Walls FIRE DEPT Date By Date PLUMBING B y Date B y Attic OT HE R G ro undw o rk Date By Date By— WALLBOARD NAILING D.W.V. Date By Date By FINAL I7SPECTION Water Line Date t-7 9-,5 ' Date By TYPE of �buFS� SN 00 Date By m er_ PHsSC OMtAF CD MT L c� EQ FK �cuEms d CD 7:Z> CL g U to i OCD V' ----------------------- 8 . 1 4 f 0 A l M'Smcs Materials Testing & Consulting, Inc. Report#F 10255 FIELD REPORT Materials Testing & Consulting, Inc. FILE NO.: DATE: 11 777 Chrysler Drive Burlington, WA 98233 Phone:(360) 755-1990 PROJECT: WA-' A - ST. Pr47TO C L ar a 194m y Fax: (360) 755-1980 ADDRESS: S12 /01 CLIENT: CITY: '5A_-1_7-nn/ ATTN: ENGINEER: ADDRESS: ARCHITECT: CONTRACTOR: 1P01 O119d PERMIT NO.: C e)fA Z40 tj-OC)151 b ,z I�G Time: U,r OQ Temp: �a /h 7-e O N S 1 E it s ift LAC 6, - eevf�, ��oQ I100N5 60- C 76 WCQ G"nrrnTi 82EN ft�T/� 1��f�7�! f t��rQi4+^�Ti�(Z, i+? T .y,�w?i.ylury� ✓��,� �75�oN� . JQct Te�(r � �4r-��G,a2 /3©�t�'S ���E calf A��•,✓�,a7"� s��� _ c�tiw Nr, r, �9�Q �Qi4c►Nti . S-A m l-le Of MILE,,LE,, M i x X;tnt60n A 1JO IA_ C_ "in1 c 4(�L� %Z-,5 7 iJ�NV en of t� 0,�� 5 e 7— O F 41- G)e l�T,,. - SEE ;/c E' arzpw wzc� 7' Q L /Y1 y KHo�JGc� Roves t Ja�'P�ct s�s9rc��P,r+us �a�R� /�+ �oNtGeaRrv��NcP ij 7-/ All-i- A)-)aCi��+6 ! REPORTED BY. REVIEWED BY: DISTRIBUTION: original: cc: cc: cc: cc: cc: All results apply only to actual locations and materials tested.As a mutual protection to clients,the public and ourselves,all reports are submitted as the cunt idential property of clients,and audtoriwion for publication of suticmrnts,conclusions or extracts tram or regarding our reports is reserved pending our written approval. 1710 Midway Court•Centralia,WA 98531 • Phone(360)330-7926•Fax(360)330-7946. Website Address: www.mtc-inc.net I M.T.C. Materials Testing & Consulting, Inc. REPORT OF FIELD INSPECTION AND COMPRESSION TEST Report#C 4123 CLIENT: Radian Communication PROJECT: WA State Patrol Academy ADDRESS: 22125 - 17'h Avenue SE, Suite 117 PROJECT ADDRESS: 2321 W. Dayton Airport Rd., Shelton Bothell, WA 98021 FILE NO: 04CM092 Attn: Wayne Maxwell DATE CAST: November 12, 2004 DATE RECEIVED: November 15, 2004 PERMIT#: COM 2004-00151 FIELD DATA Location of Placement: Communication Tower Footing#3 Sample Location: Point of placement Contractor: Radian Mix#& Proportions: 01600 Supplier& Plant: Miles,208 Cement, lbs. Quantity Placed,Cu.Yd.: 30 yd3 Flyash, lbs. No Delivery Ticket#: 111170 Water, gals. Batch Truck#: 081 Fine Aggregate, lbs. Weights Batch Time: 13:00 Coarse Aggregate, lbs. Given Sample Time: 13:20 Coarse Aggregate, lbs. Slump, inches(ASTM C-143): 4.5 Job Spec 4-5 Coarse Aggregate, lbs. Air Content, %(ASTM C-231): Job Spec Admixture, oz./cwt Air Temp., OF 540 Admixture, oz./cwt Concrete Temp.,OF(ASTM C-1064) 680 Admixture, oz./cwt SAMPLE TYPE &COMPRESSION TEST RESULTS ® Concrete(ASTM C-39) [:] Grout (ASTM C-1019) ❑ Masonry Prisms(ASTM C-1314) ❑ Cores(ASTM C-42) ❑ Lt.Wgt. Concrete(ASTM C-39) ❑ Mortar(ASTM C-39) ❑ Cubes(ASTM C-1107) ❑ Other: Log Test Date of Total Load Sample Sample Compressive Tested OBSERVATIONS No. Age Test (Lbs.) Dimensions(In.) Area Strength By (Days) (Sq. In. PSI 4-2115 7 11/19/04 117,500 6.00 28.27 4,160 RB ® Samples made by a MTC representative 4-2116 28 12/10/04 ® Samples picked up by a MTC representative 4-2117 28 12/10/04 ❑ Test results comply with applicablespedhcation 4-2118 H ® ound to comply visually ens nd specs ❑ Reinforcing steel does notcomply with project plans and specifications Gallons of water were added ®prior to/❑ 5 after sampling. REQ'D 1 28 1 1 4,000 REMARKS: MTC on site as requested. Resteel & anchor bolts in place per plans. Top 5'of concrete consolidated. Inspector was on standby due to late arrival of pump truck until 12:00. REPORTED BY: Patrick Turner, WABO Inspector REVIEWED BY: Stephen Barrie, Technical Director DISTRIBUTION: original:Client cc: Mason County Building Dept.3 cc: cc: cc: cc: All results apply only to actual locations and rnaterials tested.Asa mutual protection to clients,the public and ourselves.all reports are submitted as the wnfrdential propeny of clients.and auilromalion for publication of slalements.conclusions or emnicis from or regarding oar reports is reserved pending our written approval. 777 Chrysler Drive • Burlington,WA 98233 • Phone(360)755-1990 • Fax(360)755-1980 1710 Midway Court • Centralia, WA 98531 • Phone(360)330-7926 • Fax(360)330-7946 Website Address:www.mte-inc.net Re, 11A)l I I M.T.C. Materials Testing & Consulting, Inc. REPORT OF FIELD INSPECTION AND COMPRESSION TEST Report#C 4122 CLIENT: Radian Communication PROJECT: WA State Patrol Academy ADDRESS: 22125 - 17`h Avenue SE, Suite 117 PROJECT ADDRESS: 2321 W. Dayton Airport Rd., Shelton Bothell, WA 98021 FILE NO: 04CM092 Attn: Wayne Maxwell DATE CAST: November 10, 2004 DATE RECEIVED: November 11, 2004 PERMIT#: COM 2004-00151 FIELD DATA Location of Placement: Tower Footing#2 Sample Location: Point of placement Contractor: Radian Mix#& Proportions: 01600 Supplier& Plant: Miles, 208 Cement, lbs. Quantity Placed,Cu.Yd.: 30 yd3 Flyash, lbs. No Delivery Ticket#: 111114 Water, gals. Batch Truck#: 112 Fine Aggregate, lbs. Weights Batch Time: 15:15 Coarse Aggregate, lbs. Given Sample Time: 16:00 Coarse Aggregate, lbs. Slump, inches(ASTM C-143): 4.5 Job Spec 4-5 Coarse Aggregate, lbs. Air Content, %(ASTM C-231): Job Spec Admixture, oz./cwt Air Temp., OF 560 Admixture, oz./cwt Concrete Temp.,OF(ASTM C-1064) 670 Admixture, oz./cwt _ SAMPLE TYPE & COMPRESSION TEST RESULTS ® Concrete(ASTM C-39) ❑ Grout (ASTM C-1019) ❑ Masonry Prisms(ASTM C-1314) ❑ Cores (ASTM C-42) ❑ Lt.Wgt.Concrete(ASTM C-39) ❑ Mortar(ASTM C-39) ❑ Cubes(ASTM C-1107) ❑ Other: Log Test Date of Total Load Sample Sample Compressive Tested OBSERVATIONS No. Age Test (Lbs.) Dimensions(In.) Area Strength By (Days) (Sq. In. PSI 4-2077 7 11/17/04 149,000 6.00 28.27 5,270 RB ® Samples made by a MTC representative 4-2078 28 12/8/04 ® Samples picked up by a MTC representative 4-2079 28 12/8/04 ❑ Test results comply with applicable specification ed and 4-2080 H ® oundto�wmply at"lvdthproect visually pla�`dSpecs ❑ Reinforcing steel does not comply with project plans and specifications Gallons of water were added ®prior to/O 5 after sampling. REQ'D 28 4,000 REMARKS: MTC on site as requested. REPORTED BY: Patrick Turner, WABO Inspector REVIEWED BY: Stephen Barrie, Technical Direct DISTRIBUTION: final:Client cc: Mason County Building Dept. 3 cc: cc: cc: cc: All results apply onh In actual Iec tuom and materials Icsled. Asa tnnhml protection to clients.the public and o useka.all reports are arb nut it as the confidential property of clials and aulhorivalion for publial ion of sumo menus conclusions or emmis from or regarding our reports is reserved pending our written approval. 777 Chrysler Drive • Burlington,WA 98233 • Phone(360)755-1990 • Fax(360)755-1980 1710 Midway Court • Centralia,WA 98531 • Phone(360)330-7926 • Fax(360)330-7946 Website Address:www.mtc-ine.net Re, 11.101 M•T.C. Materials Testing & Consulting, Inc. REPORT OF FIELD INSPECTION AND COMPRESSION TEST Report#C 4120 CLIENT: Radian Communication PROJECT: WA State Patrol Academy ADDRESS: 22125 - 17'h Avenue SE, Suite 117 PROJECT ADDRESS: 2321 W. Dayton Airport Rd., Shelton Bothell, WA 98021 FILE NO: 04CM092 Attn: Wayne Maxwell DATE CAST: November 8, 2004 DATE RECEIVED: November 9, 2004 PERMIT#: COM 2004-00151 FIELD DATA Location of Placement: Footing#1 for communications tower Sample Location: Point of placement Contractor: Radian Mix#&Proportions: 01600 Supplier& Plant: Miles, 208 Cement, lbs. 5080 Quantity Placed,Cu.Yd.: 18 yd3 Flyash, lbs. Delivery Ticket#: 111059 Water, gals. 1490 Truck#: M106 Fine Aggregate, lbs. Snd 27400 Batch Time: 15:00 Coarse Aggregate, lbs. Pea 30080 Sample Time: 15:50 Coarse Aggregate, lbs. 7/8 14100 Slump, inches(ASTM C-143): 5" Job Spec 4-5 Coarse Aggregate, lbs. Air Content, %(ASTM C-231): Job Spec Admixture, oz./cwt Air Temp., OF 600 Admixture, oz./cwt Concrete Temp.,OF (ASTM C-1064) 68, Admixture, oz./cwt SAMPLE TYPE&COMPRESSION TEST RESULTS ® Concrete(ASTM C-39) ❑ Grout (ASTM CA019) ❑ Masonry Prisms(ASTM C-1314) ❑Cores (ASTM C-42) ❑ Lt.Wgt. Concrete(ASTM C-39) ❑ Mortar(ASTM C-39) ❑Cubes(ASTM C-1107) ❑ Other: Log Test Date of Total Load Sample Sample Compressive Tested OBSERVATIONS No. Age Test (Lbs.) Dimensions(In.) Area Strength By (Days) (Sq. In. PSI 4-2065 7 11/15/04 130,500 6.01 28.37 4,600 JP ® Samples made by a MTC representative 4-2066 28 12/6/04 ® Samples picked up by a MTC representative 4-2067 28 12/6/04 ❑ Test results comply with applicable specification Reinforcing steel was visually inspected and 4-20681 fl LJ ® found to comply with project plans and specs ❑ Reinforcing steel does hot comply with project plans and specifications Gallons of water were added O prior to/O after sampling. REQ'D 28 4,000 REMARKS: MTC on site as requested. REPORTED BY: Patrick Turner, WABO Inspector REVIEWED BY: Stephen Barrie, Technical Director DISTRIBUTION: original: Client cc: Mason County Building Dept.3 cc: cc: cc: cc: All—119 apply only 1.actual lucahons and malenals tested Asa munul protecoon to clients.due public and ourselves,all reports are submitted as the confidential properly of clienn.and autho-alien for publaauon of statements,conclusions or exintets frem or regarding mu reports is reserved pending our written appal. 777 Chrysler Drive • Burlington,WA 98233 • Phone(360)755-1990 • Fax(360)755-1980 1710 Midway Court Centralia,WA 98531 Phone(360)330-7926 • Fax(360)330-7946 Website Address:www.mtc-inc.net Rcs 11101 L M.T.C. Materials Testing & Consulting, Inc. Report#F 10258 FIELD REPORT FILE NO.: Materials Testing & Consulting, Inc. 777 Chrysler Drive DATE: �y �f-/O Burlington, WA 98233 Phone:(360) 755-1990 PROJECT: ' 5T P4Tko/l Fax: (360) 755-1980 ADDRESS: /a/ CLIENT: — CITY: ATTN: ENGINEER: ADDRESS: — ARCHITECT: CONTRACTOR: 0QAJ91AAJ PERMIT NO.: Time: Temp: 5 7 Q Q i E�Z- q S N kl- 4c de'Q P - DAIS 6 < e2r— M'1N fiAJCA6O 601-7'S Ge 19ene 01-t4N /SOL7-5 5` ' - f- A e�. D SE�ve C1 50`�c 3 aF d/lo0 t ra .ts` A rA - /62 ,e . 04 i9 r nl E' n/-J E t-e N M e c P5 M r T - 611Z G S F E Ql� 1�e''OoAp r z tfi z rc. TNe 4e5-r :-)r /nv '0(;�ea", to ip✓"O✓e ��k r' .I7Ar;"OeOel }1-5 �✓�Qe /N 42,1- 44)Ql- lcAALgf J- J4X) , ST55 REPORTED BY: /: � REVIEWED BY: i DISTRIBUTION: original: cc: cc: cc: cc: cc: All results apply only to actual locations and materials tested. As a mutual protection to clients,the public and ourselves,all relwrls are submitted a_c the confidential property of clients,and authonirtion for publication of statements,conclusions or extracts from or regarding our relxuts is reserved pending our written approval. 1710 Midway Court•Centralia,WA 98531 • Phone(360)330-7926•Fax (360) 330-7946 Website Address: www.mtc-inc.net L M.T.C. Materials Testing & Consulting, Inc. REPORT OF FIELD INSPECTION AND COMPRESSION TEST Report#C L' ° ',2 CLIENT: PROJECT: Gci' ! , -,7 f7-kc-V ADDRESS: PROJECT ADDRESS: StZ /e'f FILE NO: DATE CAST: DATE RECEIVED: PERMIT#: FIELD DATA Location of Placement: tJr�iL� �7/�e.�t Sample Location: Contractor: Mix#& Proportions: r-) C?(::D i Supplier&Plant: 07.) l_L-5 ze Cement, lbs. Quantity Placed, Cu.Yd.: 3c' „ 7 Flyash, lbs. A)rj it r=�Tr_ A,.)I�4T Delivery Ticket#: /j//l Water, gals. Truck#: Fine Aggregate, lbs. Batch Time: / 5- /�� Coarse Aggregate, lbs. Sample Time: j/__ Coarse Aggregate, lbs. Slump, inches(ASTM C-143): Z/, 5" Job Spec' Coarse Aggregate, lbs. Air Content, %(ASTM C-231): — Job Spec Admixture, oz./cwt Air Temp., °F e Admixture, oz./cwt Concrete Temp., °F (ASTM C-1064) Admixture, oz./cwt SAMPLE TYPE &COMPRESSION TEST RESULTS Concrete(ASTM C-39) ❑ Grout (ASTM C-1019) ❑ Masonry Prisms(ASTM C-1314) ❑ Cores (ASTM C-42) ❑ Lt. Wgt. Concrete(ASTM C-39) ❑ Mortar(ASTM C-39) ❑ Cubes (ASTM C-1107) ❑ Other: Log Test Age Date of Total Load Sample Sample Compressive Tested OBSERVATIONS No. (Days) Test (Lbs.) Dimensions Area Strength By In. (Sq. In.) (PSI) El 1 Samples roads by.ARC representative ZSamples picked up by•A(TC regeeerdslive •"J Q Test r 1t.comply with epplo-bi.spec 11w.6 n 7 Rein6 rt V steel was visuely inspected and land L—� `•.to co,rply with project plans end np— Reinf-crg steel does not mmpy with propd pa—and ap—A—t.- I cab-of wale,wa a added b D for Wy O OR. 1 . Ph g. l REQ'D — REMARKS: REPORTED BY: REVIEWED BY: DISTRIBUTION: original: cc: cc: cc: cc: cc: /tit molts apply only lu wwal l«anons and mn,mals 1w A M a n,ulual pdwm to 0-(n •llk pubhc and uursdva•all reports em whuwlt 1 ns the a fiduawt pope y of dl ,s,and autlkn-iai for r bhealim of siate,ntnu,wrkiusioro nr mwr ftn,ur regarding our r",I is naaved ending our—it-am--l. 777 Chrysler Drive • Burlington,WA 98233 • Phone(360)755-1990 • Fax(360)755-1980 i/ 1710 Midway Court • Centralia,WA 98531 . Phone(360)330-7926 • Fax(360)330-7946 Website Address:www.mtc-inc.net R- 11101 M.T.C. Materials Testing & Consulting, Inc. REPORT OF FIELD INSPECTION AND COMPRESSION TEST Report#C 4123 CLIENT: PROJECT: ADDRESS: PROJECT ADDRESS: SO. /D/ FILE NO: DATE CAST: // /2/59 DATE RECEIVED: PERMIT#: FIELD DATA Location of Placement: Leese(2 )C oaT1 L)5 -41' 7, N Sample Location: Contractor: Mix#& Proportions: Supplier& Plant: /Yj/z1OF s Ze�pp Cement, lbs. n1D Ar TCA 'oJg/rz Quantity Placed, Cu.Yd.: S Flyash, lbs. Delivery Ticket#: ///0 0 Water, gals. Truck#: Fine Aggregate, lbs. Batch Time: / : Coarse Aggregate, lbs. Sample Time: 13:26 Coarse Aggregate, lbs. Slump, inches(ASTM C-143): 4J, 5- Job Spec 4,i- Coarse Aggregate, lbs. Air Content, %(ASTM C-231): —" Job Spec Admixture, oz./cwt Air Temp., eF Tl/0 Admixture, oz./cwt Concrete Temp., IF(ASTM C-1064) Cam!' ° Admixture, oz./cwt SAMPLE TYPE & COMPRESSION TEST RESULTS h Concrete(ASTM C-39) ❑ Grout (ASTM C-1019) ❑ Masonry Prisms (ASTM C-1314) ❑ Cores(ASTM C-42) ❑ Lt. Wgt_ Concrete(ASTM C-39) ❑ Mortar(ASTM C-39) ❑ Cubes (ASTM C-1107) ❑ Other: Log Test Age Date of Total Load Sample Sample Compressive Tested OBSERVATIONS No. (Days) Test (Lbs.) Dimensions Area Strength By In. (Sq. In. PSI Q'Samples made by a MTC rop—Mmive 7 g ❑ S..ples picked up by a MTC representative 2 C7 O Test nasals comply with eppk ble apecif-M.. Reinbrdrq Heel wed—ally rmpoded and found �I'JOI/v 1.cornoy with project pte and epees OReinforcing Heel does not kpmply wah projed plarm and ap—ficat— �! �-- GMin.of water ware added Plwlon 1&O after sampling REQ'D REMARKS: -P_ /�jv RE' 10L IQ �4.w6o4 Tee( 4&"-,e REPORTED BY: c_'�/ REVIEWED BY: DISTRIBUTION: original: cc: cc: cc: cc: cc: All—11,apply only io arual Ienauon,ie,d niat�aial,teed.As•nrulual prm�tion io k:lianls,the public and ounaivn,ell nepk>.ta arc avbmihut as the wnfidranial prupasty of�liinr,,ad aude.rinabcak f r puMivM icm of.iatem.nt,,uaklLL.iona nr exns:t,bum cu regarding our 'worts is m ved pending our w 1i agwoval. 777 Chrysler Drive • Burlington,WA 98233 Phone(360)755-1990 • Fax(360)755-1980 1710 Midway Court • Centralia,WA 98531 Phone(360)330-7926 • Fax(360)330-7946 Website Address:www.mtc-inc.net g�� Ilrof M.T.C. Materials Testing & Consulting, Inc. REPORT OF FIELD INSPECTION AND COMPRESSION TEST ^ 4 120 Report#C PROJECT: a,.1M s�, �F /7K��'-r�.Q t� /J c✓+��-w wr+ CLIENT: PROJECT ADDRESS: ADDRESS: FILE NO: DATE CAST: DATE RECEIVED: PERMIT#: FIELD DATA Location of Placement: �Y-1 c�w� �T^ Sample Location: or i-r- O� Mix#&Proportions: Contractor: Cement, lbs. tier&Plant: supplier Flyash, lbs. Quantity Placed,Cu.Yd.: Water, gals.Fine Aggregate, `r Delivery Ticket#: � r ate, Ibs.111 �r Truck#: Coarse Aggregate, Ibs{°eb 300 O Batch Time: r�'0d re 7 7 Sample Time: S b Coarse Aggregate, lbs.lbs. { G'" Spec �� � Coarse Aggregate, ` Slump, inches(ASTM C-143): - Job Job Spec Admixture, oz./cwt it Air Content, %(ASTM C-231): ° Admixture, oz./cwt Q Air Temp.,OF Admixture, oz.lcwt Concrete Temp.,OF ASTM C-1064 6"3 ° SAMPLE TYPE&COMPRESSION TEST RESULTS ! ❑Grout (ASTM C-1019) ❑Masonry Prisms(ASTM C-1314) ❑Cores(ASTM C�2) . Concrete(ASTM C-39) 0 Cubes(ASTM C-1107) ❑Other: ❑Lt.Wgt.Concrete(ASTM C� Mortar(ASTM C-39) 9) ❑ OBSERVATIONS Log Test Atal Load Sample Sample Compressive Teste ge Date of To d Test (Lbs.) Dimensions Area Strength y No. (Days) In. S . In. PSI S.nvMe„res M.MTC rop.wuaNa ] s..ww•place w M•nrrc npn.a+.l- a.auviWie N-Pecw ZC p .aw 0"0-4 Bps" « n7d °«.WYMh p.°^jJ.G 0Mda w r°u ram' GO.-d-A-wen-- I ia"O.M REO'D REMARKS: ^G X Z REVIEWED BY: REPORTED BY: cc: cc: DISTRIBUTION: original: cc: cc: cc: ,caio.°rxlsea AMC-"..anciusau«atlna,Gw.«Rs�' my a ec�ud bcaiau wa melaiak IWCd.eb..,W,W p,ok aioo to ciia"Iho Pubic and umxd—k at,epo,ly ere vA-ittd n the e°ortiauia pmPaty of cAiauf..6 aabori-i-r«Pub'. «pony i.tawd Ptdin o«wriuta ttpvovd. 777 Chrysler Drive • Burlington,WA 98233 • Phone(360)755-1990 • Fax(360)755-1980 1710 Midway Court,! Centralia,WA 98531 a Phone(360)330-7926 • Fax(360)330-7946 1 ~;.. Website Address:www.mtc-inc.net