HomeMy WebLinkAboutCOM2006-00003 K-8 School - COM Application - 1/12/2006 MASON COUNTY PERMIT NO\.110
BUILDING PERMIT APPLICATION Q 0*9
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 INFORMATION CONTRACTOR INFORMATIO
Owner l r;r, r'. u Company Name taf?YMailing Address ' Mailing Address >l. !"
City.'�'71llQ LTDi- State WAJ Zip Code City State Zip Code
Phone�BQ eA 1-7-4 7,10 Other Ph. Phone Other Ph.
Lien/Title Holder P3 O N G Contractor Reg. # Exp.
E mail address E Mail Address
Drivers Lic. # h n DOB N Drivers Lic.# DOB
SEPTIC /WATER SYSTEM INFORMATION - Connect to New Septic Existin.3 Septic
Connect to Water System Name of Water System-'U4�S 1=. '2>"d �
Well Sewer System Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. Fire District s'
Legal Description Sc P kTT.AG\-l19,0
Site Address (Please include street name, street numb�and city
Directions to site (t�lT� s eG�`(r}c�► rt B. \d ( 106
Will timber be cut and sold in parcel preparation?Yes/
Is property within 200' of Saltwater cJ D Lake �,i D River/ Creek f'-1 r7 Pond N O
Wetland_Seasonal Runoff N � Stream__±Aj:� Slopes or Bluffs tom\ el
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 PRIMARY RESIDENCE ❑ SEASONAL ❑
Use of Building-&- � hi c s[i I.. Describe Work �t��j C.rS��� i�u �. i 1 Ur-4 do iris
No. of Bedrooms No. of Bathrooms Square Footage- 1st Floor 20 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. 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
MEANSPFAPROCiRESS INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180DAYS WILL INVALIDATE THEAPPLICATION.
X Date'
Owner/Owners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department `�
a / f I Q
Planning Department
Environmental Health Department 111
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
FORM MUST BE COMPLETED IN INK PERMIT NO.
PLEASE PRESS HARD MASON COUNTY
PLUMBING/MECHANICAL 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
APPLICA% T INFOFWATION CONTRACTOR INFO TIO
Owner >, s I- L' Company Name E'
Mailin�Addres Mailing Address t K i
City state_i Zip Code 26'3 °( City State Zip Code
Phone Other Ph. Phone Other Ph.
Lien/Title Holder Contractor Reg. # Exp.
E mail address E Mail Address
Drivers Lic.# N DOB P1 Drivers Lic.# DOB
SEPTIC INFORMATION - Connect to New Septic Existing Septic. Connect to Sewer System
Name of Sewer System
PARCEL INFORMATION - 12 Digit Parcel No. Q .Q 34 - o Fire District
Legal Description e_e_ A-Ft/)E'.f'4�- a
Site Address (Please include street name, street number an city)
Directions to site i N 1 L!z_'-c- 1r`1 c 1 r)I 1
Is property wit in 200'of Saltwater V-Jn Lake j r , River/Creek N -Pond
Wetland Seasonal Runoff ) Stream N 6 Slopes or Bluffs > 15% fu 0
TYPE OF JOB - New__,__Add Alt X, Repair Other Use of Building S
Location of Fixtures/Units - 1st Floor 2nd Floor____X�__ Basement Garage �T1
PLUMBING FIXTURES (Show Number of each) MECHANICAL UNITS
Type of Fixture No. of Fixtures Fees Fuel Type:Electric—,& LPCz_ Natural Gas_ Heat Pump_
Toilets Type of Unit No. of Units Fees
Bathroom Sink Furnace
Bath Tubs Heatpumps Z
Showers Spot Vent Fan
Water Heater Propane Tank
Clothes Washer Gas Outlets
Kithen Sinks Wood/Gas/Pellet Stove
Dishwasher Kitchen Exhaust Hood Z
Hosebibs 1 I Dryer Vent
Other 0 YZi Nq-L I t Other
�tiv1L1�� Base Fee CC I U r' ITS Base Fee
i TOTAL PLUMBING TOTAL MECHANICAL
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 accu an grants employees of Mason County access to the above described property and structure for review and inspection.
PROOF INt TION O�RK IS BY MEANS OF A PROGRESS INSPECT N. 1
X Date: �►� 7- 0
O wner/Owners Representative/Contractor (indicate which one)
FOR OFFICIAL USE BEYOND THIS POINT
Accepted by: Planning Pd Ck# Date Bld Pd Receipt No.
DEPARTMENTAL REVIEW APPROVED DENIED NOTES
Building Department
Occ Group—Type Constr.
Planning Department
Environmental Health Department
FEES
Plumbing & Base Fee Site Inspection
Mechanical & Base fee UFC Plan Review Fee
Wood/Gas/Pellet Stove Fee Other
Violation Fee TOTAL FEES
Request To Revise An Approved Plan
COMoi00(10- oon n3
Permit Number: Epp - Name_ �Ixd (Q n k I �f 1oo .l
Parcel Number �i v�/C� - - Q Phone Number daytime (__)
Project Address J -n Mailing Address
Please provide a complete,detailed description of the proposed revisions to the approved plans: .
........... 1�4 VILL-- 6 9 Fn
Are two sets of the revised plans or addendum indicating the changes included? ❑ Yes ❑ No
Are the approved site plans included? ❑ Yes ❑ No
Are the revisions clearly and accurately identified on the plans or addendum? ❑ Yes ❑ No
Does the plan contain an engineer's or architect's lateral or vertical analysis? ❑ Yes ❑ No
If Yes,Has the engineer or architect approved this revision? ❑ Yes ❑ No
Is a stamped and signed approval included with this request? ❑ Yes ❑ No
1Note:No structural chances to a"desicned"plan will be ipmved without the written consent of the enctneer and/or architect of record
Does the proposed revision modify the footprint or location of the structure? ❑ Yes ❑ No
If Yes,Is a revised site plan,.with all new setback dimensions included with this request?
❑ Yes ❑ No
Additional Information:
Applicant's signature Date:
office use only
. Received by:
Date Serd Assigned To Approved By Date
$, Original Valuation: $
Additional Valuation: $
q v(p TSC_ Sq.Ft. x$ $
Sq.Ft. x$ S
.H. Total New Valuation $
P.W. Additional Fees:
Additional Planning Dept. $
New Setbacks: Front / Additional Plan Review S
Rear / Additional Building Permit $
Side1. / Side2 / Additional Plumbing $
Additional Conditions/Comments: Additional Mechanical $
Additional E.H.Dept. $
Other $
Total Amount Due: $
Amount To Be Paid Up-Front S
TaeY iilii
ReviseA SRG i2?fL007
J
(1/4/2007) Charell Holcomb - ASI #14-HC K-8.pdf Page 1.-A I
T
IA Document G710" — 1992
Architect's Supplemental Instructions
PROJECT(Name and address): ARCHITECT'S SUPPLEMENTAL OWNER:
Hood Canal K 8 School INSTRUCTION NO: 14 ARCHITECT:
111 North Highway 106
Shelton,WA 98584 CONSULTANT:❑
OWNER(Name and address): DATE OF ISSUANCE: November 2,2006 CONTRACTOR:
Hood Canal School District-No.404 FIELD:❑
I I I North Highway 106 CONTRACT FOR: General Construction OTHER:❑
Shelton,WA 98584
FROM ARCHITECT(Name and CONTRACT DATE: April 16,2006
address):
Erickson McGovern,PLLC
120 131st Street South
Tacoma,WA 98444 ;
TO CONTRACTOR(Name and ARCHITECT'S PROJECT NUMBER: 24045
address):
Jones&Roberts Company
P.O.Box 1488
Olympia,WA 98507
The Work shall be carried out in accordance with the following supplemental instructions issued in accordance with
the Contract Documents without change in Contract Sum or Contract Time.Proceeding with the Work in
accordance with these instructions indicates your acknowledgment that there will be no change in the Contract Sum
or Contract Time.
DESCRIPTION:
Relocate the plump house per the attached.
i
ATTACHMENTS:
(Here insert listing of documents that support description.)
Attachment ASI#14-1
ISSUED BY Tr rARITECT:
J
Raymond Mow,Project Architect
no ure) (Printed name and title)
AIA Document G710-—1992.Copyright 01960 and 1992 by The American Institute of Architects.AN rights reserved WARNING:This AIAa Document
Is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIAa Document,or any portion of it,
may resuh in severe civN and criminal penalties,and will be prosecuted to the maximum extent possible under the law.This document was produced
by ALA soltwara at 09:41:55 on 11A 2I2006 under Order No.1000205522_1 which expires on 1=312D07.and is not for resale. \ i,
User Notes: (2199146220)
RECEIVED
• WORK ORDER v-PUBLIC WORKS DEPT, APR 13 Zoos
W. Dales — -v tq V11t0ir S
- PBRMIT E; m o - ooao 3 m "
Au�hoer
Od b ,
Type o Warkl Date:
CNARG I TCs
NAME S� J
AGENCY/00MPANY .
OIL-UNG ADDRD88
PHO"I .
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Washington State Patrol
1VA:+iNN�i1'Oh t�AT[ �A
Fire Protection Bureau
PO Box 42600 yESF P
Phone:Olympia
p(360) 753-0 00 ON TF/s o musl*
Fax: (360) 570-3136 "OR
,NS� GT/,, BF
O/y
January 25, 2006
Coo 006 - 0003
Stan Zielinski C0 m goev _ 00 3
Architect ��3
Erickson & McGovern, PLLC COm
120 131 st ST S
Tacoma WA 98584
Hood Canal 400 Elementary Schaal
General Site - Flan Review
General Notes:
January 24, 2006 70 ,8
PROJECT: � I j-f�C/y/
Hood Canal Elementary School RC'Es
Ill
Shelton WA
PLAN REVIEW Amended to 11/18/05 Plan review:
The plans and specifications for the above named project have been reviewed for fire and life safety
issues contained within the State Building Code and the following comments requirements are noted.
Please send us any meeting minutes of any meetings that you make have concerning this project.
Contact information is requested on parties involved with this project, to include phone numbers, mailing
addresses and job title.
WATER SOURCE:
1. The adequacy and dependability of the water source are of primary importance and shall be fully
determined, with due allowance for its reliability in the future. Water system was reviewed with current
water information provided by the local fire department.
2. Fire main underground thrust blocks shall be inspected by the Mason County before cover and the
underground piping shall be hydro tested at 200 PSI.
3. All underground pipes serving the fire protection system, including fire hydrants shall be installed by a
Washington State Fire Marshal licensed contractor with a "U" Designation.
4. Contractor stamped underground testing documents shall be provided to the local AHJ before
providing water to the sprinkler system.
FIRE DEPARTMENT:
1. Bollard shall protect natural gas meter, fire hydrants and fire department connections.
1 of 4
I - -
2. The building site shall be provided with approved fire apparatus access to all areas during all
construction activities.
3. Such access shall be maintained and be capable of supporting fire apparatus loading under all
weather conditions. This access shall be approved by the local Fire Chief.
* Fire hydrants and FDC approved as to location at our December 16, 2005 meeting.
4. Fire Department connections shall be located as approved by Mason Local County Fire District.
5. The fire department connection for the fire sprinkler system shall be located within 50 feet or a fire
hydrant.
6. Provide signage for fire lane if required.
7. Fire lane markings shall comply with fire department specifications as to color, size and location.
FIRE HYDRANT:
* Fire hydrants and FDC approved as to location at our December 16, 2005 meeting.
Fire hydrants shall comply with the following:
a.steamer ports shall face vehicle access.
b.shall be set so that the steamer port is a minimum of 18 inches above grade as measured to the
middle of the port.
c.steamer ports shall be provided with store fittings.
d.landscaping shall be such that it will hinder identification or operation of the hydrants.
FIRE PLAN:
1. An emergency plan with phone numbers for the site shall be developed by the general superintendent
and provided to all sub-contractors.
2. This will include location and use of portable fire extinguishers and first aid equipment.
3. It shall be the responsibility of the general superintendent to assure that the plan is followed by
everyone on the site.
PLANS/DRAWINGS TO BE SUBMITTED FOR APPROVAL:
1. Fire pump plans. CCcm ao0G� - Goo33�
2. Fire alarm and fire sprinkler systems shop drawings will be submitted prior to installation for review
and approval.
3. Fire suppression system plans and specifications protecting the kitchen hood.
4. Smoke damper drawings with locations.
5. Additional information on fire protection system for bus barn.
6. Additional information on roof smoke-hatch and its location as to the sprinkler design.
FIRE EXTINGUISHERS:
1. All fire extinguisher cabinets may be eliminated, provide one (1) extinguisher in the administration area
and one in the mechanical room. This is an option that the school district may want to take as and
exception to the code.
THESE PLANS MUST BE
ON THE JOB SITE
FOR INSPECTION
2 of 4
v
2. Fire extinguisher locations not noted on plans please submit.
WOOD SHOP:
Any wood shop equipment shall be provided with interlocks such that when any one piece of equipment
is turned on the exhaust system runs.
SMOKE BARRIERS:
All doors located within a smoke barrier wall shall be either automatic closing by smoke detection or self
closing.
COMBUSTIBLE OR FLAMMABLE LIQUIDS:
1. Temporary tanks for combustible or flammable liquids installed on the construction site may require
approval from the fire authority.
2. Approved water supplies for fire fighting shall be provided as soon as combustible materials arrive on
site.
SPRINKLER SYSTEM:
1. Sprinkler shall not be obstructed by lighting, shelving, paint, or any other obstruction.
2. Sprinkler head shall be within acceptable code distances to lighting, head diffusers, and fire alarm
devices.
3. Sprinkler inspector test location shall be on the most remote area from riser.
EXITS/OUTSIDE:
1. Travel distance to exit shall not exceed 250 feet.
2. The outside lighting shall be capable of illuminating the exit from the exterior doors to the public way.
3. The outside alarm required for the fire sprinkler and alarms systems may be combined as one device
to be located on the front, street side of the building
FIRE ALARM:
1. Return air systems. EXCEPTION: Smoke detectors are not required in the return air system where
all portions of the building served by the air distribution system are protected by area smoke detectors
connected to a fire alarm system in accordance with the International Fire Code. The area smoke
detection shall comply with Section 606.4. (IMC Section 606, Smoke Detection Systems Control).
2. Fire alarm:
a. Provide coverage in commons area.
b. Provide coverage in Gym area.
c. Provide strobe in computer lab.
d. Provide smoke detection coverage in classroom area.
e. Provide coverage in all common areas. THESE PLANS MUST BE
f. And others as agreed upon. ON THE JOB SITE
SHAFTS: frC�= INSPECTION
All shaft(s)for example elevator shaft, etc. shall be fire rated.
3of4
DOORS/ROOMS:
All doors and rooms shall be numbered or have lettering as room identifiers on doors.
GENERAL NOTES:
1. The state has not adopted NFPA 13 2002 edition as of yet, this will project will be reviewed under
NFPA 13 1999 edition.
Additional comments may be made as the project moves forward.
If you have any questions or comments, please contact Lance Talley at (360) 570-3117.
TyoS PANS MUS Th T BE
FpR/NS pECT o E
N
4of4
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1
PL;5
Structural Solulions
m/ nr^mpnnc s"o,xo am^m�oayu�m **cou�oza�n
o*p� __ . .
r�== ymNmncA,nm^yvx,//oo'Laconia.wAyu*nz'tel:zsuyny.2ro7
August 4. 2OO8
� MEMO
�
TO:� Erickson McGovern| lF/� �E �/��l� ��� '��r��
� o �� ��". KEPT no� / ^ ��-.
� ATTN: Ray Mow PARCEL
�����~U r~� �_
�~����K "��U � � ��K~
� FROM: Eric Bailey
RE: Hood Canal School District
Bus Barn Remodel(Bldg 80(V
COM2006-00032
Plan Review Response
COMMENTS:
� Following is our response bn the plan review comment:
� 1� T� mod��� �t� bui�ingd� n�si n�man�obar�e lateral system
� for�hebuUd|ng therefore Th�ohgina| oonf�urabon
� ' -
of this portion . the overall building iy essentially a3-oNed diaphragm due bothe
drive-bay penetrations along the North wall. With this remodel, the south wall
| remains unchanged |ateny||y, leaving the original lateral system in thmeaa�vvaat
| dinootionof�hebui)dinginCm^^tondunnhanged. For the
systemnorth-south dinacdon. the east
�
� end wall ot the remodel does get shortened, however there ia still adequate capacity
to resist the required lateral loads for shear and overturning. See the attached
calculation sheet for our analysis. No changes made to the submitted drawings.
� If there are any questions or comments, please do not hesitate to contact us.
E8Bvmm
�
� 05-146.01
�
� Attachment
is
EXPIRES:4121108
�
5146.01 plan review»4-06,eSh
OPCS
Structural Solutions
Seattle 811 First Avenue,Suite 510•Seattle,WA 98104•tel:206.292.5076
Tacoma 950 Pacific Avenue,Suite 1100•Tacoma,WA 98402•tel:253.383.2797
www.pcs-structural.com
April 19, 2007
Erickson McGovern
120 131 st Street South
Tacoma, WA 98444-4804
ATTN: Ray Mow
RE: Hood Canal K-8 School
111 N. State Route 106
Shelton, WA
SUBJECT: Project Closeout
Dear Ray:
To the best of our knowledge, the above referenced project has been built to the intent of the
Structural Drawings and Specifications. We are not aware of any structural issues that are left
unresolved.
This conclusion is based upon our periodic site visits and construction observations during
those visits, review of the Test Reports, and follow-up of any questions from the contractor as
they were addressed to our office.
It should be noted that we were not continuously "on-site", nor were we designated as
inspectors for this project. We did, however, attempt to the best of our ability to monitor job
progress and conformance to the construction documents during our periodic site visits, and in
particular, to monitor the construction of the lateral resisting system of shear walls, diaphragms
and holdowns.
Thank you for the opportunity to be of service to you on this successful project. If there are any
questions regarding the project closeout, please feel free to call.
Very truly yours,
PCS STRUCTURAL SOLUTIONS �. PIN
C`�F W� .p
Is
Eric S. Bailey, S.E. �e o
Project Manager
Reviewed by: o z6161 w�
Jack Pinkard, S.E.
Principal SIONA��G~�'
ESBvmm
05-146.00 EXPIRES:4/21/0
cc: Debbera Coker- Mason County Bldg. Dept.
5146 Project Closeout Letter 4-19-07.esb.doc
�:VOO CAKALSCH aL State Study and Survey 2004
Washington State
Hood Canal School District 404
B. A summary area analysis of all district facilities, in a spreadsheet format
Grade Current Study &
Elementary Level OSPI SF Survey 2001 Difference Notes
Hood Canal School K-8 65,100 77,306 12,206
C. A building conditions summary chart
No. of Building
School Grade Site Building No. of Teach. Cond.
Name Level Acreage Area Bldgs Staff Rating Year Built
Hood Canal K-8 11.5 46,856 1 20 24.5 1961/
School 1970/
1990
Gym K-8 Same 17122 1 2 33 1964
Site
Music K-8 2112 1990
Maint./ Trans - Same 4810 1 0 27.7 1961/
Bus Garage Site 2688 1990
Grand Total K-8 11.5 73,588 3 24
Z 'd 20BE-99fr [09E) uosuel Rues Jqo : jo SO 11 inr
I� —
MASON COUNTY DEPARTMENT OF TO ,.
COMMUNITY DEVELOPMENT �j �` Iftr-7-
Rr
426 West Cedar Street ♦ PO Box 186 ♦ Shelton, WA 98584
(360) 427-9670 EXT. 352 FAX (360) 427-7798 HOME PAGE—www.co.mason.wi.ur;;,, L
Special Inspection Authorization
Q (2�,�,,�,� Com.2o06-or03,
Project Owner C�C7u _ �t S�-� ET
Building Permit Number /:� �. 0D6-- 6 nn �3
Project Address \ OK Engineer/Architect of record r atc.V Sr h,
A , C� M '-Go u ev-T-�
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:
r
1. Concrete. During the taking of test specimens and placing of reinforced concrete. (IBC 1704.4)
P�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)
✓4�k- Reinforcing steel and prestressing steel tendons. Inspection of reinforcing steel including prestressing
tendons. (IBC 1704.4)
K6. 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)
Structural welding. Welding inspection shall be in compliance with AWS D1.1. (IBC 1704.3.1)
-1:4. 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)
X_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
i ;1,_15. Smoke-control system. Smoke control systems shall be tested by a special inspector per IBC Section
1704.14.
1 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:
pll�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: Re ir�ti r� u be �
:ALL cH e-L�'-20 _XE'V ewes
rcc WeAL Xf-SrI N p /3,►L s�Ls w o Y-),\I-
W VZ,I-/,
ro or that I am the legal owner's agent
Authorization: I hereby state that I am the legal owner of the project property, 9 9
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
a to by/, ason County.
Signature Printed Name i i 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.
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t 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
fulfilled and reported and to the best of
n testing were u ,
stating that all items requiring special inspection and to g p
approved design drawings, specifications, approved change
their knowledge, in conformance with the pp g g p PP 9
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.
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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
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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.
IL