Report 14 51 2c o. `o 2444 Bend Office (541)330-9155
Geotechnical Office (503)601-825c
Eugene Office (541)345-028c,
Carlson Testi Salem Office (503)589-1252
ng, Inc• Tigard Office (503)684-346c
Daily Report of Proprietary Anchors
?roject: GIBB RESIDENCE CTI Job#: No338193
.ddress: 15755 SW SERENA CT TIGARD Jurisdiction: TIGARD
TI representative: Ken Villeneuve was on this site on date: 09/24/202o to perform
3pecial Inspection for Permit: MST2o2o-00204 PO#:
SCOPE OF INSPECTION Location of concrete placement[to include grid lines,elevations(floors)
1. Checked in with superintendent or client representative: and drawing details]:
CTI OBSERVED CARL WITH At FRAMING INSTALL(3)
Name: CARL PCS.OF 5/8"DIA.ALL THREAD WITH 8"VERTICAL
Company: Al FRAMING EMB.INTO EXISTING CONCRETE STEM WALLS FOR HDU2
HOLD DOWNS.2 ALONG SHEAR WALL BETWEEN ATTACHED
� GARAGE&HOUSE,AND i AT OUTSIDE CORNER OF
2. Inspection was'IBC Continuous !TIC I Periodic EXTERIOR WALL JUST LEFT OF MAIN ENTRANCE PER
EMAIL FROM VISTA STRUCTURAL ENG.DATED
PROPRIETARY ANCHORS 08/25/2020.
Yes No N/A
L.Reviewed previous inspection reports? X REPORT SUMMARY
z.Reviewed evaluation report? X 1. Work inspected was: C Completed E In Progress
Terified following items meet manufacturer's published installation 2. Completed work inspected n was E was not in compliance
naterials. with
Yes No N/A
ITC Verified minimum embedment depth of the anchors? X Approved plans and specifications Shop Drawings
l.Verified installation of the anchors? X ❑RH n Design Change n Submittal n N/A
;.Verified anchor diameter? X Doc.No(s): PLANS Dated: 05/04/2020
i.Verified steel grade? X
7.Verified hole diameter? X 3. Noncompliance item(s)were noted this date,details on the following
3.Verified type of drill bit used? X page(?): Yes No N/A
).Verified hole cleaning method? X 4. Noncompliance item(s)were reinspected this date,details on
1o.Verified adhesive application? X following page(s)n Yes n No n N/A
Li.Verified edge distance? X Conform E1 Remain in progress
12.Verified spacing? X
t3.Verified installation torque? X
Report(s)findings were disci issed and left with
CARL
?valuation report number and date:
JULY 2020
of Al FRAMING
lame of product being installed:
>IMPSON SET XP.
atch Number: 1000086722
xpiration Date: 07/17/2022
'aced on the code,approval is required from the Building Official before the SPECIAL INSPECTED items noted above can be covered. Carlson
fisting has no authority to direct work of contractors and subcontractors.
See additional report paga(s) ❑Distnlute Attachment(s) Proprietary Anton Version I Page 1 of