Report F c,
- CITY OF TIGARD
A Program for Inspection Services and/or Material Testing
Date: 0/0/, 13,19 ooce9 +
City of Tigard: Plan Ck. No. Bup No. Sit No.
plex 67 •no p ri;t
Project Title: T/Gttee) am�/� D ice- Address
Architect of Record t-RS Q r(i,i4C /S Ph.
address: /12/ Sup Sit . lmc 71 , . /4.°) Peril`-'7"1-44)4
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Structural Engineer of Record: ti/ K t= 3 3 4/5' Ph. a.?a- `4453
address: 39 S w Ke/ly Kelly j fire-.Tl i9•UD, drie '27z0 /
Geo- Technical Engineer of Record: C�c2 Ph. CAa0 - 51e/0
address: '7 _So ZJ &r; ../ - . 4 vt).6
Provide the following information for the testing agency chosen to provide inspection services and/or testing.
Testing Agency: Ph. Fax.
address
Geo- Technical Agency:6(o e )ZUY! Ph!� Fax. ‘.20
address 7f r tD %Gf Rd . P 7Z I.D, O.
The owner certifies that the above noted Agency has been employed to conduct the
spe • inspections r observations required herein.
6 tgo - Danz L{ -
Signature of Owner Phone No. y Date
Iv Ob � ,ta� n S S�oee �y����
The following is a list of special inspection and/or services required by the 1996 Oregon
Structural Specialty Code and Tigard's Municipal Code 14.06.010 through 14.06.040.
The special inspections and/or testing services required for this project to be provided by the Testing
Agency, Structural Engineer or Geo- Technical Engineer of Record are as follows:
• Special Inspectors for the Testing Agency shall be qualified, to the satisfaction of
the Building Official, for inspections of the particular type of construction or operation.
• Special inspectors shall observe the work assigned herein for conformance with the
approved plans and specifications and, submit copies of all inspection reports and, a
final signed report in accordance with OSSC, Section 1701.3 to the building official.
_:Category Aescr,pi�on ofServ�ces
Y. Itn
,;1- M .... :: .
1. Footings adjacent to slopes steeper than 33 -1/3 % OSSC, Section 1806.4
a. Confum building footings are properly set back from descending slope
b.
2. Grading OSSC, Section 3309
a. Regular grading [less than 5,000 cu. yds. but considered unusual] • •
Requirements for engineered grading apply.
b. Engineered grading [exceeds 5,000 cu. yds.]
Submit: 1. Geo- technical engineers report and,
2. a engineering geology report.
3. an as -built grading plan and,
4. a final report prepared by the soils engineer and,
5. the final report prepared by the geologist.
C.
3. Fills OSSC, Section 3313
a. Preparation of ground. for fill on slopes exceeding 1 to 5 (20 %)
Includes benching and proper termination at the toe of the slope
b. Acceptance of fill materials
X C «tG
C. Compaction of fill material to minimum 90% of maximum density. �J
X 6e0 F/14
13125 SW Hall Blvd., Tigard, OR 97223 [503] 639 -4172 FAX [503] 684 -7297
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