Correspondence i fr- ,5
December 17, 1996 CITY OF TIGARD
O REGON
Carlson Testing
P.O. Box 23814
Tigard, OR 97281
PERMIT NO: SIT96 -0055
OWNER: Pollock/Waymire
PROJECT ADDRESS: 12570 SW 69th Avenue
PROJECT DESCRIPTION: New Building
TYPES OF SPECIAL INSPECTION: Soils special inspections.
Dear Mr. Leach:
The owner has notified us that he/she will retain your services to perform Special Inspections in accordance
with the provisions of the State Building Code, permit documents, and special inspection requirements.
The owner or the owner's agent must also confirm with you that they have authorized you to do the special
inspection work.
As the regulatory agency, the City requires that you do the following:
1. Submit copies of all inspection reports promptly to the Building Division, architect, engineer,
and the contractor.
2. Maintain one copy of each field report at the job site.
3. Submit a final report at the completion of each category of work that you inspect. (See
U.B.C. 3318 for soils special inspection final report requirements).
If you fail to comply with the above requirements, there may be cause for the City to revoke your authority as
special inspector for this job.
Should you have any questions, please call the Building Division at (503) 639 -4171.
Sincerely,
Jim Funk
Building Division
Enclosure
i:btsltemplaten notily.dot
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772
Plan Review # / - 7L e ri74 9l p 0sy F ,t.I,L I,
Date /e-- 4.,4 -47 e CITY OF TIGARD
OREGON
Soils Special Inspections
This form shall be signed by the Owner. Engineer or Architect of Record and returned to the Building Division prior to
issuance of the permit. Please note that a separate structural special inspection form may be required.
Project Address: , „ 9 f�
d.... ..... ....Project (Name:• . / O t 7v+ e
Architect of Record (Firm): p � sN Phone: aS t�S
Engineer of Record (Firm): 0 7`4 g Phone: 6 5 6
Solis Engineer: , fsovA. 7 4 f J i �ic, Phone:
Lot _ Subdivision: a& /t.L
The following special inspections shall be performe accd rdin g of t e Building Code and C Tiga Municipal
Code Chapter 14.06.010 - 14.06.040:
❑ Engineered Grading ( >5,000 cubic yards) - U.B.C. 3309.4
® Regular Grading - U.B.C. 3309.8
CO Compaction Reports (per ASTM standards listed in U.B.C. 3305)
Testing Agency: /' )?t f e i1 " (4- r n 5
Phone:
reT Other F i/ _t ct ?",er / A.) sat J Ipt. c 1 Y!
The owner hereby a -, - e : mploy the above soils engineer for the above -noted special inspections.
Signatu : of • "Aber n('�
Print Name •1. (Z,' 14 t \ (Z Phone No. Z2 X 39
Firm Date La - /0 -96
osumeAvwk+ea,sa.oee
•
125 SW Hall Blvd., 1 crd, OR 97223 (503) 639 -4171 TDD (503) 684 - 2772