Report (656) 09/07/10 TUE 10:03 FAX 503 670 9147 CARLSON TESTING 0 002
Carlson Testing, Inc. 8430 SW Hasa.
711 OR P72-74 4060 141■21V. 5:4 NE'
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FINAL SUMMARY LETTER
August 19, 2010
T0807769/T1002573
City of Tigard
13125 SW Hall Blvd
Tigard, OR 97223-8199
Attn: Building Department
Re: Burgerville #45 (Tigard) — New Construction
12785 SW Pacific Highway— Tigard, OR
Permit No.'s: BUP2008 -00246 and BUP2010-00106
Dear Sir or Madam:
This is to certify that in accordance with Section 1704.1.2 of the International Building Code, we have performed special
inspection of the following item(s) per our inspection reports only
Reinforced Concrete
Installation of Cast in Place Anchors
Installation of Adhesive Anchors
Structural Masonry
Structural Steel — Shop Only .
All inspections and tests were performed and reported according to the requirements of Project Documents and, to the
best of our knowledge, the work was in conformance with the approved plans and specifications, approved change orders
and applicable workmanship provisions of the State Building Code and Standards, as well as the structural engineer's
design changes, approvals and verbal instructions.
Our reports pertain to the material tested/inspected only. Information contained herein is not to be reproduced, except in
full, without prior authorization from this office. Under all circumstances, the information contained in this report is
provided subject to all terms and conditions of C'PI's General Conditions in effect at the time this report is prepared. No
party other than those to whom CTI has distributed this report shall be entitled to use or rely upon the information
contained in this document
If there i any further questio • , -. arding this matter, please do not hesitate to contact this office.
Res. 4 Ily submitt • •
CARL* e N TESTI , INC.
Jam 1 '. Hietpas
Prop Manager
JF
• The Holland Inc/Burgerville Restaurants — Dana Gardner danaWthehollandinc.com
BK Engineers Inc — Bill Berry
Architects Associative — Jeff Lightheart
RSV Building Solutions — Josh Lingo
RSV Building Solutions — Shawii Aubrey
09/07/10 TUE 10:03 FAX 503 670 9147 CARLSON TESTING (2 001
CARLSON TESTING, INC.
Phone: 503-684-3480/Fax 503-684-0954
PC Box 23814 Tigard, OR 97223
FAX TRANSMITTAL
To: City of Tigard Building Department
Attn: Rick Bolen
Fax: 503/6244681
From: Carlson Testing, Inc. -- Karen Shepherd
Date: September 7, 2010
Re: FINAL SUMMARY LETTER Total Pages: 2
This is the final summary letter for:
Project: Burgerville #45 (Tigard) — New Construction
Permit # BUP2008 -00246 and BUP2010 -00106
Please call if you have any questions. 503/419 -4527.
Thank You,
Karen Shepherd
Administrative Assistant