Report •
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CITY OF TIGARD ' V/ v
OREGON
Carlson Testing
P.O. Box 23814
Tigard, OR 97281
PERMIT NO: qg - c4
OWNER: P- . ac
PROJECT ADDRESS: t y tit3O5 4 ' /1 I •
• PROJECT DESCRIPTION: f' - _ 14
TYPES OF SPECIAL INSPECTION: Structural special inspections.
_ t� teary
The owner has notified us that he/she will retain your services to perform Sped a�lrions in accordance
with the provisions of the State Budding 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 cad the Building Division at (503) 639 -4171.
Sincerely,
Jim-Funk
456
B11i isk n 122.4,„/.5 fix , A✓s-/1
Enclosure
13125 SW Hall Blvd., TiOard OR 97223 (503) 639 -4171 TDD (503) 684 -2772
CITY OF TIGARD
A Program for Inspection Services and/or Material Testing -
Date: I t 1� (41$,19
City of Tigard: Plan Ck. No. to - 6 Bup No. ` ��,- 6 Sit No.
Project Title: f LtC•e_ U4- 1.41 Address I2$oS -s ' '17 -,
Architect of Record ` zuza -.re_ Ph. 223- 3f s'S
address: st3a0u vi 44. - R'¢ic.aac?,C?rz
C
omet )
Structural Engineer of Record: C. pt.nl..< .e qty Ph.
address:
Geo- Technical Engineer of Record: Ph.
address:
Provide the following information for the testing agency chosen to provide inspection services and/or testing.
Testing Agency: CQY\C4-ff Ph. 6FA.3460Fax. 8 4_ Oct s
address ID. 0. e T' • 41
Geo- Technical Agency: Ph. Fax.
address
The owner certifi - that the above noted Agency has been employed to conduct the
spe • . • : spect . - s or observations required herein.
Signature of owner -Q Phone No. Date
73
Y DEG KS '
Print name Company name
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.
6. High Strength Bolting. OSSC, Section 1701.5.6
• The installation of A325 and A490 bolts shall be in accordance with Chapter 22 Division IV
a. Verify bolt types, diameter and installation . >
Periodic inspection shall be in accordance with OSSC, Section 1701.6
•
b.
c.
7. Structural Masonry. OSSC, Section 1701.5.7 and 2105
• Other than fully grouted open -end hollow -unit masonry.
a. Visually verify placement of masonry units, reinforcing steel, inspection
of grout spaces and taking any required prisim or test specimens, and be
present during all grouting operations.
For fully grouted open -end hollow -unit masonry .
b. Visually verify the start of laying units, placement of reinforcing steel,
taking prisms or test specimens, inspect grout spaces and be present
during all grouting operations.
C. Verify that grout and mortar materials and proportions are in accordance
with OSSC, Table 21 -A for Mortar and 21 -B for grout.
d.
e.
8. Spray - applied fireproofing. OSSC, Section 1701.5.10
a. Visually verify the substrate condition, thickness determination and
confirm density report are all in accordance with UBC, Standard 7-6
b.
9. Piling, Drilled Piers and Caissons. OSSC, Section 1701.5.11
a. Present during driving of piles and subsequent testing,
b. Inspect the construction of cast -in -place drilled piles or caissons.
C. Observe placing of reinforced concrete.
•
d. Observe placement of reinforcement steel
e. . 1 l
•
10. Shotcrete. OSSC, Section 1701.5.12
a. Observe taking of test specimens
b. Observe the placement of all shotcrete used for structural members.
•
Submit a statement of compliance with plans and specifications.
C. Visual examination of completed shotcrete work.
Submit a report of the three test specimens required.
d.
SOILS Inspection Services and Materials Testing
Special Grading, excavation and filling
•