Loading...
Report Bend Office (541) 330 -9155 Geotechnical Office (503) 601 -8250 Carlson Testing, Inc. Eugene Office (541) 345 -0289 Salem Office (503) 589 -1252 Tigard Office (503) 684 -3460 Daily Report of Proprietary Anchors Client: BRIAN MAYEA Project: DAVIDSON RESIDENCE - ADDITION /REMODEL CTI Job #: T1003068. Address: 11542 SW WOODLAWN COURT TIGARD OR Jurisdiction: TIGARD CTI representative A. NUNLEY OBOA 866 was on site this date Sep. 14, 2010 to perform Special Inspection for: Permit MST2010 -00127 DFS #(s) PO Number: SCOPE OF INSPECTION Location of proprietary anchors inspected [to include grid lines, elevations (floors) and drawing details]: 1. Checked in with superintendent or client representative. OBSERVED THE INSTALLATION OF (4 VERTICAL) BRIAN fie' 1" DIAMETER THREADED ROD 1 1/8" DIAMETER, Company: MAYEA CONSTRUCTION 9" MINIMUM EMBEDMENT PER DETAIL ON SHEET #1 2. Inspection was "IBC" © Continuous Periodic REFER TO JAMES R ZACHRISON (ENGINEER) AUGUST 3, 2010 PROPRIETARY ANCHORS Yes No N/A 1. Reviewed previous inspection reports? 2. Reviewed evaluation report? X Verified following items meet manufacturer's REPORT SUMMARY published installation instructions. 3. Verified minimum embedment depth of the 1. Work inspected was: M Completed 0 In progress anchors. X 2. Completed work inspected was in compliance with 4.Verified installation of the anchors. X S. Verified anchor diameter. © Approved plans and specifications 0 Shop drawings X 6. Verified steel grade. RFI Design change E Submittal El N/A 7. Verified hole diameter. X Document #(s) Dated: 8. Verified type of drill bit used. X 9. Verified hole cleaning method. X 3. Noncompliance item(s) were noted this date, details on 10. Verified adhesive application. x following page(s). 0 Yes ❑ No E N/A 11. Verified edge distance. X 4. Noncompliance item(s) were reinspected this date, details 12. Verified spacing. X on following page(s). ❑ Yes ❑ No E N/A 13. Verified installation torque. X 0 Conform El Remain in progress Evaluation report number & date: Report(s) findings were discussed and left with ESR 2508 JUNE 1, 2009 BRIAN of MAYEA CONTRUCTION Name of product being installed SIMPSON SET -XP Batch Number 243Z184Z Expiration Date 1/12 Based on the Code, approval is required from the Building Official before the SPECIAL INSPECTED items noted above can be covered. Carlson Testing has no authority to direct work of contractors or subcontractors. lj See additional report page(s). El Distribute attachments. Page 1 of 1 Daily Report of Proprietary Anchors For: 09/14/2010 CTI Job #: T1003068 . Project: DAVIDSON RESIDENCE - ADDITION /REMODEL Notes: In some cases more than one box may be checked for a given item on the front page. Our reports pertain to the material tested /inspected only. Information contained herein is not to be reproduced, except in fi without prior authorization from this office. Under all circumstances, the information contained in this report is provided subject to all terms and conditions of CTI'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 are any further questions regarding this matter, please do not hesitate to contact this office. Respectfully submitted, CARLSON TESTING, INC. Reviewed By: Keith Gauvin Review Date: 09/24/2010 ALN /WM BRIAN MAYEA TO: CITY OF TIGARD BUILDING DIVISION JAMES R ZACHRISON CONSULTING ENGINEERS - JAMES ZACHRISON