Report r �! ® Main Office Salem Office . ?Mid Office'
P.O. Box 23814 0 Hudson Ave., NE P.O. Box 7918
Tigard, Oregon 97281 Salem, OR 97301 Bend, OR 97708
Carlson Testing inc • Phone (503) 684 -3460 Phone (503) 589-1252 Phone (541) 330-9155
FAX (503) 684 -0954 FAX (503) 589 1309 FAX (541) 330 -9163
Special Inspection
FINAL SUMMARY LETTER
September 20, 2005
T0509173.CTI
City of Tigard
13125 SW Hall Blvd.,
Tigard, OR 97223 -8199
Attn: Building Department
Re: Garrett Residence
10770 SW Farhaven Way — Tigard, OR
Permit #: BUP2005 - 00432
Dear Sir or Madam:
This is to certify that in accordance with Section 1701 of the Uniform Building Code, Title 24, we have
performed special inspection of the following item(s) per our inspection reports only:
Installation of Adhesive Anchors
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.
If there are any further questions regarding this matter, please do not hesitate to contact this office.
Respectfully submitted,
RLS2 V_TESTING, INC:
oqb- il ik/
Andrew M. EAISEDENT
President
mbw
cc: Robert Steven Garrett
Main Office Salem Office Enid Office.
• �� P.O. Box 23814 0 Hudson Ave., NE 'P.O. Box 7918
Inc. alem, OR 97301 Bend, OR 97708
Carlson Testing P hone igard , (503) Oregon 684 -97281
3460 Phone (503) 589 -1252 Phone (541) 330 -9155
9 l FAX (503) 684 -0954 FAX (503) 589 -1309 FAX (541) 330 -9163
September 20, 2005
T0509173.CTI
Permit No. BUP2005 -00432
FIELD INSPECTION REPORT
DATES COVERED: September 14, 2005
PROJECT: Garrett Residence
ADDRESS: 10770 SW Fairhaven Way — Tigard, OR
INSPECTOR: K. Parkin, COP #725
09- 14 -05: CTI representative was present on site and verified depth, diameter and cleanliness
of (10) drilled holes for added hold down anchors in rear added sunroom. Observed the owner
install (8) 5/8" diameter and (2) 1 /" diameter threaded rods into above holes using Simpson Set
Pac epoxy. Installation was per approved City of Tigard drawings dated 9/8/05 and ICBO report
#5279.
*** CHECK ONE BOX ONLY * ** YES NO
1. This is a preliminary inspection only. — OR — 0
2. The work inspected conforms to acceptance criteria listed above. If "No," the portions of the
work that are non - conforming items are clearly stated above and will be added to the NCL.
Remaining portions of the work, which are not preliminary in nature, are to be considered as
conforming.
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.
If there are any further questions regarding this matter, please do not hesitate to contact this
office.
Respectfully submitted,
J E S T U G J 4C ES G, C.
I
PRESIDENT
Andrew M. Ewing
President
KP /mb
cc: Robert Steve Garrett
City of Tigard Building Dept