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Report V . • g� o . • • Construction Inspections & Related Tests -' • �ar1son Testing, Inc. . • • . GeotechnicalConsulting • Main Office Salem Office Bend Office P.O. Box 23814 4060 Hudson Ave.. NE P.O. Box 7918 Tigard, Oregon 97281 Salem, Oregon 97301 Bend. Oregon 97708 Phone (503) 684 -3460 Phone (503) 589 -1252 Phone(541)330 -9155 Fax (503) 684 -0954 Fax (503) 589 -1309 Fax (541) 330 -9163 REPORT OF 4 X 8 CONCRETE TEST SPECIMENS Test Methods: ASTM C31/C172/C192/C617/C1064/C143 Date Mold -• • /23/2 8 Job Number: T0806993. Perm #: ,UP2008 -00063 Cli:1 t: ROBERT G:' PARTNERS INC — BOB GRAY Project: THE BROADWAY ROSE THEATRE COMPANY — REMODEL Address: 12850 SW GRANT AVENUE TIGARD OR Jurisdiction: TIGARD Contractor: ROBERT GRAY PARTNERS INC — BOB GRAY Subcontractor: Cast By: STEVEN W. LEACH Concrete Supplier: WILSONVILLE CONCRETE PRODUCTS Truck #: 62 Load #: 1 Ticket #: W133692 Weather: LIGHT RAIN Test Time: 1: 30 PM Air Temp. at Sampling Time: 55 Cylinders were cast for the following locations: INTERIOR SPREAD FOOTINGS Total Concrete Placement Location: Strength Requirement: 3500 psi fc @ 28 Days Slump: 4.500" % Air: N/T Mix Number: 307009WA Conc. Temp: 65 Cement Type: 1 -11 Max Agg: 3/4 Admix/Amt: Cubic Yards: Register Number: 0081911 Lab Location: TIGARD Set Test @ Date Test Total Area Unit Type Of Tested No. Days Rec'd Date Load PSI Fracture By 7 04/24/2008 04/30/2008 54743 12.56 4360 3 MEM 28 04/24/2008 05/21/2008 28 04/24/2008 05/21/2008 28 04/24/2008 05/21/2008 ❑ Distribute attachments. Average Pc @ 28 days Please see reverse side for additional information. • Job Number: T0806993. Register Nuth er: 0081911 Date Molded: 04/23/2008 Project: THE BROADWAY ROSE THEATRE COMPANY- .REMQDEL < 1 in. [25 mm] l / ,>/' Type I Type 2 Type 3 Reasonable well - formed Well- Formed cone on one Columnar vertical cracking cones on both ends, less end, vertical cracks running through both ends, no than 1 in. [25 mm] of through caps, no well - defined well - formed cones cracking through caps cone on other end • Type 4 Type 5 Type 6 Diagonal fracture with Side fractures at top or Similar to Type 5 but no cracking through bottom (occur commonly nd of cylinder is pointed ends; tap with hammer to with unbonded caps) distinguish from Type I Asterisked ( *) average unit PSI test results did not meet listed acceptance criteria. Remarks: ROBERT GRAY PARTNERS INC - BOB GRAY TO: CITY OF TIGARD BUILDING DIVISION T M RIPPEY CONSULTING ENGINEERS - DOUG GANNETT SODERSTROM ARCHITECTS - TIM AYERSMAN Project Manager: STEVEN W. LEACH Reviewed By: Ty Toiler On 05/01/2008 Our report pertains to the material tested only. 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. A . . .. . ,. . ,. Main Office Salem Office Bend Office . P.O. Box 23814 4060 Hudson Ave., NE P.O Box 7918 C ss�� �• gyp Inc. "Tigard, Oregori 972$1 Salem. Oregon 97301 Bend. Oregon 97708 arlson Testing, Ic .Phone (503) 684 -3460 Phone (503) 589 -1252 Phone (541) 330 -9155 Fax (503) 684 -0954 Fax (503) 589 -1309 Fax (541) 330 -9163 Daily Report of Proprietary Anchors Client: ROBERT GRAY PARTNERS INC - BOB GRAY Project: THE BROADWAY ROSE THEATRE COMPANY - REMODEL CTI Job #: T0806993. - --:= -- - 128'50"'SW 2GRANTTAVENUE�= oT.IEA`'® - =6•- - -'TTGAAD= - Address: _ - - -H_• :• - --_-- - ==Jag- diction: - - - -- - — CTI repres -. , • -_, - . HRO OBOA 646 ��' w.. an site, is date • •r \ 22, 2008 to perform Special Inspection for: 'ermit BUP2008 -00063 I FS #(s) PO Number: SCOPE OF INSPECTION Location of proprietary anchors inspected [to include grid I . Checked in with superintendent or client representative. lines, elevations (floors) and drawing details]: Name: Company: ROBERT GRAY 44 REBAR DOWELS INTO 6 NEW FOOTINGS PER DETAIL ON 5301, DETAIL #5, 23 & 9. 2. Inspection was "IBC" ® Continuous ❑ Periodic 3. Work performed: ® In the field ❑ At precast shop 4. If shop inspection do they have fabrication and QC procedures? ❑ Yes ❑ No ® N/A PROPRIETARY ANCHORS REPORT SUMMARY Yes No N/A 1. Reviewed previous inspection reports? x 1. Work inspected was: ® Completed ❑ In progress 2. Reviewed evaluation report? x 3. Verified manufacturer's anchor use conforms 2. Completed work inspected was in compliance with x A roved plans and specifications Shop drawings to acceptance criteria in report summary. ® PP P P ❑ P s g Verified following items meet manufacturer's ❑ RFI ❑ Design change ❑ Submittal ❑ N/A published installation instructions. 4. Verified minimum embedment depth of the Document #(s) Dated. anchors. x 3. Noncompliance item(s) were noted this date, details on 5.Verified installation of the anchors. x following page(s). ❑ Yes ❑ No ❑ N/A 6. Verified anchor diameter. x 7. Verified steel grade. x 4. Noncompliance item(s) were reinspected this date, details 8. Verified hole diameter. on following page(s). ❑ Yes ❑ No E., N/A x 9. Verified type of drill bit used. x ❑ Conform ❑ Remain in progress 10. Verified cleanliness of hole and anchor. x 11. Verified adhesive application. x Report(s) findings were discussed and left with Evaluation report number ICC ER -5193 of ROBERT GRAY Name of product being installed HILTI HY -150 Batch Number 222916L2 Expiration Date 07/08 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. ❑ See additional report page(s). ❑ Distribute attachments. Page 1 of 1 Daily Report of Proprietary Anchors • For: 04/22/2008 CTI Job #: T0806993. Project: THE BROADWAY ROSE THEATRE COMPANY - 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 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, CARLSON TESTING, INC. Reviewed By: Steven W Leach Review Date: 05/05/2008 RFG /JWA ROBERT GRAY PARTNERS INC - BOB GRAY TO: CITY OF TIGARD BUILDING DIVISION T M RIPPEY CONSULTING ENGINEERS - DOUG GANNETT SODERSTROM ARCHITECTS - TIM AYERSMAN C �y+ Construction Inspections & Related Tests arlson Testing, Inc Geotechnical Consulting • • Main Office Salem Office Bend Office P.O. Box 23814 4060 Hudson Ave., NE P.O. Box 7918 Tigard, Oregon 97281 Salem, Oregon 97301 Bend, Oregon 97708 Phone (503) 684 -3460 Phone (503) 589 -1252 Phone (541) 330 -9155 Fax (503) 684 -0954 Fax (503) 589 -1309 Fax (541) 330 -9163 REPORT OF 4 X 8 CONCRETE TEST SPECIMENS Test Methods: ASTM C31 /C172/C192/C617/C1064/C231/C143 Date Molded: 05/12/2008 Job Number: T0806993. Permit #: BUP2008 -00063 Client: ROBERT GRAY PARTNERS INC - BOB GRAY Project: THE BROADWAY ROSE THEATRE COMPANY - REMODEL Address: 12850 SW GRANT AVENUE TIGARD OR Jurisdiction: TIGARD Contractor: ROBERT GRAY PARTNERS INC - BOB GRAY Subcontractor: Cast By: D. SUMINSKI Concrete Supplier: WILSONVILLE CONCRETE PRODUCTS Truck #: 47 Load #: 1 Ticket #: W133 9 6 0 Weather: OVERCAST Test Time: 1 :15 Air Temp. at Sampling Time: 57 Cylinders were cast for the following locations: SOUTH FOOTINGS Total Concrete Placement Location: ALL FOOTINGS Strength Requirement: 3000 psi fc @ 28 Days Slump: 4.000" % Air: 1.10% Mix Number: 305001W Conc. Temp: 64 Cement Type: Max Agg: 3/4 Admix/Amt: Cubic Yards: 7 Register Number: 0083422 Lab Location: TIGARD Set Test @ Date Test Total Area Unit Type Of Tested No. Days Rec'd Date Load PSI Fracture By 7 05/13/2008 05/19/2008 47900 12.56 3810 4 MEM 28 05/13/2008 06/09/2008 28 05/13/2008 06/09/2008 Distribute attachments. Average fc @ 2 8 days Please see reverse side for additional information. Job Number: T 0806993 - Register Number: 00 342'2 Date Molded: 05/12/2008 Project: THE BROADWAY ROSE THEATRE COMPANY • –, REMODEL — 1 1 " ! < 1 in. [25 mm] )\. Type 1 Type 2 Type 3 Reasonable well - formed Well- Formed cone on one Columnar vertical cracking cones on both ends. less end, vertical cracks running through both ends, no than 1 in. [25 mm] of through caps, no well - defined well- formed cones cracking through caps cone on other end J am` Type 4 Type 5 Type 6 Diagonal fracture with Side fractures at top or Similar to Type 5 but no cracking through bottom (occur commonly end of cylinder is pointed ends; tap with hammer to with unbonded caps) distinguish from Type 1 Asterisked ( *) average unit PSI test results did not meet listed acceptance criteria. Remarks: ROBERT GRAY PARTNERS INC - BOB GRAY TO: CITY OF TIGARD BUILDING DIVISION T M RIPPEY CONSULTING ENGINEERS - DOUG GANNETT SODERSTROM ARCHITECTS - TIM AYERSMAN Project Manager: STEVEN W. LEACH Reviewed By: Ty Toiler On 05/21/2008 Our report pertains to the material tested only. 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. ' Construction Inspections & Related Tests Carlson Testing, Inc. • ; " . • . Geotechnical Consulting • Main Office Salem Office Bend Office P.O. Box 23814 4060 Hudson Ave., NE P.O Box 7918 Tigard, Oregon 97281 Salem, Oregon 97301 Bend, Oregon 97708 Phone (503) 684 -3460 Phone (503) 589 -1252 Phone (541) 330 -9155 Fax (503) 684 -0954 Fax (503) 589 -1309 Fax (541) 330 -9163 REPORT OF 4 X 8 CONCRETE TEST SPECIMENS Test Methods: ASTM C31/C172/C192/C617/C1064/C143 Date Molded: 04/23/2008 Job Number: T0806993. Permit #: BUP2008 -00063 Cli ROBERT GRAY PARTNERS INC - BOB GRAY Project: THE BROADWAY ROSE THEATRE COMPANY - REMODEL Address: 12850 SW GRANT AVENUE TIGARD OR Jurisdiction: TIGARD Contractor: ROBERT GRAY PARTNERS INC - BOB GRAY Subcontractor: Cast By: STEVEN W. LEACH Concrete Supplier: WILSONVILLE CONCRETE PRODUCTS Truck #: 62 Load #: 1 Ticket #: W133692 Weather: LIGHT RAIN Test Time: 1 : 30 PM Air Temp. at Sampling Time: 55 Cylinders were cast for the following locations: INTERIOR SPREAD FOOTINGS Total Concrete Placement Location: Strength Requirement: 3500 psi fc @ 28 Days Slump: 4.500" % Air: N/T Mix Number: 3 0 7 0 0 9WA Conc. Temp: 65 Cement Type: I I I Max Agg: 3/ 4 Admix/Amt: Cubic Yards: Register Number: 0081911 Lab Location: TIGARD Set Test @ Date Test Total Area Unit Type Of Tested No. Days Rec'd Date Load PSI Fracture By 7 04/24/2008 04/30/2008 54743 12.56 4360 3 MEM 28 04/24/2008 05/21/2008 72900 12.56 5800 2 BR 28 04/24/2008 05/21/2008 72700 12.56 5790 2 BR 28 04/24/2008 05/21/2008 73400 12.56 5840 2 BR Distribute attachments. Average fc @ 28 days 5 810 Please see reverse side for additional information. • Job Number: T0806993. • Re'gisterNum:er: 0,0131911 ' Date Molded: 04/23/2008 Project: THE BROADWAY ROSE THEATRE COMPANY " — REMODEL , < 1 in. [25 mm] A ?1,/ Type 1 Type 2 Type 3 Reasonable well - formed Well- Formed cone on one Columnar vertical cracking cones on both ends, less end, vertical cracks running through both ends, no than 1 in. [25 mm] of through caps, no well- defined well - formed cones cracking through caps cone on other end N - - - - • r Type 4 Type 5 Type 6 Diagonal fracture with Side fractures at top or Similar to Type 5 but no cracking through bottom (occur commonly end of cylinder is pointed ends: tap with hammer to with unbonded caps) distinguish from Type I Asterisked ( *) average unit PSI test results did not meet listed acceptance criteria. Remarks: • • ROBERT GRAY PARTNERS INC - BOB GRAY TO: CITY OF TIGARD BUILDING DIVISION T M RIPPEY CONSULTING ENGINEERS - DOUG GANNETT SODERSTROM ARCHITECTS - TIM AYERSMAN Project Manager: STEVEN W. LEACH Reviewed By: Ty Toiler On 05/22/2008 Our report pertains to the material tested only. 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. ,Main Office Salem Office Bend Office P.O. Box 23814 4060 Hudson Ave., NE P.O. Box 7918 C `� �° o Tigard„ Oregon 97281 Sarem, OR 97301 Bend, OR 97708 arlson ®� �� �� ® P FAX (503) 684 0954Q. Phone FAX (503) 589- 1 3 0 92 Phone (541) 330-9155 FAX (541) 330 -9163 April 29, 2008 T0806993 Permit N. BUP2008 -00063 FIELD IN S • "i'T DATES COVERED April 23, 2008 PROJECT The Broadway Rose Theatre Company - Remodel ADDRESS: 12850 SW Grant Avenue — Tigard, OR INSPECTOR: S. Leach COP #662, WABO #LEA745427, OBOA #243 04 -23 -08 - Concrete / Reber As requested, CTI representative was on site and inspected rebar and the placement of 10 Yds concrete (Wilsonville 3500 -psi, mix N° 307009WA) at (6) interior footings. All rebar was placed in compliance with approved project plans and specifications. One set of 4X8 test samples were cast during concrete placement. " ** CHECK ONE BOX ONLY * ** YES NO 1 This is a preliminary inspection only — OR — 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 Rortions 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, CARLSON TESTING, INC. Z even W Leach Project Manager SL /ck cc Robert Gray Partners Inc — Bob Gray City of Tigard Building Division T M Rippey Consulting Engineers — Doug Gannett Soderstrom Architects — Tim Ayersman