Report Main Office Salem Office Bend Office
P.O. Box 23814 4060 Hudson Ave., NE P.O. Box 7918
Carlson Testing Inc • Phon 684 -3460 Phone (503) 589-1309 Phone (541) 330-9155
FAX (503) 684 -0954 FAX (503) 589 -1309 FAX (541) 330 -9163
Special Inspection
FINAL SUMMARY LETTER
I 0LI
December 14, 2004 �
,
T0406934.CTI
City of Tigard
13125 SW Hall Blvd.,
Tigard, OR 97223 -8199
Attn: Building Department
Re: Hansen Residence
14111 SW Wagoner Place - Tigard, OR
Permit No.: BUP2004 -00510
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.
Respectfu ('y sub itted
CA: SO TES NG, N .
Doug as ' ` each
Chief Executive Officer
mbw
cc: Leif Hansen