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
Special Inspection
FINAL SUMMARY LETTER
Date: February 25, 2014
Job#: T1401232
City of Tigard
13125 SW Hall Blvd
Tigard, OR 97223-8199
Attn: Building Division
Re: Project Name: Taylor Residence—Remodel
Address: 13965 SW 102nd Avenue—Tigard, OR
Permit#: MST2013-00235
Per Chapter 17, Section 1704.1.2 of the International Building Code (IBC), we have performed special inspection of the following
item(s) per our inspection reports only:
Adhesive Anchors
All requested 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 construction inspection and testing services were provided and intended to help reduce the risk of construction defects,
deficiencies or omissions that arose during and after construction. Our services do not constitute a warranty or guarantee of any
type. Even with diligent construction monitoring and testing, construction defects, deficiencies or omissions in the contractor's
work may exist. It is the contractor's responsibility to perform their work in accordance with the approved construction
documents.
CTI has provided its professional services with the degree of care and skill currently exercised under similar circumstances by
members of its profession in the same locale. Statements made in our reports are based on technical judgments and should not
be construed to be conclusive representations of fact. Our reports pertain to the material tested/inspected only.
CTI's services did not include responsibilities related to determining, supervising, implementing or controlling the means,
methods, techniques, sequences or procedures of the construction or evaluating or reporting job conditions related to health,
safety or welfare.
Information contained herein is not to be reproduced, except in full, without prior authorization from this office. If there are further
questions regarding this matter please do not hesitate to contact this office.
Respectfully submitted,
CARLSON TESTING INC.
t`ic"'I;essner
Project Manager
EG/jk
cc: Tom Nolf Construction — Kim Nolf kimnolf@msn.com
City of Tigard Building Division —Walter'Chip' Barnett walter @tigard-or.gov
Miller Consulting Engineers—Charles Marquardt cj@miller-se.com
Peter& Bonita Taylor Scott.taylor @realitydirect.com
P:\Projects1Generai\2014\T1401232102-25-14 Final Letter.doc Updated 11/30/11
rnsT 07013 —6159-;C
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
Project: t } V P t'S it 4 .ev«-42_
Address: 13a (O • J 5 02'"--1- CTI Job#: Iv d —
CTI representative 4 %e /P" ' 1 was on site this date 2'14/ '14-1 to perform 471
(Inspector Name&udrt.No.)
Special Inspection for r permit 0 DFS#(s) s 2 (3 �3 Sjjurisdiction I1'``/Y c� •
In some cases more than one box may be checked for a given item.
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. "
�� � ��,� c�.����-L 1, g
Name: wt ,,en., 0- :`�t.•....' ✓� ..w1 T
Company: .a°1 I ,.`1i( LO -1,-k_5;-,t IDuG...€ cie Nast
2.Inspection was"IBC" ® Continuous p Periodic , J
1kvt ,/-* a -.0+• ,d Q4.- elPfou S ®A-)
aPpv-9Ve4 /3 co•0s,
PROPRIETARY ANCHORS
Yes No N/A
1.Reviewed previous inspection reports? -
2.Reviewed evaluation report? of REPORT SUMMARY
Verified following items meet manufacturer's
published installation instructions. 1.Work inspected was: Et Completed El In progress
3.Verified minimum embedment depth of the x 2. Completed work inspected El was ❑ was not
4.Verified installation of the anchors. in compliance with
5.Verified anchor diameter. V
0 Approved plans and specifications ❑ Shop drawings
6.Verified steel grade. p. ❑ RFI 0 Design change 0 Submittal 0 N/A
7.Verified hole diameter. d Document#(s) Dated:
8.Verified type of drill bit used. p( 3.Noncompliance item(s)were noted this date,details on
9.Verified hole cleaning method. 04 following page(s). El Yes ® No El N/A
10. Verified adhesive application. pl
11. Verified edge distance. a 4.Noncompliance item(s)were reinspected this date,details
12. Verified spacing. q on following page(s). ❑ Yes Q No El N/A ,
13.Verified installation torque. of 0 Conform 0 Remain in progress
Evaluation re o n ber dat Report(s)findings were discussed and left with
N. A of -00114
Name of product being installed N'1 i-, g 11 147 .20#11
Batch Number \ biaiaCoLZ
Expiration Date 1 1 IV
Based on the Code,approval is requiur m uildi.g Official before the SPECIAL INSPECTED items noted above can be
covered. Carlson Testing has no ty to ec .ntractors or subcontractors.
Inspector Signature: Or
0 see additional report page(s). 0 D istribute attachments. Page 1 of I
PropAnchors Ver.! 2/12/2009
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Terms: k9. 7,
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Client recognizes thaticonstruction observation and/or testing services provided by CTI are techniques
which;nay reduce the risk of construction defects.deficiencies, or omissions arising during or after con-
.
i- structign.Services pe •ozinecpy,CT1,do not constitute a warranty or guarantee of any type.•Even with
diligent construction monitoring and/or testing by CTI,construction defects,deficiencies,or omissions
j in the Contractor's work may exist.In hll cases,Client and/or the Contractor shall assigb the Contractor.-+
the responsibility for the quality and completeness of,the,wgrk and for adhering to plans and specifica-
tions. _
CTI's work or failure to perform same shall Fria-any way excuse any contractor;subcontract er,-
or supplier from performance of its work in accordance with the contract documents. _ , .
CTI will provide_its professional services to client with that degree of care and skill ordinarily exercised
` " - under similar cirAtmstances by members of its profession.This representation is in lieu of other warran-: - • ;-- •
ty or representation,either eatp sed"Or implied.It is also understood and agreed that statements made 1L
'• 1 in CTI reports are observations based on technical judgements,and should not be construed to be con- i-.
elusive representations of fact.ITconditiong'different from what are indicated in the reports come to • s
J Client's attention aikerreceipt of the reports,it is recommended that Client contact CTI immediately to •:
_ _ :'. 5authorize further appropriate evaluation. t
•
, CTi'siwork shall nbt.include determining,.supervisiirg or irnple nting the means,methods,techgigues,
sequences,or procedures of construction(CI'i shall not be respdisibie for evaluating or reporting job eoYii - F •-
,1 do related to health,safety or welfare. ' `4 ti
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