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Specifications /Kg- r/-(j)°7? Bend Office (541) 330-9155 Geotechnical Office (503) 601-8250 Eugene Office (541) 345-0289 Carlson Testing, Inc. Salem Office (503) 589-1252 Tigard Office (503) 684-3460 Daily Report of Proprietary Anchors Client: CHRISTOPHER PERRY Project: CHRISTOPHER PERRY - ADDITION CTI Job#: T1402296. Address: 13235 SW SHORE DR TIGARD OR Jurisdiction: TIGARD CTI representative L. BEADLE OBOA 1052 was on site this date Auq. 18, 2014 to perform Special Inspection for: Permit MST2014-00079 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. Name: CHRIS PER 3/5 OF 5 HOLDOWN STRAP AT NORTH WALL (2) Company: (OWNER) 1/2" TITENS WITH 4" HORIZONTAL EMBEDMENT INTO THE EXISTING FOOTING PER STRAP. AT (6) LOCATIONS 2. Inspection was "IBC" n Continuous © Periodic ALONG THE NORTH WALL PER FIRST FLOOR PLAN 2 OF 5. PROPRIETARY ANCHORS YesNoN/A 1. Reviewed previous inspection reports? X 2. Reviewed evaluation report? X Verified following items meet manufacturer's published installation instructions. REPORT SUMMARY 3. Verified minimum embedment depth of the anchors. x 1. Work inspected was: I XI Completed n In progress 4.Verified installation of the anchors. x _ 2. Completed work inspected was in compliance with 5. Verified anchor diameter. X RI Approved plans and specifications I I Shop drawings 6. Verified steel grade. X 7. Verified hole diameter. X ri RFI 0 Design change Submittal I I N/A 8. Verified type of drill bit used. x Document #(s) STRUC DRAWINGS Dated: 05/14/14 9. Verified hole cleaning method. X 3. Noncompliance item(s) were noted this date, details on 10. Verified adhesive application. x following page(s). n Yes 0 No I xl N/A 11. Verified edge distance. X 12. Verified spacing. x 4. Noncompliance item(s) were reinspected this date, details 13. Verified installation torque. X on following page(s). In Yes No I xl N/A 0 Conform [1 Remain in progress Evaluation report number & date: ESR-2713 (07/2014) Report(s) findings were discussed and left with CHRIS of OWNER Name of product being installed TITEN Batch Number N/A Expiration Date 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. USee additional report page(s). I I Distribute attachments. Page 1 of /mr ao, -X77 9 Daily Report of Proprietary Anchors For: 08/18/2014 CTI Job #: T1402296. Project: CHRISTOPHER PERRY - ADDITION 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.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. Ifthere are any further questions regarding this matter,please do not hesitate to contact this office. Respectfully submitted, CARLSON TESTING,INC. Kurtis Parkin Reviewed By: Project Manager Project Manager Review Date:08/26/2014 LB/CK CC: CHRISTOPHER PERRY BVISUALINC @GMAIL.COM • CITY OF TIGARD BUILDING DIVISION - WALTER 'CHIP' BARNETT FINAL/NCL ONLY BK ENGINEERS INC - ROBERT MCCLUNG ROBERT @BKENGINEERS.COM ZILKA DESIGN - JON ZILKA JONZILKA @GMAIL.COM CITY OF TIGARD BUILDING DIVISION - DAN NELSON DANN @TIGARD-OR.GOV 8430 SW HUNZIKER ST,TIGARD OR-PO BOX 23814,TIGARD OR 97281