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Report yl STgo (! - 000 -S , Bend Office (541) 330 -9155 Geotechnical Office (503) 601 -8250 e � Eugene Office (541) 345 -0289 Carlson Testing Inc Eugene Office (503) 589 -1252 Tigard Office (503) 684-3460 Daily Report of Proprietary Anchors Client: STONE BRIDGE HOMES NW LLC - DAN VELASQUEZ Project: ARLINGTON HEIGHTS - LOT 108 CTI Job #: T1105130. Address: 15271 SW SUMMERVIEW DRIVE TIGARD OR Jurisdiction: TIGARD CTI representative R. TAYLOR OBOA 874 was on site this date Sep. 28, 2011 to perform Special Inspection for: Permit MST2011 -00037 DFS #(s) PO Number: JOB NO. 1479 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. PER SHEAR WALL SCHEDULE ON S1 OF ENGINEER Name: BLAKE STAMPED DRAWING DATED 09/26/11 FOR TWO Company: STEWARD CONSTRUCTION HOLDDOWNS ON THE EAST WALL OF THE GARAGE UNDER 2. Inspection was "IBC" © Continuous Periodic THE WINDOW. HDU5 5/8° DIA THREADED ROD EMBEDDED (VERT) 10" INTO THE NEW STEM WALL. ANCHOR IS A SSTB2OL AS LISTED IN THE SHEAR WALL SCHEDULE. PROPRIETARY ANCHORS Yes NoN /A 1. Reviewed previous inspection reports? x 2. Reviewed evaluation report? x Verified following items meet manufacturer's REPORT SUMMARY published installation instructions. 3. Verified minimum embedment depth of the ! 1. Work inspected was: ® Completed D In progress anchors. x 4.Verified installation of the anchors. 2. Completed work inspected was in compliance with ® Approved plans and specifications fl Shop drawings 5. Verified anchor diameter. • x 6. Verified steel grade. x RFI ❑ Design change Submittal 0 N/A 7. Verified hole diameter. X Document #(s) ENGR STAMPED DWG Dated: 09/26/11 8. Verified type of drill bit used. 9. Verified hole cleaning method. 3. Noncompliance item(s) were noted this date, details on ° page(s). z following Yes E No ❑ N/A 10. Verified adhesive application. x 11. Verified edge distance. 4. Noncompliance item(s) were reinspected this date, details 12. Verified spacing. on following page(s). fl Yes E No ❑ N/A 13. Verified installation torque. x 0 Conform fl Remain in progress Evaluation report number 8.: date: Report(s) findings were discussed and left with ESR -2508 (07/01/2011) BLAKE of STEWARD CONSTRUCTION Name of product being installed SIMPSON SET XP Batch Number 0350472C Expiration Date 03/30/13 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. C See additional report page(s). 0 Distribute attachments. Page 1 of Daily Report of Proprietary Anchors For: 09/28/2011 CTI Job #: T1105130. Project: ARLINGTON HEIGHTS - LOT 108 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 fi 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. 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: 10/18/2011 RT /CK STONE BRIDGE HOMES NW LLC - DAN VELASQUEZ TO: CITY OF TIGARD BUILDING DIVISION CORE ENGINEERING PLLC - MICHAEL KINGSLEY BROWN