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Report 01/28/09 WED 16:17 FAX 503 670 9147 CARLSON TESTING R1002 , S Satan Odin End Ogler Carlson Testing, Inc wJ7JWNucAcr IA4U1J 00 NU21UAR4yRd:11 TxwJ, DA 97223 $„I..., 00 U7 iU1 &m( OA 97772 Inc.! FYx,K: (1631 DO-1160 Phan, fSfli3 }iN -//}7 17.w. fSJI/330.7115 F arm 6,W -U75I Pa 1 fb vN•flm F',r. 1.113304103 Construction Materials Testing & Inspection • Special Inspection FINAL SUMMARY LETTER January 27, 2009 CTI Job #T0808499 • • • • • City of Tigard • 13125 SW Hall Blvd • Tigard, OR 97223 -8199 • Attn: Building Department Re: Tigard Senior Center — Garden Room Addition 8815 SW Omara Street — Tigard, OR • Permit No.: BUP2008 -00317 • Dear Sir or Madam: • This is to certify that in accordance with Section 1704.1.2 of the International Building Code, we have performed special inspection of the following item(s) per our inspection reports only: • Reinforced Concrete Installation of Adhesive Anchors Wood Nailing • 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. • Respectfully submitted, CARLSON TESTING, INC. eith Gauvin Project Manager KRG /Ih cc: City of Tigard — Nick Nissen City of Tigard Building Division — Dan Nelson Nishkian Dean Structural Engineers — Deke Black LRS Architects Inc. — Peter Dixon Cedar Mill Construction Co. • • • • • Carls ®n Testi Construction Inspections & Related Tests ng, • Inc• o 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: 12/04/2008 - • Job Number: T0808499. Permit #: BUP2008 -00317 Client: CITY OF TIGARD — NICK NISSEN Project: TIGARD SENIOR CENTER — GARDEN ROOM ADDITION Address: 8815 SW OMARA STREET TIGARD OR Jurisdiction: TIGARD Contractor: CEDAR MILL CONSTRUCTION CO Subcontractor: Cast By: S . HOPPE • Concrete Supplier: KNIFE RIVER (METRO OPERATIONS) — QUALITY CONTROL Truck #: 2192 Load #: 1 Ticket#: 3201008 Weather: CLEAR Test Time: 7 : 19 AM Air Temp. at Sampling Time: 38 Cylinders were cast for the following locations: • SAME AS BELOW Total Concrete Placement Location: SLAB ON GRADE RETAINING WALL GARDEN ROOM ADDITION Strength Requirement: 3000 psi fc 28 Days Slump: 4.500" % Air: 1. 4 0% Mix Number: 4N1H1M0 Conc. Temp: 59 Cement Type: I /II Max Agg• 3/4 Admix/Amt: Cubic Yards: l l Register Number: 0088732 Lab Location: TIGARD Set Test @ Date Test Total Area Unit Type Of Tested No. Days Rec'd Date Load PSI Fracture By I 7 12/05/2008 12/11/2008 80301 12.49 6430 2 RH2 • 28 12/05/2008 01/01/2009 28 12/05/2008 01/01/2009 28 12/05/2008 01/01/2009 0 Distribute attachments. Average fc @ 28 days • Please see reverse side for additional information. t Job Number: T0808499. Register Number; 008,$ Date Molded: 12/09/2008 Project: TIGARD SENIOR CENTER — GARDEN ROOM" ADDITION < I 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 • • \ 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 1 Asterisked ( *) average unit PSI test results did not meet listed acceptance criteria. Remarks: CITY OF TIGARD - NICK NISSEN V NGN @TIGARD - OR.GOV TO: CITY OF TIGARD BUILDING DIVISION - DAN NELSON NISHKIAN DEAN STRUCTURAL ENGINEERS - DEKE BLACK FAX /503- 273 -5696 LRS ARCHITECTS INC - PETER DIXON PDIXON @LRSARCHITECTS.COM CEDAR MILL CONSTRUCTION CO Project Manager: K. GAUVIN Reviewed By: Ty Toiler On 12/12/2008 • Our report pertains to the material tested only. The information contained in this report is provided subject to all terms and conditions of CTF'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 F.O. x Box 23814 4060 Hudson Ave., NE P.O. Box 7918 Tigard, 'Oregon 97281 Salem, Oregon 97301 Bend, Oregon 97708 Carlson Testing Inc. i Phone Fax (503) 684-3460 Phone Fax (503) 589913092 Phone Fax (541) 330-9163 5 Daily Report of Proprietary Anchors Client: CITY OF TIGARD - NICK NISSEN Project: TIGARD SENIOR CENTER - GARDEN ROOM ADDITION CTI Job #: T0808499. Address: 8815 SW OMARA STREET TIGARD OR Jurisdiction: TIGARD CTi representative M. WAGONER OBOA 746/OBOA 749 was on site this date Nov. 20, 2008 to perform Special Inspection for: Permit BUP2008 -00317 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. OBSERVED INSTAL. OF 18 #4 DWLS EMBEDDEp 4 1/4" Name: WILL INTO EXIST BLDG FND PER DTL 4/S4.1 (EMBEDDED Company: CEDAR MILL CONSTRUCTION AT A SLANT) & 12 #4 DWLS EMBEDDED STRAIGHT INTO 3 FTGS (4 1/4" EMB) PER DETAIL 6/S4.1. 2. Inspection was "IBC" © Continuous El Periodic NOTE: DTL 4/S4.1 SHOWED @ 1 POINT THE LINE IS IDENTIFIED AS #4 DWLS, AT ANOTHER POINT ON DTL PROPRIETARY ANCHORS THE SAME LINE WAS IDENTIFIED AS THREADED ROD. Yes No N/A FOR WAS CALLED AND CLARIFIED IT WAS #4 DWLS, NO THREADED RODS. 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 El In progress anchors. X 4.Verified installation of the anchors. 2. Completed work inspected was in compliance with X Approved plans and specifications ❑ Shop drawings 5. Verified anchor diameter. X 6. Verified steel grade. X ❑ RFI Design change ❑ Submittal El N/A 7. Verified hole diameter. X Document #(s) Dated: 8. Verified type of drill bit used. X 9. Verified hole cleaning method. x 3. Noncompliance item(s) were noted this date, details on 10. Verified adhesive application. X following page(s). Yes No El N/A 11. Verified edge distance. X 4. Noncompliance item(s) were reinspected this date, details 12. Verified spacing. X on following page(s). ❑ Yes El No ® N/A 13. Verified installation torque. X Conform ID Remain in progress Evaluation report number & date: Report(s) findings were discussed and left with ESR -1772 (01/01/08) WILL of CEDAR MILL CONSTRUCTION Name of product being installed SIMPSON SET 22 Batch Number 245994RR Expiration Date 06/30/10 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. El See additional report page(s). El Distribute attachments. Page 1 of Daily Report of Proprietary Anchors • For: 11/20/2008 CTI Job #: T0808499. Project: TIGARD SENIOR CENTER - GARDEN ROOM 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. If there are any further questions regarding this matter, please do not hesitate to contact this office. Respectfully submitted, CARLSON TESTING, INC. Reviewed By: Keith Gauvin Review Date: 12/04/2008 MCW /CK CITY OF TIGARD - NICK NISSEN NGN @TIGARD - OR.GOV TO: CITY OF TIGARD BUILDING DIVISION - DAN NELSON NISHKIAN DEAN STRUCTURAL ENGINEERS - DEKE BLACK FAX /503- 273 -5696 LRS ARCHITECTS INC - PETER DIXON PDIXON @LRSARCHITECTS.COM CEDAR MILL CONSTRUCTION CO • ,'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 C arls ®n Testing, Inc 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 Reinforced Concrete Client: CITY OF TIGARD - NICK NISSEN Project: TIGARD SENIOR CENTER - GARDEN ROOM ADDITION CTI Job #: T0808499. Address: 8815 SW OMARA STREET TIGARD OR Jurisdiction: TIGARD CT! representative K. PARKIN OBOA 420 /WABO PAR 86 0560 was on site this date Dec. 01, 2008 to perform Special Inspection for: Permit BUP2008 -00317 DFS #(s) PO Number: SCOPE OF INSPECTION CONCRETE 1. Checked in with superintendent or client representative. 1. Mix Design approved? ❑ Yes ❑ No ® N/A Name: WILL Company: CEDAR MILL CONST 2. Monitored loads arriving at job site for correct: Mix #: 2. Type of work: © Concrete © Reinforcing Slump % Air 3. Work included: © Sampling © Inspection 3. Type of samples made? N/A 4. Inspection was 'IBC' © Continuous ❑ Periodic Number of sets Samples per set 5. Work performed: ® In the field ❑ At precast shop . 4. Inspected placing and consolidation of approx. cubic yards of concrete. • REINFORCING Yes No N/A Location of concrete placement [to include grid lines, elevations (floors) and drawing details]: 1. Reviewed previous inspection reports? x CONCRETE POUR CANCELLED. 2. Forms clear of debris? x 3. Type, grade, size, quantity, spacing and x condition conform? 4. Verified forms will nominally result in • hardened concrete of the required x cross - sectional dimensions. 5. Verified location of reinforcing steel, pipes, conduits and sleeves with respect to x minimum concrete cover. 6. Verified type and location of splices, length After samples are tested, results will follow on break report. of contact laps, and min. diameter of bends. x 7. Verified support & anchorage of reinforcing REPORT SUMMARY steel in the forms. x 1. Work inspected was: ® Completed fl In progress 8. Verified structural embedments in the forms x 2. Completed work inspected was not in compliance with with regard to fabrication, quality and type. © Approved plans and specifications ❑ Shop drawings 9. Verified structrual embedments in the forms with regard to weld inspection, quantity, and x RFI ® Design change ❑ Submittal El N/A permits issued. 10. Verified cast in place anchors. x Document #(s) C Dated: Description of structure inspected [to include grid lines, 3. Noncompliance item(s) were noted this date, details on elevations (floors) and drawing details]: following page(s). ® Yes 0 No ❑ N/A RETAINING WALL FLY & WALL PER DRWG C -4 4. Noncompliance item(s) were reinspected this date, details (CONTRACTOR PROVIDED) AND ANCHOR BOLTS IN S.O.G. on following page(s). 0 Yes El No © N/A PER APPROVED DRWGS. 0 Conform Remain in progress Report(s) findings were discussed and left with WILL • of CEDAR MILL CONST 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). 0 Distribute attachments. Page 1 of 1 Daily Report of Reinforced Concrete For: 12/01/2008 CTI Job #: T0808499. • Project: TIGARD SENIOR CENTER - GARDEN ROOM 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. If there are any further questions regarding this matter, please do not hesitate to contact this office. Respectfully submitted, CARLSON TESTING, INC. Reviewed By: Keith Gauvin Review Date: 12/02/2008 KP /JWA CITY OF TIGARD - NICK NISSEN NGN @TIGARD - OR.GOV TO: CITY OF TIGARD BUILDING DIVISION - DAN NELSON NISHKIAN DEAN STRUCTURAL ENGINEERS - DEKE BLACK FAX /503 -273 -5696 LRS ARCHITECTS INC - PETER DIXON PDIXON @LRSARCHITECTS.COM CEDAR MILL CONSTRUCTION CO • ;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 C arls ®n ' Testing Inc. 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 Reinforced Concrete Client: CITY OF TIGARD - NICK NISSEN Project: TIGARD SENIOR CENTER - GARDEN ROOM ADDITION CTI Job #: T0808499. Address: 8815 SW OMARA STREET TIGARD OR Jurisdiction: TIGARD CTI representative W. WHITE OBOA 371 was on site this date Nov. 21, 2008 to perform Special Inspection for: Permit BUP2008 -00317 DFS #(s) PO Number: SCOPE OF INSPECTION CONCRETE 1. Checked in with superintendent or client representative. 1. Mix Design approved? ❑ Yes ❑ No ® N/A Name: WILL Company: CEDAR MILL CONST 2. Monitored loads arriving at job site for correct: Mix#: P 2. Type of work: 0 Concrete © Reinforcing Slump % Air 3. Work included: 0 Sampling © Inspection 3. Type of samples made? 'N /A 4. Inspection was 'IBC' El Continuous © Periodic Number of sets Samples per set 5. Work performed: ® In the field 0 At precast shop 4. Inspected placing and consolidation of approx. cubic yards of concrete. REINFORCING Yes No N/A Location of concrete placement [to include grid lines, elevations 1. Reviewed previous inspection reports? X (floors) and drawing details]: 2. Forms clear of debris? X 3. Type, grade, size, quantity, spacing and x condition conform? 4. Verified forms will nominally result in hardened concrete of the required X cross - sectional dimensions. 5. Verified location of reinforcing steel, pipes, conduits and sleeves with respect to X minimum concrete cover. 6. Verified type and location of splices, length After samples are tested, results will follow on break report. of contact laps, and min. diameter of bends. X 7. Verified support & anchorage of reinforcing REPORT SUMMARY steel in the forms. X 1. Work inspected was: ® Completed 0 In progress 8. Verified structural embedments in the forms x 2. Completed work inspected was in compliance with with regard to fabrication, quality and type. 9. Verified structrual embedments in the forms © Approved plans and specifications 0 Shop drawings with regard to weld inspection, quantity, and X RFI 0 Design change El Submittal N/A permits issued. 10. Verified cast in place anchors. Document #(s) Dated: Description of structure inspected [to include grid lines, 3. Noncompliance item(s) were noted this date, details on elevations (floors) and drawing details]: following page(s). 0 Yes © No ❑ N/A ALL OF GARDEN ROOM ADDITION - SLAB ON GRADE AND 4. Noncompliance item(s) were reinspected this date, details FOOTINGS. NEED TO VERIFY ANCHOR BOLTS NOT on following page(s). 0 Yes 0 No © N/A INSTALLED AT TIME OF THIS INSPECTION. Conform 0 Remain in progress Report(s) findings were discussed and left with WILL of CEGAR MILL CONST 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. 0 See additional report page(s). ❑ Distribute attachments. Page 1 of 1 Daily Report of Reinforced Concrete For: 11/21/2008 CTI Job #: T0808499. Project: TIGARD SENIOR CENTER - GARDEN ROOM 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. If there are any further questions regarding this matter, please do not hesitate to contact this office. Respectfully submitted, CARLSON TESTING, INC. Reviewed By: Keith Gauvin Review Date: 12/01/2008 WRW /ARR CITY OF TIGARD - NICK NISSEN NGN@ TIGARD- OR.GOV TO: CITY OF TIGARD BUILDING DIVISION - DAN NELSON NISHKIAN DEAN STRUCTURAL ENGINEERS - DEKE BLACK FAX /503- 273 -5696 LRS ARCHITECTS INC - PETER DIXON PDIXON @LRSARCHITECTS.COM CEDAR MILL CONSTRUCTION CO 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 C arlson Testing Inc. 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 Reinforced Concrete Client: CITY OF TIGARD - NICK NISSEN Project: TIGARD SENIOR CENTER - GARDEN ROOM ADDITION CTI Job #: T0808499. Address: 8815 SW OMARA STREET TIGARD OR Jurisdiction: TIGARD CTI representative S. HOPPE OBOA 791 was on site this date Dec. 04, 2008 to perform Special Inspection for: Permit BUP2008 -00317 DFS #(s) PO Number: SCOPE OF INSPECTION CONCRETE 1. Checked in with superintendent or client representative. 1. Mix Design approved? ® Yes 0 No 0 N/A Name: WILL Company: CEDAR MILL CONST 2. Monitored loads arriving at job site for correct: p y Mix #: 4N1H1M0 2. Type of work: © Concrete ❑ Reinforcing Slump 6 +- 1 % Air 3. Work included: © Sampling IN Inspection 3. Type of samples made? 4 X 8 CONCRETE CYLINDERS 4. Inspection was 'IBC' © Continuous 0 Periodic Number of sets 1 Samples per set 4 5. Work performed: ® In the field ❑ At precast shop 4. Inspected placing and consolidation of approx. 32 cubic yards of concrete. REINFORCING Location of concrete placement [to include grid lines, elevations Yes No N/A (floors) and drawing details]: 1. Reviewed previous inspection reports? X 2. Forms clear of debris? X GARDEN ROOM ADDITION SLAB ON GRADE RETAINING 3. Type, grade, size, quantity, spacing and x WALL condition conform? * *AIR % - 1.5 +- 1.5 4. Verified forms will nominally result in hardened concrete of the required X cross - sectional dimensions. 5. Verified location of reinforcing steel, pipes, conduits and sleeves with respect to X minimum concrete cover. 6. Verified type and location of splices, length After samples are tested, results will follow on break report. of contact laps, and min. diameter of bends. X 7. Verified support & anchorage of reinforcing REPORT SUMMARY steel in the forms. X 1. Work inspected was: ® Completed fl In progress 8. Verified structural embedments in the forms x 2. Completed work inspected was in compliance with with regard to fabrication, quality and type. 9. Verified structrual embedments in the forms © Approved plans and specifications 1=1 Shop drawings with regard to weld inspection, quantity, and X 0 RFI ❑ Design change 0 Submittal 0 N/A permits issued. 10. Verified cast in place anchors. Document #(s) Dated: Description of structure inspected [to include grid lines, 3. Noncompliance item(s) were noted this date, details on elevations (floors) and drawing details]: following page(s). 0 Yes ❑ No ® N/A REINFORCEMENT PREVIOUSLY INSPECTED 4. Noncompliance item(s) were reinspected this date, details on following page(s). ❑ Yes El No © N/A 0 Conform El Remain in progress Report(s) findings were discussed and left with WILL of CEDAR MILL CONST 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. • 0 See additional report page(s). 0 Distribute attachments. Page 1 of 1 Daily Report of Reinforced Concrete For: 12/04/2008 CTI Job #: T0808499. • Project: TIGARD SENIOR CENTER - GARDEN ROOM 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. If there are any further questions regarding this matter, please do not hesitate to contact this office. Respectfully submitted, CARLSON TESTING, INC. Reviewed By: Keith Gauvin Review Date: 12/09/2008 SH /ARR CITY OF TIGARD - NICK NISSEN NGN@ TIGARD- OR.GOV TO: CITY OF TIGARD BUILDING DIVISION - DAN NELSON NISHKIAN DEAN STRUCTURAL ENGINEERS - DEKE BLACK FAX /503- 273 -5696 LRS ARCHITECTS INC - PETER DIXON PDIXON @LRSARCHITECTS.COM CEDAR MILL CONSTRUCTION CO