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Report Main Office lalem Office Bend Office P.O. Box 23814 4060 Hudson Ave., NE P.O. Box 7918 Tigard, Oregon 97281 Salem, Oregon 97301 Bend, Oregon 97708 lTestin.g 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 Proprietary Anchors Client: ACCENT RESIDENTIAL HOMES INC - ANGEL SULLY Project: MOUNTAIN VIEW ESTATES - LOT 3 CTI Job #: T0705635. A Address: 12438 SW AUTUMNVIEW STREET TIGARD OR Jurisdiction: TIGARD CTI representative A. FIELDING was on site this date Sep. 28, 2007 to perform Special Inspection for: Permit MST2007 -00048 DFS #(s) PO Number: SCOPE OF INSPECTION Location of proprietary anchors inspected [to include grid 1. Checked in with superintendent or client representative. lines, elevations (floors) and drawing details]: Name: ROBERT FRONT GARAGE WINGS 7/8" ALL THREAD ANCHOR BOLTS Company: TCB FOR HOLD DOWNS 10" EMBEDMENT. p 2. Inspection was "IBC" ® Continuous fl Periodic 3. Work performed: © In the field ❑ At precast shop 4. If shop inspection do they have fabrication and QC procedures? ❑ Yes ❑ No ® N/A PROPRIETARY ANCHORS REPORT SUMMARY • Yes No N/A 1. Reviewed previous inspection reports? x 1. Work inspected was: pi Completed ❑ In progress 2. Reviewed evaluation report? x 3. Verified manufacturer's anchor use conforms x 2. Completed work inspected was in compliance with to acceptance criteria in report summary. ® Approved plans and specifications 0 Shop drawings Verified following items meet manufacturer's RFI 0 Design change 0 Submittal ❑ N/A published installation instructions. 4. Verified minimum embedment depth of the Document #(s) Dated: anchors. x 3. Noncompliance item(s) were noted this date, details on 5.Verified installation of the anchors. x following page(s). 0 Yes El No ® N/A 6. Verified anchor diameter. x 7. Verified steel grade. x 4. Noncompliance item(s) were reinspected this date, details 8. Verified hole diameter. on following page(s). 0 Yes El No ® N/A x 9. Verified type of drill bit used. x ❑ Conform Remain in progress 10. Verified cleanliness of hole and anchor. x 11. Verified adhesive application. x Report(s) findings were discussed and left with ROBERT Evaluation report number ER 1772 of TCB Name of product being installed SIMPSON SET 22 • Batch Number 01100800 r,.. Expiration Date 7/09 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). Distribute attachments. Page 1 of 1 • Daily Report of Proprietary Ancho At- IIP For: 09/28/2007 CTI Job #: T0705635.A Project: MOUNTAIN VIEW ESTATES - LOT 3 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: Neil Shannon Review Date: 10/03/2007 AMF /MAB ACCENT RESIDENTIAL HOMES INC - ANGEL SULLY ADS @ACCENTRH.COM TO: CITY OF TIGARD BUILDING DIVISION JOHN FINKLEA ARCHITECTS - JOHN FINKLEA 1 concentrations of loose soil and gravel -size materials were present at the ground surface. These loose materials should be removed from the subgrade prior to completion of the forms and placement of concrete. Small amounts of soil and rock fill have been placed and compacted in non -load bearing areas . of the crawlspace. Stiff to hard, clayey silt fill with scattered gravel -size pieces of concrete and angular rock were also present above subgrade elevation on the south half of the structure. Based on our observations at the site and assuming the loose material is removed, it is our opinion that preparation of the footing subgrades was accomplished in substantial conformance with the plans and specifications and our recommendations for this project, and the subgrades are suitable for support of the proposed building loads. Please contact the undersigned if you have any questions regarding this correspondence. Submitted for GRI, PROF + sso y 82 0 �m `� iLC�Q,CC ` ' iv- •N,�a 7 ap 1.4 e; `' �, v� A DRIS x. /07 David D. Driscoll, PE Principal cc: Eric Esparza / Lan Pacific Inc. (eme@lanpacific.com) • G RO 2