Report — ov4-CC
Bend Office (541) 330-9155
Geotechnical Office (503) 6014250
Carlson Testing Inc. Eugene Office (541) 345-0289
Salem Office (503) 589-1252
Tigard Office (503) 684-3460
Daily Report of Proprietary Anchors
Client: PIKE AWNING COMPANY - DAN SPEARING
Project: SOLUTIONS YES - NEW AWNING
CTI Job#: T1702459.
Address: 8300 SW HUNZIKER RD TIGARD OR Jurisdiction: TIGARD
CTI representative J. DEMOTTE WABO SI 02043
was on site this date Auq. 23, 2017 to perform Special Inspection for:
Permit BUP2017-00200
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: DAN UPPER BRACKETS AND LOWER LEDGER PER DETAILS
Company: PIKE AWNING COMPANY D,E/SHEET 4. 0 WEDGE ANCHORS WITH 4" MINIMUM
� EMBEDMENT.
2. Inspection was "IBC" n Continuous I X I Periodic
(2) ANCHORS AT UPPER BRACKETS WITH 2" AND 2 k"
PROPRIETARY ANCHORS EMBEDMENT LOWER LEFT AND LOWER RIGHT. VERIFIED
YesNoN/A 40 FT/LBS TORQUE.
1. Reviewed previous inspection reports?
2. Reviewed evaluation report? »»> (CONT'D ON BACK) »»»»»»»
Verified following items meet manufacturer's
published installation instructions. REPORT SUMMARY
3. Verified minimum embedment depth of the
anchors. x 1. Work inspected was: n Completed x l In progress
4.Verified installation of the anchors. x
2. Completed work inspected was not in compliance with
5. Verified anchor diameter. x
6. Verified steel grade. x� Approved plans and specifications n Shop drawings
X n RFI 11 Design change E Submittal N/A
7. Verified hole diameter. x
8. Verified type of drill bit used. x Documents
#( ) SHEET 4 Dated: 07/2017
9. Verified hole cleaning method. x
3. Noncompliance item(s) were noted this date, details on
10. Verified adhesive application.
11. Verified edge distance. x following page(s). isj Yes n No n N/A
x 4. Noncompliancepe
12. Verified spacing. x item(s) were reinspected this date, details
13. Verified installation torque. x on following page(s). n Yes 2 No E N/A
Evaluation report number & date:
n Conform n Remain in progress
ICC ESR-2 818 (05/2017) Report(s) findings were discussed and left with
DAN
of PIKE AWNING COMPANY
Name of product being installed DEWALT POWER STUD 501
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.
x See additional report page(s). n Distribute attachments.
Page 1 of 2
Daily Report of Proprietary Anchors For: 0s/23/n17
CTI Job#: T1702459.
Project: SOLUTIONS YES - NEW AWNING
Notes:
«««< (CONT'D FROM FRONT PAGE)
THE FOLLOWING NON-COMPLIANCE ITEM WAS ADDED:
* NCL #1: ANCHORS DRILLED TO 2-4" AND 2-b-4" DEPTH, 4" MINIMUM REQUIRED AT UPPER BRACKETS.
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.
If there are any further questions regarding this matter,please do not hesitate to contact this office.
Respectfully submitted,
CARLSON TESTING,INC.
Doug Loftesness
Project Manager
JD/CK
CC: PIKE AWNING COMPANY - DAN SPEARING DAN@PIKEAWNING.COM
CITY OF TIGARD BUILDING DIVISION - WALTER 'CHIP' BARNETT FINAL/NCL ONLY
8430 SW HUNZIKER ST,TIGARD OR-PO BOX 230997,TIGARD OR 97281
Page 2 of 2
Carlson Testing, Inc.
Incompleted Items List(NCL)
Aug 28, 2017
T1702459.
Project Name: SOLUTIONS YES - NEW AWNING
Project Address: 8300 SW HUNZIKER RD TIGARD OR
Permit No: BUP2017-00200
P.O. No: Project Manager: D. LOFTESNESS
Item# Insp. Date Item Description Compliance CTI Sign-Off Date
Corrected
1 JD 08/23/2017 ANCHORS DRILLED TO 2-4" AND 2-13" DEPTH, 4"
MINIMUM REQUIRED AT UPPER BRACKETS.
CC: PIKE AWNING COMPANY - DAN SPEARING
CITY OF TIGARD BUILDING DIVISION - WALTER 'CHIP' BARNETT
Page: 1
se'
Ci ic;01,itogriizes that construction obscivation and/or testing ser%ices provided by C ore techniques
filch may reduce the risk of construction defects,deficiencies, or omissions arisin dujin ri after con-
rant ction Servicepctfoi hied h CTI do riot constitute a warranty or guarantee of any type. Itti,en P.ith
riiiigont construction monitoring and/or testing by CIL eonstruetion delet:ts,deficiencies,or omissions
in the Contractor's work mac eNi:A. In all cases.Client and the( ontractov shall assign the Contractor
the ierponsihility Cur the qUArrly Corriplewnes;()I the‘vork and 101-i:1(111C1fIng to plans rind 'ipeciflea-
k Int word..or (adult.; poriorm sante shall no a any stay eSerise any contractor,subconlractoit
iir supplier Irian pc ornitalee its sm k ri it,:eordanoe with the contract documents,
rd I \\till pro'nirt it professional services to Client with thai degree or car...'cud skill iirdirthrily exercised
under shnilai eircumstances by members or its profession.This represontation is in lieu or other warran-
t or reprcc,cola;ion.,either expressed or implied. It is also understood and cdreeJ that SlarCITICIIrS inode
11 reports are thert a-Lions based ott technical ju(Igements.„and should not he construed to be t.ain-
elusive representations or fact. If conditions different from what are indicated in the reports tcite to
Ciieiitr attention after receipt of the reports. it is recommended that Client contact (PI imincdititeP,
atithorrie ruialier rippropriate evaluation.
Cl ut welt, sldtnot include determiningt supervising or inTleinenting the ititeans;methods,techniqiitust
sequences.is procedures i.ifeonstruclion C I I shall not be responsible or i',Vd11.1.a1.111g i l'epOr1.11jOh 0011-
(linens related to health,:subtly or welfare,
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