HomeMy WebLinkAboutPermit Field Test & Inspection Report 2004-12-3 (2)
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DAILY FIELD REPORT
Date Performed:
Client:
December 3, 2004
Koala Construction
1541 Hwy 99 North
Eugene, OR 97402
Report Number:
722-40330-7
Project Name:
Burrito Amigos
Project Location:
42nd & Main Street
Springfield, Oregon
P.O. No.:
Type of Inspection:
Epoxy
Permit No,:
Weather:
Fog
Field Observations and Comments
Performed continuous Inspection dUring the Installation of 5/8" all thread epoxy anchored bolts In the follOWing locations
twelve (12) vertically placed epoxied anchor bolts placed along west Side of monolithic concrete slab on grade Prior to
Installation the predrllled holes were cleaned uSing a nylon brush and compressed air Verified minimum embeddment
depth of 12 Inches The above listed epoxy anchors were Installed uSing Simpson Strong Tie ET-22 epoxy Contractor
stated the nuts would be tightened after the epoxy has cured The epoxy anchors were Installed In accordance with
manufacturer's directions and speCifications To the best of our knowledge, the work Inspected above was In
accordance with the bUilding department approved deSign draWings, speCifications and applicable workmanship
prOVIsions of the Uniform BUilding Code Contractor was asked to notify our office when additional services are needed
I
Inspector: Rob Crawford, ICBO# 0883234-87
If you have any questions regarding thiS report, please feel free to contact us at 541-746-9649
Respectfully Submitted,
~~ Industnes, Ine
Raymond V Alipertl
Department Manager
c City of Springfield
Nagao PaCifiC
THIS REPORT IS PROVIDED FOR THE INFORMA TION OF THE CLIENT ONL Y THE REPRODUCTION OF THIS REPORT, BY ANY METHOD, AND ITS TRANSMITTAL TO A THIRD
PARTY, BY ANY MEANS, EXCEPT IN FULL, WITHOUT THE WRITTEN PERMISSION OF PROFESSIONAL SERVICE INDUSTRIES, IS PROHIBITED
"
ProfeSSional Service Industries, Inc. 1040A Shelley St . Springfield, OR 97477. Phone 541/746-9649. Fax 541/746-7163