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HomeMy WebLinkAboutSpecial Inspection Field Test & Inspection Report 2003-9-19 City of Springfield Con~:nu:Ji[r S..:r.:~~~~ qiv!:;v(1 . 22Hifll\Stnet' . Springfield. OR 97477 Telepho.,e: (54J) 726""59 . Fax: (54\) ~26.36~9 Sp~ciallnsp~ctioq An4 Tes~ng , . CD~.1...00~ - oeB~ t. Building Pennil /I LPC5 CtP o~:- t~ - O~ '. Date FI! c O~"'-( :'f(lJeCI . i:f:: ~(~O T~u~S\O'" ~'\) Proieet A~d(e5s . To applicants ~f proj~els re~uirin~ speci~1 insp~cti041 pr testillg as per Sc~tion J70 1.5 pf the prcgofl SIN~iill ~pccia'cy Co'de. PlciSse review .t~e infornation below, Wl,cn yop have li~ished.lcknolYledge an un~erstaqding q(lhe i"ronn.[ionby signi~g belpw. and retu~ Ihis (orm 10 Ihe City. . :, , ~.:' , r' " . , " . QEFO~E A ~ERMtT CA~ BE ISSUED: Th~ o","ner or owner'~ ,represpnlative, on Ihe advice of the re~ponsiplc Project Eflgineer or Afchitec.t. shall complete, sign. a~d sub~it t~ the Ciry ror review and lIpprov~llhis form c~mplelFd Oil ~olh Ih~ fron~ and ~ck.,' , ' . ." . ' . . . : . , " ,,-., l,' .' . The Owner an~'OenCr11 Copttatc~r, whe,t appficablc, shall ,Iso ~know'cdgc qtc follpwingcondi{ions appllca~le 10 $pecia' tnspe.clion ,ndlorTestin~. . '. I 0 .' '. , .. '. \ I, COlltracl9r is responsible for proper nOli'lcelion,fDr Ih, Jnspcj:tlon ~tTCJI",g olitems listed. . 2, Teillng I~boral~ry sh,lIrakc appr~riatc' famp\~ end lranspqrt the(l\ lo_lIle1r Ilborato? for proper ,valu~ion or testin~, . .' . . .' . · Copies pf all ~boralolY regorES nqd il\S~cdon~ are to' be sell I 10 I~e Cil~ by th~ Teslirs Ag~ey. I , J/ '. , . . , 3, SP.cllll l'lIP\!Clipll Ag~ney ~ 10 submit n~mClll,l1d qu~lificalio.n5 or on-sit!! SPClfiallnspei:lOr~ to th~ City ~or approval. . .,' ~. I. . 4, Sp~lall~$p~t~r shal~ proYi~e iIIspeclion repo~ to lb; building official ofaHiiu~"n actiVilies. . 5, CO,lIrllct~r is responsi~lc 10 {cvicw die Ci~ apPfDved ,laM f~r additional inspection elf testin~ requirements thaf may ~e nOI~d. BEfO~ A C~TIF'CA 11 OF 6cCUPANCy.wlL~ BE (SSUED: The' Speclpl IDspeelion:Acen~y shall sllbl'4it to ~o Building timeia' a Slal~ment that all items requ'ri~g I~specli~n havll been fulfill~d and reported and 'were Ip the best oqhe inspector' s knowled~. in cqntonnllnce ",illi th~ appr9ved p'ans, specificalions and applicable workmanship provisiors. Thpsc itc~l1s not:lesred and/or inspe~ted ~h~1l be ~oted b the Jlatemmt. The repofl i5 10 be submittc4 10 Ih~ City prior CQ a req~esl for ril',al inspections.' ' . '. . ". j . -. ..' . AC~OW~EDgME~TS W//AdrfYi A(/~ .p~p Owner Nam,c (Printed) J ..... ( /I1,r<, f(lct.{Af2/J'S EiJG/2(; Engineer or Archilecl Firm (Printed) 1'SI. Testing Laboratory Name (Printed) i' , I r l<_. __Cl \J n~.A'" ~e~'R~e ~~ V. A'iperl\ ...)o\h." 'U..\.A'M'O c.eo....<>l'. \t\~. fun, Contraclor Finn Name (Prinred) 'PSI . Special Inspection Agency Name (Printed) ,1.-\5\\ \_\.bf\Ort Building Official '~'a~e~ -i ,)) ::r- c .~ 0 .- iil go a. I ...... tIl N ~ ,'N -.j )> '-I ...... ;0 c I "" (Q 0 c C/l IN rl- >- I\J "" _OJ 0 .. '" I\J \C en 0 'I "'l 0 ()) \11 ;.- :l':- t >l (J1 en -..J .c. -0 >- w s:: .... c" .co ,,"" :;.;1 o o;l tT:1 ::::l ~ '" o z ...... :;I) == tT:1 :;.;1 :::I! o o o ...... ;.- ~ C"l :c (J1 ./>. -'- m OJ -..J 6 -'- ()) ()) .., C"l , :c . .. -& ~~ ~,p~:;I) General Contractor Signature ~V. OI.J ' Special1nsp, AgenCy~;;r;: ~. \-. :- ....R.~.nut~~. A'i~" ~ ~ ~ J\ ~ 0 Building-Official~aru e .. ~. <J o I\J ':'.. \ ADDlTlONAL INSTRUCTIONS, OTHER TEST) & INSPECTIONS: Form completed by:, 0;}O/fA/'5loN A-filc/(o/12 S //11"'_ (.:ONC".e~~ 1<6FE/:2~/T/CC;;;- /)ET/tlt... '8 /hO ~ FO;1<? (G) L.OC-1 TfO..-1JS - / .PfiOVlDESTllENCTH REQUIRE!) IlY ARCHITECT OR ENGIN~En. OR CONTRACT DOCUMENT LOCATION OF VALUes Reinforced C\lRcrel" GUllite, Grout atld Mnrtar: ' Q,anml2 Gunm_,-'~t M$ -. I I .1 I I , I '1 r " .1 'I j I . I ,j preC:Bsl(Pre-strfSse~ ConereCe: .' , Piles I~~ p~ Cln4dilli ., ' I - . I I . r .1 I ' I I I I I ; I I I S~OKf CO~Of ' ~ . t.ea~ge teS\lng -;- . Contrpl veri~cBtitll;l ROOm~G : r- : lnsul,lj~n i9s1allayonlR',Yillue. Tesl'stnpskean1'$ . " . SPECIAL INSPEC110N ANp TESTll'f<:; SCHEDULE :1 I I Ae~rco:ate Test of ~ix DJ5igp 'Reinf\)rcil\i:Test: . . Mix ~ign;Weill~mSlr C;~r1. R.ein~~lne flac~nl, 'ConllpuouS patch rla"t filsn ..~. ~ Sa~~es (Pi~kuDlQeliver~d\ . .Conlllfessio9 Te~l~ ' <;RADJNG, fXCAV A TION, AND FJLL . Acceplanc;~ teslS' .' ?SF . E.sta~lish lipal grade . Fill pl:lcemerlt In~peclio11l'continuou~ Soil pensity , . STRUCTUR~LSTEELnWELDINC; -,- Sample an~ leSI qist specific q1embers belQwj Shop mater,ial iderlifica~ion (r1J.i1I ten) , Wel~ inspection . Shop _ . Fie'~ _ UlIl'~sollie InS(l~e,jon Shop. _ . Ficlq Highstrcn4th boIling Shop _ Fielq A~2S '_ 'N X _ F . Ai90 _ N _ X F Met'" deck weldi~g inspectiD~ . Reinforcin, Steel.welding inspecciOl1 ReinforCio$ steel ;niii c~rtiflC* _ Mcral stud weldill'g inspection. COlle'rete insert w~lding'jnspection _ MQ~enl re,isling,steel frames I I :1 :1 I .A~l!rqGate 'I:e!t~ Reinf~rc!ni jeslS :Ttiidqii Test: ' M~" ~ . ,\ein(9rcin~ rlllce~e(lt fnsert Placl!lpent ; Ccmc1l!te BlI~inl ~Dner,re PI~em~, .Installp-lion ~spet~pn ' (.as! ~nl'pll!f Pick-~p gamplll~ ' :-omp~essloq Tell', TIC psi srRUCTUIl(\L WpOO: Sheat wall fUlilinll il1spe~lioll ' Shear wall ~nchofs ' ~ rnsp'ction ~f(jlu~lam flib, · InspeCtion ~ftrus,joilll fab, Sample an4 feS! c{lmpon:cnts FabriF3tion'weldi~g ofslccl accmories .FlRErROQFlNG: _ Pla~emen~ inspeption Dc~sity TFslS Thi~kness- tests rnsfect ~ching MASO~R Y: -i- : Special inslfcclio~ slressps used' rip. rg . Prelhpinary. acceptllnce fesls <rpllSOllry unil" wall pri!ln~) SubsFquent tests (lllOr1llj, gr~l, ficl9 wa.l!;lris~ ,.' PI~me~l;lns(l;fti(}f1 ~ unils, l1nrlteinr<ireemel1f Mllsonnry, monar, Sroul~' rcing sleel ccnil1clllcs , /"': ~ /,2~3 e_1 -l );I. ::r c l; 0 ~ (il, (l) 0- a. 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