062818 KRAZAN INSPECTION REPORT.pdfPage 1 of 1
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Report NO.: 09618282DFR6282018DK
DATE: 6/28/2018 Set Count: CONTRACTOR: Westerly
PROJECT #: 09618282 PERMIT #:
PROJECT: Brackett's Corner INSPECTOR: Don Keller
LOCATION: 2121' St. SW & 80 Ave JURISDICTION: Edmonds
KA P.M.: WEATHER: TEMP:
Observed the placement of 5/8" threaded rod at relocated hold down locations Lots #5,8,9,11,12,13,14. Holes drilled 10"
deep x'/4" round and cleaned as per manufacturer's recommendation. Threaded rod epoxy grouted with counter clockwise
twisting motion to remove air. Simpson ATXP Exp. 2/10/19. Reference: SS S#5151203 dated 6/12/18.
Lot 5 BLD 2016 0603
Lot 8 BLD 2016 0606
Lot 9 BLD 2016 0609
Lot 11 BLD 2016 0611
Lot 12 BLD 2016 0612
Lot 13 BLD 2016 0613
Lot 14 BLD 2016 0614
Reviewed B
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Test #:
Asset Number(s):
To the best of my knowledge, the above WAS performed in accordance with the approved plans, specifications and
regulatory requirements.
Superintendent/Representative:
Technician:
Offices Serving the Western Vnited States
Lynnwood (425) 485-5519 • Poulsbo (360) 598-2126 • Tacoma (253) 939-2500
-rhe information provded on this sport is prepared for the esclusita use of the client This sport map not be reproduced in any format o 11—a dtc ,.nttcn of the d,u,i .u;,t K-- & Av.—.,lc; l hr. rrlwn:
indreat" our inspectors observation and testing results based on site conditions and contractor activities. This information issubjectto rr,r,. pr,•,r w fill-bmmel By sit:r����e th,c rclnn. ,nrr mq,:aor �r+, n,n ac.cM
rcspanibilily for W idily of nxuh, The ssmc information has been provided by others on site