20040511.pdfDATE RECEIVED�//
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAME/NAME OF BUSINESS
Ua: MAILING ADDRESS
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CITY ZIP TELEPHONE
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NAME
4PIL5
ADDRESS
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CITY ZIP TELEPHONE
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NAME CEIL silt tq
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Ml ADDRESS
L'i I y ZIP I TEL ' EPHONE
STATE LICENSE NUMBER EXPIRATION DATE CHECKED
.142 1, 11A, 1
W!22.� -
PROPERTY TAX ACCOPINT PARCEL . NO.
00 661 i t C1- 0 0 100 3 C
91
NEW
RESIDENTIAL
PLUMBING / MECH
EADDITION
]
COMMERCIAL
COMPLIANCE OR
CHANGE OF USE
REMODEL
MULTIFAMILY
SIGN
REPAIR
10
GRAW1, GI
2) CYDS
o
FENCE
( X FT-)
DEMOLISH
1:1
TANK
OTHER
GARAGE
1:1
RETAINING WALL
FIRE SPRINKLER
CARPORT
ROCKERY
FIRE ALARM
(TYPE OF USE, BUSINfS4 OR ACTIVITY) EXPLAIN
V A
NUMBER NUMBER OF
at OF DWELLING
o STORIES UNITS
DESCRIBE WORK TO BE DONE �
�VY_11
I'TEAT SOURCE G
e:; A &
PLAN CH
/T e7,
�CRITICAL qll��
AREAS
NUMBER
ro
LOT SLOPE %
VESTED DATE
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
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SEPARATE PERMISSION.
Uj PERMIT APPLICATION: 180 DAYS
93. PERMIT LIMIT I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
CAI *APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
GIVEN is CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN�S COM
,.��NSATION INSURANCE AND RCW 18 27.
SIGNA RECWNE�Ry'�IV6121`#) DATE SIGNED
3:
PERMIT EXPIRES
USE PERMIT
ZONE. NUMBER.- 5k)
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JOB SUITEIAPT#
ADDRESS
PLAT NAME/SUBDIVISION NO.
LOT NO.
LID NO.
LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
7ESCP Approved
RW Permit Required
EXISTING PROPOSED
Strunt Use Permit Req'd
Inspection Required
HEOUIRED DEDICATION "0' FT
Sidewalk Required
Underground
Wringfoquirea
METER SIZE
LINE SIZE
NO. OF FWURES
P EQUIRED
YESY NO 13
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROIL/DRAINAGE
411 IL *2) Al qk) I ,V10,r1_,4L1U_� r;t.1 tf."racv, ftoll
ENGINEERING REVIEWED BY
--I' At - . , � ,,-
FIRE REVIEWED BY
DATE
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VARIANCE OR CU SHORELINE OR ADB# I INSPECTION BOND
REQ�Q, POSTED
11YES AN S --
SEPA REVIEW SIGN AREA HEIGHT
COMPLETE EX T ALLOWED PROPOSED ALLOWED PROPOSED
_�, I -r—, 3, C, - /, I ,� V a , 'q //
EXP I K
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSdo- FRONT SIDE REAR FRON
T UR SIDE REAR
"ol 7("' 15 � qk7` 0,'9 q, 15 z
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PARKING A LOT AREA NING REVIE" ED BY DATE
REO'D I PRQvID1
PZ_
REMARKS - ? ) A Jf/
Vj 44 a 1)
CHECKED BY ITYPE OF�CQNSTRL19TION C077 OCCUPANT
/V GROUP R-3
SPECIAL INSPE;TION ARE�W>��Wl,;e47_ OCCUPANT
REQUIRED YES Z&73� LOAD
REMARKS woe)l-=e�e 572��#
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION RECIID
j-) el 0/, to
VALUATION
Description
FEE
D
Description
scriptio'
FEE
Plan Check
_T?77 7
State Surcharge
z/5 LO
Building Permit
Le
City Surcharge
City Su rchargc
Plumbing
Mechanical
Grading
rQM
Engr. Review
Z14 s�-e
Engr. Inspection
Fire Review
Plan Chk. Deposit&'77
Fire Inspection
Receipt #
Landscapelnsp.
Total Amt. Due
Recording Fee
Receipt #
APPLICATION APPROVAL
CALL
This application is not a permit until signed by the
FOR INSPECTION
Building Official or his/tier Deputy: and Fees are paid. and
receipt is acknowledged in space provided.
OFFICIALS S19NATURE DATE
xr
(425)
771-0220 4-/
RE DATE
ATTENTION Bff 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLCO!WINSPE' 'To
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK - OWNER GOLD - ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
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K 00 DSG*. 53' 11"* E
M.I.C. ASSUMED 300.00'
DATUM TOP MON IN MON CASE
DRAINAGE SYSTEM STANDARD DESIGN
DRIVEWAY: 835 s.f.
OPEN PATH: 241 s.f.
GARAGE ROOF: 1,412 rs.f.
HOUSE ROOF: 2,131 s.f.
OPEN DECK: 218 s.f.
TOTAL: 4,923 s.f. 0v
IMPERMEABLE AREA: 4,923 s.f.
REQUIRED VOL CU.FT.: 125 c.f.
PIPE DIAMETER: 30'; 25' LONG
OUTLET ORIFICE DIA- 1/8" ATER
CATCH BASIN: TYPE� IL, CB I SPECTIO
24' ROOF O.H.
INCLUDES GUTTERS
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JE-RIAL A
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STORM -
WATER
SYSTEM
.Vl %..vy"NMv4= e&JA T OLYMPIC VIEW C04j,
SITE AREA: 8�.44 S.F. 10, 2
WATER ISEWER DISTRICT16
35% OF SITE = 3,025 S.F. T�*z 2-
- GARAGE AVERAGE GA
�ESIDENCE AND PORCHES: 1,150 S.F. GRADE 305.0' FLR
�ARAGE SHOP: 1,123 S.F.
: FTG
FOTAL ROOF AREA: 2,813 S.F. ELE
16, d
TEMpORARY CONSTRUCT109,L0 s
LEGEND OF SYMBOLS IRED 10
8 — 8 — STORM WATER TIGHTLINE TWIFAMANPEMU
w — W — WATER PIPE NOTE:
SANITARY SEWER PIPE ALL EXISTING TREES
—6-6— GAS PIPE ON SITE TO BE REMOVED
APPROVED AS NO -FED RIGHT_or--.wAy cc, N 01 DEG 11' 21" E
B NSTRLVqj'oiq I"RMIT+305.7
Y ENGINEERING AND INSPECTION REQUIRED'
q�:� A
r__Ar"T" , . S1 T R P L A N /-% _11�1__
RHENE JOHNS PLAN NORTH
A R C H I T E C T PROJECT ADDRESS: 24017 104TH AVE. NW
7310 N. Skyview PI, *BME C E OAN(cg EDMONDS, WA
Wb: 00564900100301
Tacoma, WasHngton 98406 OrERS: EVAN PIERCE AND SUSAN BLAND
Phone/Fax (253) 565-627APR 1 6 004 2708 E. PIKE ST.
SEATTLE, WA 98122
PERMIT COUNTER
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L04TH AV WE.51
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Height Calculation Worksheet
Address: 0 10 LI
Date:
fi.ispector(s): M '. k V lw�
1. Datum Point: ?Iz� U3 CS
2. Datum Point Elevation: o 'I o
3. Average Grade: 2) 2; 0
4.. Maximum Elevation Allowed: -3t-)G,n (averag,&&ade):+"'js,,z,-- Z �10 I-0,
5. Reference Point Elevation Shot to House:
2611al (datum elevation) + 3., 11b (grade to transit level tine'shot to house)
6. Measurements from line shot onto house to roof ridge:*
Total: 7 , KL
7. Actual Elevation:&; c)-.,2--1 (reference point elevation) + -1, 9 1 (measurements
from#6)=
Conclusion:
.31K. oK— (actual) is gr.eater/ less than o (allowed); therefore the house ij/
is not over the height -requirement per ECDC 16.20.30 requirements
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Height Calculation Worksheet
Address: c3 I'l 4.
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Date:
hispector(s):-
1. Datum Point:
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2. Datum Point Elevation: 0
3. Average Grade: 6 0 -L 2-�
.4. Maximum Elevation Allowed: 3-0-3-ASaveragib &ade):* '' 25**'- �L
+
5. Reference Point Elevation Shot to House:
_Z9jkL(datu m elevation) + 3,2. 6 . (grade to transit level line *shot to house)
6. Measurements from line shot onto house to b6of ridge:
(,A
337
Total
7. Actual Elevation: /3 16,a't (reference point elevation) + I J. �j (measurements
from #6)
Conclusion:
(actual) is greater I less than' U (allowed); therefore the house is/
is not over the height requirement per ECDC 16.20.30 requirements
IL
STANDARD DRAINAGE DETENTION SYSTEM
WORKSHEET
CAW BY:
'Y-
AMDPXM /,09'7* Ape- /o/. 2,0r,
DATJ&
*****DESIGN DATA
IMPERVIOUS AREA. PIPE DIA. PIPt LG ORIFICE.
J" 7/j
MENTION PIPE LENGTH OCKNG t0
XTTPW)l
roaSHED G!�� r4L HINIMM
= To ix sLaK
FROM CONTROL C1
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CONC x1x tot fflan
T CONTROL
UPPER CATCH BASIN
CONTROL CATCH BASIN RECEIVED
APR 16 2004.
SYSTEM CROSS SECTION
�ERMIT COUNTER.
exrX60.1)EEP, 4-61 SPALLS OR EQUAL rapy
0 . �!Cq
Z,x LPX' 3'.D'ECP, 3/4' CRUDED ROCK ISTING GUBE
rRm coNROL OUJTTLE� VASHD rtock
NW T"
PIRK L"
PEAF PoNE W DID CAPS
P
RIPJUP ouff"
R UNOFF SPREADER -TRENCH
FOOTING DRMNS $HAU NOT-M CONNECTED710 DETENTION SYMM'.
1. Call Engineering DivWcm (771-OM) for a tigbdine, and detention system. insoction'
before backfilling and for fuud'inspecdon&
2, Responsibility fbr operation and maintenance of drainage systems on private pwpartY is &0
responsibility of thd property owner.- materW accumulated in the -storage pipe must be flush*
out and removed from thecatch basins to allow proper operation. lie outletcoatwl orifice
APPROVED BY
6-/ -ze)04
DATE
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-22-04
City of Edmonds
Development Services Department
Engineering Division
121 5" Ave N.
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Edmonds, WA. 98020
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To Whom it Concern's,
The purpose of this letter is to attest to the location of drainage test pits which were
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conducted at the time of my short plat. Mr. Pierce recently contacted me to inquire as to C
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the whereabouts of the test pit locations. I met Mr. Pierce at the property and we mapped 0
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the pit locations as they are represented on the enclosed map.
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I hope this is sufficient enough to satisfy the pit location need in conjunction with the
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drainage date submitted at the time of my short plat. Please feel free to call if any >
questions arise.
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N 01 DEG 11' 21" E
PLAN
NORTH
N 01 DEG 11'. 21" E 104TH AV-E. WEST
+.304.u*
N 00 DEG. 53' 11" 98AL_L
D +303.0
*r-";* --- -------------
C +3 01
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IMPERMEABLE AREA: '1.293 S.F.
co, a
REQUIRED VOL CU.FT.: 112 RESIDENCE
PIPE DIAMETER: 24", 34'LONG 1150,'S F', 21-0" ROOF
OUTLET ORIFICE DIA: 1/8" �00ftP-RINt, SHOWN OAS
CATCH BASIN: TYPE 11. CB 19 (18" BASIN)
EXISTING
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SHOWN Q
+
HEIGHT CALCS
A=301.0
B=304.0
C=304.0
D=303.0
AVE GRADE=303.15
ACTUAL=--
MAXIMUM=328.15
B
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0"
SH6P
- ----- - ---
LOT COVERAGE CALCULATION
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SITE AREA: 8,414 S.F. 4r
35% OF SITE = 3,025 S.F. En
RESIDENCE AND PORCHES: 1,150 S.F. 0..')
GARAGE SHOP: 963 S.F. 0
TOTAL ROOF AREA: 2,113 S. F.
PRELIMINARY SITE PLAN
SCALE.. 1" 20'
PLAN
NORTH
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RHENE JOHNS
A R C H I T E C T
7310 N. Skyview Pl. IB302
Tacoma, Washington 96406
Phone/Fay: (253) 565-6277
OVERHANG
HED. TYPICAL
FIR TREES
EMOVED
ASHED
ASPHALT d
DRIVEWAY
N 01 DEG It- 21" E
LTH AN��. WEST
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Recelved: . 1/28/01 12:52; -> WINDERMERE REAL ESTATE ; Page 2
-26-2001-1 FRI 12:53 PM THE REAL ESTATE GROUP FAX NO. 4253477246
KEGEL ENGINEMUNG ASSOCIATES, INC.
9800 EVERGREEN WAY
EVERETr, WA. 99204
PHONE: (425) 353-1119 OR (206) 775-5424
Fax: (425) 353-7149
March 21, 2000
P. 02
RECSIVED
MAR 2 8 2000
"t0*11,10 DEPT.
Karissa Kawamto
Planning Department
City of FAlmonds
12156 Avenue N.
Edmonds, WA 99020
RE: The Bryan Mize Short Plat-drainagc plan (S-99-132)
Dear Ms. Kawamoto
Attached please find a copy of a Preliminary Drainage Plan prepared by Bryan Nfize as
part of a Short Plat application. I-Ar. Mize submitted this plan to the City of Edmoids, but
was told that the drainage plan would require the signature and seal of a professional
engineer. hi order to meet the City's requirements Mr. Mize contracted with our firm to
review and sip his Preliminary Drainage Plan.
After a site inspection and a review ofthe calculations provided by Mr. Mize, we find
these calcidations to be consistent with the City's requirements and-cornnion engineering
practice. The remits of the soil tests were consistent with the conditions observed on the
site, and the final trench size is reasonable relative io other's designed in this area.
Therefor, please accept this letter and attached Preliminary Drainage Plan as fulffliment
of your reAluirement for drainage plan signed by a professional engineer. if you have any
questions or comments please contact us at (425) 353-1119.
Sincerely,
Erflc Emerson, EIT
Reviewed and Approved By
Arnold R. Kegel, P.E.
Wifts
0 R.
WA
8980
PONAL
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";`26
-2001 FRI 12-:54 PM THE REAL ESTATE GROUP FAX NO. 4253477246
The Mize's
IG413 2400'Place SW
Edmonds, WA 98020
P. 03
R M IC44 E I V E D
MAR 2 8 noo
PLAWi-oid DPT.
Prelimfinaj:y Drainage Plan
The tests mid were performed, and the measurements achieved according to the
guidelines presented in the King County Surface water Design Manual. Hydraulics
engineer, Don Fiene at the city planner's office (Edmonds), recommended these
guidelines for the area under question, The recommended test for this area is the Sub -
Surface Maximum Infiltration Test, spelled out in section 4.5.2 of the Design Manual.
Four complete infiltration tests were conducted, yielding the following times:
Test #1
Test #2
Test #3
Test #4
Seconds bich 1
15 sec
"
75 see
70 sec.
55 sec
Seconds inch 2
95 sec
90 sec
80 sec
70 sec
Seconds itich 3
105 see
80 sec
85 sec
80 sec
Seconds inch 4
105 sec
80 sec
90 sec
85 sec
Seconds inch 5
110 sec
75 sec
90 sec
80-see
Seconds inch 6
115 see
80 see
90 see
80 see
Average titne
101 see/ inch
80 see / inch
84 sec / inch
75 sec / inch
The above data led to the use of the maximum infiltration rate of coarse sand or
cobbles for the purposes of the calculation of the sizing of the trench.
Calculation values;
Roof area 3000 square feet
Soi I texture .333 inches/min
I 00yr storm precip= 3.0 inches
Aj= (0.054PjooAR)/10Im= (0.054 * 3 * 3000)/((10)(.333)) = 145.95
K = 146/4 := 36.5'
. Minimum Trench Length = 37 Feet
Pleasc find attached a general drawing (not to scale) of the type of drainage plan
proposed. I'lease note that only 6" perf-pipe is to be allowed on premises. Scale
drawings and detailed final plan to be submitted when applying for development permit.
Bryan D. Mize, OWNER
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FROM : R JOHNS
FRX NO. : 253 565 6277
Jun. 10 2004 11:36AM P1
RECEIVer) tA�CROFOA
J U 11 1 G 2004
DEVELOPMENT 3[nVICES (;TR
Transn-dttal CITY OF r-I)4JC)&,08
"qW RHENE JOHNS
ARCHITECT
3008 N. Narrows Dr. #C101
Tacoma, "?ashington 98407
Phone/Fax: (253) 503-6825
Date: June 10, 2004
To: JanineGraf
Subject: Pierce[Bland Residence, Permit application number 04-133
LL -I--
X -
1 1 1 Portion of basement relabeled "STORAGE11
Message:
Hi Janine Attached is the basement plan with the space label "'RECREATION ROOM" changed
to "STORAGE."
Evan Pierce, the Owner, understands that the storage space may be converted to
habitable room areas in the future by obtaining a remodeling permit for the addition of non -
bearing walls and doors in compliance with the codes in effect at the time of that permit
application. It is his and my understanding that when/if he does convert the basement storage
space into habitable rooms, only the basement area being remodeled win be required to
comply with the code requirements in effect at that time (the existing portions of the residence
won't be required to be brought up to the future code requiremenst.) If tl-dE) iSnot accurate,
please advise one of us.
Thank -you,
Signed: ___J 0�c
- 148.4v I
H 00 DEG. 53' 11" E
0 r - - :�:l I
M.I.C. � �ASOSUMED 300.00- ISA L;�'
DATUM TOP MON IN MON CASE !ry
DRAINAGE SYSTEM STANDARD DESIGN 24' ROOF O.H.------,
UDENhjjrS
3 1
DRIVEWAY. 835 0. AG(;cL:FA99WNIt0 TYP.
OPEN PATH: 241 51 NAATERIAL
GARAGE ROOF: 1,412 s.f, SDR 35
HOUSE ROOF: 2J31 s.l. SCH 40
OPEN DECK: 218 s.f.
TOTAL: 4,923 sf. 0q/ N-12
H,l 0 W
IMPERMEABLE AREA: 4,923 s.f.
REQUIRED VOL CU.FT.: 125 c.f.
PIPE DIAMETER: 30'; 25' LONG
OUTLET ORIFICE DIA: 1/86
CATCH BASIN: TYPE IL, CB IPATER
INSPECTION
RESIDENCE
A=304.0
B=a04.0
C=304.0
D=aO3.0
AVE GRADE=303.15'
ACTUAL=326.08'
MAXIMUM=328.15'
REQ'D.
EXT. 166,
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N 00 DEG. 52
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D Li
+3040
E 4331'. '
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1ST R Rom.
UPPF9 FLR: '935ef.
iST FLR. ELEVl,3N.jj'
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�PTH: 302.25'
LEV6 304.41'
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CITY1
PROTERTY
GARAGE SHOP: I w
1,123 S.F. FLR ME"0304.16' sc
FTG DEP7H: 2_6 +.!
TOTAL ROOF AREA: 2,813 S.F. .1 a;. N
N ELEV. 3
T-EMN)RARY 0,061STRUCTIOW
LEGEND OF SYMBOLS ENTRANCE REQUIRED
Ic
STORM WATER TIGHTLINE TO DRAINAGE SYSTEM
71!
....C- ONCRv-p_
w w WATER PIPE
NOTE: DRIVEWAY..
88— SANITARY SEWER PIPE ALL EXISTING TREES
04
ON SITE TO BE REMOVED
—ca-6— GAS PIPE
APF'ROVED AS NOTED Air
,3H-f.O,�W Y CC "S-. N 01 DEG 11' 21" E
BY ENGINEERING A t I ug
AND INSPECTI' A L. +30&0'�vl_
ON RE
QUIRED
E PLAN
SCALE: I* = 20'
PL N NORTH."'-`-"
RHENE JOHNS
A R C H I T E C T PROJECT ADDRESS: 24017104TH AVE. NW
X1 rp EDMONDS, WA
7310 N, Skyvlew PL *Bj& E C Ep I RZ;Er 0: 00564900100301
Tacoma, Waslington 98406 . �VW, EVAN PIERCE AND SUSAN BLAND G a ro
Phone/Fax (253) 565-6277APR 1 2708 E. PIM ST. N 01 DEG 11 21" E L04TH AV TBU
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SEATTLE. WA 98122 .1.7.
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PERMIT COUNTER
SPRE�ADER
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LOT COVERAGE 1�41 e'"I ATlf)N 83
SITE AREA: 8�.44 S.F. %P.,6N I -ACT OLYMPIC V
WATER/SEIAIER DISTA
35% OF SITE = 3.025 S.F.
GARAGE AVERAGE
RESIDENCE AND PORCHES: 1,150 S.F. rjP,&nr- 'AM n'
GARAGE GRADE
AT CORNERS
305.0
AVE GR=305.0'
ACTUAL=319.3'
MAXIMUM=320.0'
NOTE:
CONTRACTOR TO VERIFY
GRADE POINTS USING TRANSIT
PER CITY OF EDMONDS PRIOR
TO START OF CONSTRUCTION
A+3014
2
+ 04
CB 16
STORM -
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SYSTEM
B +304.0
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--------------
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ER-6133
LEGACY REPORT Issued May 1, 2003
BU51ness/Regional office # 5360 Workman Mill Road, Whittier, California 90601 # (562) 699-0543
ICC Evaluation Service, Inc. Regional Office # 900 Montclair Road, Suite A, Birmingham, Alabama 35213 # (205) 599-9800
www.icc-es.org Regional Offlce # 4051 West Flossmoor Road, Country Club Hills, Illinois 60478 ho (708) 799-2305
Legacy report on the 1997 Uniform Building Code TM, the 2000 International Building Code, and the 2000
International Residential Code'D
DIVISION: 03—CONCRETE
Section: 03130—Permanent Forms
LOGIX INSULATED CONCRETE FORMS
LOGIX INSULATED CONCRETE FORMS LTD.
12150-160TH STREET
EDMONTON, ALBERTA T5V I H5
CANADA
AMC INSULATION CORPORATION
1511 PARAMOUNT ROAD
WINNIPEG, MANITOBA R2X 2W6
CANADA
BEAVER PLASTICS LTD.
12150-160TIl STREET
EDMONTON, ALBERTA T5V I H5
CANADA
FORM SYSTEMS INC.
POST OFFICE BOX 16923
WICHITA, KANSAS 67216
PERMA R PRODUCTS INC.
106 P ERMA R ROAD
JOHNSON CITY, TENNESSEE 37063
PSC MOULDING CORPORATION
840 DIVISION STREET
COBOU RG, ONTARIO K9A 4J9
CANADA
1.0 SUBJECT
Logix Insulated Concrete Forms.
2.0 DESCRIPTION
2.1 General:
The Logix Insulated Concrete Forms consist of expanded
polystyrene (EPS) interlocking rigid polystyrene foam plastic
boards that serve as permanent formwork for reinforced
concrete, exterior and interior walls and lintel beams, and
foundation and retaining walls. The interior of a building
constructed with Logix Insulated Concrete Forms must be
protected with a thermal barrier complying with Section
2602.4 of the 1997 Uniform Building Codeym (UBC), Section
2603.4 of the 2000 Intemational Building Code" (IBC) or
Section R318.1.2 of the 2000 Intemational Residential Code
(IRC), such as*a 1/2-inch-thick (12.7 mm) regular gypsum
wallboard installed in accordance with Section 2.5; and the
exterior surface must be covered with an approved exterior
wall covering. Recognition is in accordance with Section
104.2.8 of the UBC, Section 104.11 of the IBC, and, Sections
R404.4 and R611 of the IRC.
2.2 Materials:
2.2.1 Logix Insulated Concrete Forms: The Logix
Insulated Concrete Forms consist of two EPS foam plastic
boards separated by injection molded polypropylene webs,
which are preinserted into the EPS mold before molding so
that they are partially embedded into the EPS boards. The
polypropylene webs, which are spaced 8 inches (203 mm) on
center horizontally, maintain the EPS board facings at a fixed
clear distance of 4 inches (1102 mm), 6.25 inches (1158 mm),
8 inches (203 mm) or 10 inches (254 mm). Forthe standard
forms, the EPS boards are 16 inches (406 mm) high by 48
inches (1219 mm) long. The EPS boards are 2% inches (63.5
mm) thick measured at the center of the board, and have a
maximum thickness of 2'/, inches (69.9 mm). When stacked
in a running bond pattern, the Logix Insulated Concrete
Forms create a cavity where steel reinforcement bars and
concrete are placed. In addition to the standard forms, 45-
degree angle forms, 90-degree angle corner forms, taper top
blocks and brick ledge blocks are also available. Typical
Logix Insulated Concrete Forms are illustrated in Figure 1.
The 45-degree angle forms and 90-degree angle corner
forms are used to construct wall intersections. The taper top
block is used to construct corbels in the wall at the desired
locations. The brick ledge blocks are used to construct
corbels that serve as ledges, for supporting exterior brick
veneers.
The EPS foam boards are molded from beads specified in
the approved quality control manuals. The foam plastic has a
nominal density of 1.45 pcf (23.2 kg/m'), and has a maximum
flame -spread rating of 25 and a maximum smoke -density
rating of 450 when tested in accordance with LIBC Standard
8-1 or ASTM E 84. The foam plastic insulation complies as a
Type 11 rigid cellular polystyrene (RCPS) in accordance With
ASTM C 578-01.
The polypropylene webs are 8.5 inches (216 mm), 10.75
inches (273 mm), 12.5 inches (318 mm) or 14.5 inches (368
mm) in length and have a 1.25-inch-wide-by-1 4.25 inch -high
(32 mm by 362 mm), 0.1875-inch-thick (4.8 mm) flange. The
ICC-ESIegacy reports are not to he construedas representing aesthetics or tits), other attributes not specificallyaddressed, nor (ire the), to be construedas
-ndationfor its use. There is too warranty by ICC Evaluation Service, Inc.. express or implied, (is to
an endorsement ofthe subject ofthe report or a recomme
anyfinding or other matter in this report. or as to anyproduct covered by the report.
Page I of 5
Copyright 0 2003
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I I Page 2 of 6 ER-6133
plastic flanges, embedded 1/, inch (12.7 mm) below the
outside surface of the EPS foam boards, provide supports for
attaching interior and exterior wall coverings. Refer to Figure
1 for details.
2.2.2 Concrete: Normal -weight concrete with a maximum
size aggregate of 3/, inch (19 mm) and a maximum slump of
6 inches (152 mm). The maximum water—cementitious
materials ratio must be 0.5, unless otherwise approved by the
building official. Concrete must have a 28-day minimum
compressive strength of 2,500 psi (17.2 MPa). If construction
of the Logix Insulated Concrete Forms is based on the IRC,
concrete must comply with Section R404.4 or R611.6.1 of the
IRC.
2.2.3 Reinforcement: Deformed steel reinforcement bars
must have a minimum yield stress of 40 ksi (276 MPa), and
must comply with Section 1903 of the UBC or the IBC. If
construction of the Logix Insulated Concrete Forms is based
on the IRC, reinforcing steel must comply with Section
R404.4.6 or R611.6.2 of the IRC.
2.2.4 Other Components: Wood members, if not protected
from the concrete, must be preservative -treated by pressure
process with an approved wood preservative, and attached to
the wall with anchor bolts complying with Section 2304.3 of
the UBC, Section 2304.9.5 of the IBC or Section R323.3 of
the IRC. Materials other than wood, such as vinyl, are
permitted for window and door framing if approved by the
building official.
2.3 Design,
2.3.1 General: Design of concrete in the Logix Insulated
Concrete Forms must comply with Chapter 19 of the UBC or
the IBC. Walls must be anchored to the floors and roofs in
accordance with Section 1633.2.8 of the UBC or Section
1604.8.2 of the IBC.
2.3.2 Alternate Design: In lieu of calculations required by
Section 2.3.1 of this report the structural design of residential
buildings, constructed with the Logix Insulated Concrete
Forms and regulated by the UBC, is permitted to comply with
the Prescriptive Method for Insulating Concrete Forms in
Residential Construction (publication No. EB1 18), dated May
1998, published by the Portland Cement Association (PCA),
subject to all limits applicable for a flat insulating concrete
form (ICF) wall system specified in that document. The PCA
document must be made available to the building official upon
request. Buildings constructed with the Logix Insulated
Concrete Forms and designed in accordance with this section
must not exceed a height of two stories plus a basement,
where the maximum unsupported wall height is 10 feet (3048
mm).
2.3.3 Design in Accordance with the IRC: Walls
constructed with the Logix Insulated Concrete Forms must be
designed in accordance with Section R611 of the IRC. The
Logix Insulated Concrete Forms are defined as a flat ICF
system in accordance with IRC Section R404.4.2 or R611.3,
and corresponding requirements shall apply.
2.4 Installation:
The Logix Insulated Concrete Forms must be supported on
concrete footings complying with Chapter 18 of the UBC or
IBC, or Chapter 4 of the IRC.
Vertical reinforcement bars, embedded in the footing, must
extend a minimum of 24 inches (610 mm) into the block wall
system. The Logix Insulated Concrete Form blocks must be
stacked in a running bond pattern such that the polypropylene
webs align vertically. Vertical and horizontal reinforcement
bars must be placed as required by the design and the
applicable code. All horizontal and vertical reinforcement bars
must have minimum concrete protection in accordance with
the UBC or IBC. Concrete quality, mixing, and placing must
comply with Chapter 19 of the UBC or IBC. Refer to Figure 2
for typical installation details.
When regulated by the IRC, reinforcing steel for the Logix
Insulated Concrete Forms used above grade must comply
with Section R611 of the IRC.
Pressure -preservative -treated wood ledgers must be
attached to the concrete wall by removing the face shell of the
EPS units, with the height of the removed portion equal to the
depth of the wood ledger. When concrete is poured into the
wall system, the concrete -filled volume, provided for the
anchor bolts, forms a solid concrete connection from the
ledger board to the horizontal bond beam. The spacing and
embedment depth of the anchor bolts must comply with the
structural design or code requirements, whichever governs.
Anchor bolts used to connect the wood ledgers or plates to
the concrete must be cast -in -place, with the bolts sized and
spaced as required by the design.
2.5 Interior Finish:
Logix Insulated Concrete Forms exposed to the interior of the
building must be finished with minimum %-inch-thick (12.7
mm) regular gypsum wallboard complying with ASTM C 36,
attached to the flanges of the polypropylene webs. The
minimum %-Inch-thick (12.7 mm) wallboard must be installed
vertically and attached to the flanges of the plastic webs with
1.625-inch-long (41.3 mm), No. 6, Type W, coarse thread
gypsum wallboard screws spaced 16 inches (406 mm) on
center horizontally, and 12 inches (305 mm) vertically.
2.6 Exterior Finish:
2.6.1 Above Grade: An approved exterior wall covering
must be designed and installed in accordance with the
applicable code or an ICC-ES evaluation report. When the
wall covering is required to be attached to structural
members, the wall covering must be attached to the flanges
of the polypropyiene webs with either No. 6, Type W, coarse
thread drywall screws or No. 6, Type S drywall screws. The
screws must be corrosion -resistant and have sufficient length
to protrude through the flanges of the polypropylene webs a
minimum of'/, inch (6.4 mm). The screws have the allowable
pullout and lateral load capabilities shown in Table 1. The
maximum spacing of the screws shall be designed to support
the gravity loads of the wall covering and resist the negative
wind pressures. The maximum negative wind pressure is 99
psf (4.74 kPa).
Negative wind pressure capacity of the exterior finish
material must be the same as that recognized in the code for
generic materials, orin a current ICC-ES evaluation report for
proprietary materials.
2.6.2 Below Grade: Wall surfaces must be dampproofed
and, when required by the building official, waterproofed in
accordance with Appendix Chapter 18 of the UBC, Section
1806 of the IBC, or Section R404.4.11 of the IRC.
Dampproofing and waterproofing materials must be approved
by Logix Insulated Concrete Forms Ltd. and the building
official, and must be free of solvents that will adversely affect
the EPS foam boards.
2.7 Foundation Walls:
The wall system is permitted to be used as a foundation stem
wall when supporting wood -framed construction and when the
structure is supported on concrete footings complying with the
applicable code. Compliance with Table 1 8-1-C is mandatory
when regulation is by the UBC. Installation of the Logix
Insulated Concrete Forms as foundation walls must comply
with Section R404.4 of the IRC.
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2.8 Underfloor Crawl Spaces:
Logix Insulated Concrete Forms located in underfloor crawl
spaces are permitted to be exposed to the crawl space,
subject to all the following conditions:
1. Entry to the crawl space is only to service utilities, and no
heat -producing appliances are permitted.
2. There are no interconnected basement areas.
3. Air in the crawl space is not circulated to other parts of the
building.
4. Underfloor ventilation complies with the applicable code.
2.9 Fire-resistant Construction for Recognition under
the UBC:
Concrete walls meeting the construction specifications listed
in Item 7-1.1 of Table 7-B of the LIBC are formed by the Logix
Insulated Concrete Forms and have the fire -resistive ratings
specified in Table 7-B of the LIBC, for a maximum fire -
resistive period of 3 hours.
2 . 10 Special Inspection:
Special inspection is required as noted in Section 1701 of the
UBC, or Section 1704 of the IBC, for placement of reinforcing
steel and concrete, and for concrete cylinder testing, except
that special inspection is not required for foundation stem
walls conforming to Table 18-1-C of the UBC, or Table
1805.4.2 of the IBC. Additionally, when the building official
approves and recognition is under the LIBC, special
inspection is not required when all of the following conditions
are met:
1. Wall systems are a maximum of 8 feet high (2.4 m) and
are limited to use in single -story construction of Group R,
Division 3, or Group U Occupancies.
2. Maximum height of a concrete lift is 48 inches (1219 mm).
Succeeding lifts must be placed in accordance with
Section 1905.10.5 of the LIBC.
3. Installation is by properly trained installers approved by
Logix Insulated Concrete Forms Ltd.
4. The installation instructions indicate methods used to
verify proper placement of concrete.
5. Specified compressive strength of concrete used in
design is one-half of that specified.
2.11 Identification:
Each package of Logix Insulated Concrete Forms bears a
label specifying the product name (Logix Insulated Concrete
Forms), the evaluation report number (ER-6133), the phone
number and web page for the product, a checkbox for which
manufacturing location the product comes from, the date of
production, and the name and logo of the quality contr6l
agency (Intertek Testing Services NA, Ltd. —Warnock
Hersey).
ER-6133
3.0 EVIDENCE SUBMITTED
Data in accordance with the [CC -ES Interim Criteria for
Concrete and Concrete Masonry Wall Systems (AC1 5), dated
January 2001, and the ICC-ES Interim Criteria for Foam
Plastic Insulation (AC1 2), dated July 2001; and quality control
manuals.
4.0 FINDINGS
That the Logix Insulated Concrete Forms described in
this report comply with the 1997 Uniform Building Code'
(UBC), the 2000 international Building Code (IBC), and
the 2000 intemational Residential Codd' (IRC), subjectto
the following conditions:
4.1 The forms are manufactured, identified and installed
in accordance with this report and the
manufacturees installation Instructions.
4.2 When regulated by the UBC or IBC, walls
constructed with the Logix Insulated Concrete
Forms are considered Type V construction.
4.3 When required by the building official, plans and
calculations showing compliance with this report
are submitted to the building official for approval.
4.4 The EPS foam forms are separated from the building
interior with an approved thermal barrier, such as
minimum %-inch-thick (12.7 mm) regular gypsum
wallboard installed as specified in this report. Other
thermal barriers, having an index of 15 and
attachment complying with a current ICC-ES
evaluation report, are acceptable.
4.5 When regulation is by the UBC or IBC, special
inspection Is provided in accordance with Section
2.10 of this report.
4.6 When regulation is by the IRC, compliance with
Section R324.4 must be demonstrated.
4.7 Logix Insulated Concrete Forms are manufactured
by Beaver Plastics Ltd. located in Edmonton,
Alberta, Canada, and Chilliwack, British Columbia,
Canada; AMC Insulation Corporation in Winnipeg,
Manitoba, Canada; Form Systems Inc. in Haysville,
Kansas; Perma R Products Inc. In Johnson City,
Tennessee; PSC Moulding Corporation in Cobourg,
Ontario, Canada. Logix Insulated Concrete Forms
are produced under a quality control program with
inspections conducted by IntertekTesting Services
NA, Ltd. —Warnock Hersey (AA-647-2).
This report is subject to re-examination in one year.
TABLE I —ALLOWABLE PULLOUT AND LATERAL CAPACITIES OF SCREWS
SCREW TYPE
ALLOWABLE CAPACITY (pounds)
Pullout Capacity
Lateral Load Capacity
No. 6, Type S, fine -thread, corrosion -resistant screw
35
49
No. 6, Type W, coarse -thread, corrosion -resistant screw
33
49
For 51: 1 pouna = 4.4o rq.
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Page 4 of 5' ER-6133
EL6N %LlEW A' TAPER Toe Bt Or
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FIGURE `I—LOGIX INSULATED CONCRETE FORMS
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'LATE
TOP L BOTTTUM
/.,,— 45'
X
DRYWALL
N. THICKNESS 1/2')
ANCHOR BOLTS AS SPCCIFIED
TYP CUT OUTS IN FORM
(INSTALLED BEFORE POUR)
/--SUBFLO OR
IST FLOOR JOIST
LEDGER PLATE (PER CODE)
FLASHING
BRICK VENEER EXTERIOR
CUT OPENINGS IN FORM
BRICK LEDGE
FORM
CAI ALL ANCHUR LOCATIONS)
SIZE 4 1/2 X 7 HIMIMUM
.,YATE�PROII�
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+
+ +
+ +
+
\-1/2' DRYWALL (MIN. THICK)
+
+ +
+
+
+
+
+
+
+
FOOTING (CONTINJOUS)
BACKFILL +
+ +
+
(PER spcciriCATICN)
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+
+ +
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+ +
+
PER SPECIFICATION)
+ +
+
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(OVER STUNE)
+
0
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STONE AS SPEC.
(G" MIN OVCR P�PE)
(COMPACTED)
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NDISTURBED
(PER SPECIFICATION)
SUIL OR BEDROC-C
FIGURE 2-TYPICAL INSTALLATION DETAILS
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PRODUCTIMIANUAL 8-1 - INTERTEK TESTING SERVICES
Intertek Testing Services
ETLSEMKO
Aug.22,2002
To whom it may concern,
This letter certifies that Logix Insulated Concrete Forms have been subject to and
complied with all of the following testing:
• Meets 3 hour fire rating in accordance with ASTM El 19 and CAN/ULC S101
Room fire Test Standard for Interior of Foam Plastics Systems in accordance with
ASTM D1929, D635 and D2843
• CrawlSpace evaluation conducted in accordance with ICBOES requirements
Conforms to ASTM C578, with equivalency CAN/ULC S701 (standard Specification
for Rigid, Cellular Polystyrene Thermal Insulation)
• Fastener Withdrawal Evaluation in accordance with ASTM D1761
• Fastener Lateral Resistance tested in accordance with ASTM D1761
• Polypropylene web material conforms to CCI Plastic material when tested in
accordance with ASTM D1929, D635 and D2843
Applications have been submitted for the following evaluation reports:
- CCMC ER # pending
- ICBOES ER # pending
- SBCCI PST and ESI RR # pending
- BOCAES RR # pending
Testing and ongoing evaluation of Logix Insulated Concrete Forms is carried out by
Intertek Testing Services (ITS). Logix Insulated. concrete forms are a listed product with
ITS (#6245) and are eligible to display the Warnock Hersey Certification Mark.
If you have any question or concerns regarding the above information, contact the
undersigned at 1-800-668-TEST.
INTERTEK TESTING SERVICES NA LTD.
Wanock Hersey
Sheldon Warman, P. Eng.
Manager, Construction Products RECEIVED
MAY 2 6 2004
PERMIT COUNTER
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PRODUCrMANUAL 8.1 - INTERTEK TESTING SERVICES
TEST PROGRAM
1. Physical Provertles of Polypropylene Reinforcing Webs
Physical properties testing of polypropylene reinforcing web material was performed in general accordance
with the following test methods:
A. Screw Withdrawal:
r wia or nd
TCBOES AC 116 (July 200 1) "AccePtame C 1 f Nailva SpLkes� gin conjunction with ASTM
D 1761-88 (Reapproved 2000) "Standard Teit Methodsfor Mechankal Fasteners in Wood." Sections
I through 12 (two types of fasteners were tested: a type W coarse flurad drywall screw, and a type
'S' fine thread drywall screw)
Lateral Screw Resislance:
JCBOES ACI 16 (July 2001) "Acceptance oiteriafor Mails andSpikes� gin conjunction with ASTM
D1761-88 (Reapproved 2000) "StandardIest Methoalsfor Mecliartleal Fasteners in Wooit"Sections
13 through 20
C. Tensile Strength:
ASTM D639-01 "Standard Test Methodfor Tensile ProPerlies 001astics
TEST RESULTS
1. p 1gal pro ert c o Polypropylene Reint—na Wphr.
. A.
Rm
Screw Withdrawal Lateral Screw Resistance (AST—M D1761-P):
Withdrawal
Lateral
Fastener I)W
Max Load (lb3)
Max Load (lbs).
Average
Av
Type 1W, Coarse Th;;s!Drywall Screw
166
367
COV
C
Type IWI Course Thread Drywall Screw
10.6%
8.4%
e Thread Drywall Screw
169
329
COV
Type IS' Fine Thread Drywall Screw
8.4%
4.1%
Note: Test results above were based on twelve withdrawai sampics dnu wit mu, a amulp us.
Complete results are included in the Appendix D.
. Tensile trength (AST-M-P-6-3-90—Ul
Ultimate
F&I
ICov &.1 19
Note: A complete web was used with each side of the web gripped and loaded perpendicular to
the exterior surface of (he web. Test results above were based on ten samples. Complete results
am included in Appendix E.
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PRODUCr MANUAL 8A - INTERTEK TESTING SERVICES CONTINUED
DISCUSSION
ICBOESAC116 references ASTIVID11761 for lateral and withdrawal testing, TheASTIVID6117 and ASTM
D1761 are very similar in methodology, however ASTM D6117 Is used for solid sections or plastic members
and not for sheets of plastic material. In addition to this, the ICBOES ACI 16 document gives guidance on
establishing allowable loads, which ASTM D6117 does not provide. In the absence of a standard that more
specifically addresses this issue, ITS recommends that ACI 16 is more appropriate.
it is our opi nion that it is appropriate to state specific loads for this material. ASTM D5456-99 clause A2.6.1
states, "The equivalent specific gravity is determined from Table 12.2 r or Ref'. (3) such that the table value for
the tested nail does not exceed the average ultimate withdrawal resistance in pounds per inch (N/nun) from
A2.4 divided by 5.0..." The safety factor for withdrawal in ASTM D5456 matches that of AC 116, again
justifying its applicability to this issue. ASTM D5456 does not have a comparable safety factor for lateral load
resistance. In the absence of a standard that more specifically addresses this issue, we suggest that AC 116 Is
more appropriate.
Given the low C.O.V. of the web tensile test results, it is the opinion of M that a safety factor of
approximately three is appropriate. We chose to use the lateral resistance factors of ACI 16 for consistency.
CAGCULATIONS
1. Web Tensile:
842 tbs. x 0.75 = 631 lbs (Proportional limit assumed to be the same as ultimate load — brittle failure)
842 tbs. 13.2 - 263 lbs (Based on average ultimate load)
2. Fastener Testing:
(A) Withdrawal Resistance
Type "S" Screw
Type "W" Screw
(8) Lateral Resistance
Type "S" Screw
Type "W" Screw
F.u� - 178 Ib3. -�- 5 — 35 Jhs
F.x� . 166 lbs. + 5 = 33 Ibs;
F,"� � F 4 3.2 - 328 lbs. + 3.2 = 102.5 lbs
F,,,,. � F + 3.2 = 367 lbs. + 3 2 = 114 lbs
PRODUCr MANUAL
8.1 - INTERTE-K TESTING SERVICES CONTINUED
CONCLUSIONS
1. Phvsical PrODertieS of Pet ro lene Reinforcing Webs
The polypropylene reinforcing webs were found to have the following allowable loads, as recommended by
ITS when analyzed in accordance with ICBOES AC 116 (July 200 1) "Acceptance Criteria for Mails and
Spikes."(The withdrawal resistance utilized a safety factor of rive as pet ICBO ES ACI 16, Section 4.2. The
lateral resistance of both the Type "W" screws and the Type "S" screws utilize a safety factor of 3.2 when
analyzed in accordance with IC.BO ES ACI 16, Section 4. 1.):
• Withdrawal tesistance of a Type "S" fine thread drywall screw is 35.
• Withdrawal resistance of a Type "W" course thread drywall screw is 33.
• Lateral resistance of a Type "S" fine thread drywall screw is 102.
• Lateral resistance of a Type "7' course thread drywall screw is 114.
The Polypropylene Reinforcing Web tensile strength is recommended by ITS to be 263 lbs, based on a Safety Factor
of 32 analyzed in accordance with ICBO FS ACI 16, Section 4.1. The maximum negative wind pressure for a cladding
system attached to the EPS foam plastic panels is based on the maximum fastener values connected into the
Polypropylene Reinforcing Webs. For a screwed system into the webs, 8" on center vertically, and 6" an center
horizontally, the allowable negative withdrawal is 99lbs/fe. This withdrawal capacity can be converted to a wind speed
based on the following formula extrapolated from the 1997 Uniform Building Code Table 16-F at standard height of
33 feet:
q, = Kv'
where: q, = wind pressure (psf)
and: v = basic vrind speed (mph)
and: K - 0.00256
thus: v - (% -t 0.00256)"
given: q, = 99 Ibs1ft' (allowable negative withdrawal)
then: v — 197 mph
INTERTEK TESTING SERVICES NA LTD.
Warnock Hersey
Tested/
Reported by: g R. Lawson, NZCE (Mech),—
Technician, Construction Products
Reviewed by:
Manager, Construction Products
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ER-6133
LEGACY REPORT Issued May 1, 2003
ICC Evaluation Service, Inc. Business/Regional Office # 5360 Workman Mill Road, Whittier, California 90601 # (562) 699-0543
Regional Office # 900 Montclair Road, Suits A, Birmingham, Alabama 35213 # (205) 599-9800
www.icc-es.org Regional Office # 4051 West FlossmoorRoad. Country Club Hills, Illinois 60478 # (708) 799-2305
Legacy report on the 1997 Uniform Building CodeTm, the 2000 International Building Codee, and the 2000
International Residential Code'o
DIVISION: 03—CONCRETE
Section: 03130—Parmanent Forms
LOGDC INSULATED CONCRETE FORMS
LOGIX INSULATED CONCRETE FORMS LTD.
12150-16VH STREET
EDMONTON, ALBERTA T5V 1 H 5
CANADA
AMC INSULATION CORPORATION
151 PARAMOUNT ROAD
WINNIPEG, MANITOBA R2X 2W6
CANADA
BEAVER PLASTICS LTD.
1121150-166"' STREET
EDMONTON, ALBERTA T5V 1 H5
CANADA
FORM SYSTEMS INC.
POST OFFICE BOX 16923
WICHITA, KANSAS 67216
PERMA R PRODUCTS INC.
106 PERMA R ROAD
JOHNSON CITY, TENNESSEE 37063
PSC MOULDING CORPORATION
840 DIVISION STREET
COBOURG, ONTARIO K9A 4J9
CANADA
1.0 SUBJECT
Logix Insulated Concrete Forms.
2.0 DESCRIPTION
2.1 General:
The Logix Insulated Concrete Forms consist of expanded
polystyrene (EPS) interlocking rigid polystyrene foam plastic
boards that serve as permanent formwork for reinforced
concrete, exterior and interior walls and lintel beams, and
foundation and retaining walls. The interior of a building
constructed with Logix Insulated Concrete Forms must be
protected with a thermal barrier complying with Section
2602.4 of the 1997 Uniform Building CodeTM (UBC), Section
2603.4 of the 2000 International Building CodeP (IBC) or
Section R318.1.2 of the 2000 International Residential Code'
(IRC), such as'a '/2-inch-thick (12.7 mm) regular gypsum
wallboard installed in accordance with Section 2.5; and the
exterior surface must be covered with an approved exterior
wall covering. Recognition is in accordance with Section
104.2.8 of the UBC, Section 104.11 of the IBC, and Sections
R404.4 and R611 of the IRC.
2.2 Materials:
2.2.1 Logix Insulated Concrete Forms: The Logix
Insulated Concrete Forms consist of two EPS foam plastic
boards separated by injection molded polypropylene webs,
which are preinserted into the EPS mold before molding so
that they are partially embedded into the EPS boards. The
polypropylene webs, which are spaced 8 inches (203 mm) on
center horizontally, maintain the EPS board facings at a fixed
clear distance of 4 inches (102 mm), 6.25 inches (158 mm),
8 inches (203 mm) or 10 inches (254 mm). Forthe standard
forms, the EPS boards are 16 inches (406 mm) high by 48
inches (1219 mm) long. The EPS boards are 2% inches (63.5
mm) thick measured at the center of the board, and have a
maximum thickness of 2'/4 inches (69.9 mm). When stacked
in a running bond pattern, the Logix Insulated Concrete
Forms create a cavity where steel reinforcement bars and
concrete are placed. In addition to the standard forms, 45-
degree angle forms, 90-degree angle corner forms, taper top
blocks and brick ledge blocks are also available. Typical
Logix Insulated Concrete Forms are illustrated in Figure 1.
The 45-degree angle forms and 90-degree angle corner
forms are used to construct wall intersections. The taper top
block is used to construct corbels in the wall at the desired
locations. The brick ledge blocks are used to construct
corbels that serve as ledges, for supporting exterior brick
veneers.
The EPS foam boards are molded from beads specified in
the approved quality control manuals. The foam plastic has a
nominal density of 1.45 pcf (23.2 kg/m'), and has a maximum
flame -spread rating of 25 and a maximum smoke -density
rating of 450 when tested in accordance with UBC Standard
8-1 or ASTM E 84. The foam plastic Insulation complies as a
Type 11 rigid cellular polystyrene (RCPS) in accordance with
ASTM C 578-01.
The polypropylene webs are 8.5 inches (216 mm), 10.75
inches (273 mm), 12.5 inches (318 mm) or 14.5 inches (368
mm) in length and have a 1.25-inch-wide-by-14.25 inch -high
(32 mm by 362 mm), 0. 1 875-inch-thick (4.8 mm) flange. The
ICC-ESle,vacy reports are not to be construed as representing aesthetics or any other attributes not spec!flcally addressed, nor are they to be construed as
" 'a
an endorsement ofthesubject ofthe report or a recommendationfor Its use. There is no warrawy by ICC Evaluation Service. Inc., express or implied, c
anyfinding or other matter in this report, or as to anyproduct covered by the report.
Page I of 5
Copyright 0 2003
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Page 2 of 5 ER-6133
plastic flanges, embedded 1/, inch (12.7 mm) below the
outside surface of the EPS foam boards, provide supports for
attaching interior and exterior wall coverings. Refer to Figure
1 for details.
2.2.2 Concrete: Normal -weight concrete with a maximum
size aggregate of'/,, inch (19 mm) and a maximum slump of
6 inches (152 mrn). The maximum water-cementitious
materials ratio must be 0.5, unless otherwise approved by the
building official. Concrete must have a 28-day minimum
compressive strength of 2,500 psi (17.2 MPa). If construction
of the Logix Insulated Concrete Forms is based on the IRC,
concrete must comply with Section R404.4 or R611.6.1 of the
IRC.
2.2.3 Reinforcement Deformed steel reinforcement bars
must have a minimum yield stress of 40 ks! (276 MPa), and
must comply with Section 1903 of the UBC or the IBC. If
construction of the Loglx Insulated Concrete Forms is based
on the IRC, reinforcing steel must comply with Section
R404.4.6 or R611.6.2 of the IRC.
2.2.4 Other Components: Wood members, if not protected
from the concrete, must be preservative -treated by pressure
process with an approved wood preservative, and attached to
the wall with anchor bolts complying with Section 2304.3 of
the UBC, Section 2304.9.5 of the IBC or Section R323.3 of
the IRC. Materials other than wood, such as vinyl, are
permitted for window and door framing if approved by the
building official.
2.3 Design:
2.3.1 General: Design of concrete in the Logix Insulated
Concrete Forms must comply with Chapter 19 of the UBC or
the IBC. Walls must be anchored to the floors and roofs in
accordance with Section 1633.2.8 of the UBC or Section
1604.8.2 of the IBC.
2.3.2 Alternate Design: In lieu of calculations required by
Section 2.3.1 of this report, the structural design of residential
buildings, constructed with the Logix Insulated Concrete
Forms and regulated by the UBC, is permitted to comply with
the Prescriptive Method for Insulating Concrete Forms in
Residential Construction (publication No. EB1 18), dated May
1998, published by the Portland Cement Association (PCA),
subject to all limits applicable for a flat insulating concrete
form (ICF) wall system specified in that document. The PCA
document must be made available to the building official upon
request. Buildings constructed with the Logix Insulated
Concrete Forms and designed in accordance with this section
must not exceed a height of two stories plus a basement,
where the maximum unsupported wall height is 10 feet (3048
mm).
2.3.3 Design in Accordance with the IRC: Walls
constructed with the Logix Insulated Concrete Forms must be
designed in accordance with Section R611 of the IRC. The
Loglx Insulated Concrete Forms are defined as a flat ICF
system in accordance with IRC Section R404.4.2 or R611.3,
and corresponding requirements shall apply.
2.4 Installation:
The Logix Insulated Concrete Forms must be supported on
concrete footings complying with Chapter 18 of the UBC or
IBC, or Chapter 4 of the IRC.
Vertical reinforcement bars, embedded in the footing, must
extend a minimum of 24 inches (610 mm) into the block wall
system. The Logix Insulated Concrete Form blocks must be
stacked in a running bond pattern such that the polypropylene
webs align vertically. Vertical and horizontal reinforcement
bars must be placed as required by the design and the
applicable code. All horizontal and vertical reinforcement bars
must have minimum concrete protection in accordance with
the UBC or IBC. Concrete quality, mixing, and placing must
comply with Chapter 19 of the UBC or IBC. Refer to Figure 2
for typical installation details.
When regulated by the IRC, reinforcing steel for the Logix
Insulated Concrete Forms used above grade must comply
with Section R611 of the IRC.
Press u re-prese rvati ve-tre ated wood ledgers must be
attached to the concrete wall by removing the face shell of the
EPS units, with the height of the removed portion equal to the
depth of the wood ledger. When concrete is poured into the
wall system, the concrete -filled volume, provided for the
anchor bolts, forms a solid concrete connection from the
ledger board to the horizontal bond beam. The spacing and
embedment depth of the anchor bolts must comply with the
structural design or code requirements, whichever governs.
Anchor bolts used to connect the wood ledgers or plates to
the concrete must be cast -in -place, with the bolts sized and
spaced as required by the design.
2.5 Interior Finish:
Logix Insulated Concrete Forms exposed to the interior of the
building must be finished with minimum '/2-inch-thick (12.7
mm) regular gypsum wallboard complying with ASTM C 36,
attached to the flanges of the polypropylene webs. The
minimum'/2-inch-thick (12.7 mm) wallboard must be installed
vertically and attached to the flanges of the plastic webs with
1.625-inch-long (41.3 mm), No. 6, Type W, coarse thread
gypsum wallboard screws spaced 16 inches (406 mm) on
center horizontally, and 12 inches (305 mm) vertically.
2.6 Exterior Finish:
2.6.1 Above Grade: An approved exterior wall covering
must be designed and installed in accordance with the
applicable code or an ICCES evaluation report. When the
wall covering is required to be attached to structural
members, the wall covering must be attached to the flanges
of the polypropylene webs with either No. 6, Type W, coarse
thread drywall screws or No. 6, Type S drywall screws. The
screws must be corrosion -resistant and have sufficient length
to protrude through the flanges of the polypropylene webs a
minimum of'/, inch (6.4 mm). The screws have the allowable
pullout and lateral load capabilities shown in Table 1. The
maximum spacing of the screws shall be designed to support
the gravity loads of the wall covering and resist the negative
wind pressures. The maximum negative wind pressure is 99
psf (4.74 kPa).
Negative wind pressure capacity of the exterior finish
material must be the same as that recognized in the code for
generic materials, or in a current ICC-ES evaluation report for
proprietary materials.
2.6.2 Below Grade: Wall surfaces must be dampproofed
and, when required by the building official, waterproofed in
accordance with Appendix Chapter 18 of the UBC, Section
1806 of the IBC, or Section R404.4.11 of the IRC.
Dampproofing and waterproofing materials must be approved
by Logix Insulated Concrete Forms Ltd. and the building
official, and must be free of solvents that will adversely affect
the EPS foam boards.
2.7 Foundation Walls:
The wall system is permitted to be used as a foundation stem
wall when supporting wood -framed construction and when the
structure is supported on concrete footings complying with the
applicable code. Compliance with Table 18-1-C is mandatory
when regulation is by the UBC. Installation of the Logix
Insulated Concrete Forms as foundation walls must comply
with Section R404.4 of the IRC.
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Page 3 of 5
2.8 Underfloor Crawl Spaces:
Logix Insulated Concrete Forms located in underfloor crawl
spaces are permitted to be exposed to the crawl space,
subject to all the following conditions:
1 . Entry to the crawl space is only to service utilities, and no
heat -producing appliances are permitted.
2. There are no interconnected basement areas.
3. Air in the crawl space is not circulated to other parts of the
building.
4. Underfloor ventilation complies with the applicable code.
2.9 Fire-resistant Construction for Recognition under
the UBC:
Concrete walls meeting the construction specifications listed
In Item 7-1.1 of Table 7-B of the LIBC are formed by the Logix
Insulated Concrete Forms and have the fire -resistive ratings
specified in Table 7-B of the LIBC, for a maximum fire -
resistive period of 3 hours.
2.10 Special Inspection:
Special inspection is required as noted in Section 1701 of the
LIBC, or Section 1704 of the IBC, for placement of reinforcing
steel and concrete, and for concrete cylinder testing, except
that special inspection is not required for foundation stem
walls conforming to Table 18-1-C of the LIBC, or Table
1805.4.2 of the IBC. Additionally, when the building official
approves and recognition is under the UBC, special
inspection is not required when all of the following conditions
are met:
1 . Wall systems are a maximum of 8 feet high (2.4 m) and
are limited to use in single -story construction of Group R,
Division 3, or Group U Occupancies.
2. Maximum height of a concrete lift is 48 inches (i 219 mm).
Succeeding lifts must be placed in accordance with
Section 1905.10.5 of the UBC.
3. Installation is by property trained installers approved by
Loglx Insulated Concrete Forms Ltd.
4. The installation instructions indicate methods used to
verify proper placement of concrete.
5. Specified compressive strength of concrete used in
design is one-half of that specified.
2.11 Identification:
Each package of LogiX Insulated Concrete Forms bears a
label specifying the product name (Logix Insulated Concrete
Forms), the evaluation report number (ER-6133), the phone
number and web page for the product, a checkbox for which
manufacturing location the product comes from, the date of
production, and the name and logo of the quality contr6l
agency (Intertek Testing Services NA, Ltd. —Warnock
Hersey).
ER-6133
3.0 EVIDENCE SUBMITTED
Data in accordance with the ICC-ES Interim Criteria for
Concrete and Concrete Masonry Wall Systems (AC1 5), dated
January 2001, and the ICC-ES Interim Criteria for Foam
Plastic Insulation (AC1 2), dated July 2001; and quality control
manuals.
4.0 FINDINGS
That the Logix Insulated Concrete Forms described In
this report complywith the 1997 Uniform Building CodeTM
(UBC), the 2000 Interriational Building Code' (IBC), and
the 2000 International Residential Code (IRC), subjectto
the following conditions:
4.1 The forms are manufactured, identified and Installed
in accordance with this report and the
manufactureesinstallation Instructions.
4.2 When regulated by the UBC or IBC, walls
constructed with the Logix Insulated Concrete
Forms are considered Type V construction.
4.3 When required by the building official, plans and
calculations showing compliance with this report
are submitted to the building official for approval.
4.4 The EPS foam forms are separated from the building
Interior with an approved thermal barrier, such as
minimum '/,-inch-thick (12.7 mm) regular gypsum
wallboard Installed as specified in this report. Other
thermal barriers, having an Index of 15 and
attachment complying with a current ICC-ES
evaluation report, are acceptable.
4.5 When regulation is by the UBC or IBC, special
Inspection is provided In accordance with Section
2.10 of this report.
4.6 When regulation Is by the IRC, compliance with
Section R324A must be demonstrated.
4.7 Logix Insulated Concrete Forms are manufactured
by Beaver Plastics Ltd. located In Edmonton,
Alberta, Canada, and ChIlliwack, British Columbia,
Canada; AMC Insulation Corporation In Winnipeg,
Manitoba, Canada; Form Systems Inc. In Haysville,
Kansas; Perma R Products Inc. In Johnson City,
Tennessee; PSC Moulding Corporation In Cobourg,
Ontario, Canada. Loglx Insulated Concrete Forms
are produced under a quality control program with
inspections conducted by IntertekTestIng Services
NA, Ltd�--Warnoclk Hersey (AA-647-2).
This report is subject to re-examination In one year.
TABLE I —ALLOWABLE PULLOUT AND LATERAL CAPACFTIES OF SCREWS
SCREW TYPE
ALLOWABLE CAPACITY (pounds)
Pullout Capacity
Lateral Load Capacity
No. 6, Type S, fine -thread, corrosion -resistant screw
35
49
No. 6, Type W, coarse -thread, corrosion -resistant screw
33
49 1
vor tsi: i pouno = 4.4o N.
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Page 4 of 5 ER-6133
P1 AN VIEW 6' TAPFR Top BLOCK
48'-
4- �-- a I ---�
P, AN VIEV 6' BRICK LEDGE BUIC �14'-j
I IT
16'
1
SIDE ELEVATION
FIGURE 1—LOGIX INSULATED CONCRETE FORMS
4'�
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PRICK VENEER CXTfELRAtSM
\-CUT OPENINGS IN FORM
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FORM
(Al ALL ANCHOR LOCATIONS:
SIZE 4 t/2 X 7 MIMIMUM
qYATE�PROC+r
MEM�RANE+\+
+
+ +
+
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DRYWALL (MIN. THICK)
+ +
+
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FOOTING (CONTINUOUS)
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FIGURE 2-TYPICAL INSTALLATION DETAILS
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PRODUCTMANUAL 8.1 - INTERTEK TESTING SERVICES
Intertek Testing Services
ETLSEMKO
Aug.22,2002
To whom it may concem,
This letter certifies that Logix Insulated Concrete Forms have been subject to and
complied with all of the following testing:
• Meets 3 hour fire rating in accordance with ASTM El 19 and CAN/ULC S101
• Room fire Test Standard for Intedor of Foam Plastics Systems in accordance with
ASTMD1929,D635andD2843 '
• CrawlSpace evaluation conducted in accordance with ICBOES requirements
• Confon-ns to ASTM C578, with equivalency CAN/ULC S701 (standard Specification
for Rigid, Cellular Polystyrene Thermal Insulation)
• Fastener Withdrawal Evaluation in accordance with ASTM D1 761
• Fastener Lateral Resistance tested in accordance with ASTM D1 761
• Polypropylene web matedal conforms to CCI Plastic matedal when tested in
accordance with ASTM D1929, D635 and D2843
Applications have been submitted for the following evaluation reports:
- CCMC ER # pending
- ICBOES ER # pending
. SBCCI PST and ESI RR # pending
- BOCAES RR # pending
Testing and ongoing evaluation of Logix Insulated Concrete Forms is canied out by
Intertek Testing Services (ITS). Logix Insulated concrete forms are a listed product with
ITS (#6245) and are eligible to display the Warnock Hersey Certification Mark.
If you have any question or concerns regarding the above information, contact the
undersigned at 1-800-668-TEST.
INTERTEK TESTING SERVICES NA LTD.
Wanock Hersey
Sheldon Warman, P. Eng.
Manager, Construction Products RECEIVED
MAY 2 6 2004
PERMIT COUNTER
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PRODUCTMANUAL 8.1 - INTERTEK TESTING SERVICES
TIUST PRoGRAM
1. Physics i Provertles of polvoranylene Reintoming Webs
Physical properties testing of polypropylene reinforcing web material was pefformed in general accordance
with the following test mcdxK%:
A. Screw Withdrawal: is conjunct STM
ICBOESAC116puly2OOl)oAcceplanceCriwiaforNai andSpikes�"in ion with A
131761-88 (Reapproved 2000) "Standard Teit Mdhodifor Medn*al FalteJuTs in WOog " Sections
I through 12 (two qxs of fastakers were tested: a " 'Vor come thread drywall screw, and a type
'S' fine duvad drywall screw)
EL lAtersil Screw Resistance:
ICBOES ACI 16 (July 2001) "Acceptance Oiteriafor Nails andSP&Jr win conjunction with ASTM
D1761-88 (Reapproved 2000) -Standard Test MethO&fOr McchmOr'al Faften='" W004 ftSeCtim
13 ftough 20
C Tensile Strength:
ASTM D6 3 "1 'Stwx1ard 7k5f MethOdfOr Ttmik PFOPerlkl 00140tksm
TEST RLSULTS
1. Physi I ProDertics a Itne inforring Wekq
. A. Screw Withdrawal Late Sct:cwResi&tx*cc(ASTMD1761A*):
withdrawal
Fastener Type
Max Load (lb3)
I Max Load Qbs)
W�
Average I
Type IYP Coarse Thread Drywall Scmw
166
367
COV I
Type w, Course Thread Drywall Screw
10.6%
84%
Average ,
Type -S' MeThread Drywall Screw
169
328
cc)v
=ype S' Fine Thread Drywall Screw
8.4%
4.1%-
Note: Test results awvewcre oa3ea onYwcivcwunarwww=,aP1r,,,, -l-
Complete results we included in the Appendix D.
B. Tensile Stmeth rM V63&01)-.
Ultimate Tensile Strengtn ('DsJ I
Avmze 942
COV 1.7%
Note: A complete web was used with each side of the web gril;5 Wend lo�Oded p"ndicuLar to
the exterior surface of the web. Test results above were based an ten S=Ples- Complete results
am included in Appendix E.
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PRODUCT MANUAL 8.1 - INTERTEK TESTING SERVICES CONTINUED
DISCUSSION
ICROES AC 116 references ASTM D 1761 for lateral and withdrawal testing. The ASTM D6117 and ASIM
D1761 are very similar in methodology, however ASTM D6117 is used Fur solid sections of plasticmembem
and not for sheets of plastic material. inaddition to this� tho� ICBOBS ACI 16 document gives guidance on
establishing allowable loads, which AsTM D6117 does not provide. In the absence of a standard that more
specifically addresses this issue, ITS recominends; that ACI 16 is more appropriate.
it is our opinion that it is appropriate to state specific loads, for this Material. ASTM D5456-99 clause A2.6.1
states, "The equivalent specific gravity is determined ftm Table 1211 or Ref. (3) such that the table vane for
the tested nail does not exceed the average ultimate withdrawal resistance in pounds per inch (N/mm) from
A2.4 divided by 5.0..." The safety factor for withifinwal in ASTM D5456 matches that of AC 116, again
justifying its applicability to this Issue. ASW D5456 does not have a comparable safety factor for lateral load
resistance. In the absence of a standard that more specifically addresses this issue, we suggest dot AC 116 Is
more appropriate.
Given the low C.O.V. of the web tensile test results, it is the opinion of ITS that a safi;ty factor or
approximately three is apprapdate. We chose to use the lateral resistance factors of AC 116 for consistency.
CALCULA77ONS
1. Web Tensile:
942 lbs. x 0.75 = 631 lbs (proportional limit assumed to be the same as ultimate load — brittle failure)
942 ft / 3.2 - 263 lbs (Based on average ultimate lom�
2. Fastener Testing:
(A) Withdrawal Resistance
Type -S' screw 178 Jb3. -i- 5 — 35 Jb3
Type -W- Screw 166 ft. + 5 — 33 lb3
Lateral Resistance
Type OSO Screw
Type "W" Screw
F.o� m F + 3.2 = 328 Ibs. + 3 2 = 102.$ lbs
F.1w. � IF + 3.2 = 367 lbs. - 3.2 = 114 lbs
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PRODUCr MANUAL 8.1 - INTERTEK TESTING SERVICES CONTINUED
CONCLUSIONS
Physical Piroperties of Polypropylene Reinforcing Webs
The polypropylene reinforcing webs were found to have the fbIlowing allowable loads, as recommended by
ITS when analyzed in ac=dance. with ICBOFS AC 116 (July 2001) ffAcc9ptance Criteria for Nails and
Spikes. w(The withdrawal resistance utilized a safety actor of five as per ICBO ES ACI 16, Section 42. The
lateral resimce of both the Type 'W" satm and the Type 'S' screws utilize a safety factor of 3.2 when
analyzed in accordance with lCB0 ES AC 116, Section 4. 1.):
• Withdrawal resistance of a Type "S" fine thread drywall screw is 35.
• Withdrawal resistance of a Type "W* course thread drywall screw is 33.
• Lateral resistance of a Type "S* fine thread drywall =ew is 102.
• Lateral resistance of a Type "W" course thread drywall screw is 114.
The Polypropylene Reinforcing Web tensile strength is recommended by ITS to be 263 tbs. based on a Safety Factor
of 3.2 analyzed in accordance with ICSO ES ACI 16, Section 4.1. The maximum negative wind pmmure for a cladding
system attached to thi EPS foam plastic panels is based on the maximum astener values connected into the
Polypropylene Reinforcing Webs. For a screwed system into the webs, 8" on center vertically, and 6" on center
horizontally, the allowable negative withdrawal is 99lbsO. This withdrawal capacity can be converted to a wind speed
based on the following formula extrapolated from the 1997 Uniform Building Code Table 16-F at standard height of
33 ket:
q, = Kv2
where: ch = wind pressure (psf)
and: v = basic wind speed (mph)
and: K - 0.00256
thus: v - (q, + 0.00256r
given: q, = 99 lWfV (allowable negative withdrawal)
then: v — 197 mph
INTERTEK TESTING SERVICES NA LTD.
Warnock Hersey
Tested/
Reported by:
g R- Lawson, NZCE (Mech),
Technician, Construction Products
Reviewed by: L - ----`4 '— 4 1
Cain Robinson, P.Eng.
Manager, Construction Products
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CASCADE TESTING LABORATORY, INC.
TESTING & INSPECTION / ENGINEERS
12919 N.E. 126TH PLACE
KIRKLAND, WASHINGTON 98034 (425) 823-9800
EVERETT (425) 259-0817
FIELD REPORT
TO:E\IAN - F I UCE
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Is _T7EL cjS k7l AUG 3 i 200
DEVELOPMENT SERIVICES '.'I'
CITY OF EDI-.i0i4I),`
ATTN:
(2)
INSPECTION PERFORMED
i RESTEELlCONCRETE RESTEEL ONLY
RESTEEUMASONRY STR.ST[WELDING
vk.[D. STR.ST/BOLTING
OTHER
Ab,
PREVIOUS
115941.
REPORT No. No.
DATEVVEDNE�P TCERT.
NO.
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PROJECT
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LOCATION
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BEAMS
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SUPPLIER QlA0tMN -- — TOTAL CU. YD. PLACED bb
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AIR CONTENT (%) SEE CYLINDER REPORT NO. 5'7-700
�61Y ES — NO _ ITEMS I INS PECTED WERE I N CON FORMANCE WITH 8 LOG. DEPT. APPROVED PLANS
TEST RESULTS APPLY ONLY TO THE ITEMS
HEREIN TESTED. THIS REPORT SHALL NOT
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OUT THE WRITTEN APPROVAL OF CASCADE
TESTING LABORATORY, INC.
REVISED 8100
INSPECTOR(
INSPECTOR
SIGNED BY
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CAS AIDE TESTING LABORATORY, INC.
TESTING & INSPECTION / ENGINEERS
1 29 9 N.E. 126TH PLACE
'IRKILAND, WASHINGTON 9803A (A25) 823-9800
EVERETT (425) 25;.0817
COMPRESSION REPORT
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ATTN:
THE FOLLOWING WAS NOTED:
CERCRETE
FIELD TEST DATA
FIELD
REPORT No. I No. 5 2 7 0 0
DATE \NtjjNe t?UP57
T NO.
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PtEYCE KEt?.
LOCATION
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SLOG. PERMIT NO.
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EQUIPMENT USED I.D.
SLUMP CONE CSLCOO THERMOMETER CCOTHO
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CONCRETE COMPRESSION MACHINE I.D. fFUUULUUU E3 ASTIVI C-1231 SAMPLING IN ACCORDANCE WITH
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TESTING LABORATORY. INC. INSPECTOR
REVISED 1102 SIGNED BY
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MCICASCADE TESTING LABORATORY, INC.
TESTING & INSPECTION / ENGINEERS
12919 N.E. 126TH PLACE
KIRKLAND, WASHINGTON 9803A (4251 823-9800
EVERETT (A25) 259-08 17
COMPRESSION REPORT
TO:EVAN
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ATTN:
THE FOLLOWING WAS NOTED:
CERCRETE
mm n TEST DATA
FIELD
REPORT Nol kT;T'tl No.52700
DATE WLIDNE-1-joks-7,
FcERT. —NO.
AW. I k t 760t IC�kQS-ZM
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PI&LE KE5.
LOCATION
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AIR TEST METHOD: [I PRESSURE ASTM U-231 UH Lj VULUMM AZ) I fV1 U- I f 0
EOUIPMENTUSED I.D.
SLUMP CONE CSLCOO THERMOMETER CCOTHO
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CYLINDER
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SUPPLIER CEMENTTYPE CU. YARDS PLACED 10 -
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TESTING LABORATORY, INC.
REVISED 1/02
INSPECTOR(S), NAME(S) PRINTEDQUW!t�,JACQ k_k_�
INSPECTOR
SIGNED BY
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MAY-25-2004 11:15 P.02/04
CITY OF EDMONDS
SPECIAL INSPECTION AND TESTING AGREEMENT
_;Z,yp / 7 /,0 t rA III
The project at issued under b Hdin
permit number s'spe a ial - iqspq6tion pd/or testing per UBC Chapter 11
and WAC Amendments 1702. The cc=list oef special inspections is attache-d to this document.
BEFORE A PERMIT CAN BE ISSUED: The owner and contractor and special inspector shall
complete this agreement and the attached'structural test(s) and inspections schedule including the
required acknowledgments.
APPROVAL OF SPECIAL INSPECTORS: Each special inspector shall be approved by the
Building Official prior to performing any duties or inspections, Each special inspector shall submit
Statement of Qualifications to the Building Official for review. Special inspectors shall display
identification when perforniiing special inspections on site. Special inspection and testing shall meet
the minimum requirements of U13C Chapter 17 and the following:
1. Observe Work
The special inspector shall observe the site work for conformance with the approved
(stamped) plans and sp�cifications and applicable workmanship provisions of the UBC.
an aid to inspection.
Architect or Engineer reviewed shop drawings may be used only �s _meaning that the special
§pecial inspections are to be performed on a continuous. basis -
Inspector is on site at all times observing the work requiring special inspection. Periodic
inspections, if any, must have pri"ol a roval by the City.based on a separate written plan
reviewed and approved by the Wflcial and the engineer or architect of record.
V
2. Report Non -conforming Items
The special inspector shall bring nonconforming items to the immediate attention of the
contractor and note all such items in the daily field report. Any item not resolved in a timely
manner shall be immediate cause of the special inspector to notify the Building Official of the
plan deviation error, c4ange. or omission. It shall also be the duty of the special inspector to
promptly noti?y the engineer or architect.
3. Complete Daily Reports
Each special inspector shall complete and sign both tJie special inspection record and the daily
report form for each day's inspection. These records shall remain at the jobsite with the
contractor for review by the City Building Inspector.
4. Furnish Weekly Reports
The �pecial inspector or inspection agency shall furnish the City with weekly reports of tests
and inspections. The project engineer or architect, and others as designated shall also be
copied on reports. Weekly reports must include the following:
Description of daily inspections and tests made with applicable locations
List of all nonconforming items
Report on status of nonconforming items (resolved or unresolved) ded in
Iteinized changes authorized by !he Architect, Engineer and City if not inclu
nonconformance items
5.'Furnish Final Construction Report
The Necial inspector or inspection agency shall submit a final si d rt to the City stating
that I items requiring special inspection and testing were fulfiC latride�reported. And, to the
best of his/her knowledge the pro)ect is in conformance with the approved plans and
fications, approved change orders and the applicable workmanship provisions of the
WCi Items not in conformance or unresolved items or any discrepancies 'in 'inspection
inspections were
coverage, (i.e., niissed inspections, periodic inspection when continuous
required, etc.) shall be specifically itefilized in this report. R E C F— I V E D
MAY 2 6 2004
PERMIT COUNTER
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425-823-2203 P.3
P. 03/04
R. -ContrAplar. Ropoplibiliti
1. Notify the Specht) Inspector
It is the duty of the contractor,to notify the special inspector when work is ready fbr special
juspntion. Note, the items listed on the attached schedule wd as noted on the approved
plans and specifications are required to have special inspections. Adequate notice shun be
provided by the contractor so that the special inspector has time to become familiar with the
projed.
2. Provide Access to Approved Plans
The contractor is responsible for providing the special inspector access to approved plans at
thojobsite.
3. Retain Special Inspection Records
The contractor is responsible to retain at the * �bsite all special inspection records submitted
by the special inspector. These records are to�eprovided to the City building inspector upon
request.
!Q, -cily of Edmonds Building DR11niftentlResilangibilffles
1. Approve special inspectors or inspection agencies
IMe building department shall approve all special inspectors and special inspection
requirements,
2. Monitor special inspection and approve weekly reports
Work .9. tio and the, p2ribrinance, 'of special inspectors shall be
. = City
rnomlorjubmtesp= Bffc9g nInspector. His/her approval must be obtained prior to
V
placement of concrete or other siffillar ktivities in addition to that of the special inspector.
3. Issue Cerfificate of OemPanCY
The Building Official may issue a Certificate of occupancy after all weekly special inspection
I
ireports incluRling the fin report have been submitted-iirid, accepted. -
QVner Responsibiliti
Thu pVject owner or the engineer or architect of record acting as the owner's agent shall fimd
special inspection services.
E. Engineer or Architect of RecorA Responsibilities
The engineer or architect of record shall include special inspection requirements on the plans and
speciflca6ons.
ACKNOWLEDGEMENTS
I have read a7 the tma and conditions ofthis agreement.
Date _5__1Z_L5__ 140`1
0
Special Inspector\_�,,,_. ��__Patu_
General Contractor—ZAX ate, Cl/
City Building
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MAY-25-2004 11:16 P.04/04
SPECIAL INSPECTION AND TESTING SCHEDULE
MO=NAMF. BUILVINO Pmmrr "06
ly Z ,etrdA40W,�S
1UTINCANSPIMMON AGENCY a SPWLAI, 12,15PECTUR
RE[NFORCED CONCRM, GUNffE, GROUT AND MORTAR: STRUCTURAL STEEtAVELDING:
Cmcmg Gmdk Grout Morw — Sample and Tem flist spocific nx=bm below)
Agp"c Tests
R6dmins Tests
Mix Designs
Reinforcing Placurient
Bitch plant lnspcc�cvn
Impect Placing
cut Samoles
Pick-up Simplei;
Compression Tesis
— Sbap MatcriW Identification
— Wdding Inspeclion D Sbop 0 Field
— UltrasOilic Inspection OSbop 0 Field
Hish-n=A Bolting
impection C) Shop 0 Field
0 A325
0 A49D El x 0 F
Metal Deck Wiciding Inspection
114afmcing Slccl Welding InspcWon
— Meml Slud Weldiny Inspection
PRECAST/PRESTRESSED CONCRETE: — Concrete Insert Wclding Inspection
Pau Fw-Tew hv-Tenz CWddl"
AggmLue Tests
Rginfordng Tau
Tendon Tests
Mix Dezijrns
Rein(brcing Placement
In= Placenicnt
Coumte Batching
concnteplaccrricat
Installation Insepction
Cut samples
1pick-upsamples
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Compremion Tests
FIREPR FING.-
placernew Inspe0ion
Density Tests
TWckncss Tests
Inspect Patching
INSULATING CONCRETE:
— Sample and Test
— Placement Inspection
— Unit Waijbts
FILL MATERIAL:
MASONRY, — Acceptanze Tests
— Placernent Inspection
— Special Inspection Strcsscs Used — Field Density
— Ptclimirwy Acceptance Tests (Masonry Units. Will Piisms) STRUCTURAL WOOD:
— Subsequent Tests (Mom. Grout. Field Wall Prism)
— Placement Inspection of Uviits — Skx WWI Nailing In"cdm
— Inspection of GIu.IAM Fab.
— Inspection of Truss Joiu Fab.
ADDITIONAL INSTRUCTIONS OR OTHER'TESTS — Spanpic and Test Components
AND INSPECTIONS;
Form completed by: Title:
TcL-phone No.: Date:
TOTAL P.04
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMITCOORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE
PLEASE SIGN
-ENGINEERING DIVISION DATE4&��
PLANNING DIVISION DATE
PIXASESIGN,
PROJECT
SITEADDRESS-
PERMIT #20Q
ADB# DATE INSPECTED O�5
DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine compliance with - app * roved plans. final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
V GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
El Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owncr/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:tem1):b1dg:romis:ocaprv1 3/25/04
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
'n SETBACKS .....................
FOUNDATION:
Footing ......................
Wall ..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation .......... Air 3-z-aS
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ......
HEATING:
Gas Test .................... MT S7- 30-
Gas Piping ................. 3 6 --16!;
Equipment ................. F-
Commercial Final .......
EXTERIOR SHEATHING
NAILING .......................... r1W
FRAMING ........................ 7- 1 -as
FIRST FLOOR FRAMING ...
e 4--
INSULATION ...................
Floor Insulation ......... fv\
Wall Insulation ........... ILL\
Ceiling Insulation ....... 66 T- 44
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
. J� e ;,, t, +
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MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
aw WOOO"
The Initials MT are Miltol,
Thompson, a temporary contract
inspector f017 thc City.
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