PFI2013-00008 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
COMMUNITY DEVELOPMENT Permit#: PF12013-00008
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 04/16/2013
Parcel: 2S112BD00800
Jurisdiction: Tigard
Site address: 7700 SW BONITA RD
Subdivision: DURHAM ACRES Lot: 66
Project: Hulquist Sidewalk
Project Description: Adjacent to 7700 SW Bonita Rd., replace one sidewalk panel and portion of curb. Install 3"PVC
weephole.
Owner: FEES
Description Date Amount
PHONE:
Contractor:
PHONE:
FAX:
Applicant:
MARK HULQUIST
7700 SW BONITA RD.
TIGARD, OR 97224
PHONE: 503-329-8875
Total $0.00
Please sign below to indicate acceptance of conditions and return a copy with the proposed work schedule along with names and contact
information of responsible parties before beginning work.
Permittee/Applicant
Signature:
Issued By:
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
City of Tigard
.mme
Public Facility Improvement (PFI) Permit
TIGARD
General Information: • l Q A , FOR STAFF USE ONLY
Property Address/Location(s):7700 5W �,`ot 9-n Engineering
Case No.: Pel
�l'�1 PIY�d) q 1 Z2�
Receipt No.: a
�M Date: q 6
*Applicant's Name: t 1 �QVC4- `j �( Q L, Application Accepted By:
Address:—n00 SW k",ba ao / POy4X 2'376J Revised 7/1/10
City/State:
��. Zip: -Z--
Primary Contact: �f V r� REQUIRED SUBMITTAL
INFORMATION
Phone: Fax:
,/�1 (� 'w Professional Engineered Plans are required
Contractor's Name:
DI1 1` G ' for.
• Street Widening
CCB# Expiration: Subdivision Infrastructure
Address: ScA Ne 11 1 LSSbY�V1� ^ •-m 1 W • Main utility line extension:
�GL-� d Zi i3Z 0 Storm Drain,Sanitary—Tigard
City/State: p 0 Water—Tigard Water Service Area
Phone: U Fax: (includes Durham,King City and a
portion of unincorporated Washington
County)
Plans By:
**Note:See Engineered Plan
Address: Submittal Checklist attached.
City/State: Zip: For all other work:Submit scaled sketch of the
Phone: Fax: work to be done. (see attached minimum sketch
�
y� 1A I� L requirements and provided sketch area).
'• � Y V e
Description of work: l! �p Y6t—AL I:curpin\master\land use application\PFI app.docx
Cut Reno V—,Qn m&,— OY1t !SIM., " PLA-17P- Ano PC7ab cr, ar C.yrig
IA6At" '?,1% PVL Rk.2r.. py-��
Estimated value of work(within the public right-of-way): $ 3c>a. C-b
Is work related to a LAND-USE DECISION? YES 0 NO J�t
If so,please specify(MLP, SDR,SUB,etc.)case#:
Is the work related to a BUILDING PERMIT? YES F] NO '�
If so,please specify (BUILDING PERMIT) case#: toil.v C)c�-1-0
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*NOTE:Person specified as"Applicant"shall be designated"Permittee"and shall provide financial assurance for the work.
City of Tigard 1 13125 SW Hall Blvd.,Tigard,OR 97223 1 503-718-2464 1 www.tigard-or.gov I Page 1 of 4
�Existing Cut and remove sidewalk plate and Hulquist
weephole portion of curb. Install 3"pvc
weephole. Repour new plate. Residence
ori In 6' k rs Site plan
0
Scale: 1"-20'
/ N
J
ubi A
3'
00
a
x
Symbols
- FFE =Finished floor Elevation
o.
f E =Elevation
Water Meter
Property Comers
s.az '
-`h FPM ia�s
A` - =Tree Dnp Line
Erosion Control Fencing
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_103.73' _ d
Project name: Hulquist Residence Addition
Site Address:7700 SW Bonita Rd.,Tigard
Lot 66 Durham Acres
Submitted and submitted by: Mark Hulquist,
7700 SW Bonita Rd,Tigard, OR 97224/PO Box 23761,Tigard,OR 97281