7962 SW CHURCHILL WAY FILE NO. q
CHURCHILL WAY - 7962 STP. OPN. PERMIT
'1.
6`
1
C1'I'Y OF TIGArD
DMITTDIIURE REQr - r
This form is a -imlti-use form. Appropriate receipts mast be attached. Docimentation
is irportant for all purposes. Staple d=mx:ntation tc; form.
VENDOR NO.: — DATE:
PAYA=- 70: RF•JQUFSTED BY:
Approved request due wedri-s y
10:00 AM to A/P for checks by
Friday.
MISCELTJVT 0US E{PTMrIURFS: --- — — —�
Date Description, invoice No., etc. Account No. Amount
Its
d aSStrra„ce �e-r /O—ZZCdO $ ZGO
.�ff�CJ'DiOcy��yra
,qt o
A'7/-Z//74A j cv
TOTAL
Mileage $0.255
APPROPRIATION BAIMCE: AS OF: -- STCZM7URE:
(Up to $25 UO) Section Matk3ger �._—.--- Purct�. Agent --
($25.01-2,500.00) Dk isi<�.)n mwiager _--
($2,500.01-7.,500.00) Dept. Head
($7,500.0.1-15,000.CO) City Admini:.trat.or
($15,000.01- ?) ?r,,;al Contract Review Board ^
ke/1501r
APPLICATION -- STRr-ET IMPHO' 1ENT/EXCAVATION COPY TO:
Xl (WHI I I -FILE
ORD INAvr., E NO 74-14 ® (YELLOW)-INSP.
(INSTRUCTIONS ON SEPARATE SHEET) ® (PINK)-OTHER AGENCY-bldg.
�j (BLUE)-APPLICANT
APf ROVED X APPLICATION NO.:p_�455
NOT APPROVED ❑ CITY OF TIGARD,OREGON FEE AMT.: III
PENDING FEE. PMT. ❑ CITY HALL RECEIPT N : _ 91-211743 _
PE14DING SECURITY El PUBLIC WORKS DEPARTMENT By DATE-- -- 4 / 8 / 91
PENDING AGENrY "OK" U Application and Progress Record —
MAINTENANCE BONp
PENDING INFO.-,OATl< N D FOR STREET IMPROVEMENT/EXCAVATIGN AS REQUIRED X
ANNUAL Lp
PENDING VARIANCE. I7 - EXPIRATION DATE:
PERMIT NO.: ___41_0 DATE ISSUED 4.�_9_I 9J• - BY: ' r
( 1 ) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL _ Cgpgc %Ap Sidewalk
& Driveway-Apron AS DESCRIBED !IERE!N, IN FULL. ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT Timf & CO. Cement 6129 NE Skionore Portland, OR 97218 # 281-1981
NAMt. ADDRESS CITY ---- PHONE-----.-
CONTRACTOR__ Same
NAME
-- --- — --
--------- -ADDRESS CITY PHONE
PLANS BY City--Standards and Spe:ificatoina- - - ---
NAME — ------ITY-- --- —"- --PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): E 1,200.00
DOLLARS
FOR OFPICE USE: -� - - f
12) EXCAVATION DATA. FOR
x s 14-200-00—
STREET
,2L1D,.()Q STREET DESCRIPTION^ PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CI•I CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
-_ TYPE LENGTH V' IJTH DEPTH ITEM A QUANTITY
STF EET -
P 11
urch
3W Ch1 iaa (se h
atta ed) INSP,IEc-
R 71 ON
ESTIMATED STREET OPENING DATE: / / g
ES IMATED STREET CLOSING DAT:.': / T
- - / -- -- E
D
STREETi
(3) SECURITY NO. _ __--_ -- SECURITY AMT 96 112QO.J0_-. CLOSEL
SURETY CO. Allen Baumer,--L Wj rj____ FINAL 5• .Z y/
00311'DJ(KAYO CHECK X CASH L1 •ON6: INSPEC
(4) PLOT PLAN. INDICA I SITE PERTINENT PHYSICAL SPECIAL,°ROVISIONS /CONDITIONS.
FEATURES; ':XCAVATION LOCATION AND EXTENT, N 1. Notify City Inspector, Carl
Viewe (#639-4171), 24 hours
prior to starting work; also J
1 I I 1 prior to pouring concrete.
2. Excavator must comply with ORS
JAB - --
? I 757.541-.571 (prelocation of
CHURCHHILL ►9AY t —
-r --- -- _-- _-- utilities, etc.).
3. All work shall conform to City
1 I I ----- standards & specifications.
1 I Work Site
I I I 4. Traffic &-Pedestrian saf:ty must
1 1 (7962 SW I I 1 I
^hurchill Way) be provided for by the contractor.
(5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPI Ir ANTS TO CONDUCT WORK WHERE
RIGHT OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO ."EC;,SIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINIT ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
APPLICANTSSIGN ATURE ..X '�%.�' &S " DAZE
Dennis Ross CCB# 71767
CITY OF TIGARD - RECEIPT OF PAYMENT RECEIPT NO. :91-211'743
CHECK AMOUNT : 1248. 00
AME : BAUMER. ALLEN & LORI CASH AMOUNT 0. 00
DDRESS : 7962 SW CHURCHILL WAY PAYMENT DATE : 04,'06 '91
SUBDIVISION
TIGARD, OR 97224-
-URPOSE OF PAYMENT AMOUNT RAIL) PURPOSE OF PAYMENT AMOUNT PAID
USTOMaR DEPO 1200. 00 PURLIC IMPROV- _410-91 48. 00
OTAL AMOUNT RAID - - - -> 1248. 00
ALLEN BAUMER
LORI A. BAUMER 139
79(32 SW. r)HURCHILL WAY 694-0853
TIGARD, OR 87224 _19
PAY TO
ORDER OF E
Kay sank of Oregon — -F-----b O t L A R 5
Getaway Office
BANK Po ,IQ=N ORFi122Street
1: 12 300 20t 0 13 9 --
Proposal No.
Proposal
FROM ''� � ,J, � „ �IC��P/f� Sheet No.
Date
Proposal Submitted To Work To Be Performed At
Name /l/!�/� - � r Street -5 —
Street_ City _Stale__
City____ Date of Plans
StateArchitect
Telephone Number_— �j.'
We i,-reby propose to furnish all
the
�ma erials and perform all the labor necessary for the co m letion of All material is guaranteed to be us specified, and the above work to be performed in accordance with the drawings
t and specifications submitted for above work and completed in a substantial workmanlike manner for the .um of
Dollars l$ f 7 mo ----).
with payments to be made as follows:
1
— A ---
Any alteration or deviation from above specifications invc.lving extra costs, will be executes only upon written order;, and will
be,:ome an extra charge over and above the estimate. All agreements contingent upon strike:, accidents or delays beyond our
crnfrol. Owner to carry fire, tornado and other necess� insurance upon above work. Workmen's Compgnsation and Public
Liability Insurance on above work to be taken out bytAJS4 �o/r1�a�l�rsf— stn
Respectfully wbmittecl
r'^r
Note— This proposal iray be withdrawn by us if not accepted within days
ACCEPTANCE OF PROPOSAL
The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as
specified. Payment will be made as outlined above.
Accepted __.__ Signature
Date —_—Signature—.—
TOPS FORM 3450 LITHO in u. 5. A.
it fe
1y
24 0" MAX. 12=0" MIN.
—`--- DRIVEWAY -- R'W LINE
W CONTRACTION JOINT OPTIONAL
cr SIDEWALK
> LOCATION
B SIDEWALK EXPANSION JOINT LJ
EXPANSION JOINT
-- CURB JOINT —
`r,
1
3 ' 0 6''0" MW. 12' -0" MAX. 6' - U� MIN. '12' ' 0" MAX. 3.'0l. I
FACE OF CURB
-SIDEWALK `ADJACENT TO CURB, SIDEWALK AWAY FROM CURB
PLAN
- 1-1/2" EXPOSURE
USE EXISTING EXPANSION
JOINT OR SAWCUT AND
ELEVATION B—B PLACE COLD JOINT
SEE DWG. NO. CS-306
STREET —.-.
COMPfACTED SUBGRADE� 2" OF 3/4" MINUS
SECTION A—A
NOTES
I. CONCRETE SHALT_ HAVE A MINIMUM BREAKING STRENGTH 13" 3000 PS.1.
AFTER 28 DAYS , 6 SACK MIX.
2. CURB JOINT SHmLI,. BE A TROWELED JOINT WITH A MINIMUM 1/2" RADIUS
ALONG BACK OF CURB.
3. EXPANSION JOINTS SHALL BE 1/2" PREMOLDED ASPHALT IMPREGNATED
MATERIAL OR EQUAL , EXTENDING FROM S'JBGRADE TO FINISHED GRADE .
4, SEE DWG. NO. CS-300 AND NO. CS-305.
i
WASHINGTON COUNTY
DEPARTMENT OF LAND USE RESIDENTIAL DRIVEWAY
ANC TRANSPORTATION
DATE CIVIL EN91NEER DRAWN ANWA NO. WASFL COUM" NO.
iT •�_ y Z. --- AEA b.es NONE
DW-- 200
1 R/W
5'
CU
MIN.
CURB JOINT - J:=TE 5
�- 2
ROAD �
4 I•
2" OF 3/4"-O
COMPACTED SUBGRADE
SIDEWALK ADJACENT TO CURB
R/W
-- 5 MIN 6
ROAD -_7-
_________,_ SEE MOTE 5 1
2' OF 3/4"-0 '
COMPACTED SUBGRADE
SIDEWALK AWAY FROM CURB
NOTES :
I CONCRETE SHALL BE 3000 PSI, AT 28 DAYS , 6 SACK MIX , SL-UMP RANGE
OF I V2" TO 3"
2. PANELS TO BE 5 FEET LONG
3. EXPANSION JOINTS TO BE PLACED AT SIDES OF DRIVEWAY APPROACHES ,
UTILITY VAULTS ,WHEELCHAIR RAMPS , 9 AT SPACING NOT TO EXCEED 45 FT.
4 FOR SIDEWALKS ADJACENT TO THE CURB 9 POURED AT THE SAME TIME AS THE
CURB, THE JOINT BETWEEN THEM SHALL, BE A TROWELED JOINT WITH A MIN I,'2"RADIUS.
5 SIDEWALK SHALL HAVE ._ MINIMUM THICKNESS OF 6 INCHES IF MOUNTABLE
CURB IS USED OR IF SIDEW^'_1� IS INTENDED AS PORTION OF DRIVEWAY .
OTHERWISE SIDEWALK SHALL HAVE A MINIMUM THICKNESS OF 4 INCHES .
6. DRAIN BLOCKOUTS IN CURBS SHALL BE EXTENDED TO BACK OF SIDEWALK WITH 3"DIA. PLASTIC
PIPE AT 2 % SLOPE CONTRACTION JOINT TO BE PLACES OVER PIPE.
WASHINGTON COUNTY
.i`DEPARTMENT OF LAND USE CONCRETE SIDEWALK
AND TRANSPORTATION
DATE CIVIL�E/NGtNEERR DRAWN APWA NO. WASK COUNTY NO�
CS —' 30�
AEA b'A2 NONE
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