14867 SW KENTON DRIVE-1 *><w°I�M+�•+rr4Nr' tN�lAMHY�'"Q4-. •FIMr:.?. "'IN�MWrM•�dMMMe9MMMse�r�grM•IYk1ea14#IMr ��'M'#Y��M� �
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APPLICATION — STREET IMPROVEMENT/EXCAVATION TO:
ORDINANCE: NO. 74-14 �Z X (WHITE)-FILE
, 13(YELLOW)-INSP.
(PINK)-CITHERAGENCY b1d
NS'FRUCTIONS ON SEPARATE SHEET)
i (BLUE)/-APPLICANT
APPROVED 74 APPLICATION NO.:
NOT APPRC VED Ll CITY OF TIGARD, OREGON FEC AMT.: : 1A-(11O I .
PENDING FLE. Phi? 11CI CITY HALL RECEIP f�lp,4 _-j�_��L��
PENDING SECURITY ❑ PUBLIC WORK, DEPARTMENT DATC
PENDING AGENCY ''OK'' ❑ Appli(ation and Progress Record
MAINTENANCE BOND M—
PENDING INFORMATION 0 FJR STREET IMPROVEMENT/EXCAVATION AS REQUIRED
ANNUAL J
PENDING VARIANCE Cl EXPIRAT ON DATE.r
PERMIT NO.. - DATE ISSUED: BY:
(1) APF LIGATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL _�1'_QBM_S _vR C.A'PT AI. AND
T MAINLINE AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREPIENTS.
APPLICANT _Jay Miller Builder, Inc. P.O. Pox 23291 'Tigard, OR 97281 684-7543 �
NAMEADORESS CITU PHONE
CONTRACTOR - (ane)
NOME ADDRESS T -��CITY PHONE
FLAN; BY__ per City statx�rds & / t:;
NAME ADDRESS CITU �- -��PHONE
ESTIMATED IMPROVEMENT- TOTAL VALUATION ( COST): 5 400.00
DOLLARS
FOR OFFICE ----__-_sem...-- C""1"'(2) EXCAVATION DATA: OAA x s 4ijE00 ^ = s . 16.00
STREET DESCRIPTION PROGRESS & INSPECTION ST%TUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED
TYPE LENGTH WIDTH DEPTH ITEM 6 QUANTITY ITEM DATE REMARKS/TYPE BY
STREET
Kenton Drive Attach OPENED) a TION
E —
Q
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ESTIMATED STREET OPENING DATE:_-_ , / S
ESTIMATED STREET CLOSING DATE: _ / / E w—V
STREET
(3) SECURITY NO. SECURITY AMT.: S .- 400.00 .. CLOSED _
SURETY CO.: FINAL
Yi?lt1Ak.-cp CHECK CASH U BOND INSPEC.
(4) PLOT PLAN- INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS /CONDITIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT.
u see attached speAal
SI'Z'E: 14867 S.W. I provision conditions �—
Kenton Dr.i.v,3 I — --
(See attached stip)
1 I
(5) NOTF THE CITY OF TIGARD DOES NOT, HEREBY. GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
R1=14. OF WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
-r' = APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CI FY AND
EMPLOYEES AGAINST ANY IN;UR-Y OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS,
APPLICANTS SIGNATURE DATE
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Speclal Conditions/Provisions:
1. All work shall conform to City of Tigard, Oregon, Standards and Specifications.
Note the attached Detail Drawings (U.. 4 # 300, 350, 360, and Tigard # S-2)
applicable hereto.
2. Notify City Inspector Letha Thomas (#639-4171; 24 hours oefore starting any work. F
Removal/replacement work and damage repair work shall be promptly initiated and
completed to the City's satisfaction. No work shall be considered complete until
it is accepted by the City. The City reserves the right to cause testing and
certification of work or repairs to be performed, to the City's satisfaction, at
permittee's expense.
4. Erosion control shall be provided for by the contractor.
ti . ORS 757.541-571 applies (pre-notification for location of underground facilities,
etc.).
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BUILDING SEWER PIPE, SIZE
AS SPECIFI 0
PLANT FABRICATED TEE FITTING
ON SEWERS 180 AND SMALLER. BACKFILL 2X4
FIELD TAP ON EXISTING SEWERS AGAINST PLUG TO
AND NEW SEWERS LARGER THAN I PREVENT PWG
l BLOWOFF 6 SECURE
THAN 18. 2X4 IN PLACE WITH
I TRENCH BACKFILL.
SEWER MAIN PLAN ill
AR LATERAL
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EXTEND AT LEAST
GROUND 12"AGOVE SUR'ACE
SURFACE
MINIMUM SLOPE FOR
G' PIPE= 0.010, FOR
4"PIPE = 0.0._' NAFt
0. ---MAR KE CONNECTION I
KER
MAGNETIC TAPE—
GRiYN ./BLACK LF—TIERS (WASTEWATER)
Gn,r:.N x,SLAG( LETTERS (STURM DRAIN)
a
PLUG
0
3/40-0 PIPE ZONE MATERIAL
Al SPECIFIED
•�� SUPPORT TEE WITH
REDOING GRAVEL,
MliMMUM 2'0" WIDE Sl DE
BUILDING SEWER
UnIO" • I
of Wasl"a"Ccoumly
owg. No. 300
+ 4.
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PVC SADDLE (TE,E)
STRAP RETAINER RIDGES i
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— —RUBBER GASKET
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SEWER PIPE
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I zTA!.\'LESS STEEL STRAP
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x PVC SADDLE SHALL BE ASTM 3034 SDR 35
x PVC COMPOUNDS SHALL BE ASTM DI784 WITH CELL CLASS OF 12454-B,'C
OR 12364-C
d, ALL ELASTOMER I C SEALS (RUBBER GASKETS) SHALL BE AST$w F 4TT
x STAINLESS STEEL BANDS SHALL BE 300 SERIES, FULL 9/16" WIDTH BAND,
5/16' SHOULDERED HEX HEAD, SLOTTED SCREW AND IS CADIUM PLATED,
CARBON STEEL.
x INSERTION HOLE SHALL BE CORE DRILLED.
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PVC GASKETED
urffd
SADDLE sewerage
8r1
DRAWING NO. iso
--- ---- '�
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I . COMPLETE RUBBER SLEEVE (ASTM"C-443)
INCLUDES A MOLDED SEGMENT THAT HOLDS
IT IN PLACE. r
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{ 2. STAINLESS STEEL BAND (9/16" SERIES 300)
�- "uul SECURES UPPER HALF OF RUBBER SLEEVE TC THE
PVC HUB.
3. PVC HUB (ASTM 3034 SDR 33)
DRIVE INTO CENTER OF RUBBER
SLEEVE AFTER SIEEVE IS PLACED
IN HOLE.
I 3 1
_2
CONCRETE PIPE ! `
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NOTE: ALL INSERT'A-TEE HOLES SHALL BE MACHINE DRILLED.
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I NSER.TA - -r E E unwed
DRAIhf I NG NO. 360 UfA Qoawncy
Y
MIN. ,5•' A G IN 2 LIF T5
STREET AREAS I .2UT OF STREET AREAS x
IAw cur
EXISTING I.
SECTION RESURFACING 170
'
9 : ••• ,/ CLASS A
~
BACKFILL
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CLASS B - o * V
3/4!-0 GRANULAR . ' r
BACKFILL 0• -• r Q
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PIPE BAS-E:
BACKFILL IN STRE AREAS
L IF3/W IS AGAINST CURB, FI l.L ROC;% r0
BACK OF S/W
2.If S/W 13 NOT AGAINST cin a, FILL ROCK
2'BACK FROM CUNB
CITYO PIPE BEDDING 'AND
IF i'I .4R� BACKFILL DETAILS
OREGON OE51GN by AF'F'Rwf.O 13Y fJVAwN 15y
GA R E5
FPAWING No.
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INSPECTION N5jeTCE
Citp of Tigard Buildlnq Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4I75 Business Phone: 639-4171
Inspection.
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j Footing Plbg. Underslab Mech. Rough-in Appr/Sdwlk ,
Found. I
Plbg. Top Out Cas Line FINALS j
Poet/Beam Stcuct. San. Sewer
Framing -Bldg.
Post/Beam Mech. Rain Drain
Insulation -Plumb. /
Plbg. Underfloor Later Line gyp. ed.
-Mech.
Dnte Requenteds1G
kLeTimOi AMAddress: '/ PermitBuilder: .
TIM FOLLOWING CORRECTIONS ARE REQUIRED: -----�
a
Inspector:_;/re%C-� ��._
Date:�� 14
APPROVED2 `
hISAPFROVEb APPROVED SUBJECT TO ABOVE
_Call For Reinap.
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CITY CSF TIGARD
COMMUNITY DEVELOPMENT!DEPARTMENT
13125 8W Hall Blvd.Tlgard,Oregon 97223+N'99 (503)939-4171
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CITY (1F TIG IRI) ftF.1..:1: I Fr T OF-* PAYMENT RFC'f.I K`'I' NCI. :93-2,44804
CHECK 011OUN T 32. 511
1\1(llylf:: s M.11-l_ER, JAY I ASH AMUI..IN 1- s 0. 00
y' ��T11)Rf=.F3ri : AYMf::N'T I:�n F
G' a 10/04/93
SUE117IV1S1ON s '
PURF'I'lS 01= Pf4YMF:N-T AMCJIJN f FAIL) PI IFtP08E OF PAYMENT AMI:'ll_1N T. PA t D
!'I .1-1111A I NI:I PERM Y;C3. ON WAN G: W.C:K FE. 6. 25
BUILD PER
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IYI..UMHINO PERMIT j
14867 aW KPW ON
j rf OTAL.. AMOUNT PAID - _ -> 321. �0
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