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11220 SW 78TH AVENUE-1 IF FILE NO. 484-92. 78th AVENUE - 11220 STR. OPN. PERMIT I r,vi„ AP LICATION - STREET IMPROMENT;EXCAVATION COPY TO: (WHITE)-FILE R ODI N A E NO. 74-14 ® (YELLOW)-INSP. (INSTRUCTIONS ON SEPARATE SHEET) Xj (BLUE)APPL CANTNC'Vb1 • APPROVED A APPLICATION NO.: SZ-C7 — CI'I'X OF TIGARD, OREGON 4 ty NOT APPROVED Ll CITY AMT.: f _ _1 _ �— PENDING FEE. PMT. ❑ CITY HAM, RECEIPI�j ZZS8V � ,rO l 9� PENDING SECURITY 11 PUBLIC WORKS DEPARTMENT dvY` _- DATE — — — — — — PEN')ING AGENCY "OK" ❑ Application and Progress Record MAINTENANCE BOND X PF-t—ING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED ANNUAL PENDING VARIANCE i I EXPIRATION DATE. PERMIT NO —9 Z_ - _ DATE ISSUED: ' .-_L_���J_g.z-- BY: .__ - —• (1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL. --ROOF RAI DRAINS k_ EXISTI_NG_____ STORM DRAIN LINE AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS APPLICANT David Green 11220 S.W. 78th Ave. Tigard, OR 97223 620-8485 . _._.____. PHONE NAME - ADDRf SS CITU CONTRACTOR __Kerr Contractors 8101_ S.W. Nyberg Rd. Suite 219 Tualatin OR 97062 692-5514 NAME _ ADDRESS CITY —NONE PLANS BY _-p4gCity Standards- _ NAME A6—D E 3 C- CITY --- ESTIMATED IMPROVEMENT TOTAL VALUATION ( :OST): $ DOLlwws FOR OFFICE USE' fMIN (2) EXCAVATION DATA: 0.04 x s srREET DESCRIPTION PROGRESS & INSPECTION STATUS NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TTYPE T BY TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY _ STREET !;),PENIED EC- 78th Ave. see attached - R TION to _ U — ESTIMATED STREET OPENING DATE._- � � ET _ — ESTIMATED STREET CLOSING DATE: -- E D STREET (3) SECURITY NO. _ SECURITYAMT.: :- a.QQ•UO CLOSED 11,E FINAL SURETY CO. -_�__.� INSPEc.. CHEGN 1✓ � CAfH ❑ sonD�. _ (4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL _ SPECIAL PROVISIONS J CONDITIt:NS: FEATURES, EXCAVATION LOCATION AND EXTENT. 1. Notify City Inspector Carte Vieweg (#639-4171) 24 hrs. before startin i 1 ( (SITE: 11220 SW 78th Ave(. ) ► 1 - work. I i /'9ti�C.1rk.2rC.�1 I ( I ?• Work shall. conform to City rl ' 1 Standards/Specifications work is "' - 1 J" not considered complete until A p e - - - - - - - - - - - - - - - - approved by Inspector. S. . 78th Ave. 3. ORS 757.541-.751 applies (ree: a prenotification, etc. - Utility Co. Apt, --- � - A L _ _- -� 3, 1� 4. Trench's shall be closed at the I I P U) i end of each days work; traffic/ped. —saw y control evices are re alr —e prov for. (5( NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PF_RM133ION TO APPLICANTS TO CONDUCT WORK WHERE RIGHT OF WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON. THE 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 HARMLUSS THE CITY AND EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS. - APPLICANi5SIGN A1'URE DATE � b3mv L Gvree vis •, �� N c�d�c s S �zv,d �rccv. po►.��-,..�c� ©r. 9 7213 Zssu�r, depot i� ��rt'W. n 2 0 1 +cf 25 4500 2 500 ui L3 Z08 1 n Q 3 M> 4600 1505 1-, - .88Ac L 24 4400 o c o 7 137.n 3 6 0 0 23 4300 4900 n 0 - N N U , 0 5 - 4 22 4201 �( m. 7 O 2 0 1504 .79Ac. 5000 N 4 - N 13 .d9 --- o v r 4100 — — m ( _129.60 — _ -1 !P y 21 VALEto LL b5 23aasb 3 . 7 51 u U 700 m .29AC. �0 400v .54 .4 c. = L = 800 141.6 V ~ yl E_ .2.3 Ac. 8 tL'S 15,6561 � 0 0 1503 W ~ 3900 _ .904c 19 �) 5201 — — z .—f— 900 ^ AC. .PJAc. m 4s o 9 0 0 0go 0 3800 18 5300_ )044 Ac. ` — - 1000 1616 See ' I U .Ps Ac. �OC �. �ro L, s 0 1 3700 0 0 " 1�� 1502 1501 - 53Ac. 7 1/1 I I G 0 12II .PJ Ac W 5402 ° 16 3600 ./7Ac n m g n M t 1 0 °v °0 5401 0 1200 - - J7 4c. - .23 Ac. o _ m 12 c 1400 n 15 3500 5400 — PB Ac. .464c. 1300 acs No 11,510) b — r k Y F d ° N o ,ITIAL POINT 411,NMY the PC Na fee a'* 114. , - n a seits 125.60 246 1 tat S.W. c R 91� PIFAFFL. E STREET 1 6O SEE MAP T Ft J Y V�i_ 9� 1.411 S"uC It fl E - T sway C. _ l 1 ter__ 36 � w PARK \, m I I _ 1 BUILDING SEWER PIPE, S12E AS SPECIFIED I PLANT FABRICATED TEE FITTING ON SEWERS 18" AND SMALLER. I BACKFILL 2X4 FIELD TAP ON EXISTING SEWERS AGAINST PLUG TO AND NEW SEWERS LARGER THAN I PREVENT PLUG THAN 18". 1� BLOWOFF 0 SECURE� 2X4 IN PUCE WITH TRENCH BACKFILL. �-SEWER MAIN ���� .OR LATERAL_ I 1 EXTEND AT LEAST GROUND 12"ABOVE SURFACE SURFACE MINIMUM SLOPE FOR b" PIPE= 0.010, FOR 4"PIPE: 0.020. CONNECTION MARKER : MAGNETIC TAPE GREEN w/BLAGX LETTERS (WASTEWATER) GREEN w/BL" LETTERS (STORM DRAIN) PLUG ,.- 3/4"-0 PIPE ZONE MATERIAL • • SUPPORT TEE WITH AS SPECIFIED REDOING GRAVEL., � ) WOMUM 2'0" WIDE DE ETU I L D I NG S EWE R U 4 0 �f(.. le!. " •A .x.-, of Wo,04"llon Courft Dvvg. W 300 , 1 ------------- S,Y of MIN. 3., ,A G IN 5ALJSTREET ARF_AS I CL1j — OUT OF STREET AREAS EX/STING SCCTlON I 2'OF 31,4,•'.d•'_ RES(,RFAClNG CLASS A BACKFILL cLAss B . v 3/4~-0 GRANULAR • ~ BACKFILL d , U • �• • O ° _ Ltj tlu Ncn •;f' •oma' O v •� ? o o• •t G W �W o. •n ` 0 • 4 •o a Q1 o I o � S•'�. o •I � •a a / .13 o'.O Co a •• ° 4 ,y a '• � A1ftiE RAST AA!'XFILL f�E ARF.A4 L,IFs/W 13 AGAINST CURB, FILL. ROt;,i TO BACK OF s/W Z•lF 3/W Is NOT AGAINST CURB, FILL. ROCK 2'BACK FROM CURB CITYOF TIFARB PIPE BEDDING AND BACKFILL DETAILS OREGON OF51GN by GA (._.� -XC- E--- IZ.F� L7A Ot _ NYS �ZAI•.J I NG NO. S-2 COMPLETE RUB3ER SLEEVE (ASTM'C-4431 INCLUDES A MOLDED SEGMENT THAT HOLDS IT IN PLACE. 2. STAINLESS STEEL BAND (9/16- SERIES 300) C SECURES UPPER HALF OF RUBBER SLEEVE TC THE PVC HUB. 3. PVC HUB (ASTM 3034 SDR 351 DRIVE INTO CENTER OF RUBBER SLEEVE AFTER SLEEVE IS PLACED IN HOLE. i 3 1 2 1� -�/ CONCRETE PIPE T' I � I NOTE: ALL INSERTA-TEE HOLES SHALL BE MACHINE DRILLED. unifled I NSERTA - TEE DRAWING N0. 360 _ I i i i e PVC SADDLE (TEE) I I STRAP RETAINER RIDGES I I I i - RUBBER GASKET I I SEWER PIPE I STA'NLESS STEEL STRAP I * PVC SADDLE SHALL BE ASTM 3034 SDR 35 * PVC COMPOUNDS SHALL BE ASTM D1784 WITH CELL CLASS OF 12454-8/C OR 12364-C r ALL ELASTOMERIC SEALS (RUBBER GASKf_TSi SHALL BE ASTM F477 w STAINLESS STEEL ©ANDS SHALL BE 300 SERIES, FULL 9/16" WIDTH B/.ND, 5/16' SHOULDERED HEX HEAD, SLOTTED SCREW AND IS CADIUM PLATED, CARBON STEEL. i ■ INSERTION HOLE SHALL. 8E CORE DRILLED. PVC GASKETED unHW se'w+ea��arofte SADDLE UfA agwy DRAWING W. 350 .DEFINE:entret=case->eng definition incorrect ENGINEERING PERMIT 4 PERMIT # . . . . . . . : ENG92-002.1 DATE ISSUED: 04/10/92 3\1: PRIM. PERMIT #. : ENG92-0021 Jj SITE ADDRESS. . . : 112.20 SW 78TI] AV PARCEL: 1S136CA-01000 ' SUBDIVISION. . . . . ZONING: R-4 .5 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . PERMIT TYPE. . : SOP IMPROVEMENTS QUANT RATE VALUE AGREEMENT DATE: / / GRAD/EROS ASSURANCE EXPIRATION--- STREET PERFORMANCE: / / SAN SEW E MAINTENANCE: / / STM SEW UTILITIES ALL OTHER I TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ Remarks: STREET OPENING, TO INSTALL A ROOF RAIN-DRAIN LINE AND CONNECT IT TO THE EXISTING STOR14 LINE IN 78TH AVE. Permittee: ---------------- FEES -----•--------- DAVID GREED] type amount by date recpt 11220 S.W.78TH .AVENUE OPEN $ 4 .00 JSH 04/3.0/92. 225895 TIGARD OR 97223 Phone #: (503) 289-8989 j Engineer: ENGINEER NOT ON FILE $ 4 .00 TOTAL Phone #: ------- REQUIRED INSPECTIONS ------- Permittee/Agent Signature: ---STORM SEWER-- -----STREET--- _ M.H . & C.B. CRB LINE & GRADE PIPE LN & GRD SUBGRADE BCKFLL & CMPCT BASE ROCK AIR & TV TEST LEVEL COURSE City of Tigard, Oregon WEARING COURSE 13125 S .W. Hall Blvd. ---SAN. SEWER--- TRAFF & PED CONT P.O. Box 23397 M.H. & C.O. MONUMENTATION Tigard, Oregon 97223 PIPE LN & GRD STRFETLIGHTING Phone #: 639-4171 BCKFLL & CMPCT WALK./APRON/RAMP AIR & TV TEST FOR INSPECTION, CONTACT: ----GRADING------ Carl Vieweg #639-4171 (office) --REPR`S/ADJ,S-•- CONTOURS #780-2647 (mobile) DRAINAGE ----PATHWAYS---- EROSION CNTL. CT171 OF IaGIURD EITEND1-ItPE RBZTWr ""'I" form is a form. Appropriate- receipts nuls-t 3be attached. Documentation r for all purposes. S'-Iple documentation to form. VkTIDOR NO. : DATL. PAYABIF. TO: + RBQUEgITD BY: T=>- gtqL�I-L-? Z 175 Approved request due'-Wed,,wsday 10:00 AM to A/P for chrKks by Friday. MI TaVRES: Date DO----criPti0TI, IrrrOicL- No., etc. Account No. Amount 00 -SVLV:20x e 10 - Z-Z-00C') I(-)C) — Z) Z --------------------- --- `ti--- -- 'MrAL Mileage $0.255 APIMPRIATION BAIANCE: AS OF: SIGNATURE: (UP to $25.00) Section Manager Porch. Agent ($25.01-2,500.00) Division Manager ($2,500.01-7,500.00) Dept. Head ($7,500.01-15,000.00) City Administrator ($15,u00-01- ?) LOcal Contra&- Review Board t1501F ----__._.._ .__..�_..r.�.-..._-.t......�...-.�_.-.-....,..._..�....-..�..__:•--�-.._'-�,�'.. -._...-.-•r�--'71A"--ar'r_r+','•^^»�...,:,...yn........-t•.r-.....-fT-ti....r...�.«f"'n"a^'^.m-».................-.. -(CATION STREET IMPRO"-HENT/EXCAVATION COPY TO: OR DINAI.-E NO. 74-14 ® (WI-i1FILE rtj (YELLLOO W)-INSP. (INSTRUCTIONS ON SEPARATE SHEET) M (PINK)-OTHER AGENc`,bldg. & (BLUE)-APPLICANT APPROVED x APPLICATION NO.: .. 5'z� C11'Y OF 7'IGARD OREGON NOT APPROVED [] � FEE AMT.: f-q- y PENDING FEE. PMT. ❑ (;I I�' 1-IALI. RECEIP .�__"_- PENDING SECURITY ❑ PUBLICWORKSDEPARTMENT BY DATE 4-- /Q l ?Z PENDING AGENCY "OK" ❑ Application and Progress Record MAINTENANCE BOND �R PENDING INFORMATION ❑ FOP, STREET IMPROVEMENT/EXCAVATION AS REQUIRED - ANNUAL PENDING VARIANCE 7 EXPIRATI N DATE: �1 / PERMIT NO, gC. "9 Z DATE ISSUED: L���l y_ -.__ BY: (1 ) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTAL(_ '-(-F RAIN DRAINS J EXISTING ;'('ORM DRAIN GINE —_ AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS i APPLICANT -David Green 11220 S.W. 78th AvL,. lilgacd, OR 97223 620-8485 NAME ADDRESS CITY - ------PHONE ----- CONTRACTOR- Kerr Contractors 8101 S.W. Nyberg Rd. Suite 219 'Tualatin OR 97062 692-5514 NAME ADDRESS CITY PHONS --- PLANS BY _.-perCity Standards- _ NAME ADDRESS' CITY PHONE ESTIMATED IMPROVEMENT TOTAL. VALUATION ( COST): E 100.00 DOLLARS - e f��-N. ' (2) EXCAVATION DATA: FOP4 oFFlcff USE: r.MI 0.0 X f . STREET DESCRIPTION PROGRESS & INSPECTION STATUS NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY STREET _ QPj;NLP /I�i"il r"t 4'•.: see INSP C- R TION E — - - W U ESTIMATED STREET OPENING DATE:. E S ES1(MATED STREET CLOSING DATE:- T _ E D - (3) SECURITY NO. SECURITY AMT.: t LLOS 100.00 ET ------ i.L O S ED SURETY CO.: FINAL • �� CHECK CASH a SON_D IN$PEf_', 5'I Z ►u (4) PLOT PLAN' INDICATE SITE PERTINENT PHYSICAL SPECIAI,PROVISIONS/ CCINDITIONS: FEATURES. EXCAVATION LOCATION AND EXTENT. 1. Notify C).ty inspeucor Carl Vieweg (SITE: 11220 SW 78th Av (#639-4171) 24 hrs. befoce startin� 1 I . ) I � ) work ( ) Work shall conform to City 1 Kik�rc� I 1 2.�. I Standards/Specifications; work is _ _ I not considered complete until approved y Inspector. t-�S. 78th Ave. ci _ so __—_ -.- 3. ORS 757,541-.751 applies (roe: -P. ._ _ _ _ __ _ _ _ _ _ prenotification, etc. - Utility Col I� 4. Trench's shall be closed at the e end of each days work; traffic/ped ISaLety UU11CF01 ftVtCWWr. o be proViow tor. (5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHFRE RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON THE 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 CITY AND EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS APPLICANTS SIGNATURE / ���� ���"'�� DATE- / / CITY OF -3-1CARD RECEIPT OF PAYMENT Rra",E, Y w). -9P-0015895 CHECK AMOUNT - 100. 00 NAME GREEN, DAVID CASH AmnwNT' a 4. 00 t361 78TH 51" PAYMENT DATE t 04 10 SLIBDIVTSION TIGARD, OR 97223- PURPOSE OF PAYMF-.N,r AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID 4. 00 C PERMIT 0484--92 STREET OPENING PERMIT T01Fal. A0l(7UNr PAID 00 —— — ———--- —— - Nona= DAVID M. GREEN 383 24.703&q2 PAY To THE ORDER()F , ,�_ d¢ �- _ - 'ra Bank of America Oregoti ---- Vf 1: 32 30 70 3130 1:0 313 3lll 213 5 1, Slll� GS 2 31110F M s►ROct_ 1 f Tt—1 -- - \ G 1 I 1 1 1 1 olp r our + I r 1 36 -� PA AK A1� CITY OF TIGARD STREET OPENING PERMIT APPLICATION DATE y% z • APPLICANT'S NAME /-�/ V!`<) T ADDRESS ZIP c"7� PHONE 07—7—S�d • CONTRACTOR'S NAME (-U Y1, g4Q 'D ADDRESS - Jir ZIP Cl 70 L. PHONE • PLANS BY ADDRESS �� c PHONE ZIP e_ • DESCRIPTION OF WORK PROPOSED TO BE DONE: AO c-s-e Leif) c•) 25?! L'>AZAt l Ser.. • ESTIMATED VALUE OF WORK (within public right-of-way) : $ _ • WORK LOCATION/*R.V ADD ESS' �1?�Q S 70 • IS THIS WORK RELATED TO A LAND-USE ACTION? IF SO SPECIFY (MLP, SDR, ETC.) NO. • IS THIS RELATED TO A BUILDING PERMIT? IF SO, SPECIFY (BLDG. PERMIT) NO. -V nip (OVER) CITYOFTIFARD COMMUNITY DEVELOPMENT DEPARTMENT GY RD 13126 BW wi BNd. P.O.Bac 23M.TOW,Orcoon UM(6O3)639-4176 / PLUMBING PE:RNIT PERMIT #. . . . . . .. : PLM9`-0t 3,! r�.-4171 SATE ISSUED: 04/06/92 SITE ADDRESS. . . : 11220 SW 78TH AV PARCEL: 1S"136CA-0100u' SUBDIVISION. . . . : ZONINGe R-4. 5 BLOCK. . . . . . . . . . a 1_OT. . . . . . . . . . . . . . CLASS OF WORK. . s ALT GARBAGE D I SPOSAL.S. . a MOBILE HOME SPACES. : TYPE OF USE. . . . aSF WASHING MACH. . . . . . . a BACKFLOW PREVNTRS. . : OCCUPANCY GRP. . sR:3 FLOOR DRAINO). . . . . . . : TRAPS. . . . . . . . . . . . . . : STORIES. . . . . . . . . WATER HEATERS. . . . . . s CATCH AASINS. . . . . . . .. FIXTUREC___—__—_.._..._.___ LAUNDRY TRA`r'5. . . . . . a S[: RAIN DRAINS. . . . . : SINKS. . . . . . . . . s URINALS. . . . . . . a GREASE. TRAPS. . . . . . . . LAVATORIES. . . . . s OTHER FIXTURE. . . . . : TUB/SHOWERS. . . . s SEWER 4INE (f't ! . . . . a WATER CLOfSETS. . a (,CATER LINE (ft ) . . . . a DIS14WASHERS. . . . a RAIN DRAIN (ft) . . . . s 100 Remarks : TIE INTO 5TORM DRAIN Uwnera —__..___.___.__ _.__ ___._..__..__..._._ . ..._......_._.. . _._.._ FEE'S DAVID GREEN type amoiAnt by date r.ecp' J IPS O SW 78TH PRMT $ 30. 00 JL.F( 04/09/9 5PCT $ 1. 50 JLH 04/09,")2 — T ICARD nR 97i223 'hone #8 Contras::tor: --_ —_.___. .._ _._.._.__..____.___......_._........... KERR CONTPACTOR S 8101 SW NYBE'RG RD TUPL.ATIN OR 9706 Ph n c7 e 01 11 11. 30 TOTAL- 72549 OTAL'72399 --- -- -– REQUIRED I NSPE.CT T ONS ---- lhie persit is issued subJert to the regulations contained in the Final Inspection Tigard Municipal Gale, State of Ore. Specialty Codes and all other appl±cable laws. All Mork will be done in arcordance with approved plans. This persit will expire if work is not started within 18@ days of issuance, or it work is suspended for acre than 160. day5, ._...__......... _. ....__...._._._.......___..__.._._..__ . F Call far• inspecticin — 6S9-4175