15045 SW 79TH AVENUE FILE NC,- �U6-92
79th AV'SNUE - 15045 STR OPN PERMIT
�I
4
P
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ENGINEERING PERMIT
PERMIT #. . . . . . . : ENG92.-0051 DATE ISSUED: 07/21/92 By:
PRIM. PERMIT # . : ENG92-0051
SITE ADDRESS. . . : 15045 SW 79TH AVE PARCEL: 2S112BD-02000
SULJIVISIGN. . . . : DURHAM ACRES ZONING: R-4 .5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :37
-----------------------------------------------------------•--------------------
: ERMIT TYPE. . : SOP IMPROVEMENTS QUANT RATE VALUE
:AGREEMENT DATE: / / GRAD/EROS
ASSURANCE EXPIRATION--- STREET
PERFORMANCE: / / SAN SEW
MAINTENANCE: / / STM SEW
UTILITIES
ALL OTHER
TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
Remarks: STREET OPENING, TO INSTALL A (TEMP. ) A.C. DRIVEWAY APPROACH AND TO
EXTEND AN EXISTING CONCRETE CULVERT THEREAT.
Permittee: ---------------- FEES --------------
HOSS PAVING, INC. type amount by date recpt
22500 S.W. QUATAMA RD. OPEN $ 9 .00 JSH 07/21/92 229715
HILLSBORO OR 97125
Phone #: (503) 681-8029
Engineer:
$ 9.00 TOTAL
Phone #:
------- REQUIRED INSPECTICNS -------
Permittee/Agent Signature: ---STORM SEWER-- -----STREET-..----
M.H . & C.B. CRB LINF & GRADE
PIPE LN & GRD SUBGRADF;
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 STREETLIGHTING
Phone #: 639-4171 BCKFLL & CMPCT WALK,APRON/RAMP
AIR & TV TEST
FOZ INSPECTION, CONTACT: ----GRADING-----
Carl Vieweg #639-4171 (office) ---REPR' S/'ADJ,S-- CONTOURS
#780-2647 (mobile) DRAINAGE
----PATHWAYS---- EROSION CNTL.
APPLICATION - STREET IMPRO` 'RENT/EXCAVATION COPY TO:
ORDINANE NO. 74-14 (WHITEWFILE
t
(YELLOW)•INSP.
(INSTRUC--IONS ON SEPARATE SHEET, (PINK)-OTHER AGENCY-bldg.
® (BLUE) A�P''P�LICANT
APPROVED !% APPLICATION NO.:S-171 -- --
NOT APPROVED [ CITY OE TIGARD, OREGON FEE AMT.. S 9.00
PENDING FEE.PMT. CITY HALL RECEIPY NO. 92-229715
PENDING SECURITY
PURL lCWOR KSDEPARTMENT BY J.S.H. _ DATE 7/ !21 92
— — — — — — — — — — — — — — — —
PENDING AGENCY "OK" Application and P-ogress Record
MAINTENANCE BOND M
PENDING INFORMATION -
FOR STREET IMPROVEMENT/EXCAVATION AS HFUU141LU
❑ `
ANNUAL Li
PENDING VARIANCE ❑ EXPIRATION fAE:
PERMIT NO. Z- DATE ISSUED: �_I z�l _ _.. BY.
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL (TEMPS A. DRIVEWAY RON AND _
MEND 12" CONC. CULVERT AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT _ROSS PAVING IN '._ 22500 S.W. QUATAMA RD - HILLSBORO, OR 97124_ # 681-8029 —
NAME - ADDRESS CITY PHONE
CONTRACTOR - SAME -- ------ -
--—� NA ---ADDPESS CITY PHONE
PLANS BY PER CI'T'Y STANDARDS & SPECIFICNTIONS -
NAME ADDRESS CITY --PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST). $ -_225.00 _
DOLLARS
FOR OFFICE USE. MIN.
(2) EXCAVATION DATA o.o4 x f 226-QQ ■ i —.-
STREET __— DESLoIPTION PROGRESS A: INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY
--^—T STREET
—� - SEE AZTAC ED - R PION
Q L
U
ESTIMATED STREET OPENING DATE: / --L— — ET I+`
ESTIMATED STREET CLOSING DATE: ED ski
STREET
(3) SECURITY NO. - SECURITY AMT.: $ 225.00 — . CLOSED
SURETY CO. _ FINAL
'xxx I0� k CHFCH—X_— CASH O •OND INSPEC.
(4) PLOT PLAN: NDICA-rc .SITE PERTINENT PHYSICAL SPECIAL PROVISIONS /CONDITIONS:
FEATURES; EXCAVATION VGCAT;0N AND EXTENT. 1- Notifv City Inspector Carl Vieweg
(639-4171) 24 hrs before starting
1 I I I
work.
2. All work shal onform to City
- `
Standards & Specifications.
3. ORS 757.541-.571 (Utility Co.
-- ----------- ---- - -- - - - prenotification, etc. ) applies.
4. Traffic control must be provided
` for by contractor.
I I i +—work area � I 5. Erosion control must be provided
II
SITE: 15045 S.W. 79th IV4. for contractor.
(5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TOAPPLICANTSTO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION .S THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON,
THE APPLICANT AGREES TO DEPOSIT THE PEQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT CSF THE WORK, AND TO SAVE_ HARMLESS THE CITY AND
EMPLOYES Ar'AINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIO'vS.
1 /
APPL CANTS SIGNATURE �` DATE 1._—__�—.—L�
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684 7297 CFI,N* of TIGARD U002/002oziooz
PROPOSED EDGE
OF SHOULDER
2"CLASS � C"A.C. PROPOSED EDGE
4" 2"-0 OF PAVEMENT
SLOPE VARIES
W I
w <
W� aC
0 at
w w W �
4 f O J
Z
t
0 ,_ w =� #
TYPICAL SECTION
W < A.C. DRIVEWAY
{
h " _
O 0
v
PROPOSED EDGE
er OF SNQIILDER
4" 2" p PROPOSED EDGE
1 1 I
1
OF —PAVEMENT
g1 OPE VARIES
W i N TYPICAL SECTION �-
x x GRAVEL DRIVEWAY
1 a = a
PROPOSED EDGE
TYPICAL PLAN OP SHOULDER PROPOSED EDGE
OF PAVEMENT
A.G. CR GRAVEL DRIVEWAY 4�
• �.�...�..�--- SLOPE VARIES
pe G R.to
-f'UNLE43 OTHERWISE NOTED
—
SEE DWS. NO. DW-202
i
} � TYpICAL SECTION
4t ,ALTERNATE
1
WASHINGTON COUNTY DRIVEWAY DETAILS FOR
��-�DEPAR-T MFNT� OF LAND USE '
~ — AND TRANSPORTATION NON - CURBED AREP
CIVIL ENG{NCER WN APWA NO.
WASK C70UNTY NCL
DATE NONE_ ��_ 20�
�� ---_-- r✓ �-�S
-------- �5��ls ,tr..1 `7���v�._- -------- -- _ ,C/.ta.,u l_ wo�Gy�✓
ts����r
v /tC '0 50 350
Soo
___ ______ _��___-- --- _ _ _.__ - -•- �- �o
C.CJ(_ Z8y
a
4 � �
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_t
oqe-
CM OF 171GARD
DMENDITURE RDWEST
"Idfl, form is a nulti-u--e form- APPr0P--'iate rOCIAPts mist be attached. DOcuMentation
' j TPortant for all pit-poses. Staple doct'soontation to form.
VENDOR No. DATE:
PAYABIE TO: RUXEMM BY:
roved request t reWedrxesday
/P r
10:00 AM to A P r checks by
Friday.
MISCMANIMUS EXPENDICIURES:
Date Dr---,criPtj.on, Tirvoice No. , etc. Accamt No. Amount
C--v uob
Am
L
L
't No.
-7-C)C>C
7t
9-L-,zT9-7 I S '2/
IM I$
Mileage $0.255
APPROPR=ON BALANCE: AS OF: KaWIUE:
(Up to $25-00) Section Manager. Punch. Agent
($25.01--2,500.00)
($2,500.01-7,500-00) Dept. Head
($7,500.01-15,000.00) City Acbdnist-rator
($15,000.01- -':1) Local Contract Review N-vipi
,.1501-F
-ATION - STREET IMPRO` HENT/EXCAVATION COPY TO:
® (WHITE)-FILE
ORDiNAtN�E NO. 74-14 (YELLOW)
(PINK) OTHER AGENCY—bldg
(INSTRUCTIONS ON SEPARATE SHEET) BLUE) APPLICANT
APPROVED APPLICATION NO.:
NOT APPROVED [] CI I l ')I' I IGARD, OREGON FEE AMT.: E y.00 —
PENDING FEE. PMT. ❑ Ci7'l' HALL RECEIPT NO.: --92-22971.5 D
PENDING SECURITY [] PUBLIC WORKS DEPARTMENT _ -BY IT.v.f; U:_ - - _ -TE 7/121 /- - - - - __
S --
PENDING AGENCY "OK" ❑ Application and Progress Record MAINTENANCE BOND ---
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRUD
ANNUAL
PENDING VARIANCE ❑ EXPIRATION DATE: __ ---
PERMIT NO [ _c1Z---- , DATE ISSUED 1- __L---I BY.
(" ) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL TE1NP. A. DRIVEWAY APRai _AND
EXTEND 12" COND. CULVERT AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT -_ HOSS PAVING INC- 22500 S.W. QUATAMA RD HILLSialO, OR 97124 J # 681-8029
NAME ADDRESS CITU PHONE
CONTRACTOR - - SAME - �_. --- --- -
NAME ADDRESS CITY _PHONE
- PER ZCIT
PLANS BY - _ Y STANDARDS & SPECIFICATIONS - ---,E-,T- NAME T ADDRESS Y PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ 225.00 ,-
DOLLARS
FOR OFFICE UiE..__ MIN.
(2) EXCAVATION DATA: _ 0.04 X S_.22,5.,QQ__- = S-.21_r10 _____,_
STREET __- DESCRIPTION PROGRESS & INSPECTION-STATUS
NAME SURFACE Cu. CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE T BY
TYPE LENGTH WIDTH DEPTH ITEM_ & QUANTITY --
��- STREET �
A1TAC.' IE[: INSPEC-
y.w. 7 I —� R E TION —
Q
ESTIMATED STREET OPENING DATE: / __—_ T --
ESTIMATED STREET CLOSING DATE: ___ E
STREET s e[G1r l.lE ��L
(3) SECURII Y NO. SECURITY AMT.: :_22,5.00 _ . CLOSED 7-22-!'Z
SURETY CO.: _ _____-__ _ - FINAL qq
t� �MOIIL�CH[CN X- CASH ❑ •OND INSPEC. 7�1../" L
(4) PLOT PLAN: INDICATE SITC PERTINENT PH'.'SICAL _— SPECIAL PROVISIONS/ CONDI IONS:
FEATURES, EXCAVATION LOCATION AND EXTENT. 1_ *OtlfV City Lospector Carl Vieweg
(639-4171) 24 hrs before starting
I
work.
I I
I + I 2. All work shal onform to City
- — I Standards & Specifications.
3. ORS 757.541-.571 (Utility Co.
--- - ---- ---- — -------- prenotification, etc. ) appl ien.
4. Traffic control must be provided
for by contractor.
I L + 1
t 1 work area I I S. Erosion control must be provided
+ v�. I
I + SITE: 15045 S.W. 79t1; for by conttastor.
(5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO COVUUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE REQUIPED SECURITIES. TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT rO LONDUCT OF THE WORK, AND TO SAVE HARMLE.S THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICAN I'S ACTIONS
1
APPLICANTS SIGNATURE DATE_i r.. J
L�
LNSPPCf1ON NOTICE
city of Tigard Bu"ding Departoent
13125 SW Hall Bled_ ard, Oregon 97223
Inspection Line (ROC-o-Phone): 63v-4175 Business Phone 39-4171
Inspectio►u`
Footing Plbg. Underelab Mech. Rough-in r/Bdwll�.!
Found. Plb,. Top Out, Gas Line FINALt
Poet/Beam Strurt. San. Sewer Framing -Bldg.
Poet/Beam Mech. RaU D•'stn Insulation -Plumb.
Plbg_ Underfloor WaterLineGyp. Bd. -Koch.
Date Requeetedt 1 s� Tues _7,e AN PK
Addreaa:_—_� �(1C/ (� Permit #t _
Builder•
THR FOLI,WING CMRREMIONS ARE REQUIRM
I
i
tnspwtur:—� -- Datol_
APPPOVED DIS D APPROVED SUBJECT To ABOVE
G11 For Minep.
I
CITY OF TIGARD - RECEIPT OF PAYMENT RECEIPT NO. :92-2 9715
CHEECK AMOUNT 234. SIN
NAME : HOSS PAVING INC CASH AMOUNT 0. 0Q1
ADDRESS : 22500 NW QUATAMA ROAD PAYMENT DATE 07/: 1/92
HILLSBORO, OR SUBDIVISION
97124--
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
CUSTOMER DEPO _ 225. 00 PUBLIC IMPROV 9. 00
7jZ
6 C
TOTAI- AMOUNT PAID - - - -> 234. 00
HOSTS PAVING INC. 2984
0(lATAMA RD. 881-9019
�fill I-SBORO, ORFGON 97121 RANO 217� � p DANCH 1't i
PAY
TO THE n
ORDER OF-0; ��! �� ( lQ Aa
- -- DOLLARS
U.S. BANK
UNIT4110*TATSIll NATIONAL"ANN OF OnEOON
FOR-�.
1-110 84 : 1210002201: i 74 00 i0 3330
CITY OF TIGARD
STREET OPENING PERMIT
APPLIATION
DATE 71,)11�2-
�rJr.»5 t
• Af# fANTS'NAME
ADDREFS J50 L6 -7 9
T� r� , 0-e . C117APg ZIP
PHONE 'i<?,3
�"i,"oC, £c r
• CONTRACTOR'S NAME _1` 55 �a_y r,� /n
ADDRESS o�6 0'V A),W
1 ►l�sl�w. ort 97/.24/ ZIP
PHONE L5o 3) 68/_60,;,�V
• PLANS BY 01A.
ADDRESS
ZIP
PHONE
• DESCRIPTION OF WORK PROPOSED TO BE DONE: �t,�,���i �nt t 3/y -
.
/4• ESTIMATED VALUE OF WORK (within public right-of-way) : $
• WORK LOCATION/SITE ADDRESS: r � 1 Aw 7,
• IS THIS WORK RELATED TO A LAND-USE ACTION? IF SO SPECIFY (MLP, SDR, ETC.) NO.
t�u
• IS THIS RELATED TO A BUILDING PERMIT? IF SO, SPECIFY (BLDG. PERMIT-) NO.
dP-.r (OVER)