14685 SW 83RD AVENUE-2 FILE NO. 512-:)2
83rd AVENUE - 14685 STR OPN Pr-':MIT
ENGINEERING eERMIT
PERMIT #. . . . . . . : ENG92-0059 DATE ISSUED: 09/02/92 By:
PRIM. PERMIT #. : ENG92-0059
SITE ADDRESS. . . : 14685 SW 83RD AVE PARCEL: 2S112BC-03200
SUBDIVISION. . . . : HAMBACH PARK ZONING: R-4 .5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :16
-------------------------------------------------------------------•------------
PERMIT TYPE. . : SOP IMPROVEMr:NTS QUANT RATE VALUE
AGREEMENT DATE: / / GRAD/E, )S
ASSURANCE EXPIRATION--- STREET
PERFORMANCE: / / SAN SEW
MAINTENANCE: / / STM SEW
UTILITIES
ALL OTHER
TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$
Remarks: STREET OPENING, TO INSTALL A PRIVATE 4" STORM DRAIN LINE AND TAP THE
PUBLIC MAINLINE.
Permittee: ---------------- FEES ---------------
OREN WILSON type amount by date recpt
10525 S.W. 69TH AVE. OPEN $ 8 .00 JSH 09/02/92 231269
TI13ARD OR 97223
Phone # : (503) 246-7624
Zugineer:
$ 8 .00 TOTAL
Phone #:
------- REQUIRED INSPECTIONS -------
Permittee/Agent Signature: ---STORM SEWER-- -----STREET-----
_ M.H. & C.B. CRB LINE & GRADE
PIPE LN & GRD SUBGRADF.
BCKF'LL & CMPCT BASE ROCK
AIF. & 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 9-12.23 PIPE. LN & GRD STREETLIGH'TING
Phone # : 639-4171 BCKFLL & CMPCT WALK/APRON/RAMP
AIR & TV TEST
FOR INSPECTION, C014TACT: ----GRADING-----
Carl Vieweg #(39-4171 (office) --REPR' S/AD,J,S-- CONTOURS
#790-2647 (mobile) DRAINAGE
----PATHWAYS---- FROSION CNTI..
APPLICATION - STREET iMPfiO 'TENT/EXCAVATION rf
ORDIIVAI,.'E NO, 74-14 COPY TO:
(INSTRUCTIONS ON SEPARATE SHEET) (WHITE)-FILE
(YELLOW)-INSP.
(PINK)-OTHER AGENCY bldg.
APPROVED (BLUE) APPLICANT
NOT APPrtOVED ❑ CITY OF TIGARD. OREGON APPLICATION NO.:
PENDING FEE PMTFEE AMT.. S 8.00
� CI7'1' HAIL _
PENDING SECURITY RECEIPT O•; /p Z-ZIjIZ�pR
PUB
L IC WORKS DEPA R TMEN T
PENDING AGENCY ''OK'' C] B,, "-'--
Application and Progress Record _ —_ _DATE 9 /7- /97
PENDING INFORMATION [IFOR STREET IMPROVEMENT/EXCAVATION
PENDING VARIANCE 1 AS F4EQt_jjp ED
MAINTENANCE 80N0 N
-'�'-- -- ANNUAL C
PERMIT NO. -1z:)'/ 7---` Z EXPIRATION DATE.
- DATE ISS(JED: — _
(11 APPLICATION IS HEREBY MADE TO EXCAVATE E FOR AND)(WMX
MYYX MAINLINE * SAP_ AN ' ISTING S
AS DESCRIBED HEROIN, IN FULL ACCORDANCE WITH CITY R QUIREMENTS.
APPLICANT Mr. Oren Wilson 10525 SW 69th Ave.
NAME -- - Ttgard/ OR 97223 _
CONTRACTOR q���,, A ADowcss --- -- 246-7624
^ —'-TTv ONE
NAME _47�._.-.-YY.�..L7Qr2v.111�-
vH
PLANS BY per City Standards - ADDREss
ESTIMATED IMPROVEMENT Aoor+Ess
TOTAL VALUATION ( COST): E 200.00
(2) EXCAVATION DATA: _-- - - - I OLL'iRg
OFFICE US
srREET ,04 X =0MIN
DESCRIPTION �---- - s ---8�DO-
NAME SURFACE CUT CUT CUT PROGRESS & INSPECTION STATUS
DEPTH _
- TYPE LENGTH WIDTH DMATERIAL INSTALLED
_ ITEM pUANTITY ITEM DATE REMARKS/TYPE BY
83r ve. ---- STREET
see att ched PEN D _
INSPEC-
R TION -'
E _
rST'IMATEI' STREE. Q
' OPENING DATE: U
ESTIMA TED STREET CLOSING DATE: -- E
--- L / T
131 SECURITY NO- ---_-_ -��' ---�--- _ E ---
- SECURITY AMT.: t 2Q0.�p D
SURETY Co.: STREET
---- µ _ --'-'—'-- CLOSED
Eck CMM ❑ FINAL �//�1
(4' PLOT PLAN: INDICATE SITE PER-IiNENT
BOND INSPEC. 1/3 9L n,,,vtl111/
FEATURES. EXCAVATION LOCATION AND EXTENT. SPECIAL PROVISIONS ll�
/CONDIT TIONS
I work area ) ffx
I Standards%pecitications
SITE: 14685 SW 83rd Av�. l
2. Not, . Carly - e� 6_41771)
_._----
CURB - � ` - _ _ ` I 1�s ctor, 24`_hrs. before
- _ —tfOre
• - _ _ starting work and, also, before
-r 83rdAVENUE covering work.
•c�Ite -, _ _. .. 3. ORS 757.541 - .57.1 applies
(Utility Co.s prenotification, etc)
5) NOTE THE CITY -r-`
OF TIGARD DOES NOT, HEREBI'
RICHT OF-WA Y JURISDICTION IS THAT OF WASHINGTON COUNTY
GRANT PERMISSION TO APPLICANTS 'r0 EG CONDUCT WORK WHERE
THE APPLICANT AGREES TO DEP OR THR
OBIT THE REQUIRED SECURITIES• TO COMPLY WITH STATE OF RALLOPERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENt TO CONDUCT OF THE WORK
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM, APPLICANTS ACTIONS.
AND TO SAVE HARMLESS THt L ,;r AND
APPLICANTS SIGNATURE
-- DATE
IF
Crry or 1111GIM
'This Form is a multi-use form. Appropriate receipts mist be at-t.aa.cd. Docwmntation
important for all purposes. Staple documentation to form.
VENDOR NO.: — - _ DATE: -�-- �- 17 Z --- —
PAPA= TO: MY, C)F e VLn
W AS-0-" _ RDQ�EU BY,
_ S7 w i !o NNkv e_
vif-
Approved request e Wednesday
10:00 AM to A/P for checks by
Friday.
MISM US EXPENDITURES:
Date De--xiption, Invoice No. , etc. Ac cxunt No. Amount
Z2000 $ 2-00 _
Mileage $0.255 I
APPPOPRIATION B1l'_,ANCE: AS OF: SIGNATURE:
(Up to $25.00) Section Manager i_- -- Purch. Agent ._-_-
($25.01-2,500.00) Division Manager
($2,5'0.01-7,500.00) Dept. Head — __ -------- ---- --
($7,500.01-15,000.00) City Administrator
($15,000.C`1- ?) Local Contract Review Board
-
-',/1501E
I
COPY TO:
ATION - STREET IMPRt'�, cMLNT/EXCAVATION IS (WHITE)•FILE
(YELLOW)-INSP.
ORDINANCE NO. 74-14 (FINK).OTHER:a��!-NCY bldg
(� {BLUE)•APPLICANT
(INSTRUCTIONS ON SEPARATE SHEET) �j /1
' APPLICATION NO.: S --�—
APPROVED 1IIGARU, OREGON FEAMT.: s _ 8.00
NOT APPROVED ( {11O _r-r 2-7-
--�-�._--
-------.-
CITY BALL Zy Z
PENDING FEE. PMT. ❑ J�N! .1ATE L
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT - _ _, _ _ _ _ - - - - - - - -
PENDING AGENCY "OK" ❑ application and Progress RccOrd MAINTENANCE BOND +t-[
ROUIREO
---
AS
FOR STREET IMPROVEMENT/EXCAVATION AS IEAU
PENDING INFORMATION ❑ EXPIRATION DATE; ----1------
PENDING VARIANCE
-- c9 . B Y:
7
17 L DATE ISSUED: __�_�__---
PERMIT N O.: �— �,_ _.-
--�-
j I) APPLICATION IS EBY MADE TO EXCAVATFOR
AIND(N* ACCORDANCE WITH CITY REQUIREMENTS.MAINLINE _ AS DESCRIBEDHEREIN,
_-- 97223 246-7624
Mr. Oren Wilson 18525 SW 69th Ave. Tigard/ OR CITV--- — PHONE—
APPLICANT NAME ADDw[
Cyton Excay. P.O. 1x�� 4'72 Wilsonville OR
CONTRACTOR Brian CPE
NAMIt ADDRESS
per City Standar - _ - CITV PHONE
PLANS BY -- -- NAME ADDRESS
200,00
QO
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $
DOLLARS _ ,-_---•------
M [ MIN, Y
OFF'IC Lj;}E:W� - x 8.00
(2) EXCAVATION DATA: 0.04 X s_ O)(0)-- -- -
DESCRIPTION _
PROGRESS & INSPEcTION STATUS
-� RF_MARKSITYPE BY
STREET T MATERIAL INSTALLED I1L'E^� V;.-i --
NAME SURFACE CUT CUT EP — •-
TYPE L..ENGTH WIDTH DEPTH ITEM S QUANTITY STREET
--
_ ImSpEc-
3ee att checi rE7IC`.�
83rd Ave. Q
U
4
S J �L_—
ElTIMATED STR'r'ET OPENING DATE _-----J- --L— —
EST'M i%TIED STREET CLOSING DATE: D
STREET
SECURITYAMT.: $ 200.00,. CLOSED
(:v) S�_CUFtITY NO. -
FINALC.
�
� INSPE
SURETY CO.. _ __ uMNDs
SPECIAL PI JVISIONS/CO DITIONS:
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL
F[ATURES; EXCAVATION LOCATION AND EXTENT. L. All work shalcifiLo Ci�C-
-I--"'''! HX Standards/Specifications
catlone
work area I
I 2. Notify Vieweg (639-4171),
1 ) d Av 83
SITE: 14665 SW r . 1 I
City Inspector, 24 hrs. before
starting wrxk aax3, also, before
covering viurk.
83rd AVENUE 3, ORS 757.Ml - .571 appliAs
Utility Co.s prerotificattop, etc)
-calla-• � �\ � , - 'I
1 1 -
i 1 1
t 1
�.
CANTS TO CONDUCT WORK WHE4E
05j NOTE THE CITY OF TIGARD^DOES NOT. HEREBY. GRANT PERMISSION TO APPI_I
RIGH1.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 PERTINEN' LAWS AND
CMPL?YEFSAGAINST IIFICATIONS PERTINENT To COND'JCT OF THE WORK, AND TO SAVE ANY INJURY OR DAMAGEWHICH MAY RESULT FROM APPL CANTS ACTIONSFS THE CITY AND
E
APPLICANTS SIGNATURE
/r y
1
INSPECT' 40TICE
City of Tigard ding Depac-t=ent
13125 SN Ball Blvd. _Jgarde O-_egon 97213
Inepec�Lcn Line (Rec-O-Phone,: 6?j-4175 Lin iness Phone: 639-4171
Inspection: l L�;�7 7- -'/, -Pit i -�1�C W-------
Footing Plbg. Underela) Mech. Rough-in Appr./Sdwlk
Found. Plbg. Top Out Gee Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Mater Ling Gyp. Bd. -Hoch.
Date Requented: J�'- l L Timer AM _ PH
.> � 3
Addceee: s Yecmit is S_2—
Builder•
Tf1E MLLOPJING CORRECTIONS ARE REQUIRED:
Inspectors
�&PRDYlO OI APPROVJSD SUB.IISCT TO ABOVE
call Mer IlMlnstp.
CENTEN Of CR NO /M
't. S 8905: 19.60 .- SEE MAP
3L 870 204.00
4 S 7103 53.00 2S I 1;'bb
• 5 S 8405 9300
(I N 7301{!W 1,5100
1 S 11701H IN INI 40
0
v
S. c
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.� TERM �- S.Y'a
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C.R. 73c'`
♦09/85!
_ JC
16YI°t �e -%oV15 '191-27392 ./Rg ROW. drti 9. 6800
16} tip +?O.74T\jV 120 01 6900r76001600 00in $ 95.447000' ' 83 rd
710o -'
40 �
a 40 i\ I `� (1 „I 7 ; 730Q\
� 1
/ bb 2"L
11V 1'. 11.•, a•d .. `
---1/ / 2100 2200 P.3uo s U1.4.rdr f\3,'100 •f�1_
S.W. NNEBROOK /
�.1� - a woo
STREET 6 /I i�,J`/.� �_:� /�( ' r_�`:;+•
/ "�•.�.. A)9,. „T� Fr: V''U 7400
/ V
/ 2000
f 0� C, �pr �U f I •3100 tly �bJ W
/ ?'• L Icy,21 11 •1 0.
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2S I II / 1900 " 9 ' 1� I
l.� 0, 3 _115_ .__ 3000 Q
. 2600 m
y n
1800 W 10 io 14 -
` 2 R ilk _ L8 - -— 3800!
W 91- el 1.
IOb 52 i-- 2700 2800 2,300
F 1700 ? "' 1
° w II 12 13 39Ui?
N
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.IS..,,P 1513
S.W. MURDOCK STREET
' 4600 000 4400 300 4200 1 ,_
f; '�' M1
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30 9 29 0 28 27
263 11411IAI 111 N 89° -)n, 3d, w W
3" .�._
so
6100 6200 6300 6400 6500 6Ei00 6700 r; 4H.11
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BUILDING SEWER PIPE, SIZE AS SPECIFIED I
PLANT FABRICATED TEE FITTING
ON SEWERS 18" AND SMALLER. BACKFILL 2X4
FIELD TAP ON EXISTING SEWERSJ'-
AGAINST PLUG TO
AND NEW SEWERS LARGER THAN I PREVENT PLUG
THAN +8". I BLOWOFF 6 SECURE
2X4 IN PLACE WITH
I
SEWER MAIN /TREK-H BACKFILL.
�--
.OR LATERAL PLAN I
I
EXTEND AT LEAST
GROUND 12"ASPOW SUP.ACE
SITRFACE -
MLNIMUM SLOPE FOR
6" PIPE: 0.010, Fol
4"PIPE - 0.020. -- �9F7�1/ICE CONNECTION
k RKFR :
MAGNETIC TAPE ---��
GREEN w/BLACK LETTERS (WASTEWATER)
GREEN w/BLACK LETTERS (STORM DRAIN)
1
P Luo
3/4"'-0 PIPE ZONE MATERIAL
RT TEE WITH AS SPECIFIED
SUPPORT
REDOING GRAVEL,
MMNUM 2'0~ WIDE Sl DE
BUILDING SEWER
u
bwg N.:) 300
f
i
, PVC SADDLE (TEE)
STRAF RETAINER RIDGES-
I I
R_U
BEER GASKET
SEWER PIPE ,
STA ' `'_ESS STEEL S fR.4P
■ PVC SADDI.F SHALL BE ASTM 3034 SDR 35
• PVC COMPOI,NDS SHALL BE A;;TM DIT84 WITH CELI CLASS OF 12454-8/C
OR 12364-C
■ ALL ELASTOMERIC SEALS (RUBBER GASKETS) : HA L BE ASTM F477
■ STAINLESS STEEL BANDS SHALL BE 300 SER I E'-, VUI.L 9/166' WIDTH BATA,
5/16' SHOULDERED HEX HEAD, SLOTTED SCREW A,� IS CADIUM PLATED,
CARBON STEEL.
■ INSERTION HOLE SHALL BE CORE DRILLED.
PVC GASKETED
�
SADDLE Ufa"
DRAWING N0. 350 ��
-----
07
I . COMPLETE RUBBER SLEEVE (ASTM C-443)
INCLUDES A MOLDED SEGMENT THAT HOLDS
,
IT IN PLACE.
2. STAINLESS STEEL BAND (9/ 16" SERIES 300) I
SECURES UPPER HALF OF RUE38ER 'SLEEVE 7C -, HE
I
PVC HUB.
i
3. PVC HUB (ASTM 3034 SDR 35)
DRIVE INTO CENTER OF RUBBER
SLEEVE AFTER SLEEVE IS PLACED
IN HOLE.
i
2
CONCRETE PIPE
�7l/Z.���1�17111
NOTE: ALL INSERTA-TCE HOLES SHALL BE MACHINE DRILLED.
INSERTA -- TEE Qoagency."'��
DRAWING NO. 360
------------
a
MIN. 3*" A C. IN 2 LIFTS --
sew Cur -_
STREET AREAS I OUT OF STREET AREAS
ExISTINc _ �
SECTION
2"OF 3/.a p..
RESURFACING
• ' �j CLASS A
•� - a ,
BACKFILL
" v
CLASS B
S/4`-0 RRANULAR _ Z)
U
e Q
�• • p . Z
W ,o t • n - ,o
N o ) t W
cn
O• Or_�. O• �'e e •� e
� Q
o O n• � o
u
C7 •I a '
2 6.
.e O.
O • o f 'e ' O
PIPE IIASc
BACKFILL IN 3EAREAS
1.
—IF S/W IS AGAINST CURB, Fll i ROC , TO
BACK OF S/W
2.IF S/W 11 NOT AGAINST CURB, FILL ROCK
2'BACK FROM CURB
CITY'OF' TIFARD PIPE BEDDING AND
OREGONDE51c,N BACXFILL DETAILS
f5Y AF"ZCJ/EC) 131' d
G A QAl.1N
�clu_t R 12):
IDATE
NTS 8�30 ncuwzi a No
I
I
:9c:—�.:::;1c69
CITY OF 'f I GARD — RECEIPT OF F='AYMENI CHCCI�.F AMOUNT : ;�0, L7I0 I
CASH AMOUNT - 0. CIO
VAME. : WIL-SON, OREN PAYMENT DATE
ADDRESS - 10525 SW 69TH SUBDIVISION
PORTLAND,
OR 9;cc:.3-
AMO' INT F'AIll P'URP'OSE OF F'AYMFN"f
AMOUNT PAID
PURPOSE OF PAYMENT -0
00. 0
F'UBI_IC IMPROV _ �� 8• � CUSTOMER -DEPO
STREET OPEN11,46 PERMI"f
TOTAL_ Ah'IOi.iNT RAIL) - -' -
•.•Rfn+wwtNtnaMf•R1Mw-WtxKw,wxrarwv.n.uvvx,!wr,H+wfMN7!Jai!wyyti»AH!MkM,M�1M!!t!!a�MNShb�1MMUMNAMtMMkM�„.+h+�s!NfM.�+NsnM!6!M!!rW►'Mh.................... .., .,. ..... ,.r�w,Mlbf
OREN S. WILSON
MICHELLE B. WILSON - •-:. � L. :.._.... _._ _ 79.53
10525 S.W.69, 246-7624 -
c
PORTLAND, OREGON 97223 q
�, fe-easifaso -
Pay 10 '!
I he Order Of
—
,� (hrllars
CONSOLIDATED FREIGHTWAVS FyMPLOVEES r
FEDERAL CREDIT UNION 3230 i
PO PU,k:377"PAID.OR Qr21) r
PAVAEIIs. IRU fool FvF�RFFN MNK,9UTn F, WAI
bis _
Iof
?953
1: 1250663901: 769L3619298611' _
gd ,,,, 13ITY OF TIGARD
STREET OPENING PERMIT
APPLIATION
DATE n
• APPLIANT'S NAME 1�' nveon
ADDRESS � ; ,,� •'S L1./ 6/ �li'�,
ZIP. _
PHONE ! ��
• CONTRACTOR'S NAMEJ yl
X�
ADDRESS
I ZIP —
PHONE
• PLANS BY
ADDRESS
ZIP
PHONE
I
• DESCRIPTION OF WORK PROPOSED TO BE DONE: T4e ---
• ESTIMATED VALUE OF WORK (within public -fight-of-way) : $
• WORK LOCATION/SIS E ADDRESS:
• IS THIS WORK RELATED TO A LAND-USE ACTION? IF SC SPECIFY (ML.!', SDR, ETC.) NO.
• IS THIS RELATED TO A BUILDING PERMIT? IF SO, SPECIFY (BLDG. PERMIT) O. � " 006
(OVER)
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