11587 SW 90TH AVENUE-2 a
FILE NO. 413-91
90th AVE. — 11587 STR OPN PERMIT
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ENGINEERING PERMIT
VE'?;iIT # . . . . . . . : ENG91-0014 DATE ISSUED: 04/16/91 By:
PRIM. PERMIT # . : ENG91-OC14
SITE ADDRESS . . . : 11587 SV1 90TH AVE PARCEL: 1S135DC-08200
JUBDIVISION. . . . : PARTITION PLAT 1990-5 ZONING: R-4 . 5
BLOC'. . . . . . . . . . . . LO'T'. . . . . . . . . . . . : 2
----------------------------------------
PERMIT TYPE. . : SOP IMPROVEMENTS QUANT RATE VALUE
AGREEMENT DATE: / / GRAD/EROS
ASSURANCE EXPIRATION-•-- STREET
PERFORMANCE: / / SAN SEW
MAINTENANCE: / / STM SEW
UTILITIES
ALL OTHER
TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5
Remarks: STREET OPENING, TO INSTALL A SANITARY SEWER SERVICE LATERAL.
Permittee: -.--------------- FEES -- --___
J.B. INISULATION CO. type amount by date recpt
P .O. BOX 23695 OPEN $ 32.00 JSH 04/16/91 212059
TIGARD OR 97223
Phone # : (!,,03) 684-8558
Engineer:
ENGINEER NOT ON FILE
$ 32.00 TOTAL
Phone #
-------- REQUIRED INSPECTIO'.YS -------
Permittee/Agent Signature: ---STORM SEWER— -----STREET-----
M.H. & C .B. CRB LINE & GRADE
----- -- PIPE LN & GRD SUBGRADE
BCKtL,L & CMPCT BASF ROCK
AIR & TV TEST LEVEL COURSE
City of Tigard, Oregon WEARING COURSE
1312.5 S .W. Hall Blvd. . --SAN. SEWER--- TRAFF & PED CONT
P .O. Box 23397 M.H. & C .O. MONUMENTATION
Tigard, Oregon 97223 PIPE LN & GRD STREE'TLIGHTING
Phone #' 639-4171 BCKFLL & CMPCT WALK/APRON/RAMP
AIR & TV TEST
FOR INSPECTION, CONTACT: - ---GRADING-----
Carl Vieweg #6�9-4171 (office) --REPR' S/ADJ , S-- CONTOURS
#'780-2647 (mobile) DRAINAGE
----PATHWAYS---- EROSTnN CNTL.
COPY TO:
APPLICATION -- STREET IMPRO' HENT/EXCAVATION (WHITE)-FILE
ORDINA,. E NO 74-14 (PINK)-OTHER
INSP. n��,,
(PINK)-OTHER AGENCV+A++�+y•
(tNSTRUCTIONS ON SEPARATE SHEET) (BLUE)-APPLICANT
APPLICATION NO.:
APPROVED A 32.00 _
NOT APPROVED �] CITY OF TIGARD,OREGON FEE AMT.: S 9 -ZI ZOS
CITY HALL RECEIPT
PENDING FEE.PMT. ❑
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT B'�_ DATE — — — — — — —
PENDING AGENCY "OK" ❑ Application and Progress Record MAINTENANCE BOND,M
FOR STREET IMPROVEMENT/EXCAVATION AS REQUIREt) SSS
PENDING INFORMATION ❑ ANNUAL
EXPIRATION DATE: One ear _
PENDING VARIANCE ❑ _
PERMIT NO.: 4�3=9 ( DATE ISSUED _'4 ��-- BY
( 1) APPLICATION APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL SAN LTAR SEWER ATERAL AND
MAINLINE TAP __ _ _ AS DESCRIBED HEREIN, IN FULL ACCURQA14CE WITH CITY RErUIREMENTS.
_ 34rri
,Sr►sal���ov� Com. P e '�R,.9_1 2
APPLICANT `�jim Boryska _____14535 SW Osprey 232 _Bei-_;rton Y �MDNE
-NA MC _ ADDfiE45
X3)17
Bob Straus
_----- - --clTv - v►+oNe
CONTRACTORNAM! ADDR[3S
PLANS BY._Per City Standards And Specifications �IT� PHO
NAM& ---RE85
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ 800.00----
DOLLARS-
FOR OE'FI� - — :
F717 CMIN.
..'� ,
(2) EXCAVATION DATA: 0.04 XS_ •( --�: *�---
DESCRIPTION PROGIR INSPECTION STATUS
STREET ITEM DAYE REMARKS/TYPE BY
NAME SUTYPEE CUT CUT CUT LENGTH WIDTH DEPTH MATERIAL
TEM IA a IIQUANTITY
STREET
P N '
INSP C-
- -- ¢ TA'CC 'E )� TION _
U� 90hA
U
E
ESTIMATED STREET Of 1 KING DATE: -----L--
1 _-.�- E
ESTIMATED STREET CLOSING DATE:: ---1 D --
s- STR1.7E'r 1
SECURITY AMT S 1300.00 CLOIED J
(3) SECURITY NO. -_ FINAL
SURETY CO p�qINSFEc. -24 'i
,`IipggWpseaw cHEl.µ X cASH_7_90 ND
(4) PLOT PLAN. ,NDICArE 517E PERTINENT PHYSICAL
SPECIAL PROVISIONS/CONDITIONS:
FEATURES EXCAVATION LOCATION AND EXTENT. 1) All WCXk Slab oatcon'ib City S ig
An3 qxr-if icatims.
1 i q 1 I 2) rEx avatc c mist C 3rpiy With (TIS 7!5/-571
1
1 , � (Utility pc--laatirn Fes.) --
3: Om`xac�tnr Mast AIM-de rix' Traffic: Ar"
U A e - .., - `• - - - - - - 1 lurian cJalarol.
AYE �c' -
SW 90TH i, --
- --.—---- 4) OXItacL City Lt�r Carl Jieweg 24 ii:'-
' _ Pci�x `ib Begiming AtW Wxk (�ln).
K
.c��s -, _ x - •- - - -- - - - -` c (P 5) Inet�ec'tirn BeforE &-Y-dialing i:� �ec}ai.rac
Andy AL9DI A HacT 9urfa --Patch Ls tired
r�e
I C7 1At 'L Erj Of Ci3Cf t L�Y3 WrXIC.
! '
(5) NOTE. THE CITU OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WOFIK 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 PERTINEN ' LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK. AND TO SAVE HARMLESS THC CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT rPOM APPLICANTS ACTIONS
lM-- ���._-/yy/��/_ /y /�
APPLICANTS SIGNATURE DATE �G w/�--------�� V � / --
J.8• uu �
LONG RAD'11S LONG RADIUS
BENDS NOT - �� SERVICE
BENDS AS CONNECTION
GREATER THAN 45" REQUIRED- PIPE
1
Ll__--
200 MIN.
PREFER °
TRUNK, MAIN, OR WIRE SERVICE TO
LATERAL SEWER CONTINUOUS 4x4"
TRENCH WALL - �- OR 2"K 6" TEE FRAME.
MUST EXTEND FROM
p\?� i' SEWER TO UNDISTURBED
G4:eA'oP•t`�\�� i•� EARTH.
S ti
''f FSP �i;:• � �
4"t 4" BRACE
20° TO TCO i COMPACTED ORAVEL
FIACKFI'-L TO UNGISTf'gBED
EARTH, MINIMUM 2'-0" WIDE
' MAIN, TRUNK, OR MAIN, TF.UNK OR LATERAL
LATERAL SEWER (B )
USE ONLY WHEN WORKING AREA
PROHIBITS USING (A)
COMPACTED GRAVEL UNGER 12'.
COMPACTED GR WEL OR CONCRETE
ENCASEMENT BETWEEN 12' AND 16',*-
DEPENDING ON SOIL CONDITION
CONCRETE ENCASEMENT OVER 16'.
OVER 1:' USE CAST IRON AND, / ---
COMPACTED GRAVEL IN LIEU OF _
CONCRETE ENCASEMENT.
1
*MAY GO TO 24' DEPTH IF THE
TRENCH Ai3O' E THE PIPE IS COMPLETE
LIMITED YU 30" ACCORDING TO
BACKFILL CALCULATIONS. - ---CONCRETE
I 11� ENCASEMENT
-- 'Al
�1
POUR 814E FULL
VERTICAL
(CONCRETE �L '�'.i �f•, `710TH OF TRENCH
ENCASEMENT)
• r
' TO BE USED ONLY
WITH PRIOR AGENCY ►'�. ,.
APPROVAL. ■� y. '�•'' '
SIDE SEWER -
CONNECTIONS
Unill,td S°w°I°ge AprncY
MIN. 3" A G IN 2 LIFTS
STF -ET AREAS _UT OF STREET AREAS
EXI ST1 NG
SECTION
RESURFACING # /71-77`
2'OF 31W,_ --:8-
CLASS A
• e / BACKFILL
o ••
2 O" — ��• /
s ,
,314=O GRANULAR �
• U
BACKFILL pcn
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SAJ
4 .o o ct:
' -Q--' o •o o / o • e
d. O •e I b .a O
cn
PIPE BAS c
BACKFILL IN STREET 4hEA3
L IF3/W I?AG.4IHST CURB, F".L ROCA TO
BACK OF 31W
2-IF 3/W 13 NOT AGAINSf CURB FILL ROCK
2'9,ACX FROM CURB
E. C17T)YOF TIGARD PIPE BEDDING AND
BACKFILL DETAILS
REGON UE51GN �•• _ ' BYDCZAWGA
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Cl i'Y OF TIGARD _
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-itliz form is a multi-use form. Appropriate receipts .:a1st be attache. DOcumnt-at'011
c irrq:)oi.tant- for all p-p�s• Staple ciocxzrmnt�ati0n to form.
VF WJX NO.:
_ Dom: - -_Z 7
RIIDIT SiM BY: _
PA.YAHL•E 70. - -
0 19s, Approved raga due Wednesda
10:00 AM to A/P for checks by
Friday.
MIS:'F.[3ANBOUS ZpEMIMPES: Account No. Amomt;
DateCrirfiion,wCrirfiion, Irnroice No. , etc.�('��-- -
Mileage $0.255
APPRopr, . ON BALANCE: AS OF: _ -- SIGNMURE: ----
(Up to $25-00) Section Mar.-.gar -- — Pur:ch. Agent -
($25.01-2,500.00) Division Mand,-j,-A- _---_-
($2,500.01-7,500.00) Dept. Head($7,500.01-i5,000-00) City Administrator
($15,000.01- ?) Local Contract Review ;3orird
/150]F
_ .,...- -r -c:,r...-..,..--.'-- -+te•-r--^�^•.,.^^-�+w..r-+p+^s>roi'ynlq^,r�„'T"'."'7''.......-....F.,,--...-.r-- •---"',P'T^",r...•►�..-•+�-�r.�-.r-+.^'^+.-'-"'^ 'i,.
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APIPLICATPON -' STREET IMPRO' 1/IENT/EXCAVATION COPY TO:) FILE
ORDINAN,,'E NO. 74-14 �'' (YELLOW)•INSP. p��},
(PINK).OTHER AGENCY` LC- .
(INSTRUCTIONS ON SEPARATE SHEET) (8'-UE).APPLICANT
APPROVED In APPLICATION NO.: 45,4
NOT APPROVED 11 CITY OF TIGARD, OREGON FEE AMT.: S
''C'/DING- FEE. PMT. ❑ CITY HALL RECEIPT
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY_ _ DATE�'' _�L _�_
PENDIN> AGFNCY "CK- ❑ Applicetion and Progress Rec-ird
MAINTENANCE BON D,�k_ —
PENDING INFORMATION El FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED E�
ANNUAL J
PENDING VARIANCE h EXPIRATIONDATE: One Year
_ q
!'[RMIT NU.. __— i- -1�___---• DATE ISSUED: __ ' _�1-�'1-�y--- BY:
(1) APPLICATION IS HEREBY MADE 'TO EXCAVATE FOR AND INSTALL RAT'rAi� EWr'it ArERAL AND
AINLINE TAP AS DESCRIBED HEREIN, IN FULL ACCOR ANCE WITH CITY REQUIREMENTS.
,Zns.�,� law+ I�r• 'i7Z'Z3 ;xl��t-1.916 Heil:
APPLICANT�Tm BO rysa 14535 SW •met�rey t:i2 [ eaverton, OR 8722
NAME ADDRESS Cj73 PHONE i
CONTRACTOR Bob Straus - - �:�-t1L1.7
�- NAME ADDRESS CIPHONIC
fY
PIANS BY_Per City Standards And Specifications _
NAM'E-- AQDRE �I CI- li PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ 800.00
DOLLARS
-_ -T•- -- JD
OR OF, 7=U SE: C"lIN.
(2) EXCAVATION DATA: oa x sSTREET _ DESCRIPTION PROGRESS & INSPECTION STATUSNAME SURtrACE CUT CUT CUT MATERIAL INSTALITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM & QUANTTRNETED
N$P C•�(� A I ATC IED E TION
O
U
ESTIMATED STREET OPENING DATE: ^.___�.�_.— rT
ESTIMATED STREET CLOSING DAT C: / ED
��l).1.)U STREET
(3) SECURITY NO. _ — SECURITY AMT.: S . CLOSED
SURETY CO.. _ __ FINAL_
f-4?W*NWE0 CHECK X CASH t7 DOIVD 7 INSPEC.
IF
(4( PLOT FLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS /CONDII IONS.
rEATURES: EXCAVATION LOCATION AND EXTENT to AllykrK x1.11 I. '11U LU alai :kaI, ' 13
r Anti %ecificatia'e.
2) pxmvatoc Mit 03gAy With CPS 75`7-571
I
(Utlliry Pr+elocatibm Eta:.)
3) gantrrx-ttx Mast PLvvi,cle 0br !h'afflc; ArI1J
SW 30`1'H AYE . , 1 urian o�al.
4) ukntact city I►%Jector Q3cl Yieliag A It'S
E*=1cr ib Beyin� Arts, Wxk (til"171), j
" -• -- ,� r _ - - - - - - - - _ I. - - - ! ef�
) lnec.-Iia, k3efcze dadcfi lliry L E ui ~i
a) I NrJ, Luso, A M&Cd Surface P&*dl IS ReEptimi
� +� I c•� I At the 14t Of e-Mb iJelys W:xic.
(5) NOTE THE CITY OF TIGARD DOES NOT, •IEREBY. GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-CF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES. TO COMPLY WITH ALL PERTINFNT 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.
fl j2 y
n;'rLICANTS SIGNATURE 7T t* - DATE
CITY OF T I GARD - RECEIPT OF 1='AYME NT RECEIPT NO. :91-21 -.059
CHF_Ci, AMOUNT : 832. 00
CASH AMOUNT 0. 00
AME : J. P. INSULATION CO. PAYMENT DATE 04/16/91
DDRESS P. 0. BOX c:X69 SUBDIVISION
11087 SW 9af1-I AVE.
T I GARD, OR 97223-
AMOUNT PAID I D
'URPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT --
32.
'UBLIC IMPROV 413-91
00 CUSTOMER DEPO
li
S
1
h
TREET OPENING PERMIT
OTAL AMOUN) PAID - -
00
—' — United States National Bank of Oregon
Ciackamas.Oregon
J. B. INSULATION CO. 2422
PO BOX 23695 1230176 CHECK No. '1008995
TIGA.RD, OREGON 97223
PAY DATE AM 011NT
TO THE
ORDER Or �� /�� �� �/C lP•'`.D ��/�/�� ��./AI
J B. INSULATION 0.
11200699 511' 1: 1 2 3000 2 201: 176 0004 96 n2
0008995
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