14955 SW 92ND AVENUE-1 a
FILE NO. 3 —�C
92ND AVENUE — 14955 STR. OPN. PERMIT
CITY OF TIGARD
EXPENDITURE RDQUEST
-11is fonu is a multi-use form. Appropriate receipts most be- attached. t,)OC�=.ntation
is important for all purposes. Staple documentation to form.
VENDOR NO.: _ DATE: _ 3
PAYABLE TIO: �Ey�h�S � 'zQ V1 RBIQUESTED BY: — / —
'�10
Sin `111�5L_ * Approved request due -Y
10:00 AM to A/P for c he:k-s by
Friday.
MISCE11ANDOUS EXPEN MURE'S:
nate Description, Invoice No., etc. Account No. Anount
00
500 .
MPAL $ 500,
APPROPRIATION BAIANCE: _ AS OF: - SIGNATME:
(Up to $25.00) Section Manager --__-��-�- Purch. Agent
($25.01-2,500.00) Division Manacter
($2,500.01-7,500.00) Dept. Head -
($7,500.01-15,000.00) City Admi.nisUat,or
($15,000.01- ?) local Contract Review BCM-d __-- -- —-
ke/1501F
APPLICATION -- STREET IMPROvEMENT/EXCAVATION COPY TO:
ORDINANCE NO. 74-14 (WHITE)-FILE
(YELLOW)-INSP.
(INSTRUCTIONS ON SEPARATE SHEET) (PINK)-OTHER AGENCY RI-ry'I
(BLUE)-APPLICANT
APPROVED
APPLICATION NO.: �y�R
NOT APPROVED Gt (-.I I l O I IGARD, OREGON Do
FEE AMT.
PENDING FEE. PMT. [i CITY IIALL
RECEIPT No.:
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY _-sk` DATE_ 08 /.J..3 /�_
PENDING AGENCY "OK" ❑ Application and Progress Record _ a - - - - - - - - -
PENDING INFORMATION O FOR STREET IMPROVEMENT/EXCAVATION MAIASER"EQU REBOND ,r_
]l
PENDING VARIANCE ANNUAL ❑
EXPIRATION DATE:
PERMIT NO DATE ISSUED: _ /> L12s? BY:
(1 ) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL WJE p�C
-- AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
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APPLICANT _ __�EI`�N►S SI�L14 p(' �j j _� _ � `
NAM[ ADDRESS G IT PHONE
CONTRACTOR - CO"r-RE. E 62
''')
NAM[ ADDRESS --__..-_ IS ht�(O bL`Ci-_ZZ,Vr;
PLAT,':, 2Y CI PHONE
1 Y PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $
--
---_- _---,---`- -- -- -_. DOLLARS
(Z) EXCAVATION DATA: +OGRESS
ORFIc�is%--- -- ---- '`, M,N.
f.--.�I�_0 A
STREET DESCRIPTION & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MRTERIAL INSTA _
TYPE LENGTH WIDTH DEPTH IYEM 6 QUAEM GATE REMARKS/TYPE BY
ill SFRNED QU
INSP C Z,4 CPA
yx(~
R TION I
E
Q i 1 �b�
ESTIMATED STRCET OPENING DATE:�pp - / �, � -
E;TIMATEp STREET CLOSING DATE: TF
(3) SECURITY NO. SECURITY AMT. $ d oa STREET
SURETY CO.: a,Ll -- CLOSED A( IL -
_ FINAL `1
C[pTIFIEDCH[CK lI _ CASH rOND C INSPEC. 7LC' d F1
_ _ _
(4) PLOT PLAN_ INDICATE SITE PERTINENTPHYEICAL --��-
FEATURES. EXCAVATION LOCATION AND EXTENT, SPECIAL PROVISIONS/CONDITIONS:
l) A// e71Ter.��
I
NnRTH I 1 ier-I
R 1 L 1 I ,
----
I
S NOTE THE CITY OF TIGARD DOES NOT. HEREBY, GRANT PERMISSION 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 W!i'H ALL PERTINENT Lr WS 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 AC'T'IONS
I�.
APPLICANTS SIGNATURE
DATE J / / c,
\jO `1 rk , 3lzv`4r
Z- �
S �� ne,
November 8, 1990
CITY OF TIGARD ,
1
OREGON
Mr. Dennis Swafford
14955 S.W. 92nd Avenue
Tigard, Oregon 97223
RE: Driveway Access
Mr. Swafford:
I have tried to call you but you were not available and I have also
left a message for you to give me a call. So instead of this
exchange of phone calls I thought it best to give you the
information in letter form.
You had requested infc,rmation as to another suitable product that
would replace the "seal coat" that I had mentioned before. I have
done some checking and Albina i'u�l Co. has such a product; the name
of the product is Quik Stik. I talked to Dave (281-1161) and he
said he would be willing to send a person out to do the job; the
approximate cost is $50. 00. You may contact Dive at you
convenience and make arrangements; be sura to mention my name and
that I had talked to him in reference to :his job.
As we had discussed in our meeting with Mr. Pat Riely, as soon as
you contact me, I shall make an inspection and if all is
satisfactory we shall release all portion: of the bond except what
will be need to cover the cost of the "seal coat" application;
$50.00.
If you have any questions please feel fres to call me at 639-4171
ext. 318.
Sincerely,
n
"V
((/
&ri topher R. Davies, P. E.
Development Review Engineer
ed/rvafford
13125 SW Hall Blvd„P.O.Box 23397,Tigard,Oregon 97223 (503)639-4
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INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
Phone: 6394175
Type of Inspection —
Date Requested--7 � Time / A.M. P.M.
Address .-__
/L1� J ��� h Permit
Owner—_ Lot #
BuilderThe following BuilcAng Code defici cies are required to be corrected:
t Y
c CA) --
1 _
J i ) t i1NRiid�i
Presented to �` ___-- - � �pproved
Inspector i e ` — - Disapproved
Date
CALL FOR REINSPECTION
YES ❑ NO ?
�i
i
INSPECTIr— NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard. Oregon 97223
Phone: 639-4175
Type of Inspection __I
Date Requested -- - Time _..___ A.M. P.M.
Address Permit
Owner Lot #
Builder t
The following Buil Code deficiencies are required to be corrects
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Presented to _ __ pproved
Inspectur 'r Q�Dipprovecl
Date -8- 24 - go
CALL��REINSPECTION
>� F:1 NO
APOLIrATION — STREET IMPR( _MENT/EXCAVATION COPY TO:
ORDINANCE NO 74-14 (WHITE)•FILE
(YELLOW)-INSP.
iNSTRUCTfUNS ONSEPARATE SHEET) (PINK)•OTHER AGENCY BLDG
(BLUE)-APPLICANT
APPROVED APPLICATION NO.: 'Y.2,,,
NOT APPROVED ❑ CIT OI' I IGARD, OREGON FEE AMT.: S ,,710. C0
PENDING FEE. PMT. ❑ CITY HALL RECEIPT NO.:_ 940
PENDING SECURITY ❑ PUBL IC WORKS DEPA R TMEN T By ---:I-'S— DATE_._Pig_.L.r2 190
PENDING AGENCY "OK" ❑ ..pplication and Progress Record _
MAINTENANCE BOND >r�
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED >t
ANNUAL. ;_7
PENDING VARIANCE ❑ EXPIRATION DATE:
PERMIT NO 323 jL'? -_ DATE ISSUED: Li 5.-- BY: _ 5/2?--_--
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL- DO 1VELJ aAC�4
-- -- AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
1b" 1 Sw �htv elE LArE OsIaEGr7
APPLICANT DENtits swr-)y FORD �t�
,LNAM� �(a35
PHONE
CONTRACTOR OWCRETE 62f6.27-
NAME ADDRE3s - ---- > — -- — oi'�i
NE
PLANS BY -_
NAME_-
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): _ _ SCG GU
40.0:4X
DOLLARS(2) EXCAVATION DATA. FFICE USE: o["'MIKs5STREET _ DESCRIPTIONROGRESS & INSPECTION STATUS
NAME SURFgCE CUT CUTCUT MATERIAL INSTATYPE LENGTH WIDTH DEPTH ITEM Q QUANTITY ITEM DATE REMARKS/TYPE BY
L. ►.S Lj j,) j=� I r r 17 STREET
OPENED
INSP C-
R TION
E
�.� Q
U
ESTIMATED STREET OPENING DATE:- / / `ID E
S
ESTIMATED STREET CLOSING DATE: / ). / G E
TREET
(3) SECURITY NO, SECURITY AMT.: $ 4_15 `(- CLOSED
SURETY CO. -�_ _ _ FINAL , p
-_ - -- CERTIrliso CHt.C.K _ CASH BOND INSPEC. All I D, SRI p
-a-Paz r
(4) PLOT PLAN INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISION$/CONDITIONS:
FEATURES, EXCAVATION LOCATION AND EXTENT. )
A& ilark _S/ii�� Orf�nrrJ-,
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tz N D RT►i
CURB —/ (� — -
CURB _ _ 1 _ _ � /' c —
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,�.,�.w,._.. _ ----- --
NOTE THE CITY OF TIGARb bOE9 NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION 15 THAT OF WASHINGTON COUNTY OR THE STATE OF ORFGON,
THE APPLICANT AGREES TO DEPOSIT THE RFQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARML.E35 THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR D lI0Adll,,WHICH MAY RESULT FROM APPLICANTS ACTIONS
- 1
APP LICANtS SIGNATURE .�� DATE..-
y (
7 _l= i ? Carty i1 iE(~E r-T OF 'PAYMENT F;ECE IP1Z ANO. :9t,1-�2041 1�^ i
CHECK. A`10UNT : 520.0(l i
CASH A113UNT c).00
ADDRES '11-: NE OFtEGON ST 'PAYM'ENT DATE : '06/2'/90 i
ryUBDIVI1'D:ON
SHERWOOI; OR 9714()-- i
Uig t" OF PAYMENT �',MCL�hi PAIDi.1 !moi('',0 ,L� OF r',WMENT AMOUNT PAIL
C'JSTO IES; DEFO 50()_00 UBU I C I MF-T,:OV _ �20.00 i
FEPmJT NO 387-90
I
TOTAL_ Ah1QUNT PAID
- - 520, 0C., I
I
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DENNIS R. SWAFFORD ODS 510211 11 1 18
310 NE. OREGON ST. 525-5562
SHERWOOD, OR 87110 �� , 21-mm.-in
19_-
PAY TO THE
ME" — –�=! — J $ SZc
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IMPORTANT ME6
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FOR(Zu -�l"i ? G
DATE 3v -l'IME ��� P.M.
OF
PHONE
AREA CODE NUMBER EXTENSION
TELEPHONM- PLEASE rALL
CARIE TO BEE YOU WILL CALL AGAIN
WANTS TO BEE YOUT RUSH
RETURNED YOUR CALL SPECIAL ATTENTION I
MESSAGE_ 47
SIGN[ _
LITHO IN U.9A.
tOPS IV FORM 3002S
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