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10130 SW HILLVIEW STREET-1 FILE NO. 467—�'2 HILLVIEW ST. SW — 10130 STP. OPiq PERMIT c COPY TO: APPLICATION -- STREET IMPRO 'MENVEXCAVATION X) (WHITE)-FILE ORDINA,E NO. 74-14 ®Z (PINK)- )-INSP. OTHERAGE (INSTRUCTIONS ON SEPARATE SHEET) ;(j (SLUE)) APPL CANTNCY b1C',g• APPLICAYION NO.: _S:"ALZ --- APPROVED -,..._ NOT APPROVED [] �-I I'N' Ol' 'I'l(,ARD, OREGON FEc AMT.: S_� �2ZZ-3 i©1°a PENDING FEE. PMT. ❑ CITY HP.L�. RECEIPT N — By _� - DATE I PL' IDINGbECURITV ❑ PUBL IC WORKS DF,'A R TMEN T _ _ _ _ _ _ _ _ - _ - - - PENDING AGENCY "OK" ❑ Application and Progress Record MAINTENANCE BOND r — FOR STREET IMPROVEMENT/EXCAVATION AS REOUI RE I_ PENDING INFORMATION ❑ ANNUAL EXPIRATION DATE' PCNDING VARIANCE ❑ _ PERMIT NO - DATE ISSUED: . - (1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALLSewer_ ViC�L.ateral - AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS. rol 4Tu ian 10130�W Hillview ., Tigar�7� __639--1,602— PHONE — l�PPLi..ANT _._�_.-- -�--_-- - ADDNE s ciTr C__ NAME 139E5 SW Far)ninotn,�Bd•-_ -B�saYert4D. qZOS?5_--_543M5o5N.3a CONTRACTOR _SieTlClS,IME — Aor+NEs+- uTy PLANS PlyHON NAME ADUpE83 � ESTIMATED IMPROVEMENT TOfAL VALUATION ( COST): S 550.00 DOLLAris FON OFFICE USE:YM�� (2) EXCAVATION DATA: 0.04 X S_ DESCRIPTION PROGRESS & INSPECTION STATUS STREET — r ITEM DATE REMARKS/TYPE BY NAMe 1iURFACE CUT GUT CUT MA"fiR1ALINSTALLED TYPE LENGTH WIDTH -APTH TEM A QUAN Y STREET Hilly A. 8' 4' 7' 3 4 minus & A•L. Iris Ec_ R 'TION • - E U -- E ESTIMATE D STREET UPENIN —. .:i DATfi: .-�-��� T �- ESTIMATED STREET CLOSING DATC: — �.-- STREET -- SECURi i Y AMT: S_-5.tr0&-Q .—.• CLOSED (3' SECURITY NO. - FINAL 2 ev!� SURETY CO.: — INSPEC. ZC Z Ic•Jcc E �C HEGH CASH O Jv�lOND� SPECIAL PROVISIONS /CONDITIONS: (4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL NOL'lf C1tY Inspector Carl Vleweg FEATURES; EXCAVATION LOCATION AND EXTANT. 639-4171 24 hours before starting I I I 2. All work shall conform to work. 1 — & Specifications.City Sts...".a~ds.. applies (re:Lz 3. ORS 757.541.._ CURB = - utili�celocation• etc. ). S.W. 100th Avenue - - 4. Traffic control shall be provided for, by contractor. Street closure is not allowed. — i I X Kwur.ksite i r 5. A hard surface patch is required •,q y I w S I at the end of each days work , m (1.0130 SW Hil.lvie )I — _ — I 1 _ - `Ir17kK WHERE (S) NUTE THE CITY OF I1,,ARD DOES NOT, HEREBY, GRAN'r PERMISSION TO APPLICANTS TO CONDUC RIGHT-OF WAV JURI.,DICTION IS THAT OF W. SHINGTON COUNTY OR THE ST•.TE OF OREGON THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL. PERTINENT LAWS AND CONSTRUCTION SPCCIFICATIONS PERTINENT 'TO CONDUCT OF THE WORK. ANO TO SAVE HARMLESS THE CITv AND EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH .MAY RESULT FROM APPLICANT'S ACT!ON:, DATE .- APPLICANTS ATE ._APPLICANTS 31ONATURE 1 c cn Ir Z ct W O W Ln / Z,wry -j o3 LJ F— N c Li Ol r O aa 0 p o o a o U � f0- d "2� o O • l i�4 - ��; M cu � v w on (D •`S Ole • a 1t1.' o r � - �, or, ..t In Ln 904 O �, .-� M'S 4 = a 3nN3Ad81 18 CIN 06 4�U01 � ,lam\\�oc� r Q a � � �• ( �~K ) '�•� e ° 16* -Olz�r 0 c N t• a n i Wk84 IL 94A F— In -- 0 .CY — N art •e sii.� f- 01 3nN3AV cn s - r ilk `,J C.) 00 ti 0 V) z RZ > I kjo A zo CL E Ot 0 z to� kr)LLJ F I lox LCLIJ V*),q.0 cr co *11 -1 ILy r i MIN. 3-' A G IN 2 LIFT5 - , STREET AREAS I OUT OF STREET AREAS 6Aw cur --- — — EXISTING -�--/T/7 SECTION RESURFACING 2-of 31A!.-0• •. j , / / \. CLASS A BACKFILL CLASS 83/4=O GRANULAR BACKFILL - 0 • .a • ♦ iL a 0 Q Q] ►V C Q c 4 ., Q W - -- ° o• a Q a- Q\N �o • d a � a D � �. Q I G •� O 2 d. --J-- .� 41 m y ELLLq• � T •4' � •O 1'1 PE 9A5- BACKFILL IN STREET AREAS I.IFSAV ISAGAIN9TCURB, FILL ROC.i TO BACK OF 4/W 2.1F 3/W IS NOT AGAINST CURB, FILL ROCK 2'BACK 1-11014 CUR13 PIPE BEDDING AND C►JTYQFTIGARD BACKFILL DETAILS OREGON DE51CN BY i .Af F'R.OVEa B'( MA1..IN by GA 5C1ILE DATE - nt2AW INC f�L .Y ---- NT5 �I PVC SADDLE (TEE) I I /% STRAP RETAINER RIDGES 1 1 1 1 :� RUBBER GASKET I - SEWER PIPE i I STA NLESS STEEL STRAP • PVC SADDLE SHALL BE ASTM 3034 SDR 35 • PVC COMPOUNDS SHALL BE ASTM DIT84 WITH CELL CLASS OF 12454—B/C OR 12364—C I Y ALL ELASTOMERIC SEALS (RUBBER GASKETS) SHALL BE ASTM F477 • STAINLESS STEEL BANDS SHALL BE 300 SERIES, FULL 9/16' WIDTH BAND, 5/16' SHOULDERED HEX HEAD, SLOTTER SCREW AND IS CADIUM PLATED, CARBON STEM. ■ INSERTION HOLE SHALL. BE CORE DRILLED. a 1 PVC BASKETED ur rd se'wler�e SADDLE �r DRAWING N0. 350 UfA a � R ` r i f YLJ - I � 1 BUILDING SEWER PIPE, SIZE AS SPECIFIED PLANT FABRICATED TEE FITTING ON ScWERS 18" AND SMALLER. BACKFILL 2X4 F'EL.O TAP ON EXISTING SEWERS AGAINST PLUG TD AND NEW SEWERS LARGER THAN ( PREVENT PLUG THAN 16". t BLOWOFF & SECURE 2X4 IN PLACE WITH -- TRENCH BACKFILL. SEWER MNN OR LATERAL PLAN t - I EXTEND AT LEAST GROUND 12"ABOVE SURFACE SURFACE —/i MINIMUM SLOPE FOR ti" PIPE= 0.010, FOR 4 PIPE= 0.020. Sf32VIC£ CONNECTION MARKER WRAP 12-16 GAUGE GREEN LOCATOR WIRE AROUND 2X4 — -- ,-�"--PUJG 3/4"-0 PIPE ZONE MATERIAL �z� r AS SPECIFIED — SUPPORT TEE WITH BEDDING GRAVEL, MINIMUM 12'0" WIDE Sl DE BU 1 L D I NG 5 EWE R Uf Unified Sewerage Agency of Washington County 24( CITY OF TIGARD EXPM)rAMRRDUEST E"JE5r 'Ib-i, fonn is a multi-use form. Appropriate receipts must be attached. D.<amientation important_ for all purposes. Staple docuni--ntatjon to form. VENDOR. NO. : M m-': z-4 -17- PiVABLE TU: --KeAvxe-A�A MLAWLArt IV%C- Pi-ViEsI�D BY Approved request due Wednesday 10:00 AM to A/P for checks by Friday.. MISCEIZANEOUS EXPUMM JRES: Date Descmiption, Invoice No., etc. Acx"unt No. Alromit I z 7-000 550. A—_5 'I-ileage $0.255 APPROPRIATION BALANCE: AS OF: SIGNAIURE: (Up to $25.00) Section Manager _,_ Purch. Agent ($25.01-2,500.00) Division Manager ($2,500.01-7,500.00) Dept. [lead ($7,500.01-15,000.00) City Administrator. ($15,000-01- ?) Local Contract Review Board / I 501r V w � r _ COPY TO: APPLICATION - STREET IMPRO ` MENVEXCAVATION Ul (WHITE)-FILE ORDINA�,E NO. 74-14 ® (VFLLC,'i-INSP. J (PINK)-OTHER AGENCY bldg (INSTRUCTIONS ON SEPARATE SHEET) (BLUE)-APPLICANT APPLIr.ATION NO.: APPROVED 22.00 NOT APPROVED ElCITYOF TIGARD, OREGON FEE AMT.. f ----- ('I I N' HALL RECEIPTN `1 Z�"�-�S 10 PENDING FEE. PMT. ❑ / PENDING SECURITY 13 PUBLIC WORKS DEPARTMENT By _ _ _ DATE— - _ PENDING AGENCY "OK" ❑ Application and Progress Record MAINTENANCE BOND r-1 FOR STREET IMPROVEMENT/EKCAVAT ION AS REQUIRED PENDING INFORMATION LJ ANNUAL EXPIRATION DATE;,— PENDING VAPIANCE ❑ 1 PERMIT N O. DATE ISSUED: .._ a_._1 -L_. __�-��---- � �_ -- APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL . AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS. APPLICANT �npY1 lien 10130 SW Hillview _ Tiyard_L OE2 PHONE Q2r.r _.__.�l_s7. •Ili1__-- ___-- - ----CITv-�--- NAME ADDRESS C O N T R A C T U [3L18G1�LM e 1�'_ 'rI�'trlr--------� �1— CITY 1_`�.[.1�'2__�.���N E -- ADDRESS PLANSBY _- ---- CITY --- - NAME ._�_a�-- ADDRESS ESTIMATED IMPROVEMENT TOTAL VALUATION COST): $ ml� 550.00 _ —_.. - -_-_— ------ FOR OFFICEU : 2) EXCAVATION DATA: 0.0-1 x s 50E.00 DESCRIPTION PROGRESS & INSPECTION STATUS STREET __ NAME ,URFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY STREET 3 4 minus & A.C. `) 1NSP C I R TION —� E I Q U 1__ / / -� ESTIMATED STREET OPENING DATE:._.-�. 12. S/ �7 / 92 _ T E —"" ESTIMATED STREET CLOSING DATE: �--- D -----_—_ -- s-s-- STREET (3) SECURITY NO. ,_ _ SECURIT AMT.: $ 5`�0•UO-- CLOSED _ FINAL �O SURETY CO.: _ -- -_ INSPES CE.N TIF III D CHECK CASH O GOND '' i _ �^ SPECIAL PROVISIONS /C DI IONS: �4) PLo T PLAN: INDICATE SITE PERTINENT PHYSICAL 1 NAL PR City jttlipec 1 I Carl Vieweg FEATURES; EXCAVATION LOCATION AND FXTENT. 1 639-4171 24 hours before starting. 1 Ik 1 I 2. All work shall .:a1fOrm ho wor . ( I r• II City Standards & Specifications. I I - - ----- --- -- -- r I - { 541-.571 applies (re - - / l'�tS 757. :_ URB 40 utility prelocation, etC.). S.ti. 100th Avenue q• Traffic control Mall be provided _ for, by contractor. Street closur-4 aye - � � u , �' •_ - - - - - -� r� y ^ _ is not allowed. — I > i Rworksi-i i 5. A hard surface patch is required ill.view 5 . ) ) at the end of each days work 1 a ( (101:30 .>w H I _ I _ _ (5) 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 WITH ALL PERTINENT LAWS AND CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CI'rY AND EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS f � / APPLICANTS SIGI,:ATURE _ .DEFINE:entrct=case->eng definition incorrect ENGINEERING PERMIT PERMIT #. . . . . . . : ENG92-0004 DATE ISSUED: 02/13./92 By: PRIM. PZR.MIT #. : ENG92-•0004 v� SITE ADDRESS. . . : 10130 SW HILL VIEIr; ST PARCEL: 2S102CC-02300 :UBDIVISION. . . : FRELEON HEIGHTS NO.2 ZONING: R-3.5 ELUCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :8 ------------------------------- --------------------------- ----------------------- PERETT TYPE. . : SOP IMPROVEMENTS QUANT RATE VALUE AGREEOENT DATE: / / GRAD/EROS ASSURAN^.E EXPIRATION--- STREET PERFORMANCE: / / SAN SEW MAINTENANCE: / / STM SEW UTILITIES ALL OTHER TOTAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ Remarks: STREET OPENING,TO INSTALL A SANITARY SEWER LATERAL. Permittee: --------------•-- FEES ---------- ---- KENNEDY PLUMBING type amount by date recpt 13985 SW FARMINGTON RD. , OPEN $ 22 .00 JSH 02/11/92 223108 BEAVERTON OR 97005 Phone # : (503) 643-5535 Engineer: ENGINEER NOT ON FILE $ 22 .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. Hail 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 FOR INSPECTION, CONTACT: ----GRADING----- Car.1 Vieweg #639-4171 (office) --REPR' S/ADJ,S-- CONTOURS #780-26,17 (mobile) DRAINAGE ----PATHWAYS---- EROSION CNTL. • r CITY OF TIGARD OF PPYMENT RECEIPT NO. :yE-EE311218 CHECK AMOUN- TC50. ze NAME KENNcLY rZILL,fe$ING CASH A!,"OI:N" c. z ILI AD.. 413985 SW FARMINGTON RDE L C . : 1i��: AYMNT A-� 4' B W 8:)I BEAUERTON, O; 97001- F- -��= .Sc AMOUNT PAIL: -�� :�_= Or =AYMENT ='UBLIC :MPROU ?E. 00 LUSTO�''ER DEC=O 'ERM I T =.+c 7-S FIX KENNEDY Pf-UMBING, INC. FUM WIEWTa-M Du= or, , VIA 5178 13W5 9r. FAR"MCI(OM Fr. ^1. 5ty-443-5335 t�.�o►1 NIUS BRAW31111 eEAVEM OW, (M V?W PORnAM. t>A Or zv-a-ttao :)7/9- .5176 as+44.41== I E SFE.', F:F"'� CIT `,F p .0. SOX IS QM 2:-L ? ? 8 al ��