14120 SW HALL BLVD FILE NO. 2-
HALL BLVD. - 1'411.0 STR. OPN.PERMIT
APPLICAT:vN - STREET IMPR EMFNT/EXCAVATION COPY TO:
(WHITE)-FILE
ORD;N,.,4CE NO ?A- '4 ViOLUE, -INSP.
E] IYELLOW) -OTHER AGENCY
(INSTRUCTIONS ON SEPAPr.I"E SHEET) 6PINKI -APPLICANT
APPROVED l APPLICATION NO.: ZT
4
NOT APPROVED [_1` CITY OF TIGARD, OREGON FEE AMT.: S_ !ZV-
PENDING FEE.PMT. ❑ CITY HALL RECEIPT NO.: — sl 4-
✓
PENDING SECURITY ❑ PUBLIC WORKS DEPA R TMEN T BY �N`-- DATE 5
— — — — — — — — — — — — — — — —
PENDING
— — — — — — — — — — — — — —PENDING AGENCY "OK" Q Application and Progress Record
MAINTENANCE BOfID
PENDING INFORMATION Cl FOR STREET IMPROVEMENT/EXCAVATION AS REUOUIPED
ANNAL ❑
PENDING VARIANCE L] EXPIRATION D 7E:
1 1
PERMIT NO.: Z-15'5 DATE ISSUED: ---_s_/ 30/ BY: ._
r>. 1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL
_. AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT ��� , Ste _ l �0 Lc'/��9'/l /y4 �c �� __ G32-
ADD RE CIT / PHONE
CONTRACTOR d'f7�/C�' X'JriC <'-�'io��i. �Cac'ISQL / +Z cC_./ -213 TS,/
/ NAME T
ADDRESS ` CITY PHONE
PLANS BY -_- ' C'
NAME ADDp ESR CITY PHONE
ESTIMATED IMPROVEMENT TOTAL VAL.UA'I ION ( COST): $ (aoo do
Do LLwws
6-12) EXCAVATION DATA. —`u FOR OrprIC s USE:�.p -- - 'Z�IMIN.
_ o. $
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTA]LEtR
DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM AI QUA
•CESTIMATED STREET OPENING DAT.',:— /ESTIMATED STREET CLOSING DATE• ._ _ /✓'(3) SECURITY NO. 7L SE U I YAMT. S �•f��
SURETY CO.: ?et' <N 4r Owls,(,'/ad-c 'w- C-40 FINALT
CERTIFIED CHECK n CAlSH O SON INSPEC. 1,/` ��f �L
1 (4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS/CONDITIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT.wl �—
► wo r s z` cow v w� �4c
/� I S S S Gc. s• �S
---__- -- -- _ _- #CYl-41 't1l
I I ) I
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NOTE THE CITY OF TIGARD DOES NOT, HERESY, GRANT PERMISIIION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATC 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!Y AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE W ICH MAY RESULT FROM APPLICANTS ACTIONS.
APPLICANTS SIGNA rURE G �~ DATE
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GU;T)Mf. BY' L)ONALU 14klb' o.tla..d, OR
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CITY OFT117ARD No 5134
12155 5 VY ASH
P.O-BOX 23397
TIGARD,OR 97223
Name
'Address
Lot "-ap---- Subdivision/Acldress
-.
Peri;lt i7g Bldg Cash Check
Sewer b1her Rec B
Acct. No. Description Amount
10.432 Bulkjlrlg P,--t Fps'''
10-431600 Plumbing I', , I I rq,!, --
10.431-601 Meclia—nicw ; i ern
10.230-501 State Bldg 7a-
10-433 Plans Check Fe#�
10.435 Other Licenset, b Pf?rrmlF,
30443 Sewer Connection
30.444 Sewer Inspect-i-on
24.448 Street Syst Dev Cha-r-go
25.449-610 Parks�—Syst---Dev- Charge
25449-620 Parks 11 Syst Dev. Charge
31.450 Storm Drainage Syst Dev Charqv
107Z0-—' Business Tax
I0-434 Alarm Pe-f IM,I
10-227 sail
10-455- Fines - Iraffic/Misd/ParPing
10-230- CPTA Traffic/Mtsd/Vic. Aent.
10-456 Indigent Defense
30.446-401 Sewer Service/USA
30-446-402 Sewer Service/Clly
31-447 Storm Drainage
-40-475 Bancroft Prin. Pymt.
40.471 Bancroft int. Pymt,
10-451 Ot er aarges for Services
ToirAL P,
DEPT.
r—
PLEASE TAKE. THIS TO THE CASHIER FOR A RECEIPT
NAME: '�1r� �-1y�S i-+=`..'.'_� - _ --- DATE - 5 --so
ACCT. M DESCRIPTION AMOUNT
10--220 Refundable Performarvice Bond Deposit
10-435 Sian Permits _ HOP TU
10-436 Public Sewer Plan Check Ins ectiion Fee -s
10-436 Public Storm Plan Check/Inspection Fee s_
10-436 Street Dedication/Public Improvement Fee s _
10-436 Street Opening Permit # Zi 5S -_ 4 Z'4
10--440 Subdivision Applications:
- ----- o _—MLP -
10-441 Zoning Applications:
ZC CPA ZOA PD Misc
SCE -- CU SLPy
21-442 Street Light
10-451 Document Sales :
Engrg. P anning Bldq_______
10-451 Street and Traffic Signs
10-451 Land Use Actions/Fees: SDR
TOTAL s z�
(1045p)
May 21► 1987 CI E i ®F TIIFA RD
OREGON
25 Years of Service
1961-198
Northern Home Improvement
600 S.W. 10th
Portland, OR
Attn: Mr. Donald C. Lambert
RE: Street Opening Permit No. 215-85
Gentlemen:
Enclosed, please find the original performance assurance bond #SB 44728
for the aforsaid project. All work has been satisfactorily ccmpleted
and maintained for the required period of time. Northern Hone Improv-
ment/Mr. Lambert's obligation hereinregard is fullfilled.
Sincerely, 1
-:-
/JzS. Hagman
Engineering Technician
cc: Oregon Automobile Ins. Co.
13125 SW Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223 (503)639-4171
OREGON AUTOMOBILE INSURANCE COMPANY
HOME OFFICE • PORTLAND,OREGON 97207
Bond No. SB 44728
KNOW ALL MEN BY THESE PRESENTS: That we, DONALD C. LAMBERT DBA: NORTHERN
HOME IMPROVEMENT , as Principal , and the OREGON AUTOMOBILE
T-N UP/',NCE C !1P , a corporation of the State of Oregon, lawfully doing the
business of Surety in the State of Oregon; as Surety, are held and firmly bound
unto CITY OF TIGARD, OREGON, as Obligee, in the sum of
SIX HUNDRED AND NO/100-------------------------------- (t 600.00-------
or tom-ti�icFsurn weII and truly to-be-pa1d-web dun ourselves , our heirs, executors,
administrators , successors and assigns , firmly by these presents.
IN WITNES') WHEREOF, we have hereunto set our hands and seals this 28th
day of May 1985 _
THE CONDITIOfIS OF TRIS OBLIGATION ARE SUCH , That WHEREAS, the above bounden
Principal is desirous of obtaining a permit in accordance wrth Ordinance No. 76-11
of the City of Tigard, Oregon for construction in a public right-of-way, to w—
it;
S.W. Hall , Tigard, Oregon
o� r-t-1e period beginning t 1c 28th day of May _, _ 1985
NOW, THEREFORE , if the said Principal shall , during the continuance of the
term for which said permit shall be granted, faithfully observe and honestly comply
with the proviFions of said permit and restore said right-of-way to gcod or better
condition as e; isted prior to said construction, then this obligation shall be void
and of no effect, but otherwise to remain in full force and effect.
l !P AGGREGATE LIABILITY OF THE SURETY HEREUNDER shall in no event exceed the
pentaly of the bond as stated above. The surety may cancel this bond by giving 10
days written notice to the Obligee, the Surety, however, will remain liable for any
default occurring during (lie period up to the expiration of said lO days notice.
DONAW C. LAMBERT DB NORTHERN HOME IMPROVEMENT
'f'
Pri-Jpal
OREGON AUTOMOBILE INSURANCE COMPANI'
JDarl r'aT , t Orney in aCt