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7125 SW HAMPTON STREET FILE NO. _]� HAMPTON ST. •- 7125 STR. OPN. PERMIT '-!Ay 23, 19130 'north's Plumbing Inc. 17120 SW Shaw Street .,eaverton, OR 97005 ,"I"A 3ond SA32629 gentlemen: ]?lease find ealloapti lion-1 the of Tila-id is rilleasill, to make R s-ut (n street v41 iiis -..III 1 '125 TI ll&iptoi, 'ripar.-Y, tyre mon Thank yoti for yolir co—o}-arlitio-i .:ittar. Yours tvijy, Public RT,Tipjr Enelt APPLWATION - STREET IMPRC •MENT/EXCAVATION COPY TO: ❑ (WHITE)-FILE ORDINAI.CE NO. 74-14 ❑ (BLUE) -INSP. ❑ (VELLOW).OTHER AGENCY (INSTRUCTIONS ON SEPARATE SHEET) ❑ (PINK)-APPLICANT APPROVED ❑ Ar'r,..ICATION NC.: J la — NOT APPROVED ❑ CITY OF TIGARD, OREGON FEE IMT.: S TS_T_-_�__ _ PENDING FEE.PMT. ❑ CITY HALL RECEIPT NO,: /`� d PENDING SECURITY ❑ PUBLIC WORKSDEPARTMENT BY� A= = DATE Z/ PENDING AGENCY "OK" ❑ Application and Progrcae Record MAINTENANCE BOND �3,F MSZ PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REOUIRED ANNUAL ❑ PENDING VARIANCE ❑ EXPIRATION D)kTE:VIA— PERMIT I1" NO.: _L� ?� `DATE ISSUED: ��.__ 1.�' 1�..5� . BY: �- VIA— ' -----_� �J -- -- (1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL __fir._ __ _ __ AS DESCRIBED HEREIN, IN FULL At ZORDANCE WITH CITY REQUIREMENTS. APPLICANT No_>Fth f a Plumbins Inc., 1712D S.W.Shw St., Beaverton, Oregon, 97005 (049-% NAME ADDRESS CITY PHONE CONTRACTOR As Abave ____-_. __._.- -�_-__ NAME AD'DR ESS CIYY PHONE PLANS BY NOME - - ---ADDRESS CITY P HONE ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ _ 1m•0 DOLLARS �� (2) EXCAVATION DATA: ? FOR OFFICE USE: - - - nMiN. -"/ O 0.02Xi 06ac =S STREET DESCRIPTION PROGRESS & INSPECTION STATUS NAME SURFACE CUT CUT CUT I MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY TYPE LENGT ., WIDTH DEPTH ITEM R QUANTITY Iv a t0l1aoRhul _ 2ft. WI 6 rt. Carr iron ft. STRNED — 94'1 C- B ON �r •.�Y C�i �E' Q u _ ESTIMATED STREET OPENING DATE: Or.-L15 1 1 S _ ESTIMATED STREET CLOSING DATE: Alta / 15 i 1 T B E D (3) SECURITY NO. ._.,�! � SECURITYAMT.: $ CLOSET SURETY CO.:Q- '0401?lr-'040la =Nt-oyo�u C O,- FINAL C RTI FI :0 GHECK 1 CASH ❑ YONn rV INSPEC. (4) PLOT PLAN: INDICATE S:TE PEI-.TINENT PHYSICAL SPECIAL PROVISIONS/CONDITIONS. FEATURES: EXCAVATION LOCATION AND EXTENT. 0 (F) NOTE THE CITY OF TIGARO DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE RIGHT-OF-WA'/ JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE CF OREGON. THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PEi1TINfNT LAWS AND CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLlSS THE CITY AND EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS. APPLICANTS SIGNATURE: n DATE— FAR, APPLICATION — STREET IMF `VEFAENT/EXCAVATION COPY TO: n IWHITEI- FILE ORDI..ANCE NO. 74-14 ❑ (BLUE) - INSP. I (IoSTRUCTIONS ON SEPARATE SHEET) ❑ N ) OTHER AGENCY A D IPINK)H) -APPLICANT APPROVED ❑ APPLICATION NO.: .OT APPROVED ❑ CITY OE •I IGARD, OREGON FEE AMT.: : PENDING FEE PMT ❑ CITY FIA1.1. RECEIPT NO.: PENDINGSECURITY (] PUBLIC WORKSDEPARTMFNT' Bv _______ PENDING AGENCY "OK" ❑ Application and Progress Record MAINTENANCE BOND PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED ANNUA:- PENDING VARIANCE L�I EXPIRATION DATE: L--.__— PERMIT NO DATE ISSUED: /_ BY (1) APPLICATION IS HEREBY MAGE TO EXCAVATE I OR AND INSTALL _ AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS. APPLICANT NAIVE. ADDRESS CITY CONTRACTOR NAME _._._-._- ADDRES! - __ CITY PLANS BY NAME - --. ADDRESS _—_._--_ -_._-___--_- CITY —_. PHONE ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ DOLLARS (2) EXCAVATION DATA. Fall-oFF1c�j�qu��s��jj MIN. _- _ 0.02X $1 V� = f — STREET DESCRIPTION PROGRESS & INSPECTION STATUS NAME FURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY STREET -- PENED iNSPE - _ R TION d� — — E Q U E ESTIMATED STREET OPENING DATE: .-___�.__—L---L._ —_--_ S T -- ESTIMATED STREET CLOSING DATE: _—_� � � _.. E (3) SECURITY NO. SECUR;TYAMT.: $--. cLasEo __ _ SURETY CO.: __. FINAL CERTIFIED CHECK U CASH ❑ BOND INSPEC. _ (4) PLOT PLAN. INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS /CONDI-IONS: FEATURES: EXCAVATION LOCATION AND EXTENT. — _— ` ---�- - 1 mow,- I 1 P w� 'r w. � � .�. �_- w .... .�� ► �� 7�� -_ __-- 1 C5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WH17RE RIGHT-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR THE STATE OF OREGON. THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND f'ONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS APPLICANTS SIGNATURE _ DATE. _— IL__. CITY OF TIGARD--12420 S.W.MAIN—TIGARD,OREGON 97223 RECEIPT DATE:- --— �� hF' " 7E AMOUNT:$-9-j�—LR- ----DOLLARS ' NAME EL ,_ _ CASH: ` ADDRESS: !L70 a M.O.:- j 0 OF — FOR: ACCT.• PERMITS SURCHARGE AMOUNT r I SEWER BILLINGS 40-364 BUSINESS LICENSE 05-331 PLUMBING PERMIT 05-332 MECHANICAL PERMIT 05.332 BUILDING PERMIT 05-333 SEWER CONNECTION 40-363 SEWER INSPECTION 40-365 SYSTEM DEV,CHARGE 25-366 PARK DEV.CHARGE #1 30-367 — f� PARK DEV.CHARGE #2 30-368 _ ZONING ADJUSTMENTS 05-362 -- -^ — TOTALS RECEIVED BY PERMIT NUMBIRE AlSIONID: Numbw Amount _Number Amount Number_ Amount is t . BOND BOND # SB 32629 FuNOW ALL bTN BY 'D IFSE PP.ESI' 7S: That w,?, North Plumbing, Inc. , as Principal, and the Oregon Automobile Insurance Company , a corporation oryan.ized under the laws of the State of Oregon , and authorized to transact the business of Surety in the State of Oregon 19 as Surety, are held and firmly bound unto _ City of Tigard, Oregon in the just and full sum of ONE THOUSAND TWO HUNDRED AND N0/100 ------- ( $1,200.00 ---) , for which sum, well and truly to be paid, we bind our- selves, our heirs, executors, administrators, successors and assigns jointly and severally, firmly by these presents. Sealed with our seals and dated this _ 14th day of _November 19 78 THE CONDITION OF THIS OBLIGhTION IS SUCH, THAT WHEREAS: North Plumbing, Inc. _ has made application for a permit . to make a cut in street & install sewer at 7125 SW Hampton, Tigard, Oregon. NOW, THEREFORE,* If the said Principal shall abide by the terms of said permit, then this obligation to be void: otherwise, to rem-iin in full force and effect. s. IT IS AGRFTD THAT the Surety's liability under this bond shall remain in force for a period of one (1) year following the completion of work for which the permit has been obtained. • North Plumbing, Inc. Oregon Automobile Insurance BY: VVJ1 �slon Vick�L. N .cAttorney-iii-fact r O NORTH PACIFIC INSURANCE COMPANY XXOREGON AUTOMOBILE INSURANCE COMPANY Referred to as the Company P.O.BOX 74 • PORTLAND,OREGON 97207 POWER OF ATTORNEY #412 THIS POWER RESTRICTED TO BONDS AND UNDER FAKINGS NOT IN EXCESS CF $ 100,000.00 KNOW ALL MEN BY THESE PRESENTS: That the Company,an Oregon corporation having its principal office in the County of Wash- } ington, State of Oregon, does hereby nominate,constitute and appoint: a U VICKI L NICHOLSON of Beaverton,Oregon its true and lawful Attorney-in-Fact, to execute s?al and deliver for and on its behalf as surety, any and all bonds and undertakings, recognizancet,, contracts of indemnity and other writings obligatory in the nature thereof;which are or may be allowed, required or per- LL mitted by law, statute, rule, regulation, contract or otherwise, and the execution or such instrument(s) in pursuance of these presents, f shall be binding upon the said Company as fully and amply to all intents and purposes, as if the ssrne had been duly executed and ac- ccw knowledged by its regularly elected officers at its principal office. U• This Po%.er of Attorney is made and executed by authority of a Resolution adopted by the Board of Directors of which the following is a true and exact copy: "RESOLVED that the President, Executive Vice-President, Secretary,Treasurer, Vice President,Assistant Vice-President or Assistant Treasurer shall have power ano aut: ority to appoint Attorneys-in Fart, and to authori7e them to execute on the behalf of the Company and attach the seal of the Company thereto, bonds and undertakings, recognizarces,contracts of indemnity and other writings obligatory in the nature thereof, and P / may at any time revoke the authority of any such Attorneys-in Tact." AL�t11TYQflIT1Y4HET6ff CONFERRED SHALL EXPIRE AND TERMINATE WITHOUT NO TICE AT MIDNIGHT OF IN WITNESS WHEREOF, TheCo any has caused these Itj�sents to be signed and its corporate seal to be affixed by its authori7ed officer this 14th day of February _ 19 / O NORTI-I PACIFIC INSURANCE COMPANY 270 OREGON AUTOMOBILE INSURANCE COMPANY (Seal) 1-s Leo A. Cassinelli STATE OF OREGON ) Leo A. Cassinelli , Asst. Vice President COUNTY OF Washington ) ss: On this_.14th day of _EjE�iruary __ , 1977 before me,a Notary Public ;;z d for the State of Ore- gon,personally came Leo�;(d� p]�_� _ ,the individual,to me personally known who executed the preceding instrument,and being by me duly sworn,said that he is the therein described and authorized officer of the Com- pany; that the seal affixed to said instrument is the corporate seal of said Company,and the said corporate seal and his signature were duly affixed by the author`.ty and order of the Board of Directors of said Corporation. IN TESTIMONY WHEREOF 1 have hereunto set my hand and affixed myOfficill Seal at Portland,Oregon, the day and yer,r first 11-inve written. Joan Partee My commission expires: �S� ---�Ldy 17. —• t - Joan Partee NotaryP"b"` STATE OF OREGON ) SS: COUNTY OF WASHINGTON I 1, Neil E. Hokkanen, Jr. _ Secretary of the Company,do hereby certify that the foregoing is a true and correct copy of a Power of Attorney,executed by said Company,which is stii! in ford and effect. IN WI1 ivtSS WHEREOF, I have hereunto set my hand and affixed the*ai of the said Corporation,at Portland,Oregon,this 14tllday of. Nove Ther , 19.78 . O NOR rH PACIFIC INSURANCE COMPANY Q OF EGON AUTOMOBILE 1 SURANCE COMPANY