Loading...
14430 SW MCFARLAND BLVD FILE NO. 3(o5 -�J MCEARLAND SW - 14430 S'I'R. OPN. PERMIT APPLICATION - STREET IMI VEMENT/EXCAVATION PY TO: FILE ORDINANCE NO. 74-14 ( • (YYELLOELLO W)-•INSP. (INSTRUCTIONS ON SEPARATE SHEET) ❑ (PINK)-OTHER AGENf:Y (BLUE)-APPLICANT APPROVEDAPPLICATION NO. + tC� NOT APPROVED \( ' CITY OF TIGARD, OREGON FEE AMT. S PENDING FEE. PMT. ❑ CITY HAL[. RECEIPSp� PENDING SECURITY 11PUBLICWORKS DErARTMENT By DATE - // ' /Q(,7_ PENDING AGENCY "OK" E) Application and Progress Record MAINTENANCE BO"D_M PENDING INFORMATION CJ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED ,7EV-� -�- ANNUAL ❑ PENDING VARIANCE EXPIRATION 9ATEi PERMIT NO.: DATE ISSUED: �s_ 1 t L__ BY (1) APPLICATION IS HEREBY MADE TO ►:XCA'v ATE FOR AND INSTALL _.LI LIKAK,I AS D11SCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS. APPLICANT � 2b G,Ni_ -9440� NAME ADDRESS CIT MHONE CONTRACTOR `S NAME -'---ADDRESS CITY ��i FHONE PLANS B Y _>i'.—� ; _3C t �� NA E ADDRESS �� -"""" ►HONE ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): Z DDLI.ARS ---- ---- Ft H OFFIC[US[-_Gp!M MIN. (2) EXCAVATION DATA: non .. , _ZQQ-s_ _ - _ STREET DESCRIPTION PROGRESS & INSPECTION STATUS NAME SURFACE CUTJIVIDTH CUCUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY i_ TYPE LENGTDEPTH ITEM !! QUANTITY STREET OPEN / T ��' ' tr - F TION -- �►t EQ U ESTIMATED STREET OPENING DATE �_ / �� / ��G S ESTIMATED STREET CLOSING DATE L / TE STREET (3) SECURITY NO. SECURITY AMT: S c1.osFD SURETY CO . - _- - --- - ' FINAL ceRnFlEu c.r�ecH n CASH eDNo INSPFC. (4) PLOT PLAN INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONZ/CONDITIONS: FEATURES; EXCAVATION LOCATION AND EXTENT. 1 1 I I d 1 I I 1 1 1z �!J � e- X13 10 11 1 1 1 1 URB - r _ _ - _ .. �< \ Cti<s7/LtC. c -rci cCJC►1 j= Alf y �-.,ary'l ••�- TO %A I ,1k�F' - I o 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 WITH ALL PERTINENT 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. f., APPLICANTS SIGNA r�`RE CITY OF TIGARD mwimI'IURE RBwEsr This form is a multi-use form. Appropriate receipts rust be attached. Documentation is inport-nt for all purposes. Staple documentation tc form. Vr14DOR NO. : [LATE: - Cl - O PAYABLE 2t7: � j1/� y� ,,��, F��� I2I7�2UFS'i�71 BY: _ —— '- r Ac"', ----- _SCO, - -� 0 C�4 4 __ * Approved request due Wednesriay `t'727-3 T 10:00 AM to A/P for checks by Friday. MISCELIANBDU.S F.XPEND17I=: Date Description, Invoice No., etc. Account No. Amount rLZUOO _ Z ZCJIAL — JL Mileage $0.255 APPROPRIATION BAIANCE: -_ _ AS OF: SIGNATURE: (Up to $25.00) Section Manager . Purch. Agent .._-_-- ($25.01-2,500.00) Division Manager ($2,500.01-7,500.00) Dept. Head ($7,500.01-15,000.00) City Achi nistrator ($15,000.01- ?) Local Contract Review Board ke/1501F APPLICATION — STREET IMI VEMENT/EXCAVATION j(WHTTE) Py O: ORDINANCE NO. 74-14 -FILE (YELLOW)-INSP. (INSTRUCTIONS ON SEPARATE SHEET) ❑ (PINK)-OTHER AGENCY 114(BLUE)-APPLICANT APPROVED APPLICATION NO. (G/- .'VDT APPROVED ❑ �'II ti� ��1' 'I((,ARI), OREGON FEE AMT.: E PENDING FEE. PMT. ❑ ct'fY IIALL RECEIPT, 4O,: _. j b ""?c)0 PENDING SECURITY n PUBLIC WOR KS DEPARTMENT nY-- DATE "1 /�L 0 PENDING AGENCY "OK'' ❑ Appli•.ation and Progress Record _ `+� _ - - - - - - - MAINTENANCE BO(VDf PENDING INFORMATION C7 FOR STREET IMPROVEMENT/EXCAVATION As HF(,UED J. �'��� PENDING VARIANCE (] ANNUAL EXPIRATION 9ATE PERMIT NO. DATE ISSUED: BY: ""`�-.•- �_ — -� (1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL �._ _ Lit, AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS. �� 97"124 APPLICANT _ - f IQ 15� ` �� 71� M(�F�� al��.77WRb 4zo-s144o NA ADDRESS CITY P ONE CONTRACTOR - COMBS� - NAT1�T!— ACITv 'PHONE PLANS By --_..""--. Cie =1%[5�1L NAME ADDRESS CITU NONE - COLLARS ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): E 200) -- .---: - COLLARS (2) EXCAVATION DATA: _ nolo oeFicF use- _•� -_- MIN-= o.04 X S STREET DESCRIPTION PROGRESS & INSPECTION STATUS NAME SURFACE CUT CUT CUT MATERIA(_ INSTALLED TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY ITEM DATE REMARKS/TYPE BY n _OPENED STREET a Y,1�"'�k P E N E D 6 Z- r 1 - l i j f (1 R If 1 /Z TION U _ ESTIMATED STREET OPENING DATE: 1-21 f '!;P© E S ESTIMATED STREET CLOSING DATE: — ( 31 SECURITY NO. W_ SECURITYAMT.: $ 'ZOO `"'� STREET >L.. i:LOSED SURETY CO. _ FINAL -- --- - 1F-xw cr.RTlrlra cHECH �" CAS- BOND [ INSPEC. (C Z� QO � (4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL r_ SPECIAL PROVISIONS/CONDITIONS, FEATURES; EXCAVATION LOCATION AND EXTENT. 4 412P/ CURB - ,— It. URA ,_ t_:0 Ap III t ✓ (S) NOTE THE CITY OF TIGARU DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANT$ 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 CITY AND EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS, APPLICANTS SIGNATURE DATE 1 INSPECTION NOTICE City of Tigarc Ading Department P O Box 2.3397 Tigard, Oregon 97223 Phone 639-4175 Type of Inspection — Date Requested Time A._ .__P.M. Address —_ Permit Owner � s:'Y>`_.�►yf� ��_ Lot #_ Budder '� ✓ — _ _ The following Building Code deficiencies are required to be corrected: v�J Presented to _ — Approved Inspector ,,. (� Disapproved at CALL FOR REINSPECTION ❑ YES C-I NO 24' - 0" MAX. 12' - 0" MIN. _ DRIVEWAY R/W LINE A -- --�-- w —CONTRACTION JOINT OPTIONAL Q SIDEWALK > LOCATION B SIDEWALK EXPANSION JOINT '1 8 EXPANSION JOINT �-- CURB JOINT A _. 3' ' 0 6' -0" MIN. 12' -0" MAX. 6' - 0" MIN. 12' 0 MAX i FACE OF CURB SIDEWALK ADJACENT TO C JRB SIDEWALK AWAY FROM CURB PLAN 1/2" EXPOSURE USE EXISTING EXPANSION OINT ELEVATIc�N Q-6 1!_AC OR SAWCUT AND P!_ACE COLS JOINT. --� SEE DWG. NO. CS••306, STRFET -- COMPACTED SUBGRA13 2" OF 3/4" MINUS SECTION A—A NOTES I- CONCRETE SMALL HAVE A MINIMUM BREAKING STRENGTH OF YXJOl0S.I. AFTER 28 DAYS , 6 SACK MIX. 2. CURB JOINT S14ALL BE A TROWELED JOIN1 WITH A MINIMUM 1/2" RADIUS ALONG BACK OF CURB. 3. EXPANSION JOINTS SHALL BE 1/2" PRENOLDED ASPHALT IMPREGNATED MATERIAL OR EQUAL , EX TENDING FROM SUBGRADE TO FINISHED ORADG . 4, SEE DWG. N0. CS--300 AND NO. CS-305. WASHINGTON S-305. WASHINGTON COUNTY DEPARTMENT OF LAND USE RESIDENTIAL DRIVEWAY AND TRANSPOR''ATION DATE CIdI�MV1EE� DRAWN APWA NO. WAW COUNT NO. Q ' '�!•••,.,,, ACA b 65 NONE DW-- 200 01- T I G P R D F E C E I P T 0I= ,,I r fJ 0 (j 0 H--Z 1 206 OC. f,D r,E z—,IS MOFENC. FEED OR JEwN Wic)UNI* 0: 00 F-'-O. BOX 230044 1 E r1j I POFTLAND, OF 57-723- FIJI-4 POSE OF PAYMENT AMOUNT PAIDJ-UIQ; -C 5-90 E.00 oc, ;'LDTitL A110(JN1- PAID 208. 00 F & M INDUSTRIES FEAD OR JEAN MOnENO 9777 P. O. BOX 230044 PORTLAND, On 91223 24-2011/1230 "AY '0 THE )BOER Or 711 s " A R S Key nmnk Heowtm Off FERD OR JEAN MORENO BANK4735 9W Hall Riv ip P.O.Box zype 0savotion,01`19 5 usnirik"') 0 711• i! Lpinn pnLLi: np. Lntn ? quo