7095 SW SANDBURG STREET-1 w,
FILE NO.
SANDBURG ST. - 7095 STR. OPN. PERMIT
NSTNN PIRSTPUE _ A 110211 LIE"TIr1r.r�1 CO VM aa Rj [M�DCTMr�L
8001 S.E. Johnson Creek Blvd. Portland,Oregon 97206
503/777.1471 DATE
nTTENTIbrI JOB NO
11/9/78 1055
TO CITY OF TIGARD RE
Bob mpson
P.O. Box 23397 Fewel Comer Building
Tigard, Oregon 97223
GENTLEMEN:
WE ARE SENDING YOU XXI Attached ❑ Under separate cover via the following items:
❑ Shop drawings ❑ Prints ❑ Plans
❑ Samples ❑ Specifications
❑ Copy of letter ❑ Change order U Cop of bond
COPIES DATE NO. DESCRIPTION
1 11/8/78 6336864 Copy of Bond to obtain driyeway permit for Fewel Comer—L142.
THESE ARE TRANSMITTED as checked below:
❑ For approval El Approved as submitted
❑ Resubmit—rr)pies for approval
Q�( For your use ❑ Approved as noted
❑ Submit--copies for distribution
IgI( As requested ❑ Returned for corrections
❑ Peturn_ corrected prints
❑ For review and comment ❑
❑ FOR BIDS DUE _ tg 0
REMARKS_ ___
COPY TO_
SIGNED:. Beta-Wol lam, Asst, Operatior,_Mgr.
If encloluret ars not W rioted,kindly ratify is at once.
rrfran
,,GENERAL FORM Bond No. 6336869
i
eFIREMAN'S r.R(AAN S.UNOINRURANC[COMRAN.
� FUND 7N(AM(RIC AN INSURANC[COMRANT
NAtIONAL SUR[T1'CORRORAIION
AS[OCIAt[O INO(MNIit CORRORAlION
.,
\ AMERICAN AMIRICA N AU TOMOeIL[INSURANCE CO.—,
1 I N SU P ANC E COM PAN 1 V.3 NOM[OrrICt SAN VPANCISCO,CALIrORNIA
11
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I
KNOW ALL MEN BY THESE PPESENTS,
That we, ._YESTWQ_Qk-CONSTRUCT.]AN C0. .
(hereinafter called Principal),as Principal,and_FI$EI [�_ .� ...hVSUR1INGFiSOMFANl' a corporation organited and doing
business under and by virtue of the laws of the State OiCALUOVr i),,,�,and duly licensed for the purpose of making,guaronleeing or be.
coming sole surety upon bonds or undertakings required or authorised by the laws of the State of
_ (hereinafter called Surety)as Surety,are held and firmly hound
unto
hereinafter called Obligee) in the lust and lull
sum Of ONE THOUSA.4D FIVE HUNDRED__AND_NO _)
L�T!{5=-_-'^_'-__-r_---c Dollop (/_1,500..OD�
lawful money Of the United Stoles at America,for the payment of which.well and truly to be made,we hereby bind ourselves and our and
each of our successor and assigns, jointly and severally, firmly by these presents.
THE CONDITIONS Or THIS OBLIGATION ARE SUCH THAT, WHEREAS,
3 the above bounden Westwood Construction Co. has requested or obtained a permit
from the City of Tigard In connection with Ordinances 74-14 and 76-11 for
installation of driveway at 7095 S. W. Sandburg Road, Tigard, Oregon.
NOW THEREFORE, if the said Westwood Construction Co. shall comply and faithfully
perform the work in connection with said permit, then this obligation to be void;
A
1
otherwise to remain in full force and until one year atter the date of the
issuance of the permit.
IN WITNESS WHEREOF,said Principal and said Surety have caused these Prenents to be duly signed and sealed this
day of _�_ November � I91.@_
WESTW/yy��l3ICJNS1 UC CO.
FIREMAN'S_F-UND_INSURANCE.COMPANB__-- -
S—Iy
M. H. Webb AilerniyIedoel
scaxautc LfL)Ilr1rTD sr '
A/rr) Wiff-H PECCtAL)DµAlf.TO
LJ
GENERAL POWER OF ATTORNEY
FIREMAN'S FUND INSURANCE COME'ANY
[NOW ALL MEN BY THESE PRESENTSt That FIREMAN'S FUND INSURANCE COMPANY, a Corporation duly organized and ext nling
under the laws of the Slate of Coldornia,and having Its principal olfice In the City and County of San Francisco,in said Slate,has made,
constituted and appointed,and does by these presents make,constitute and appoint
----M. H. WEBB-----
PORTLAND, OREGON
its true and lawlul Allorney(s)-In-Facl, with lull power and authority hereby onferred In its name, place and stead,to execute, seal,
acknowledge and deliver any and all bonds, undertakings, recognizances or other written obliga—
tions in the nature thereof
and to bind the Corporation thereby as fully andto the same extent m II such bonds were signed by the Resident, sealed with the
corporate sed of the Corporation and duly attested by ILL Secrelory, hereby ratifying and confirming all that the sold Allorney(s)-in.
Fact mm/do In the Premises.
This power of attorney Is granted pursuant to Article Vlll, Section 90 and 91 of Bylaws of I'IREMAN'S FUND INSURANCE COMPANY
adopted on the 19th day of November, 1965.and now In full force and effect,
-Article Vill, .letrint.,ret ..d .lalA.,tiv d Neddrsl .1sNatee1 Arrrrloirr, sed Alto...#401'ort ..d 'farem to .crept Iwod Prsdrss end Valid
ASJ•eronru, '�. r• �
S.:non YO 1 ,nter.rt.r. Thr Chairman of the Beard al ppirectum t • Ptesidrpl.any Vice•Prosldrnl ur any other oetgon quthorisod by Ihr Booed
91 0—o.rs.Ihi�.t'�auman al the Board est Daecicn the Pusnlrnt m any Vice-Preudenl i—it.from time Io:ime.nppemr Pool eat Asuuanl Secretr res and
Altom.yo in Fact to npqum and act for and an be{talf of U,.Corocration and Averts to accept legal procoti and maks appoarancss let and on arhall d
11,4 Cotmrin..&
S.ction 3I .I nrh,,.+rv. Thr Awborny of wch Peud•nt Asenwnl Socretnrtes. Mameyo m•roci,and Agrnls shall be no prescab.d In the Instrumnnl
rrtd.nctnq thea apppmtmrnl,and any such appointment and all nuthmil0 utonted tturoby may be revoked at any rime by the Board at Dirodriro or
by any Astoria empsiwor.d Io make such arrairnmetir
1
Thispower of attorney is signed and sealed under and by the authority of IIIc following Resolution adopted by the Board of Directors
of FIREMAN'S FUND INSURANCE COMPANY at a meeting duly called and hold an the 15th day at July, 1966,and that said Pesolution
hats not been amended or repealed:
"RESOLVED, that the signature at any Vice President. Assistant Secretary, and Resident Assistant Secretary of this Corroralion, and
the seat of this Corporation may be alfixed or printed on any power of attorney, on any revocation of any poyesr of altaincy, or an
any certificate relating thereto, by facsimile, and any power of attorney,any revocation of any power of attorney,or carllficale bearing
such Facsimile signalure or Facsimile seal shall be valid and binding upon the Corporation"
IN WITNESS WHEREOF, FIREMAN'S FUND INSURANCE COMPANY line caused thenar presents to be signed by its Vice-President,
and Its corporals seal to be hereunto affixed this, 201:11 day of. _P1dTGff19_1-L
q"' d X. A1'8 FUND INS R�EECCCOOMM'PANY
JAMPS 11.WELLS,Vkv-Prdoldesl
STATE OF CAUFORNFA,
CITY AND COUNTY OF SAN F'RANCISC.O ev.
On Ihb_29t.h_day,oL- _March__ _ 1915_., before are personally came James H. Wells, to me known, who,
being by mJ duly sworn,did depose and any that he is Vice-Resident of I'MEMAWS FUND INSURANCE COMPANY, the Corporation
des:-rtbed in and which executed the above instrument; that he knows that seal of said Corporation; that the seal affixed to the said
instrument Is such corporals seal; that it was aro ala:ed by order of the Roand at Directors of said Corputatfon and that he signed his
name thereto by like order.
IN WITNESS WHEREOF,1 have hereunto met any hand and affixed any official seal,Iha day and year herein Real above written.
H.ulwunuumuwnunuuuno111nat rnennnl�
m 6RADY NEWBERRY
NOTARY PUBLICCAUFOR—CALIFORNIA
J:Cut CITY I COUMV OF SAN r1 OSto - � _i AUT NLWK:AA. ate PPublie
kyr CwttwMsbn wins fop.it,1416
�11r1rtr11i11111Utr1111IM/IrJ111111/IN1r11/I/IUMll IrO CERTIFICATE
STATE OF CAIJFORNIA,
M.
CITY AND COUNTY OF SAN FRANCISCO
I Ihr err 1,rt,gn•J A:vrtani Secrebny of 1`101:MAWS FUND IW,'UNANCE COMI'ANY, a CA1.I1-011NIA Curlwr•aiml, DO HFNCRY
C I III Wy d,n rtes• I ,-:I •Ind utter h•"1 I-iwi R or ATTnlltlt:v n:,•ro i,, t„'I I ac. nrrl h t. cwt houn tev„k A. and htriL•nroor”
.t' ... ., 1 „ , ,t,., I,y Ir 1 „�� ., ,,. I, ,, „ I' 1..,,. I ' .+r• tet, nl l,uit. „�.,
•i •x„ ..•t.,i •y r. Ir'y' r •.•, t r, 8th t..V .t November :7B
•,Ai._cam• WINif(U:D N.BHOWNE,Mwlanl Wcnlery r
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APPLICATION - STREET IMPRC RENT/EXCAVATION COPY TO:
ORDINANCE NO, 74-14 El IWHITE)-FILE
❑ lewa►-INSP.
(INSTRUCTIONS ON SEPARATE SHEET) ❑ (YELLOW) •OTHER AGENCY
`/ ❑ (PINK)-APPLICANT"
APPROVED 7E APPLICATION NO.: -,Zf
NOT APPROVED U CITY OF TIGARD, OREGON FETE AMT.: $
PENDING FEE. PMT. (] CITY HALL RECEIPT O.: ---� 7
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY _ DATE �� / 7/ :Z
PENDING AGENCY ''OK" ❑ Application and Progress Record
PENDINI, INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION MA'ASEREQUIREDON o*
ANNUAL O
PENDING VARIANCE EXPIRATION GATE:
PERMIT NO. % '7� ZS:- DATE ISSUED: . �__LL--3L � _ , BY: _ i ,�a�! •-`.
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL
----- _ AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT �Lc-'E1.
MAMF- ADDRESS / �CITY PHONE ---
CONTRACTOR 1�L= i L�u� D f> _ elfe-1 St �j/1n.l0") C41 j,Z,Q f(-
A ADDRESS CIT\ ONR E T-
PLANS BY
NAME ADDRESS PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): S /25-0 .. ZL--tt:f0
DOLLARS
(2) EXCAVATION DATA: FOR OFFICE USE:
_ 0.02 X f = S
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITLM 8i QUANTITY
STREET
OPENED_
N.. G
TION
F
n
U _
ESTIMATED STREET OPENING DATE: / -L__— S
ESTIMATED STREET CLOSING DATE: L / �E "-
- D
(3) SECURITY NO. ��p�" STREET
�J1rL�L SECURITY AMT.: E /i Sao �� CLOSED
SURETY CO.: ��tlfAMLi Fes/ ,R.,y�u .� FINAL --
___ _ CERTIFIEDCHECK U CASH ❑ •OND INSPEC.
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS/CONDITIONS
FEATURES; EXCAVATION LOCATION AND EXTENT.
I
1 I I 1
(5) NOTE: THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-LIF-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 ANrI
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
APPLICANTS SIGNATURE '� z DATE / / _
APPLICATION - STREET IMPR( -MENTIEXCAVA T ION COPY TO:
ORDINAi-4CE NO. 74-14 ❑ WHITE) PILE
❑ IoLUEI •INSP.
(INSTRUCTIONS ON SEPARATE SHEET) ❑ IVRLLOW) -OTHER AGENCY
❑ (PINK)-APPLICANT
ROVED Q APPLICATION NO.:
NOT APPROVED CITY OF TIGARD,OREGON FEE AMT. $
PENDING FEE. PMT. ❑ CITY HALL
RECEIPT NO.:
PENDING SECURITY [] PUBLIC WORKS DEPARTMENT BY — DATE I / _
PENDING AGENCY "OK" E] Application and Progress Record — — — — —
PENDING INFORMATION U FOR STREET IMPROVEMENT/EXCAVATION MAI AS REQU REBOND R -
PENDING VARIANCE ANNUAL ❑
_- EXPIRATION DATE:
PERMIT NO.: DATE ISSUED:
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL _
-- AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT
NAME ADORES! -- _
CITY - PHONE --
CONTRACTOR
NAME ADORE59 PNONE--------
PLANS BY
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ T
DOLLARS
(2) EXCAVATION DATA: �^ FOR oFFi a USE,
0.02X9 _=f
STREET DESCRIPTION _ PROGRESS & INSPECTION STATUS
NAME SURFACE CU'f CUT CUT MATERIAL INSTALLED
�— TYPE LENGTH WIDTH DEPTH ITEM QUANTITY ITEM DATE REMARKS/TYPE BY
STRNETD / --P
INSPE -
R TION
E a
QU
ESTIMATED STREET OPENING DATE: / / E
3
ESTIMATED STREET CLOSING DATF / / T
-----�—_ — - -- -- — ED
(3) SECURITY NO. SECURITY AMT.: $ CLROSET
Cq
SURETY CO.: --
-- FINAL
_ __ CERTIFIED CHECK CASH 0 NONO u — INSPEC.
(4) PLOT PLAN: INDICATE SITF PERTINENT PHYSICAL
FEATURES, EXCAVATION LOCATION AND EXTENT. SPECIAL PROVISIONS/ CONDITIONS:
I 1 1 1
NOTE THE CITY OF 'rIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
FLIGHT-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 _� /
I CITY OF TIGARD—12420 S.W.MAIN—TIGARD,OREGON 9722.s
RECEIPT
DATE: _�1=--7— K- __.AMOUNT: S.�O
I _ _
ILLARS
CASH:_
ADDRESS'- ADO/ %� (.Istir.�a r
1 �C. CHECK:.__
i of F
FOR: ACCT. • PERMITS SURCHARGE AMOUNT
SEWER BILLINGS -- f— 40-364
f
BUSINESS LICENSE 05--331 _ —
7
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 — - -
F
I PARK DEV.CHARGE #1 30-361 — ----
PARK DEV. CHARGE #2 30-368
ZONING ADJUSTMENTS 05-362 -
! 3�6 'CEJ
_ TOTALS
RECEIVED BY:
PERMIT NUMBERS ASSIGNID:
f Number Amount Number —Amount Number Amount
S — S RECItPT s
1� /� "� ,
`r
s
l
City of igard �
iNSPECTION REQUEST
for
4SPEr,TION TIME: '+` _ PERMIT NO .
DATE: /71 DATE ISSUED :.
WNFRR
ADDRE S S
ANTRA .TOR
�T
'EST : Air ❑, Water❑ , Visual ,IL aboratory
?ESULT: Approved O nisapp,oved) Pending p
KETCH: ��y,•c��
i
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INSPECTOR DATE
OTE: Attach supplemental telt data beret?]