6601 SW OAK STREET FILE NO.
OAK ST. - 6601 STR. OPN. PERMIT
I
CITY OF TIc,ARD _
DTUMIT=, REQUEST
giiir form is a multi-use form. Appropriate receipts must be attached. Documentation
i..; i M Cant for all purposes.- Staple documm- tation to form.
VENDOR NO.: _e DATE: — 9 ---
PAYABLE TO: _ M,1 z v� S,�or rn Cov sLa _ RE)N( S`I'ED BY: --
_S SC. Iti,wwZIZ —��
Approved request a Wer3r)iasday
10:00 AM to A/P for checks by
Friday.
MT.SCELIANEOUS UTENDMURFS:
Date Description, Invoice No., etc. Acxx mt No. Amount
�.�'UfJ� . .. ��.s�.lra.v�c.e. �uy �p - ZZU�p_ $ 5l►�
P 44f(p -
C�� P ���g�k z5-s
TOM
Mileage $0.255
APPROPRIA!TlON BALANCE: AS OF: SIGMA=-:
(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 Administrator
($15,000.01- ?) Local Contract Review Board
g1501F
�IISPECTTON NOTICE
City of. Tigard B• ding Departsent
13125 SN Hall Blvd. lard, Oregon 97223
Inspection Line (R/ec-O-Phon" 63975 Business Phone: 639-4171
Inspecti.on:•__��4�
Footing Plbg. Underelab t.:4ch. Rotoh-in Appr/Sdwlk
Found. P1bg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Post/Beam Mach. Rain Drain InaU)At.icm -Plumb.
Plbq. Underfloor Water Line Gyp Bd- -Meeh'
Date Requested: zv -___ _Tines!: AM PH
Address: Permit_ l:
c U
Hu i lder -- —
THE FOLLOWING CORHZCTION`S ARE R2WlR='
e
l -
Inspectors 51. _�L•
APPROVED DISAPPR04APPROVED BUWXCT TO ABOVE
(' "Call For Rainap.
APPLICATION - STREET IMPR '\1ENT/EXCAVATION VCOPY TO:
LE
OR DI N E NO. 74-14 }(�[( •
VR����►[ (YYELLOELLO W)-INSP.
(INSTRUCTIONS ON SEPARATE SHEET) (PINK)-OTHER AGENCY—Bldg
X$ (BLUE)-APPLICANT
APPROVED }S APPLICATION NO.: +91
NOT APPROVED CITY OF TIGARD, OREGON FEE AM r.: fX60'00
PENDING FEE PMT. 0 CITY HALL RECEIPT rl�_!1 -Z!nEr
PENDING SECURITY 0 PUBLIC WORKSDEPA.RTMENT B=_"��u DATE =t_I T /9� w
PENDING AGENCY "OK" Q Application and Progress Record
MAINTENANCE BOND
PENDING INFORMATION ❑ �t
FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED
ANNUAL
PENDING VARIANCE EXPIRATION DAT /
PERMIT NO.: �.�_r�. DATE ISSUED: l_��1_9� , BY:
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL -San-Sew -Lateral &
Mainline Tap _ _ _— AS DESCRIBED HEREIN, IN FULL. ACCORDANCE WITH CITY REQUIREMENTS
APPLICANT -lilaca.__�1�� 1Q4$9 c1 _212 ___-Cl 3?.015 _ 658-35 6
NAME S�bDESS _--___------- --- -- PHONE
CONTRACTOR Timberline Dev. P.O. box 279_ Glads on O$17Q27 _656-_M3___
,_..._.
AM! --- ADDRESS CITY PHONE
PLANS BY—Per Cit Standards S cifications __
�� NAME ADDRESS--- ------- _ -----------QFY u PHONE -----
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $
DOLLARS
!2) EXCAVATION DATA: FOR OFFICE USE.
0.04 x s .ljc=_ = S
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARK,/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY
STREET
OPENED[7E k C Se tache
_
ESTIMATED STREET OPENING DATE: / /ESTIMATED STREET CLOSING DATE: 1 /
D
(3) SECURITY NO. _ SECURITYAMT.: t 1,500.00STREET
_ . CLOSED
SURETY CO.: FINAL I C ,
grAt CHUG K 7q� cnsH ❑ sotvD INSPEC. 17 Wec
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS/CONDITIONS:
FEATURZS: EXCAVATION LOCATION AND EXTENT. 1) All work shall conform to
City standards and
specifications.
I # I I
2) Notify CilyInspector Carl
—� _ _ _ Vieweg (#639-4171) 24 hours
before starting work.
3) O.R.S. 757.541 allies (re:
�rC
utilities prelocation, etc. ).
(S) NOTE THE CITY OF 'tIGARD DOES NO'f, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT OF-WAY JURISDICTION IS THAT OF WASIIINGTON 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 -r0 SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST ANY INJI, RY OR DAMAGE WHICH b1AY RESULTFROM APPLICANTS ACTIONS
APPLICANTS SIGNATUREY �T- - U _ eel f C
�l���///��-� DATE ,F, 1 /
---..._. . ... - _._ .-._..,. --•,- ..--..,-.,...-.T-.F.-�....,..a+-+r-.r-y--.....-.�.r...._..—..---••--r—•....,..,,.,..�._._........--r'---.r--+-•-+.�v--"".-.'w.--"7---r---,.....-.^-^�•--^r--r.._..�.......,.,.,..._.il
I
APPLICATION - S1 BEET IMPROf MENT/EXCAVATION COPY TO:
ggyygggg (WHITE)-FILE
ORDINANCE NO. 74-14 !p�(YELLOW)-INSP.
il��(PINK)-OTHER AGENCY=Hldgi
(INSTRUCTIONS ON SEPARATE SHEET) J(X (BLUE)-APPLICANT
i
APPROVED [.X APPLICATION NO.: —!+,I
NOT APPROVED 11 CITA A f F TIGARD, OREGON FEL AMT.. S- geEJ0.00
PENDING FEE. PMT. 13 CITY HALL. RECEIPT NO.,_-tel '"' Z1-7 Z�
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT Br_M `' _ DATEII
PENDING AGENCY "OK'' E] Application and Progress Record
MAINTENANCE BOND
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REt]UI RF:D
ANNUAL
PENDING VARIANCE ❑ EXPIRATION DATE.
—�—
PERMI'T NO.: A4�m•_'aL- , DATE ISSUED _._�_-1_l _l L.._ B e. , i- N, /y
r 1
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALLevi_( -ah.ara� --
_Mainline Tap AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT 11ilan,._SkCO_ _ - _—� SE Itb 212x__ _ Cl Arkwma� 9 --_ 659-351
NAME AD ES -- PHONE
CONTRACTOR Timberline Dev. P.O. Box 279 Gladstone, OR 97-021656=8Z53
NAME ADDRESS CITY PHONE
PLANS BY -Ler City Standards/Specifications
NAME ADDRESS
ESTIMATED IMPROVEMENT TOTAL_ VALUATION ( COST): $ _1,500,00
DOLLARS
FOR OFFICE USE. r MIN. --
(2) EXCAVATION DATA: Boo x S S_�Q.QIl__
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
SURFACE CUT CUT CUT MATERIAL INSTALLED
NAME ITEM DATE REMARKS/TYPE: BY
TYPE LENGTH WIDTH DEPTH ITEM &_QJANTITY
'--Ttll-- 5TR[ET
PEN D
INSPEC-
Qak R TIOP, — r �
E
ESTIMATED STREET OPENING DATE: _1�_._��__ S
ESTIMATED STREET CLOSING DATE: / --. ,ED
I {I SECURITY NO.Y� _ SECURITY AMT.: $ 1,500.00_ STREET —
SURETY COFINAL /�
- -- - INSPEC. `� -0-,) U C I
!/i'RI'It'* CHECH CASH U BOND',.
(4) PLOT PLAN. INDICATE SITE PERTIN[1`T PHYSICAL SPECIAL PROVISIONS /CONDITIONS
FEATURES: EXCAVATION 1_OCATiON AI4D EXTENT. 1 ) All work shall confocal to
(v, =k S/ree7� City standard and
1 I I 1 specif icatb ms,
I 1 I 1
Notify City Insppctor Carl
/ \ Vieweg (#639-4171) 24 hours
Wfore starting work.
---- s. 11r. 3) O.R.S. 757.541 applies (re:
aroma
utilities,pre.locattom Iatc.),
T1, -
I
(5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT MERMI9s1ON TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURIS'DICTION 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 SPECIFICATIOIIS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEE'; AGAINST ANY INJI RY OR DAMAGE. WHICH MAY RESULT FROM APPLICANTS ACTIONS.
APPLICANTS SIGNATURE ', 1 DATE
MIN. 3" A C IN 2 LIFT5
STREET AREAS I OUT OF STREET AREAS
cAw Cur-- — —_�
ff rXISTING
l� l
SECTION RESURFACING
CLASS A
BACKFIL
O v �
2"- o"— - -
CLASS B
.S/4=0 GRANULAR / Q
/
IIACKFILL 0
\\ •v . a / W
1 tL l � 41
uj
co
n (Dc
C1 cp -p . - • d o y
0 0
C7 ',---
— . A 0•• 4
W 7 i. -• o
cn d •a u
PIPE BASS
BACKFILL IN STRE AREAS
I.IFS/W IS AGAINST CURB, FILL ROC i TO
BACK OF S1W
2.IF S/W IS NOT AGAINST CURB, FILL_ ROCK
2'BACK FROM CURB
PIPE BEDDING ANDITYOFT� i�R� BACKF•ILL DETAILS
I OREGON CJESICiN PAY AprF:uwEd F3Y DRAhJN p,Y -
GA
5C111_t LJATE C�J~t�1.11NG
No.
NTS /3J1 S-2
i
I
BUILDING SEWER PIPE, SIZE AS SPECIFIED I
_ Iz
PLANT F�.BRICATED TEE FITTING
ON SEWERS IB" AND SMALLER. BACKFILL 2X4
FIELD TAP ON EXISTING SEWERS AGAINST PLUG TO
AND NEW SEWERS LARGER THAN I PREVENT PLUG
THAN IB" I BLOWOFF 16 SECURE
2X4 ;N PLACE W,TH
SEWER MAIN
/TRENCH BACKFILL.
/--_
OR LATERAL P LA N
1
EXTEND AT LEAST
GROUND f 12"ABOVE SURFACE
SURFACE
MINIMUM SLOPE FOR
G" PIPE_ 0.010, FOR
4°PIPE_ 0.020. ---SIWCE CONNECTION
IMRKER
WRAP 12-16 GAUGE
n
GREEN LOCATOR
U `WIRE AROUND 2X4
3/4"-0 PIPE TONE MATERIAL
:'*A-- SUPPORT' SPECIFIED
SUPPORT TEE WITH
*� BEDDING GRAVEL.,
MINIMUM 20" WIDE J I DE
BU I L D I NG S EWE R
U
of
Unified Sewerage Agency
of Washington County
24(
q. 67.51 671 ..,� �
S 4Y'b IQ :' a� 5500 0 s 0 5700 ; i
N a .�
THIS MAP IS FURNISHED AS A I 33 34 35
CONVENIENCE BY: ' 33r.%O � / ►- �
STEWART TITLE �`
11 2r� r
e• �1 99
THIS MAP IS NOT A' -,,ZY AND DOES NOT = '� `
SHOW THE !-)CA' ION OF ANY IMPROVE- 10- 5 4CIO 580e Q
VENTS THE COMPANY ASSUMES NO LIA• 491,
DILITY FOR ANY ERRORS THEF,EIN 3400 a 3212
53
v 5900 Z
1^E 23
31 37
0 35n
v. Q vs X12 9E ,1. r
N ~
5200 sc�e:a Ln I/
30
38
3600 N Ile
14 51GU 610C`Q)7 _- Lf)> - , , ,
_I 1x•'.,99 �^' U
Cfl
292 .. 39 ;t'l
3700 0 (D'j 15s IcsFe 10770
_------' se I 6200
3800 4 29 4C,
3
� o w
I1 :4
_ 124
39 o- 49027 r 6300
100 00 r r.. _ 41
100* 17
r` ~
4000 19 `O "7 4811
1 pr' 640,:)
4100 r, 18 2F 4 1z 42
J , 0
or
Np/ 4 700 .
19 14.48 / 6500 I
25 N
�4Z00 24
v) C600
T 2e / ` 1 4500
is 1;'IMG 1 v,
23 Igo
204 — PA M(
2200 2201
4300 ._.�.1:?^�;.__ .' ; , T F
�1. v
.? 441.0
21 of
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+
W ____ _ STREET
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C' Y OF T 1 CARD -- RECEIPT OF PAYMENT RECEIPT NO. 1-21'7215
CHECK AMOUNT I5f.0. VICI
IVAirF: : MILAN 1-3{{OR0 CONSTRUCTION DASH AMOUNT Q'. 'X)
ADDREE;S : 18680 SE HWV 21: PAYMENT DATE 09./1
SUSOI V IS?nl,;
CLACKAMAS, CSR 9l015-
FIURPOS OF t'IAYME.iV'1- AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
CUSTOMER DE FOCI 1500. 00 PUBLIC IMPROV 60. 00
STI4ELT OPENING PERMIT #446--91
IUTPL. AMOUNT PAID - - - -> 1560. 00
.�Ml'•.IMti���.:_'{•1S ..,,YN':,.+, i1 vi'fi'••-J.: II..
MILAN SKORO CONSTRUCTION 0181 181
18880 SE HM' 212 656-3516 24-2211230
+� CLACKAMAS, OREGON 97015 BRANCH 178
PAY
TO THE
x ORDER OF —-� -- �� - I
rr_t.
LIARS
------'"—""" 1J.3. BAnIK
UNITED STATES NATIONAL SANK OF OAEOON
"'000 LB Ll" I: L 2 3000 2 201: L713 00113 196i�' _ -