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Site Data
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GENERAL
Legal Description REVISIONS
10-21-87
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MAC4 c N7_IFISAITO S ASSOCIATES.II
Legend
• 957 ALLRIOHTSRESERVED
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As Issued For H.L. Green Construction Bid 10-21-87 12874
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NOTE: 1 F TH IS M ICROF I LMED I -- -+�� 3 4 _---- 5 6 - 7 — 1e t� 10 11-- 12
DRAWING IS LESS CLEAR THAN
THIS NOT IM-1T IS DUE TO
QUALITY OF THE ORIGINAL -
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19 2
MARCH 30
I.�, 9
FILE NO.�? %C
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UPPER BOONES FERRY RD. - 15750
STR. OPN. PERMIT
QTY OF '11GAM) J
m-,imriU1i'E RIwr•:,4r
Thi_c: form is a multi-txsse form. Apprcpriate reoeipts mist be attached. Documentation
is-,"important for all purposes. Staple documentation mentation t o form.
Pj�IARLE '110: _ F2 C-k c Rc�� `��: X�2lc� L �' 1
tom'If:Sr"ril) BY:
D `17_ c -------- * kpProved request due Wednesday
-0:00 AM to A/P for checks by
Friday.
MCSANEOUS Ea{nNDMME-S:
Date De<rxi,, - rn, Lr voice No., etc. Account No. Amount
II f�t. 1 Ut��� a< 1 •�:i�y ���c c�rn
'Z--z DOC) s Z3Z0
,
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— -- -- ZMAL
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Mileage $0.255
API'ROPRIATI:GN BALANCE: - - AS OF: — - :,1-' NATURE:
([lE: to $25.0(7) Sc3cctarn Manager -- - RI ch. Agent _ --
($25.01-2,500.00) Division Man,-(j(r
($2,500.01-7,500.00) Dept. 1{ead
($7,500.01-15,000.00) City Administrator
($15,000.0].- ?) Local Contract R.-!view Board
\`�ke/1501E ---
APPLICATION - STREET IMPRO' -MENT/EXCAVATIONC PY TO:
}�(WHITE)•FILE
ORDINF,Is%E NO. 7414 (YELLOW)-INSP.
(PINK).OTHERAGENCY-10114
(INSTRUCTIONS ON SEPARATE SHEET) (BLUE)-APPLICANT -c�
APPROVED APPLICATION NO.:
NOT APPROVED L CI I Y O rIGARD, OREGON FEE AMT.. S _LZ. 7 u`
PENDING FEE. PMT. ❑ GI Il HAIL RFCEIPIT 7-47
PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENTer_��� DATE--J L!�L�
PENDING AGENCY "OK" ❑ Application and Progress Record MAINTENANCE BOfQD fR _-_-
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED ;ppl
ANNUAL
PENDING VARIANCE U EXPIRATI N ATE: �1'T �' —
PERMIT NO.: -2'-70 -r'_[ DATE ISSUED - ��._L�� 7
-7 BY:
(1) PLICATION IS HEREBY MADE 10 EXCAVA FE FOR AND INSTALL
AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIRLsMENTSf�
APPLICANT _I"1 I\—��6.�_?.1Zt IELN�.t�11— C I (SGV 511 /�2-VICHCG� Or }a._ _ �Z'T•���4J
NAME ADDRESS _1 J, CITY C�� `j� PHONE
CONTRACTOR - 1.—L� S �i^ I S 11�I 1 SZ2 S"`"�t Z44.0
AM M ADDS
— CITY 7 ►�MON��—..__.—
PLANS BY--- �A#aLS"NAADDRILSS city -- - - �No E ---
00
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): = Z3ZO 10
DOLLARS
---
^s--�—� FqR OFFICE USFL1�I MIN.
(2) EXCAVATION DATA: 0.04 x S _2-_sZt2
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE RLMARKS/T"PE BY
TYPE LENGTH WIDTH DEPTH ITEM d QUANTITY ^_- �____,__-
STREET
OPENED
INSPEC- -- --�------ -'
R TION _
E
-.—. Q -
----
ES'rIMATEDSTREETOPENINGDATE: T
ESTIMATED STREET CLOSING DATE: I L _ _ ED ---
STREET
(3) SECUPITY NO. -__ TSECURITY AMT.: Z 0' CLOSED —
7/ 2�C, .�- FINAL �J�llt SURETY CO : vwC � �� -x BOND INSPEC. r7 zn 7(,
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS - CONDITIONS ,
FEATURES; EXCAVATION LOCA TION AND EXTENT. , �{ � �, �
(UAB
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(5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERM19SION 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 PFRTIr4ENT 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 AC 11ON5
APPLICANTS SIGNATURE A-)&Anc DATE -�{-
CITY OFTIOARD No. 25914 CITYOFTIVARD No. 26915
13525 S.04 HALL BLVD
P.O. BOX 23397 13125 SW. HALL BLVD
Date . P.O. BOX 23397
TIGARD, OR 97223 Qatr — _
TIGARO.OR 37223 Date
Name _ � 1 �,t ✓ / / . ! l ✓L
Name
Address
Address
Lot Block/Map Subd�vision/Address C
Lot I Block/Map Subdivision/Address
Permit#-s Bldg. Plumb Cash Ch k I
�` Permit #'s Bldg. Plumb Cash C
Sewer f Other Other Rec. By +
Sewer Other Other Rec. By.
Acct. No. Description Amount
! 10-432 Bu0clin Permit Fees Acct. No. Description Amount
10-431-600 Plumbin Permit Fees 10-432 BuildingPermit Fees
10-431-601 Mechanical Permit Fees t0-431 600 Plumbing Permit Fees
! '
10-230-501 State 8!dq, Tax ; 10-431-601 Mechanical Permit Fees
10-433 Plans C heck Fee
i
10-230-501 State Bldg. Tax
30-443 Sewer Connection 10-433 } Plans Check Fee
30- Sewer Inspection 30-443 Sewer Connection
51-448 Street Syst. Dev. Charge 30-444 1 Sewer Inspection
52-449.610 Parks I Syst. Dev. Charge 51-448Street Syst. Dev- Charge
52-449.620 Parks II Syst. Dev. Charge 52 449-610 Parks t Syst. Dev. Charge
31-450 Storm Drainage Syst. Dev. Charge -- 4x9-620 Parks II Syst. Dev. Charge
10-430 Business Tax -- 31-45C Storm Drainage Syst. Dev. Charge !
10-434 Alarm Permit 0 43430 Business Tax
! 10-227 Bail 10-434 Alarm Permit
10-455- Fines-Traffic/MisdiParking 10-227 Bail —
?-230 CPTA Traffic!MisdlVic. Asst.
10-455-
---- Fines-Traffic/Misd/Parking
16 456 Indigent Defense - - - 10-230- CPTA T-afficlMisdlVic. Asst. ---~
30-122a0t Sewer Service/USA --- — 10- 54 6 Indigent Defense --- —�
30-122-402Sewer Service/City 36-% - 30-122-401 Sewer Service/USA
- !
0-123 Sewer Sevice/City Maint- 30 122.402 Sew r Service/City 309,o
30-125 Unmched 30-123
TSewer SevicelCity Maim-
31-1 f4
aint31-124 Storm Drainage 30-125 - Unmatched
40-475 Bancroft Prin. Pymt. i 31-124 Storm Drainage
40-471 Bancroft Int. Pymt. - 40-475 Bancroft Prin. Pymt.
40-471 Bancroft Int. Pymt.
TOTAL
CUSTOMER
*s CUSTOMER
Pov T LAND fi M— I'll.11C., 1Ih ?Ill
MACKENZIE ENGINEERING INCORPORATED vAri Fu: WFS rG NN HANK 1; -
0690 S.W Bancroft Street
Portland,Oregon 97201 14557
DATE CHECK NO VENDOR Nr1
11-17-87 14557 j -- -42
NOT TO EXCEED***$1,000.00*
PAY - City of Tigard MACKENZIE ENGINEERING INCORPORATED
'rO THE -
ORDER - — �
OF ���. - - ---
11'01455711' 1: 1232020151: 21 40366 611'
F"3
"'Rem"
08570
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Aese,L.P. PACTRusr TOWFR BRANCH,P.O. BOX 6564 24.22 207
111 S W.Rfah Ave.,Since 2930 UNITED STATES NATIONAL BANK 1230
Portland,Orngan F47204 OF OREGON PORTLAND,972266564
PaY EXACTLY ***1,320 DOLLARS OG CENTS
11/11/111 1 **4`21.320.00
Flf CITY OF TICAPD PACIFIC REALTY ASSOCIATES, LP.
SEWER/BUII-DING PERMITS
13125 SW HAIL BOULEVARD .x.�
TIGARD, OR 97223
11800115 7011' 1: i 2 3000 2 201: 20 7 0006 651311'
0% 17400 CASH BOND-PUBLIC IMPROVEMENT 87111563 2320.00 1410
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ri ( U.F�1
_ --- - n 8 W
MACKENZIE ENGINEERING INCORPORATED
0690 S.W. BANCROFT STREET PORTLAND,OREGON 97201 (503)224-9560
November 16, 1987
City of Tigard
Attention: Mr. John Hagman
13125 S.W. Hall Blvd.
P. 0. Box 23397
Tigard, Oregon 97223
Re: PacTrust - OB II, Building D
Project Number 287450
Dear John:
As requested through Bill Bailey of our office, the following shall serve to document
the construction costs for• work in the right-of-wa,y of Carman Drive.
Total Construction: 220 lineal ft.
Curbs: Existing
1. Remove Asphaltic Concrete Walk: 1,110 sq. ft. at $.50 = $ 555.00
2. Construct Commerical Driveway: 200 sq. ft. at $2.00 = 400.00
3. Construct Standard Sidewalk : 910 sq, ft. at $1 .50 = 1,365 GO
TOTAL ESTIMATED COST $2,32 .00
I hope this adequately addresses your needs for bonding and permitting ,,n this project.
Sincerely,
alu5uj
David G. I-arson, P.E.
Project Manager OHE3ON
1
'A' a
DGL/jct oil, 4 v 13, i910-
1nG LPR:
cc: Bill Bailey
Dave Welsh , / 7.4/7,
Dick Buono - PacTrust
97 ` �_kt SL,I u"�'