11245 SW 90TH AVENUE-1 FILE NO. Lyc?11.�
90th AVENUE - 11245 STR. OPN. PERMIT
VOTICE OF BOND ':0 INSURANCE COMPANY OF AMERICA
CANCELLATION L IAL NSURAtCE COMPANY OF ANICRICA
SW�QO FIRST NATIONAL INSURANCE COMPAMi
OF AMERICA
HOME OFFICE: S)I'ECO PLAZA
SEATTLE. WAST IrJGTON 98185
CC: OLESON & OLESON )NSTRUCTION
TRAUTMAN, PERRIN & HALE INS 03- 1729
(OBL.IGEE'S NAME/APDRESS)
TO: CITY OF TIGARD
DEPT . OF PUBLIC WORKS
TIGARD OR 97223
You are hereby notified that SAFECO INSURANCE COMPANY OF AMERICA Surety upon
Type of Bond: ANNUAL STREET OPENING PERMIT PERFORMANCE BOND
Bond No. 5343673
dated effective 02/20/ 1990
(MONTH. DAY. YEAR)
on behalf of (PRINCIPAL'S NAME/ADDRESS)
OLESON & O'.ESON CONSTRUCTION
RT . 1 BOX 904
BEAVERTON OR 97007
desires to cancel and does hereby cancel said bond in accordance with the cancellation provisions contained therein or in applicable
laws or regulations. This notice is
mailed to you on FF.RRITARY 16, 111''10
(MONTH. DAY, YEAR)
and is effective ID DAYS AFTFR RECETT"T nF TIIIS CANCEI,t,ATTnN NOTICE.
SAFECO INSURANCE COMPANY OF AMERICA
Shirley Mill ORNEY-N-FACT)
�Iancollation Acknowledged: (PLEASZ SIGN AND RETURN THE DUPLICATE OF THIS NOTICE) CE COAI:+ty`
SEAL K
By: � .... �,1.`CY11.1—`�`-ly C�s_ t�_> >c•�'+yy Jr 19 M,
Ge7�'►A \�' leck J
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ZNTH. DAY. YEAR)
CANCLIL REASON: AGENT 'S REQUEST . NON-PAYMENT
3-110MQ0 N1 1!/1t MReplotaeC t,aalma,k of SAFFCO r.,,,Po,.,'
PRINTF() IN I——
APPLICATION °- STREET IMPRO VIENT/EXCAVATION CuwY '(O:
S(WHITE)-FILE
ORDINANCE NO. 74-14 (YELL.OW)-INSP.
(PINK)-OTHERAGENC W6
U (INSTRUCTIONS ON SEPARATE SHEET) '
` � �BLUE)-APPLICA'JT
APPROVED y, APPLICATION NO.: _ 2, I
NOT APPROVED Lj CITY OF TIGARD, OREGON FEE AMT. I
PENDING FEE. PMT. ❑ CITY HALL RECEIPT _
FENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY DATE_ 3 -3
PENDING AGENCY ''OK" O Application and Progress Record _ —
MAINTENANCE BOti; Ip�
PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRLD �
ANNUAL.
PENDING VARIANCE ❑ EXPIRATION DATE:
0 49
PERMIT NO.: 2-4S"'e-_ _ DATE ISSUED _ _ _ _L_� � BY ,
(1 ) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL a_-2_v1a _-
MZ►v�_,7• AS DE CRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
APPLICANT � _ _____
NAME ADOR[55 / �i �—Q CITY N
t o-ar- Ccs
CONTRACTOR �� SHONE
E DDRESS CITY
PLANS BY __-_
NAM ADDRESS CITY 4O� NE ---
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ OO LL A r _
(2) EXCAVATION DATA: FOR& FICC`E USE - — —� —fvrTMON.
0.04 X i ®oma- S____-3z
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM & QUANTITY
STRZF-T
l• PEN _
INSPE -
R T10N
E
Q
ESTIMATED STREET OPENING DATE __ _. / � _ S
ESTIMATED STREET ('LOSING DATE. / / T
E
53A3L -_ >:- D
STREE
(3) SECURITY NO. _. SECURITY AMT !S • �""' CLOSET
SURETY CO.: FINAL
CIF 1
_..._ L t'
cRTIFI[ �/
c c HE( CASH CAlN n INSPEC.
•ONO
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS /CON (TIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT.
CI V,
L✓
t
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I
(S) NOTE THE: CITY OF TIGARD DOES NOT, HEREBY, GRAN PERMISSION TO AP LICre*ANTS TO CONDUCT 'NC`!'K WHERE
RIGHT-Or-WAY JURISDICTION IS THAT OF' WASHINGTON COUNTY OR THE STATE OF' OREGON.
THE APPLICANT AttFtr_F,S TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALP_ PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIO045 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. - �,J/ DATE
APPLI A/T' 10 -
+ y/ STREEO�RU'
PRLENT/EXCAVATIO! COPY TO:
WHITE
)77•F''IL�{E
A ' NO. 74-14 a((YELLOW)
TtiO PINI )•OTHER
-I�A_G�FN
C.._.W__
6r``
(INSTRUCOSEPARATESHEETI �sBLUE)•APPLICANT
APPROVED `^A APPLICATION NO.:NCITY OF TIGARD, OREGON APPROVED El FE AMT f
PENDING FEE. PMT. ❑ CI'i'Y HALL RECEIPT 5��.��.._.
PENDING SECURITY ❑ PUP L IC WORKS DEPA R TMEN T BY� DATE - 31 3 /10
PENDING AGENCY "OK' ❑ Application and Iv)gress Record MAINTENANCE bOf`�D
PENDING INFORMATION ,.� FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED �p
ANNUAL
PENDING VARIANCE ❑ EXPIRATION DATE: Z-�Y
PERMIT NO. 2-4Is "87 DATE ISSUED: -. J l �. L_ �--7__ BY:
(1) APPLICATION IS HEREBY" MADE TO EXCAVATE FOR AND INSTAL:
Qr_r___w+-.X►_ \� AS DESCRIBED HIFREIN, IN FULL ACCORDANCE WITH CITY REIQUIREMEN-
• v� �• � �✓4-Ire--
APPLICANT
_
Q NAME ADt5RE9[ / CITY N�
CONTRACTOR
Z�DDRI�SS CIT �"j17�'I- PHO,VE
P L i.N S BY__— _e':Z[
� - - --- -- -- - -
NAM€ ApORl55 CITY PHONE
ES1 IMATED IMPROVEMENT TOTAL VALUATION ( COST): $
DOLLARS
(2) EXCAVATION DATA: s f FOR ovR'ic�uu[: -- OMON.
0.04 X f 37-
STREET
-STREET DESCRIPTION _ PROGRESS & INSPECTION STATUS
NAME SURFACE CU" CUT CUT MATERIAL INSTALLED ITEM DATE REMAR✓S/TYPE BY
TYPO LENGTH WIDTH DEPTH ITEM A QUANTITY
STREET
INSPEC•
R TION
Q
ESTIMPTED STREET OPENING DATE:_-,.I- L:i . 6Z $
ESTIMATED STREET CLOSING DATE: _ / / ED
t STREET
(3) SECURITY NO. -._ SECURITY AMT. E .__ ��' _ CLOSED
SURETY CO.: ._"SS2FINAL ,� '
/ do
C1
_
CERTIFIED CNECK CA[M f7 eOND INSPEI:. +
(4) PLOT PLAN: INDICATE SITE PERTINEN t PHYSICAL SPECIAL PROVISIONS/CONDITIONS.
FEATURES; EXCAVATION LOCATION AND EXTENT.
1 ( W C I 1
C�
1
CURB .
(5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO AP LP ICANTS TO CONDUCT WORK WHERI
RIGHT-OF-WAY JURISDICTION IS THAI 7F WASHINGTON COUNTY Olt THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOS T THE REQUIRED SECURITIE. , TO COMPLY WITH ALL PERTINENT LAWS ANI
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE YORK, AND TO SAVE HANMLESS THE CITY AN,
EMPLOYEES AGAINST ANY INJURY OR nAMAGF WHICH MAY RESULT FROM APPLICANTS ACTIC,NS.
APPLICANTS SIGNATURE � - `•��'� DATE / 3 /
l t PLEASSEE�TAK9 THIS TO THE CASHIER FOR A _RECEIPT
NAME: ��ac �� Jl.'iE: 3 -3
ACCT. DESCRIPTION Y AMOUNT
10-220 _ Refundable Performance 'fond Deposit _ a
10-435 - Sign rermits 10P TU `
1.0-436 Public Sewer. Plan Check/'nspection Fee
10-436 Public Storm Plan Check/Inspection Fee
10-436 Street Dedication/Public Improvement Fee
C--504 36 1 Street Opening Permit
10-437 Subdivision Applications:
S MLP
10-438 Zoning Applications:
ZC CPA ZOA FD Miac
SCE ("TSLPy t
10-440 Other Planning Pecs:
SDR
Non refundable portion of Appeal Pees 3
10-220 Refundable portion of Appeal Fees
21-442 Street Light Fee
101-451 Docuaent Sales:
Bagrg. Plaunim Bldg. _
10--451 Street and Traffic Signa
10-430 Bus iti:ess Tax $_
TOTAL
(1045P)
i
CITY OF THA RD No. 20521
13125 S.W. HALL BLVD.
P.O. BOX 23397 Date-;,..:---
TIGARD,OR 97223
Name
Ad
dregs
Lot BlocklMap SubdivisfonlAddr�ss
Permit M's Bldg. 'lumb
Cash Check
Sewer Other Other Rec. By i
Description Amount
Acct. N �. —
10.432 —�Building Permit Fres
10.431-600 Plumbing Permit Fees -
10.431.601 Mechanical Permit Fees
10-230.501 -tate Bld . Tg ax _
10-433 Plans Check Fee -
30-443 Sewer Connection ---
30-444
_30-444 _ Sewer Ins ection
51.446 StreeL§yst. Cev. Charge
52-449.610 Parks I Syst Dev. Charge
52.449.620 Parks II Syst. Dev. Charge
M31,
450 Storm Drainage 5yst. Dev. Charge
10.430 Business Tax —
10.434 Alarm Permit.--
10§227
- - —
10.227 Bail
10.455 Fines TrafficlMisdlParking
10-230 CPTA TrafficlMisdlVic. Asst.���
-1-045&-- Indigent Defense
30.122.401 Sevier servicelUSA
"-To-122-402 Sewer Service/City 30%
30-123 Sewar SevicelCity Malnt.
30125 Unmatched
'31 124 form Drainage _ _
q Bancroft Prin. Pymt. —_
q0-q� - Bancro t Int. Pymt. _
___ _—TOTAL _._. .
� CUSTOMER
POWN.ALL, TAYLOR AND HAYS, INC.
INSURANCE
P
1, iCi? w 48W, i,RIPnrH OR
SInICE -
H BEAVERTON.OREGON 97005
503-646.1 131
March 2, 1987
City Engineer of
The Cicy of Tigard
ivr'M: John Hagerman
Please find attact.ed the Surety Rider Bond for the following location:
11245 S.W. 90th
Tigard, Oregon
This is an extention of Bond #5343673.
Thank you for your time and attention.
Linda L. Brogan
Commercial Department
V�
* tAt ti� r