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14955 SW 92ND AVENUE-1 a FILE NO. 3 —�C 92ND AVENUE — 14955 STR. OPN. PERMIT CITY OF TIGARD EXPENDITURE RDQUEST -11is fonu is a multi-use form. Appropriate receipts most be- attached. t,)OC�=.ntation is important for all purposes. Staple documentation to form. VENDOR NO.: _ DATE: _ 3 PAYABLE TIO: �Ey�h�S � 'zQ V1 RBIQUESTED BY: — / — '�10 Sin `111�5L_ * Approved request due -Y 10:00 AM to A/P for c he:k-s by Friday. MISCE11ANDOUS EXPEN MURE'S: nate Description, Invoice No., etc. Account No. Anount 00 500 . MPAL $ 500, APPROPRIATION BAIANCE: _ AS OF: - SIGNATME: (Up to $25.00) Section Manager --__-��-�- Purch. Agent ($25.01-2,500.00) Division Manacter ($2,500.01-7,500.00) Dept. Head - ($7,500.01-15,000.00) City Admi.nisUat,or ($15,000.01- ?) local Contract Review BCM-d __-- -- —- ke/1501F APPLICATION -- STREET IMPROvEMENT/EXCAVATION COPY TO: ORDINANCE NO. 74-14 (WHITE)-FILE (YELLOW)-INSP. (INSTRUCTIONS ON SEPARATE SHEET) (PINK)-OTHER AGENCY RI-ry'I (BLUE)-APPLICANT APPROVED APPLICATION NO.: �y�R NOT APPROVED Gt (-.I I l O I IGARD, OREGON Do FEE AMT. PENDING FEE. PMT. [i CITY IIALL RECEIPT No.: PENDING SECURITY ❑ PUBLIC WORKS DEPARTMENT BY _-sk` DATE_ 08 /.J..3 /�_ PENDING AGENCY "OK" ❑ Application and Progress Record _ a - - - - - - - - - PENDING INFORMATION O FOR STREET IMPROVEMENT/EXCAVATION MAIASER"EQU REBOND ,r_ ]l PENDING VARIANCE ANNUAL ❑ EXPIRATION DATE: PERMIT NO DATE ISSUED: _ /> L12s? BY: (1 ) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL WJE p�C -- AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS. b I SW i__ APPLICANT _ __�EI`�N►S SI�L14 p(' �j j _� _ � ` NAM[ ADDRESS G IT PHONE CONTRACTOR - CO"r-RE. E 62 ''') NAM[ ADDRESS --__..-_ IS ht�(O bL`Ci-_ZZ,Vr; PLAT,':, 2Y CI PHONE 1 Y PHONE ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): $ -- ---_- _---,---`- -- -- -_. DOLLARS (Z) EXCAVATION DATA: +OGRESS ORFIc�is%--- -- ---- '`, M,N. f.--.�I�_0 A STREET DESCRIPTION & INSPECTION STATUS NAME SURFACE CUT CUT CUT MRTERIAL INSTA _ TYPE LENGTH WIDTH DEPTH IYEM 6 QUAEM GATE REMARKS/TYPE BY ill SFRNED QU INSP C Z,4 CPA yx(~ R TION I E Q i 1 �b� ESTIMATED STRCET OPENING DATE:�pp - / �, � - E;TIMATEp STREET CLOSING DATE: TF (3) SECURITY NO. SECURITY AMT. $ d oa STREET SURETY CO.: a,Ll -- CLOSED A( IL - _ FINAL `1 C[pTIFIEDCH[CK lI _ CASH rOND C INSPEC. 7LC' d F1 _ _ _ (4) PLOT PLAN_ INDICATE SITE PERTINENTPHYEICAL --��- FEATURES. EXCAVATION LOCATION AND EXTENT, SPECIAL PROVISIONS/CONDITIONS: l) A// e71Ter.�� I NnRTH I 1 ier-I R 1 L 1 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 W!i'H ALL PERTINENT Lr WS 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'T'IONS I�. APPLICANTS SIGNATURE DATE J / / c, \jO `1 rk , 3lzv`4r Z- � S �� ne, November 8, 1990 CITY OF TIGARD , 1 OREGON Mr. Dennis Swafford 14955 S.W. 92nd Avenue Tigard, Oregon 97223 RE: Driveway Access Mr. Swafford: I have tried to call you but you were not available and I have also left a message for you to give me a call. So instead of this exchange of phone calls I thought it best to give you the information in letter form. You had requested infc,rmation as to another suitable product that would replace the "seal coat" that I had mentioned before. I have done some checking and Albina i'u�l Co. has such a product; the name of the product is Quik Stik. I talked to Dave (281-1161) and he said he would be willing to send a person out to do the job; the approximate cost is $50. 00. You may contact Dive at you convenience and make arrangements; be sura to mention my name and that I had talked to him in reference to :his job. As we had discussed in our meeting with Mr. Pat Riely, as soon as you contact me, I shall make an inspection and if all is satisfactory we shall release all portion: of the bond except what will be need to cover the cost of the "seal coat" application; $50.00. If you have any questions please feel fres to call me at 639-4171 ext. 318. Sincerely, n "V ((/ &ri topher R. Davies, P. E. Development Review Engineer ed/rvafford 13125 SW Hall Blvd„P.O.Box 23397,Tigard,Oregon 97223 (503)639-4 � r A (,leo r " �/ LZ/� ��"1�GE G!1 w',• �.,.L� L"zi_O� � f'���� �"v �iG-Clc,..C�.. ' i INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 6394175 Type of Inspection — Date Requested--7 � Time / A.M. P.M. Address .-__ /L1� J ��� h Permit Owner—_ Lot # BuilderThe following BuilcAng Code defici cies are required to be corrected: t Y c CA) -- 1 _ J i ) t i1NRiid�i Presented to �` ___-- - � �pproved Inspector i e ` — - Disapproved Date CALL FOR REINSPECTION YES ❑ NO ? �i i INSPECTIr— NOTICE City of Tigard Building Department P.O. Box 23397 Tigard. Oregon 97223 Phone: 639-4175 Type of Inspection __I Date Requested -- - Time _..___ A.M. P.M. Address Permit Owner Lot # Builder t The following Buil Code deficiencies are required to be corrects rI Q V1 11r, f AY -F— C_4 Tr r� J-P� M cw C -2A Presented to _ __ pproved Inspectur 'r Q�Dipprovecl Date -8- 24 - go CALL��REINSPECTION >� F:1 NO APOLIrATION — STREET IMPR( _MENT/EXCAVATION COPY TO: ORDINANCE NO 74-14 (WHITE)•FILE (YELLOW)-INSP. iNSTRUCTfUNS ONSEPARATE SHEET) (PINK)•OTHER AGENCY BLDG (BLUE)-APPLICANT APPROVED APPLICATION NO.: 'Y.2,,, NOT APPROVED ❑ CIT OI' I IGARD, OREGON FEE AMT.: S ,,710. C0 PENDING FEE. PMT. ❑ CITY HALL RECEIPT NO.:_ 940 PENDING SECURITY ❑ PUBL IC WORKS DEPA R TMEN T By ---:I-'S— DATE_._Pig_.L.r2 190 PENDING AGENCY "OK" ❑ ..pplication and Progress Record _ MAINTENANCE BOND >r� PENDING INFORMATION ❑ FOR STREET IMPROVEMENT/EXCAVATION AS REQUIRED >t ANNUAL. ;_7 PENDING VARIANCE ❑ EXPIRATION DATE: PERMIT NO 323 jL'? -_ DATE ISSUED: Li 5.-- BY: _ 5/2?--_-- (1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL- DO 1VELJ aAC�4 -- -- AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS. 1b" 1 Sw �htv elE LArE OsIaEGr7 APPLICANT DENtits swr-)y FORD �t� ,LNAM� �(a35 PHONE CONTRACTOR OWCRETE 62f6.27- NAME ADDRE3s - ---- > — -- — oi'�i NE PLANS BY -_ NAME_- ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): _ _ SCG GU 40.0:4X DOLLARS(2) EXCAVATION DATA. FFICE USE: o["'MIKs5STREET _ DESCRIPTIONROGRESS & INSPECTION STATUS NAME SURFgCE CUT CUTCUT MATERIAL INSTATYPE LENGTH WIDTH DEPTH ITEM Q QUANTITY ITEM DATE REMARKS/TYPE BY L. ►.S Lj j,) j=� I r r 17 STREET OPENED INSP C- R TION E �.� Q U ESTIMATED STREET OPENING DATE:- / / `ID E S ESTIMATED STREET CLOSING DATE: / ). / G E TREET (3) SECURITY NO, SECURITY AMT.: $ 4_15 `(- CLOSED SURETY CO. -�_ _ _ FINAL , p -_ - -- CERTIrliso CHt.C.K _ CASH BOND INSPEC. All I D, SRI p -a-Paz r (4) PLOT PLAN INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISION$/CONDITIONS: FEATURES, EXCAVATION LOCATION AND EXTENT. ) A& ilark _S/ii�� Orf�nrrJ-, —44ol L tz N D RT►i CURB —/ (� — - CURB _ _ 1 _ _ � /' c — Of 1 n A,-3 - ,�.,�.w,._.. _ ----- -- NOTE THE CITY OF TIGARb bOE9 NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE RIGHT-OF-WAY JURISDICTION 15 THAT OF WASHINGTON COUNTY OR THE STATE OF ORFGON, THE APPLICANT AGREES TO DEPOSIT THE RFQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARML.E35 THE CITY AND EMPLOYEES AGAINST ANY INJURY OR D lI0Adll,,WHICH MAY RESULT FROM APPLICANTS ACTIONS - 1 APP LICANtS SIGNATURE .�� DATE..- y ( 7 _l= i ? Carty i1 iE(~E r-T OF 'PAYMENT F;ECE IP1Z ANO. :9t,1-�2041 1�^ i CHECK. A`10UNT : 520.0(l i CASH A113UNT c).00 ADDRES '11-: NE OFtEGON ST 'PAYM'ENT DATE : '06/2'/90 i ryUBDIVI1'D:ON SHERWOOI; OR 9714()-- i Uig t" OF PAYMENT �',MCL�hi PAIDi.1 !moi('',0 ,L� OF r',WMENT AMOUNT PAIL C'JSTO IES; DEFO 50()_00 UBU I C I MF-T,:OV _ �20.00 i FEPmJT NO 387-90 I TOTAL_ Ah1QUNT PAID - - 520, 0C., I I i DENNIS R. SWAFFORD ODS 510211 11 1 18 310 NE. OREGON ST. 525-5562 SHERWOOD, OR 87110 �� , 21-mm.-in 19_- PAY TO THE ME" — –�=! — J $ SZc a wr w+�el o�1 _ - �s.a oma. rp �o ew MFM(. �: 1 2 3no 20 L ie: 26 21.6 34 au• 4 1 18 NONE"����. III-7� N J f1 2 1 m m 0 4 t' p s N Y mcr o - a io 9 c Q �\\� W z v u- z X J m o - O a I w % a zn O U W' o (r a I �-- 0 D J a �? T W W > . F- I (� ., fL Z O `'---►1 � � x . .I w I o V) I o —T cr a- I I W LL O I ` Q tl Q1 I i W 0 cn Q N I I `1 > a J o I z -iw N '`' o z N O V v1 v1 cr Ki W 2 li a Y Q d .� 7 W - a �. O a cn 6 m n wo i r J n n lel r Uja m 11-1 M J U -- � a V J o � � � U w z U O Q N O Ocr z z Ir � � U U J U- O 11- O ^ w U Z l J tl �� O O • c J N if (a 11 � 7 N � N t' Q V J =� U. a � Y V f W w V7 M �1) t � • V) w ( I 0 } <� o 0 v rr :n r / = m OU vi CLv .v _O Q 0 N • ~ p U w w J `, cr tun cr w�- i V) U- F— J ! O Q It W CD >- acrz Ld a n. Z w o j Zo I a � o a - - --- ".vea A (A �r v' z m o 4` z WCL 0.z uM 1' I (I N Q X _j Z t.9 p w ---- maca w a vm w f- o z z — — — �'t9b50 68 N I ' w I ❑ � 8 'I LUe IrI } w LnN I � (� I Ll� m A > Cl W ti 27 o ` 1_l__l to Cf) w -- p O J J JLrIas IMPORTANT ME6 //-- ,�y1I1 55 r �L�/ FOR(Zu -�l"i ? G DATE 3v -l'IME ��� P.M. OF PHONE AREA CODE NUMBER EXTENSION TELEPHONM- PLEASE rALL CARIE TO BEE YOU WILL CALL AGAIN WANTS TO BEE YOUT RUSH RETURNED YOUR CALL SPECIAL ATTENTION I MESSAGE_ 47 SIGN[ _ LITHO IN U.9A. tOPS IV FORM 3002S 12'�(o lel `�`�►txA c t G 1I I V -, cue � ho �u