13950 SW 104TH AVENUE-1 FILE N0. "FS9 - b
104TH AVLNUE - 13950 STR. UPN. PERMIT
CITY OF TIIFARD
August 15, 1989
OREGON
Walsh Construction Co.
3015 S.W. lot Avenue
Portland, OR 97201
Re: Street Opening Permit No. 289-88,
Bond No. 819GO36-2
Gentlemen:
This is to notify you that we have closed the permit for work performed at
13950 S.W. 104th Avenue; all work having been satisfactorily performed- Vie
city no longor has an interest in the assurance posting identified above.
Thank you for fulfillment of the permit obligation in an efficient manner.
Sincerely,
John S. Hagman
Engineering Technician
jr/walsh.jon
cc: Continental Guaranty & Credit Corp.
13125 SW Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223
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APPLICATION --- STREET IMPRC" 'MENT/EXCAVATION COPY TO:
OR DI NA),dC'E NO, 741 4 (WHITE)-FILE
(YELLOW)-INSP.
(INSTRIIrTIONS ON SEPARATE SHEET) ❑ (PINK)-OTHER AGENCY
(BLUE)-APPLICANT
APPROVED 2•
APPLICATI DN NO.:
NOT APPROVED (.11 Y OF TIGARD, OREGON FEL AMT.: s e2
PENDING t-EE PMT. [j CITY HALL �Z- �—
RECEIPT NO.: �
PENDING SECURITY [i PUBL IC WORKS DEPA R TMEN T BY . l. ) DATE •7 _S+'
PENDING AGENCY "OK" (_; ;�ppL1 alion and Yrogtcas Record — G�/ —
PENDING INFORMATION C_i MAINTENANCE BOND /��/O3��z
FOR STREET IMPROVEMENT/EXCAVATION As REOUIREU
PENDING VARIANCE [] ANNUAL C
_ EXPIRATION DATE: 10614F 1/E/4/-2—_
PERMIT NO Z�___!r' DATE ISSUED I'
�_ - — -- _ BY:
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL .
S DESCRIBED HEREIN, IN FULL ACCQRDANCE WITH CITY F;E UIREMENTS.
APPLICANT/ U � -fit _ �_ I �-�- (�l �1 t�j
N A E 1 2 L✓�s
op �AO ES -� , CIT PHONE
CONTRACTOR _
' NAM
S
citr
PLANS BY �/��!/-y� _
-- NAME ADDRESS--- � --- C17Y MON
It
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): S
— �jDOC?•
(2) EXCAVATION DATA: aoW oaFlcl(NsE: m • MIN
Da U
o nn_x
STREET DESCRIPTION PROGRESS & INSPECTION STATUS _
NAME SURFACE
CUT CUT CUT LENGTH WIDTH DEPTH MATERIAL
IAIi INSTALLED
STALL D � /TYPE BY
ITEM DATE REMARKS
INSPEC-
R TION
• E —
Q
_ lJE _
ESTIMATED STREET OPENING DATE / S
ESTIMATED STREET CLOSING DATE: T --
E
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(3) SECURITY NO. SECURITY AMTs_ C�'� CTREET
LOSED
SURETY CO.. FINAL 1 i fL�rc� ,/q
�:Erl�Ir lE 1,c,�t t.h cASN ❑ /OND INSPEC.
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL -- SPEFIAy PR�CIVISION /C DI-VIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT.
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(5) NOTE THE CITY > F TIlGv4ARD DOES NOT. HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHPE
RIGHr-OF-WAY JURISDICTION IS THAT OF WASHINGTON COUNTY OR T}IE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES, TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICATIONS PERTINENT TO CONDUCT Or THk WORK. AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST ANY INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS
APPLICANTS SIGNAQwr "" DATE � 1
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CITY®F TIOA- R® Pio. 32290
13125 S.W. HALL BLVD.
P.O. BOX 23397
TIGARD, OR 97293 Date
Name — - --__
Address
Lot Dlock!Map Subdivision/Address --
Permit #'s Bldg. Plum—b- Cash Check
Sewer Other Other
e
Acct. No. Description
10 432 _Amount
Building Permit Fees
10431$Q� Plumbing Permit---Fees ---- --
10.431 601 Mechaninal PPrmie Fane ------ —
MARLANU HENDRRSON CONSTRUCTION
.6881 SW NAPA 692-3740 5049
TUALATiN,OR 97062
t� �] N 1811210
PAY ETHE r+�
ORDER
OF
DOL
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i�
IftOREGON �Hnah
.w� BANS Q46 ..6u»
1: L 2 3000 &6 51:30 17 708 5 50 i.9
V-Ilea sewer bevicelCity Maint. -
-1 Jnmatched -----
1-1 Storm Drainage -
an�ro t PrIn. Pymt.
4 1 _ �ancrotnt. y�mt. r;�_• —
TOTAL
ACCOUNTING
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