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Page No. 1 CONDITIONS/CORRECTIONS FOR CASE NO.: ENG97-0046
RALPH PETERS
13365 SW 107TH AVE
08/06/97
1) THU CONTRL- SPECIF (CITY) -- The City's standard specification for traffic control is "Manual on
Uniform Traffic Control Devices for Streets and Highways", U.S. Dept. of Transportation, FA L A ,
1988 Ed.
2) TRAP CONTRL- CONTR RESPON FOR -- Traffic control shall be provided for by the contractor in
accordance with the City's standard specification and, also, in accordance with a City (job
specific) approved traffic control plan. A copy of the approved traffic control plan shall be
available at the work area.
3) TRAF CONTRL - ROAD CLOSURE -- Public roadway shall not be closed to traffic, at any time, without
having first obtained written approval from the City Engineer. The permit holder iu responsible for
provision of timely notification of traffic flow disruptions to area wide Emergency Services
(Tigard Police Dept., Tualatin Fire & :fescue) and to Tri-Mer and Tigard School District.
4) TRAF CONTRL - PRIV PROP ACCESS -- Access to existing properties shall be maintained at all times,
Including normal delivery service and mail service and if not, shall be cause for work stoppage
until effective accers is established,
5) TRAF CONTRL - DEVICES IN PLACE -- Traffic control devices, flagpersons, etc., shall be in place
prior to initiation of construction work and shall be effectiv-`y maintained.
6) TRAF/NOISE CONTROL - WORN HRS -- No work will be permitted during the hours of darkness, nor
between 9:00 p.m. to 7:00 a..n. Monday through Friday nor between 9:00 p.m. to 8:00 a.m. Saturday,
nor between 9:00 p.m. to 9:00 a.m. Sunday.
7) TRAF CONTRL - MIN LANE WIDTH -- Minimun travel lane width shall be twelve (12) feet] pedestrian
ravel shall also be provided for.
8) 'IkAF CONTRL - CITY CAN MODIFY -- The City reserves the right to add to or modify traffic control
requirements as -ay be ne^essary to effectively control traffic and to assure public safety.
9) INSP 24 HR NOTICE REQUIRED -- ille hermit holder or his contractor shall notify the City'z 1110pector
(Paul Izat) (Matthew Harr.11) at 6639-4171 twenty-four (24) hours prior to commencing work,
twenty-four (24) hours prior to any staged inspection and atter completing work covered by the
permit.
10) PERMIT 6 PLAN REQ ON SITE -- A copy cf the permit and all attachments, and a copy of the approved
t construction plan and all a:,endments shall be available at the work area. All work shall conform
to the permit terms, conditions and provisions and to the r:ity approved permit plane, and approved
�- plan amendments and to the City's Standards and Specifications and to these General Conditions.
�r Changes to any of the aforsaid must be approved by the City, in advance of work performance.
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N 11) HAZARDS - CERT OF INS -- Maintenance of the work area and approach roads in the responcibility of
t,ie permit holder. The work area and approach roads shall be maintained in a clean condition, free
'^ from obstructions and hazards. A copy of the permit holders Certificate of Insurance shall be
J
available at the work area.
12) DEBRIS - MATERIALS -- The spreading of mud or debris or storage of materials or equiptment of any
LL) kind upon any public roadway is strictly prohibited and violation shall be cause `or immediate
J
cancellation of the permit. The City may at any time order immediate cleanup and stoppage of work
to accomplish cleanup.;
11) EROSION CONTRL RPQ -- Effective erosion control is required. Erosion control devices must be
installed and maintained meeting D.E.Q. requirements. The City may at my time order corrective
action and stoppage of work to accomplish effective erosion control.;
14) REPAIRS - LIKE MATERIALS REQ -- Property disturbed by construcCion activity shall lie seeded with a
standard grass mix; shrubs, flowers, barkdust, existing signs, pavement markinga, mallboxs, etc.,
shall be reestablished, reinstalled or replaced, with like kind and material.
Page No. 2 CONDITIONS/CORRECTIONS FOR CASE NO.: ENG97-0046
RALPH PETERS
13363 SW 107Th AVE
08/06/97
i5) DRAINAGE CONTRL REQ -- Effective drainage control is required. Drainage shall be controlled within
the work site and shall be so routed that adjacent private property, public property and the
receiving system is not adversely impacted. The City may at any time order corrective action and
stoppage of work to a:complish effective drainage control.
16) UTILITIES PRELOCATION REQ -- Oregon law requires following the rules adopted by the Oregon Utility
Notification Center. Said rules are set forth in OAR 952-001-0010 through OAR 952-CO1-0080. Copies
of the rules may be obtained from the Center by calling (503) 246-1987. If you have questions about
the rules, contact the Center. NOTE: Damage to utilities shall becorrected at the permit holders
expense.
17) UTILITY LOCATIONAL CONFLICTS -- Contractor must verify all existing utilities for both vertical
eln•ation and horizontal lccation prior to start of work (pothole before digging if necessary).
Shoulu conflicts arise and redesign or relocation of facilities be necessary, it shall be done at
the permit holders expense. Changes must be approved by the City in advance of work performance.
Contractor shall coordinate the work with affected utility agencies.
1s) TRENCH - PATCH/SAFETY/LIABILITY -- A temporary hard-surface patch (Cold mix A.C. or Hot mix A.C.
base paving) shall be placed on trenche within roadways at the end of each days work. No trench,
on site or off site, shall be left at any time in an unsafe condition. The permit holder in
iesponcible for and is liable for hazards or damage resulting from the prosecution of the work.
19) REPAIRS REQ - INSPECTORS OPINION -- Work provided for under the permit shall include repair of
existing facilities (roads, ditchs, etc.) as may be necessary, in the City Inspectors opinion, to
overcome deterioration or damage which occured in conjunction with the work authorized by the
permit. Corrective work shall be done at the permit holders expense.
20) TESTS/REPT'S TO VALIDATE CLAIMS -- The City's Inspector may, at their discretion, require provision
of tests and or reports from the permit holder, permit holders engineer or contractor to validate
claims of material or construction adequacy/compliance. Such tests/reports shall be provided at the
permit holders expense.
21) RELEASB - WAIVER REQ -- The permit holder shall provide a copy of a properly executed Release k
Waiver document to the City for each ownership disturbed by construction activity, as evidence of
disturbance resolution and owner satisfaction.
221 MONUMENT PROTECTION REQ -- Existing monuments, property corners, and survey markers shall be
protected. Replacement shall he at the permit holders expense.
231 PROBLEM SOLVING - RESPON PARTY -- The permit holder shall provide to the City Inspector, in
rl writing, the names and 24 hr emergency telephone number of two (2) persons who have authority to
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N resolve problems, take corrective action and, in general, will be responsible in case of an
F—
emergency. The permit holder shall � -ify the City Inspector, in writing, of any/all assignment
�-^
changes.
24) CONSTR SAFETY - RESPON PARTY -- The permit holder shall cause his contractor to provide to the City
Inspector, in writing, the name and 24 hr emergency telephone number of a designated "Competent
Person" responsible for construction safety as per OR-OSHA, Chap. 437, Div. 3 Construction,
Subdivision P - Excavations. The contractor shall notify the City Inspector of any/all assignment
changes.
25) ESMT/RT OF ENTRY - RESPON -- It is the sole responsibility of the permit holder to provide for
proper right-of-entry ..nd/or easements prior to starting work. Proof of right-of-entry, or
properly executed easements, shall be provided to the Citv. The City wig ll in no way be construed
to be liable for the permit holders failure to obtain or provide for proof of right-of-entry or
easements.
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Y '
Page No. 3 CONDITIONS/CORRECTIODS FOR CASE NO.: ENO97-0046
RALPH PETERS
13365 SW 107TH AVE
08/06/97
26! SEWER CONN PERM-r RFQ -- A sewer connection permit is required to he obtained, from the Cit.y,s
Building Department, prior to connecting any structures to the sanitary sewer system.
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SERVICE LATERAL PIPE SECURE 2X, IN PLACE 1
SIZE AS SPECIFIED AGAINST PLUG V/ BACKFILL
10 PREVENT PLUG BLOVOFF \
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'SANITARY MAIN
OR LATERAL
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F TATION! DIST NCE TO NEAREST MANHOLE. I
II (NEED TO IDENTIFY UF,TREAM OR DOWNS R1
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LENGT-4: SHOVDISTANCE FROM MAIN TO END OF LATERALHEIGHT; TOTAL LENGTH OF 2x4 AT [NO OF LATERAL MIN
Z�iA710N 36'
LOTH: AS SHOWN ON APPROVED SET OC PLANS
LENGTH MARKINGS TO FACE STREET
t2- QEF GROUND MAGNETIC
MIN2xc — COLOR CODE SURFACE SURFACE TAPE
3G' L
LO1" (GREEN-SANITARY(
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GROUND _
MAG/TAPE \
(GREEN V/BLACK LETTERS)
2xc
PIPE
i i6^ PLUG
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;; •o a�•••a assL � MINIMUM SLOPE FOR 3/4'-0 PIPE ZONE
�o`: tFa� • l 6' PIPE - 0.010 MATERAL AS SPECIFIED
•a •• G' PIPE = 0.020
Fy •0 Q p� SUPPORT TEE VITH
' I BFDOING GRAVEL,
MINIMUM 2.0' VIDE ELEVATION
SAN I T A R Y unified
sewerage
SERVICE LATERAL agency
DRAWING N0. 170—SA
FILL 0QAt1!SAMI SCI LI/IAVIW. SdIIOSAC ►LOI
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STRAP FETA PE;:
FvC Si�DDLE ( TEE )
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- SEvER PIPE STAINLESS STEEL.
STRAP
PVC SADDLE SHALL BE ASTM 3032 SDR3S
+�
PVC COMPOUNDS SHALL BE ASTM D138Z WITH CELL CLASS OF 12ZSZ-B/C
OR 1236:.-C
ALL ELASTOMERIC SEALS (RUBBER GASKETS) SHALL BE ASTM F477
STAINLESS STEEL BANDS SHALL BE 300 SERIES. FULL 9/16" WIDTH BAND,
5/16 ' SHOULDERED HEX HEAD, SLOTTED SCREW AND IS CADMIUM PLATED,
CARBON STEEL.
* INSERTION HOLE SHALL BE C,)RE DRILLED.
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P V C 464P FST unified
UfAsewerage
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S A E agency
DRAWING NO. 180-SA
•I,t Dn•r,,S WI N D .vlrw t0,1Ct4
MIN. 3' A-C. IN 2 LIFTS
STREET AREAS I OUT OF STREET AREAS
SAW CUT I
6'
EXISTING SECTI
RESURFACING
• •• •;•; ° 0 0 0••0 0 0
0 ° 00 /
0 0 0 o p o o °0 0 o
00 0 0
0 ° o ° /
0 0
0 0 °
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CLASS B° / ./ / X
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° BACKFILL ° CLASS A
p ° EACKFIIl
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3/4" - 0"" J
GRANULAR BACKFILL ° °° ° p o 0 000 d
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PIPE BASE
BACKFILL IN STREET ARFAS _
1. IF S/W IS AGAINST CURB, FILL
ROCK TO BACK OF S/W.
2 IF S/W IS NOT AGAINST CURB,
FILL ROCK 2' BACK FROM CURB.
PIPE BEDDING AND
BACKFILL DETAILS
REFE,"CE APrRQVED BY DRAYM BY
M-406 (MOO.) .AB
Cl Ty OF�IIGARD SCAB DATE oma. Ftf
O sGm N.T.S. 7-9-93 .t0CTAf S J)
EXISTING PAVEMENT DIG OUT REPAIR �---SAW CUT OR GRINDING
/AC
0 00000 0 poo�t
000 0 0 0 C0 ° 00 0 o
� AGGREGATE BASEROCK
Ooppoo��0°OoQo �o0 00�00 0
0000 00000 0 0 0000
COMPACTED SUBGRADE
f° RESIDENTIAL LOCAL STREETS:
AC - 6" ASPHALTIC CONCRETE,
AB - 4" (1-1/2m - 0") AGGREGATE BASEROCIy ��..
.. OR war /
Ac �' 8" ASPHALTIC- CONCRETE
MINOR'GQ,LLECTOR STRE7TS,,•AI<
i COMMERCIA�L`INDUSTRIAL LOCAL STREETS:
AC - 7" ASPHAL-1C CONCRETE,
AB - 4" (1-1'/2" - -07) AGGREGATE BASEROCK
i OR
9" ASPHALTIC CONCRETE
MAJOR COLtF�CTOR STREETS:
ton
~ AC - 9" ASPHALTIG..CONCRETE,
AB x„47 (1-1/2" - 6"),AGGREGATE BASEROCK
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PAVEMENT DIG OUT REPAIR DETAIL
REFERENCE APPROV[D BY DRAWN BY
CITY OF TIGARD GAA rA8
SCALE DATE DWG FILE
OREGON N.T.S. REVISED 5-26-94 J;DETAILS/DIG-DUT.DWG
GENERAL NOTES
1. TRAFFIC SIGNS TO BE 48' X 48'
aw mix" O BLACK ON ORANGE.
100. 2 NO COLLECTOR STREET LANE Q.OSURES
MIN. I OR LOCA STREET CLOSURES DURING
THE FOLLOWING TIME PERIODS:
we s werw*via
p
7:30 - 81:30 A.M.
100' I 4:30 - 5:30 P.M.
MIN.
FLAOM3. THE CITYS STANDARD SPECIFICATION
O FOR TRAFFIC CONTROL IS "MANUAL
• ON UNIFORM TRAFFIC CONTROL
100
MIN. DEVICES FOR STREETS AND HIGHWAYS%
in I U.S. DEPT. OF TRANSPORTATION,
u
FLAGGER FHUA, 1988 EDITION.
< y
P� 100' 4. ACTUAL SIGN PLACEMENT TO BE
O MIN. ■ ■ ADJUSTED IN FIELD. DO NOT REDUCE
Z 50 MIN. BELOW MINIMUMS WITHOUT CITY
-
12 -1 APPROVAL
'
MIN.
I■ j 5. THE CITY RESERVES 'THE RIGHT TO ADD TO
■ 100 OR MODIFY TRAFFIC CONTROL REQUIREMENTS
I ■ MIN z AS MAY BE NECESSARY TO EFFECTIVELY
■ in CONTROL TRAFFIC AND TO ENSURE PUBLIC
FLAGGI R ■ SAFETY.
u-
100 < 6. NO LANE CLOSURES WITHIN 200 FEET OF
A TRAFFIC SIGNAL WITHOUT PRIOR CITY
I M N.�-7A Z APPROVAL
O R�.wuo
1
10O'
I MIN. LEGEND
O OW LAW
0000 AM"
m-+ d TRAFFIC SIGN
I 100'
i-
MIN. ® CONSTRUCTION ZONE
N p -' coarw,c.■, ■ TRAFFIC CONES OR
APPROPRIATE DELINEATION
DEVICE.
c�
TRAFFIC CONTROL
TYPICAL DETAIL
�» APPROVM
CITY OF TI GAR D CAB
SCALE DATE DWG FU
OREGON H.T.S. 7-9-93 1 DET/TRAFCcx4T.DWG
Constniction Ins,pcction &Rclated Tests
Testing,1 esting, Inc. Geotechnical Consulting
X77-}.�/`-22 P.O. Box
JOB NO.
_ —._ Tigard, Oregoonn 97281
Aug 289 1997 Phone(503)684.3460
REPORT OF IN-PLACE DENSITY TESTS FAX 1503) 684-0954
Client TOY-A EXCAVATING
Project _ SEWER LINE - SW 1t)7TH AVE
13365 SW 147TH - TIGARD OR
Material Description O/4"-_O- ROCK FROM TIGARD SAND 21 GRAVEL
Max. Dry Density _ 1 lr�.'2 —lbs./cu. ft. Optimum Moisture 15.5 _°'o Method of Test AASHTO T-99
Serial M 24466 NUC :3444 _
r DATE OF TESTADi- ELEV. FIELD IN-PLACE DENSITY—
TEST LOCATION COARSE MAX. MOISTURE LBS.icU.FT.)
TEST NO PARTICLES DENS. FT. % WET DRY COMPACTION
CIENIER1 13F 107TH
8-11 4.5 124.0 118.7 1()()+
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Remarks:
cc: CITY OF TIGARD
TECHNICAL DIRECTOR
C. CROXFi iRD /CRW Reviewed By -_-----_--------------
p,Vffd dyeports porta i n to the material tested/ i nGpe-7-ted only. CARLSON TESTING INC.
fnf(irmation contained herein is not to he reproduced, e.Ncert in full, withluit prior mithorization faun this office.
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CIT OF TICARU BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Phone: 639-4171
1
Date Requested: �-—� A.M. / MST:
Location: G l L-Q— BUR
Tenant: Suite:— Bldg: NEC:
_
(Cdntrac _ Phone: �_ C� s-4t /!I PLM: _
T
Owner:_ Phone: ELC
_ ELR:
5- . 11, O-3o,S-
BUILDING BLDG(con's) PLUMBING MECHANICAL ELECTRICAL. SITE
Site Post/Beam Post/Beam l'ost/Bcam Cover/Service Sewer/Storm
Footing Roof tJndl,USlab Rough-In Ceiling Water Line
Slab Framing Top Out Gas line Rough-In UG Sprinkler
Foundation Insulation mer Hood/Duct Reconnect Vault
Bsmt Danip Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Shetu/Shcath Fire Spklr/Alm Crawl/Found Dr Ileat Pump Low Volt
Approved Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Apprrved Not Approved Not Approved Not Approved
FINAL FINAL 'FINAL FINAL FINAL
i rein. c ion O Reinspection fee of S required belt next inspection O I Inable to inspect
1r.:pci tr,r � _— — Date:_ � __��_ Page _ of
CITY OF TIGARD
A� a
DEVELOPMENT SERVICES SEWER CONNECTION
13125 SW Hall Blvd.,Tigard,OR 97223 (503)639-4171 FERMI T
PERMIT fl. . . . . . . : 0'WR97- 30`
DATE ISSUED: 08/04/97
PARCEL: 2S 103DA--04 100
SITE ADDRES7). .. . : 1336J SW 107TH AVF,
SUBDIVISION. . . . . I.0NIN3: R- 3.
BL..00K. . . . . , . . . . LOT. . . . . . . . . . . . . . JURISDICTION: TIG
TENANT NAME. . . . . :PETERS
USA NO. . . . . . . . . . . FIXTURE UNITS. . . . 0
CLASS OF WORT%. . . :AL,T DWELL.I NG UNI TS. . : 1
TYPE OF USE. . . . . :SF NO. OF BUILDINGS: 1
INSTALL TYPE. . . . :L.TPSWR I MPERV 'SUPFC-)C E: 0 s f
Ramat^ks : Ml.tst pr_raup, fill, and cap septic system.
Owner,:
RALPH J PETERS type amaUTI t by elate recpt
10800 SW FAIRHAVEN WAV PRMT $ :'04?r. 00 JSD 08/04/97 9'7-2'97668
TIGARD OR 97223 INSP 'G 30. Oe JSD 0A/04/97 97-297888
Phone
OWNER
()hone 2-2235. 00 TOTAL
. Reg #. . .
REQUIRED I NSPECT I ONr .......______
This Applicant agrees to comply with all the rules and regulations Sewer Inspection
of the Unified Sewage Agency. The permit expires 180 days from Septic Tank Fill
the date issued. The total amount paid will be forfeited if the
porvit expires. The Agency does rot guarantee the accuracy of the
side sewer laterals. if the sewer is not located at the measurement
given, the installer shall prospect s feet in all directions from
the distance given. If not so located, the installer shall purchase
a "Tap and Side Sewer" Permit and the Agency will install a lateral.
ATTENTION: Oregon law requires VOL to follow rules adopted by the _ _ _ _ _-_ - ......
Oregon Utility Notification Center. those rules are set forth in CAR
95e-001-3010 through OAA 952-0001-0080. You say obtain copies cf
N these rules or direct questions toby calling 15031246-1987,
red by � � Permittee Signatr_rre : *gr
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I +...++++++-h+++++^F+4.++i--F+++++•f+++++++++++++-F++4- ++4++4+++4+++•++++++++++++++++++i-+
Call. 639--41.75 by 6:00 p. in. for- an inspection needed tf)e next b+.%siness clay
i-++++++-t+4.+++4--+-+-# -r•t+++++i•+i+-f++++.++{++++++++++4•++4+-+++i++++ { ++++•++-h++-F++++++i+4
r.r►
#
Y OF TIGARD Residential Building Permit Application Pian Check
Recd By
5 SW HALL BLVD. New Constriction Additions or Alterations Date Reed
!GARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E.
503-639-1171 Date to DST i
503-6847297 Permits 777-_>`-035t:>
Print or Type called
Incomplete or illegible applications will not be accepted
t Nam*of.Protea game
Job
Address Site Ad
dret�L � �U>
Architect Mailing Address
M Aix
City/State Zip Phone
Name C L / Name
Owner Mail Addiess _ f l OW
11 / J �L En Meer Mailing Address
cru. 6- /c'i�te zi <<.17y�P�� g
Name City/State Zip Phone
General Describe work New O Addition O Alteration O Repair O
:OntraCtOr Mailing Address to be done:
Additional Description of Work:
Cay/State Zip Phone
Oregon Const.Cont.Board Lic.# Exp. Date
Att leh Copy of
Current COT Business Tax or Metro# Exp. Date PROJECT
Licenses VALUATION
Name
Mechanical NEW CONSTRUCTION ONLY:
Sub- Mailing Address Sq. FL House: Sq. Ft. Garage
Contractor GtylStare Zip Phone Comer Lot YES NO Flag Lot YES NO
check one) (check one)
Oregon Const.Cont.Board Lic.# Exp. Date I Restricted Audio/Stereo Burglar
Attach copy of Ene gy System Alarm
Current COT Business Tax or Metro# Exp. Date Installation Garage Door HVAC
-1Cen3es _ Opener Systems
NarTe (check all that Other:
Plumbing apply)
Sub- Mailing Address Will the eler:trical subcontractor wire for all YES NO
Contractor restricted energy installations? _
C.tyrState Zip Phone Has the Subdivision Plat recorded? I N/A YES NO
Oregon Const. Cont. Board L,c.# Exp. Date Reissue of MST#: Solar Compliance
Attach Copy of (Calculation Attached)
Current Plumaing Uc # Exp. Date I hearty acknowledge that I have read this application,that the
Licenses information given is correct, tnat I am the owner or authurized
v COT Sue nese rax or Morro d Exp. Dare agent of the owner, and that plans submitted are in compil;nce
- —
Name with Oregon State laws
-� Electrical X
Signature of Owner/Agent D
C4
Sub- '.1a ling Address Contact PersorfNarm 7 e
Contractor
C,ty/State Zip Phone FOR OFFICE USE ONLY:
Plat#: Map/TLO:
tttach Copy of
Oregon;;oust. Cont. Board Lic# � Exp Date
Setbacks: Zone: Solar.
Current E!ec ncai Lc s I Exp Date
Licenses Engineering Approval: Plai,ning Pproval: TIF:
COT 3usiness Tax or rdetro# I Exp. Cate I
REVIDL.00C (DST) 3.97
MST. Permit (BUILD) (UBUILDII X
Plumb. Permit (PLUMB) (UPLUMB)
Mech. Permit (MECH) (UMECH)
ELC/ELR Permit (ELPRMT) (UELPMT) _
State Tax (TAX) (UTAX)
BLDG:
PLUMB:
MECH:
ELCIELR:
Plan Check
MST: (BUPP-N) (UBUPLN)
Plumb: (PLUMB) (UPLUMB)
Mech:
(MECPLN) (UMEPLN)
CDC Review (BUILD) (CDCBLD) (UCDC)
CDC Review(PLN) (CDCPLN) KIA
Sewer Cannon (SWUSA) (USWUSA)
Reimbur. District ( ) ( )
Sewer Inspection (SWINSP) (USWINS) = _
Parks Dev Charge (PI(SDC) N/A _
Residential TIF (TIF-R) (UTIF-R)
Mass Transit TIF (TIF-MT) (UTIF-M)
Water Quality (WQUAL) (UWQUAL) —
Water Quantity CvVQUANT) (UWQANT)
Erosion Control Prmt (ERPRMT) (UERPMT) _
Erosion Planck/USA (ERPLN) (UERPLN)
Erosion Planck!COT (EROSN) (UEROSN)
LO
Fire Life Safety (FLS) (UFLS)
TOTALS:
I:SFREMDL.DQC (DST) 6197
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Pusiness Phone: 6)39-4171
(2n�
Date Requested: _ _ I 1 A.M. P.M. MST:
Location: -37�� ! v / BUP:
Tenant: Sui, Bldg: ._ MEC:
Contractor: Phone: _ =� PI.M: _
Owner: _ Phone: ELC:
—�r!YYI.I.C�d�� � v 9L l � �QL✓�_�1.__11 r� ELR:
�— SIT: _
BUILDING BLDG(can't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam PosUBeam .over/Service Sewer/Storm
Footing Roof UndFl/Slab Rough-In Ceiling Water Line
Slab Framing Tout Gas line Rough-In UG Sprinkler
Foundation Insulation ewe Flood/Duct Reconnect Vault
Bsmt Dan•p Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Shear/Shcath Fire Spklr/Ahn Crawl/Found Dr I]eat Pump Low Volt lsc.
Approved fared-- Approved Approved Approved
Appr/Sdwlk Not Approved ofpproved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FINAL FINAL
J
C7
11;
C7 Call fa7rV, c `'C7 Reinspec ' n f of S required before nest inspection O l Innhle to inspect
i
Inspec or — - t).re -- Page------of --
.P O Y - A Proposal rv�.
• EXCAVATION INC.
21258 SE LANSING LN. �ht?et f10.
BORING,OR 97009
OFFICE:666.6357 • PAGER:299-5478
Proposal Submitted To: Work To Be Performed At:
Name 7 , 4 4
Street �Car1 a l� l � SC(/ , ! C 7 -- Street
city City State _
State n n — Date of Plans
Phone Architect
We hereby propose to fumish the materials and perform the labor necessary for the completion of
r
;
/1q .a( el u Mh
/ i
loll
All material is guaranteed to be as specified',and the above work to be performed in accordance with the drawings and specifications submitted for abgve
work and completed in a substantial workmanlik anner for the s m of Dol lars
with payments to be made as follows: ��2' � _L e s�C �P f
Any alternation or deviation from above specifications involving extra Respectfully submitted !e
costs,will be executed only upon written orders,and will become P Y
1 an extra charge over and above the estimate. All agreements Per -u
contingent upon strikes, accidents or delays beyond our control.
L Owner to carry fire,tornado,and other necessary insurance upon
n above work.Workman's Compensation and Public Liability insurance Not -This proposal may be rawn by
on above work to be taken out by:
us if not accepted within days
I
J
"Not responsible for broken water lines ani,unrl,rground utilitif s.
L:
J
ACCEPTANCE OF PROPOSAL
The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as specified.
Payment will be made as outlined above.
Date Signature * A�
Signature
CITYOF TIGARD u L L t) I Q-(., T-' C-topY_
DEVELOPMENT SERVICES ENGINEERING PERMIT
PERMIT #. .. . . . . . : EN097-0046
13125 SW/Hall Blvd.,Tigard,OR 97223 (503)639.4171 PRIM. PERMIT #. . : ENG97-.004(
DATE ISSUED: 08/06/77
SITE ADURE::S`::,. . . : 1.3315 SW 10. TH CiVf-: PARCEL: S103DA---04100
SUBDIVJSIGhI. . . . : ZONING:R-3. 5j
RLOGK. . . . . . . . . . . LOT. . . . . . . . . . . . . : JURISDICTION: TIG
PERMIT TYPE. . a SOP PUBLIC IMPRV QUANT. (LIN FT) VAL.UE
AGREEMENT DATE: / / GRAD/EROS $
ASSURANCE EXPIRATION-,---- STREET i
PERFORMANCE: / / SAN SEW
MAINTENANCE r / / STM SEW
PATHWAYS t
Ai L- OTHER
TOTAL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E
F?emarkq. : STREET OPENINP,, TO TATS AN EXISTING NSA[ MAINLINE S{MIIIARY SEWER LINE
AND INSTALL A SIDE: SANITARY 9EWER LATERAL.
I•eI,m i t t e:+: __._..____. ___ __.__._ FEES ____._____..._____-
type amount by date recpt
OPEN $ 32. 00 ORA 08/06/97 97-298022
MISD $ 800. 01A ORA 08/06/137 97-298022
Phone #:
E:�:gir�epr~:
_ _.�_....._.....__� $ 8-147% 00 TOTAL.
Phone #:
REOU I RED INSPECTIONS
Permittee/AcT1atUre ---STORM SEWER--- -- ---STREET-.-•---
�; M. 1i. & C. R. CRH L. I NF & GRADE:
AIPEw I-N & GRD SUPGRADE
r _, _led01
i BCKFLL. A. C:MF'C'T BASE: ROCK
AIR & TV TEST LEVEL COURSE
t,ity of Ti Mrd, Oregon WEARING COURSE
t:31.25 S. W. Hall 131vd. ......._.SAN. SF:.WER---- TRACT' & PED CONT
1'I CARD, Oregon 97223 M. H. & C. 0. MONUMENTAT x ON
)hone #: F1,39-4171 PIPE LN & G.ZI aTREETLIGHTING
BCKFI-L & C'MPCT WAL.K/APRON/RAMP
AIR & TV TEST
OR INSPECTICIN, CONTACT: ----GRADING--•- -
l.etha Thomns #62,9-4171. (office) ---REPR' S/AD.T, S---. CONTOURS
#780-2647 (mobile) DRAINAGE.
_.-.-..-PATHWAYS------- EROSION CNTL.
SPEC I AI.- CONDITIONS: