8800 SW SATTLER STREET FILE NO.
BATTLER STREET-BbUU STR. UPN. PERMIT
CITYOF TIIFAPD
April 24, 1989 OREGON
Mr. Kirk D. Martin
12220 SW Danfield
Beaverton, OR OR 97005
Re: Street Opening Permit #266-87 Assurance Release
Dear Mr Martin,
This is sent to notify you that the work has been found to be satisfactory arid,
further, that the City subsequently acknowledges that the permit assurance bond
(#804047) is now considered void.
Sincerely,
John Hagman A
Engineering Technician
jlh
cc: Contractors Bolding & Insurance Co.
1213 Valley St.
Seattle, WA 98109
13125 SW Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223 (503)639.-4171 ----------
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STREET OPENING PERMIT
PERFORMANCE BOND BOND NO.804047
KNOW ALL MEN BY THESE PRESENTS that we, - �.;_�} D Martin Cons r i -i m _
, as Principal, and Contractors Boncliticr end T11FA ran(-Q Convany_
as Surety, are jointly and severally held and bound unto the City of
Tigard, Oregon, in the sum of **Five llundrecl**
Dollars ( X00.00 ) for the payment of which we jointly and
severally bind ourselves, our heirs, executors, administrators , successors and assigns
firmly by these presents.
THE CONDITION OF THIS BOND IS SUCH:
That whereas the Principal herein has made application to the City Engineer of the
City of Tigard for a permit to bore under or gut concrete
within the City of Tigard right-of.-way of
Settler Street _Tigard, Oregon, under the
provision of Ordinance No. 74-14 and 76--11 Code of the City of Tigard , and whereas said
application was approved by the City Engineer of said City and a permit therefor issued,
subject to and upon certain conditions, directions, stipulations, terms, provisions and
requirements provided for in said permit, a copy of which permit is attached hereto and
hereby made a part of this bond to the same extent and effect as if written herein and
specific reference now made to all the terms, provisions, specifications and
requirements set out, declared and provided for in said permit;
NOW THEREFORE, IF THE Principal herein shall faithfully and truly observe the terms,
I provisions, conditions, stipulations, directions and requirements of said permit and
shall in all respects, whether the same be enumerated herein or not, faithfully compl;
with the same and shall assume the defense of , indemnify and save harmless the City of
Tigard, its officers, agents and employees from all claims, liabilities, loss, damage or
Injury which may have been suffered or claimed to have been suffered to persons or
property directly or Indirectly resulting from or arising out of the operations or
conduct of said Principal or any avibcontractor in the performance of the work under said
permit and shall indemnify and make whole the City for any injury or damage to any
street, highway, avenue or road or any part thereof, resulting from the operations or
conduct of said Principal or any subcontractor in connection with performance or conduct
of the work under said permit , and shall In all respects faithfully keep and observe all
of said terms, provisions, conditions, stipulations, directions and requirements, then
this obligation is void, otherwise it shall re-nein in full force and effect .
WITNESS our hands and seals this 20th day of AurTust , 19 87
Kirk D PI<inrtin Const citon
\
(Seal )
(Seal )
Principal
Countersigned by:
Agent Contractors Bondi and Insurance Cortmany
Attorney-in-Fact
(JH:bs/0916P) lane Thorsen
CONTRACTORS BONDING limited 1213 Valley StreetSeattle, WA
LA AND INSURANCE COMPANY Power of Attorney (206)622-705Z
KNOW ALL MEN BY THESE PRESENTS that CONTRACTORS BONDING AND INSURANCE COMPANY,a corporation duly organized and existing ender the laws of the State of Washing
Ion and having its principal office in Seattle,King County,Washington,does by these presents make,constitute and appoint JANE THORSEN,o!Portland,Oregon,its true and lawful
attorney in tact,with full power and aulhorlty hereby conferred in its name,place and stead,to execute,acknowledge and deliver contractors'license bonds issued pursuant to RCW
Chapter 18.27 and ORS Chapter 701;electricians'license bonds Issued pursuant to RCW Chapter 19.28;miscellaneous bonds,as those bonds are generally understood in the trade,
not exceeding the penal sum of$25,000;other license bonds not exceeding the penal sum of$25,000;and permit bonds not exceeding the penal sum of$25,000;and to bind
the Company thereby as fully and to the same extent as if such bonds were signed by the President,sealed with the corporate seal of the Company and duly attested by its Secretary,
hereby ratifying and confirming all that the said attorney In-fact may do in the premises.Said appointment is made under and by authority of the following resolutions adopted by
the Board of Directors of the CONTRACTORS BONDING AND INSURANCE COMPANY on April 18, 1986.
RESOLVED that the President is authorized to appoint as aftorney in-facl of the Company JANE THORSEN with power and authority to sign on behalf of Me Company
contractors'license bonds issued pursuant to RCW Chapter 18.27 and ORS Chapter 701;electricians'license bands Issued pursuant to RCW Chapter 19.28;miscel
laneous bonds,as those bonds dre generally understood in the trade,not exceeding the penal sum of$25,000;other license bonds not exceeding the penal sum
of$25,000;and permit bonds not exceeding the penal sum of$25,000.
RESOLVED FURTHER that the authority of the Secretary of the Company to certify the authenticity and effectiveness of the foregoing resolution in any Limited Power
of Attorney is hereby delegated to the following persons,the signature of any of the following to bind the Company with respect to the authenticity and effectiveness
of the foregoing resolution as if signed by the Secretary of the Company:Donald Sirkin,Janet K.Lorraine,John T.Dyment,Rikka Gronnel,Gerald A. Usselman,
Gary Bailey and Terrie Rehm.
RESOLVED FURTHER that the signatures of the President,Notary Public and person certifying authenticity and effectiveness,and the corporate and Notary seals
appearing on any Limited Power of Attorney containing this and the foregoing resolutions may be by facsimile.
RESOLVED FURTHER that all resolutions adopted prior to today appointing the above named as attorney in fact for CWTAA` BONDING AND INSURANCE
COMPANY are hereby superseded. gONDI !�!!
IN WITNESS WHEREOF,CONTRACTORS BONDING AND INSURANCE COMPANY has caused these presenls to be s,�-Zlll s ravdeett 4gs cailllo/ali5eal to be hereto allixed
this 18th day of April, 1986 GO R po,Q ••
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CONTRACTORS BONDING AND INSU
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BY _ Jam___—_.— —.— -�--.- /�j ••. ���d
Steven A Gaines, President ,��Nii�y�y /�Ir�• I
STATE OF WASHINGTON-COUNTY OF KING /// �\1LEEN �- f, �,r •1979
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.1,i �+�►•••...CS.cc..• � y�N TSN
On this 181h day of April, 1986,personally appeared STEVEtylr GAIN ntt4lrl�� '1be Ant of the corporationlRalplt;� �k oing Limited Power of Attorney
and acknowledged said limited Power of AHorne ih� tee anb•v61a la p�qQ de,d y �yuafion,for the uses and purpo es therein mentioned,and on nath slated
that he Is authorized to execute the said Lim , Power 4 AtlArrvy "i,Q9 fo•�``� h
IN NESS E F, I hay e to s no a tat slfte dael-amA a44hove written
Notary Public in and for the 5t of Washington, res ingxS�e :•?0' lcjlbr ••• r• `TIS
The undersigned,acting under authority of the Board of Director((.,�iA 11M�5_•Q •IQINSURANCE COMPANY,hereby certifies,in lieu of Certificate of the Secretary
of CONTRACTORS BONDING AND INSURANCE COMPANY,that thtr7�yxR H;4 j104,true and correct copy of the Original Power of Attorney Issued by said Company
and does here by.�p,�certify th he sell ower of Attorney is still l�i"Rr��nert�elfeL��n
GIVEN under my hand at this--.20 �N. day of- _ 19 �^ 7
PoaJT01.01•US052886
APPLICATION -- STREET IMPR` rMENT/EXCAVATION COPY TO:
ORDIN.,.ACE NO. 7414 (WHITE)•FILE
(YELLOW).INSP.
(INSTRUCTIONS ON SEPARATE SHEET) C] (PINK)-OTHER AGENCY
�F,r(BLUE)•APPLICANT
APPROVED APPLICATION NO.: - 3C� Z
NOT APPROVED Cl CITY OF TIGARD, OREGON FEL AMT.
PENDING FEE. PMT. ❑ CITY HALL RECEIP
PENDING SECURITY El PUBLIC WORKS DEPARTMENT ByY - DATE g I / 81
PENDING AGENCY ''OK" ❑ Application and Progress Record r
FOR STREET IMPROVEMENT/EXCAVATION
MAINTENANCE REQUIRED M
PENDING INFORMATION ❑
ANNUAL
PENDING VARIANCE I.� EXPIRATIO D TE: CTA!'_
PERMIT NO z�� "� DATF ISSUED ' l ZQ/ BY:
(1) APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL rE, lVA -.___ :_aK>_ eRl4t1`► , iJ
M-'-1AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENTS.
/� // M / // % III
APPLICANT __Y/I'K /,/•SIN IZ�ZZO 5,1.4// ba"04eJd sve��os, &�j 97DUS 1210 3�D�
1 NAME 1 ADDRESS CITY PHONE
._
CONTRACTOR1r 1+, IZr�►H�� w�y��
AME
•V�y�rff,rum AbDRE98 CI Y �MONE
PLANS BY � , V��� \ '{r' 93c�/ 5 s.�dQF,�j72ZZ �11� 779'417�
NAME -w.ITT, ADDRESS CITY PHONE
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): S
DOLLARS
FOR OFFICQ USES Nr MIN.
(2) EXCAVATION DATA:
0.04 X S S =S zr.2.
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME. SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM 8 QUANTITY
STREET
_ P N
LA-) R TIION
E
/ Q
ESTIMATED STREET OPENING DATE:� � �-•/ / c 7 ES
ESTIMATED STREET CLOSING DATE: c T - -
E
(3) SECURITY NO. 804047 S CURITY AMT.: S S(J0, - STREE'r
I7N�.--[1- t CLOSED
SURETY CO.: _�K*ry&4hetis .•he ns;l� FINAL A
CERTIFIED CHECK i CASH GOND '. INSPEC. -1 ��, r Q
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS/CON (TIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT.,)�
1 ILA
r'� _ I , ��:.��s�cre. �
1 1 1 I I Q C r H� rr
C � �` f l L._ �Cy
URB \ r \ ___ _ F/Ldp/-�� I� S. rT
I 1 ( I
1 I i 1
(5) NOTE THE CITY OF TIGARD DOES NOT, HEREBY, GRANT PERMISSION TO APPLICANTS TO CONDUCT WORK WHERE
RIGHT-OF-WAY JURISDICTION IS THAI' OF WASHINGTON COUNTY OR THE STATE OF OREGON.
THE APPLICANT AGREES TO DEPOSIT THE REQUIRED SECURITIES. TO COMPLY WITH ALL PERTINENT LAWS AND
CONSTRUCTION SPECIFICA rIONS PERTINENT TO CONDUCT OF THE WORK, AND TO SAVE HARMLESS THE CITY AND
EMPLOYEES AGAINST AN" INJURY OR DAMAGE WHICH MAY RESULT FROM APPLICANTS ACTIONS.
1
APPLICANTS SIGNATURE DATE _�5��./ /
PLEASE TAKE THIS TO THE CASHIER FOR_A RECEIPT
NAME: tC.J, - _---Y -- z 0 -8
ACCT. y DESCRIPTION — -�
AMOUNT
.10--22000 Refundable Performance Bond Deposit _ $�
10-43500 _ Sign Permits HOP TU $
10--43600 _ Public Sewer Plan Check/Inspection Fee-_ $
10-43600 Public Storm Plan Check/Inspection Fee _ $�
10-43600 Street Dedication/Public Improvement_ Fee $
10--_43600 ) Street Opening Permit -g� $
��—
10-43601 Street and Traffic Marking__v - $
21-44200 ' Street Li ht Fee
10-43700 SubdiviDion �
p.MAR IN 'CONSTRUC'T'ION
12220 SW
KIRK DENFIELD W-3401
gCAVERTON.ORE0614
$ """"_
OOUlARs
PAY TO THE _
ORDL.R OF — —s
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un�trofTATESNnT�
FOR_
1045P/0023P
/ No. 24932
Clll(OF TI��I�
" 13025 S.W. HALL BLVD.
P.O. BOX 23397 Vete%
TIGARD,OR 97223 �
Name
Address �— --
Lot Block/Map Subdivision/Address
Permit #'s Bldg. Plumb Cash Check
Sewer v Other - QthE�r ---- Rec.By
Acct. No, Description Amount
10.432 Building Permit Fees_ _
10.431.600 Plumbing Permit Fees _
10.431.601 Mechanical Permit Fees---
10-230-501
ees _10.230.501 State Bldg. Tax
10.433 Plans Check Fee
30.443 Sewer Connection
30.444 Sewer Ins tion
51.448 Street Syst. Dev. Charge
52-449-610 Parks I Syst. Dgv. Charge
52-449-620 Parks II Syst. Dev. Charge
31.450 Storm Drainage Syst. Dev. Charge
10.430 Business Tax _
10-434 Alarm Permit
10-227 Bell
10.455- Fines-Traffic/Misd/Parking u
10.230- CPTA Traffic/Misd/Vic. Asst.
1J-456 Indigent Defense —�
30.122.401 Sewer Service/USA i-
30.122.402 Sewer Service/City 30%
123sewer evice/City Malnt.t.
30-125 Unmatched
1.124 Storm Drainage
40.47 Bancroft-Fr—In. Pymt. _T
4 -471 Bdncroft Int. Pymt. —
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