9860 SW SERENA WAY-2 I
,1 .� ... F AI•.Mur•YIk1YxbMRY1+f/'+TM}/wp{y/,,..!1�.. -_.- _
1;
1
'.1
ADDRESS:
q91A Lo 's-a Lk)au�,
�ry
1
c '
tt
i�
n.
is\i ecords\microflm\targets\building.doc
d:
4 ,. .
1
...a�.,�_.,...... a ..._....�..�•..v� ....-..,w....q..,....,�.--.......�,....-. .v+••..n.a..__.... .,,i... �:nV ivly+'Pt4'PlM�iw r.ivtw r—/-1�. ......�.. .. . _ .�
APPLICATION - STREET IMPROVEMENT/EXCAVATION COPY To
(WHITE:
LX )-FILL
ORDINANCE NO. 74-14 / (YELLOW) -INSP.
(INSTRUCTIONS ON SEPARATE SHEET) q (PINK)•OTHF_R AGENCY blag1
Id (BLUE)-APPLICANT
t
APPROVED APPLICATION NO.:
CITY OF TIGARD, OREGON FEC AMT.: : 22.00
NOT APPROVED 1.1 -- —
PENDING FEE PMT. ❑ CITY HALL. RECEIP —
�rf� _1+ ZS )
PENDING SECURITY ElU
PUBCWORKSDEPARTMENT BYL1���1 —
_DATE
PENDING AGENCY "OK' ❑ 1pplieaUOn and Progress Record
MAINTENANCE BOND +R.. —_,—
PENDING INFORMATION O FOH STREET IMPROVEMENT/EXCAVATION AS REQUIRED
ANNUAL
PENDING VARIANCE ❑ —_� — EXPIRATION DATE:
PERMIT NO. '�R_"`_fL�'- DATE ISSUED: :;7 BY:
(I i APPLICATION IS HEREBY MADE TO EXCAVATE FOR AND INSTALL_ REMOVE DEFECTIVE _ M_SIDWML,K
& REPLACE IT AS DESCRIBED HEREIN, IN FULL ACCORDANCE WITH CITY REQUIREMENT5.
4&-C Way cell a 639-3494 (night)
APPLICANT _Georgia P. Willa 9860 SIV Serena, way Tigard, Or 97224___244-7.563 (days
NAME ADDRESS CITU PHONE
CONTRACTOR _ Anderson's Concrete Inc. 10130 SW Tigard Ave. Tigard, OR 97223 684-5638 _
NAME ADDRESS CITY F F46-14E
PLANS
PLANS BY - Per City Standards/Spec ificaticxls __
NAME DRESS CITY
ESTIMATED IMPROVEMENT TOTAL VALUATION ( COST): S S 550.00
DOLLARS
(2) EXCAVATION DATA: FOR OrrICE USE: MIN.
-
o.m x s 550.00 —=s
STREET DESCRIPTION PROGRESS & INSPECTION STATUS
NAME SURFACE CUT CUT CUT MATERIAL INSTALLED ITEM DATE REMARKS/TYPE BY
TYPE LENGTH WIDTH DEPTH ITEM 6 QUANTITY
STREET
OPENED
Serena Way ( •.4�.3 attach j) INSP a
_ R TIOV
EQ 1
U _
E
ESTIMATED STREET OPENING DATE: L �_ � S
ESTIMATED STREET CLOSING DATE: __.._ / E
D
550• STREET
(3) SECURITY NO. -------- SECURITY AMT.: s 55 _.. cLosEo _
SURETY CO.: /0 FINAL
CN[Clt CASH D DOND INSPEC.
(4) PLOT PLAN: INDICATE SITE PERTINENT PHYSICAL SPECIAL PROVISIONS /CONDITIONS:
FEATURES; EXCAVATION LOCATION AND EXTENT.
(To Durham Road) N --- --
- See At-tachA,,41 -
1
CURB
1 I I I 1
SIUTA WAY
1 C7 I BITE:
I I _
1 9F36t� AM Rarer t4ay I
(S) NOTE THE CITY OF TIGARD DOES RZTT. HEREBY GRANT RMISSION 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 WITH ALL PERTINENT LAWS 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 ACTIONS.
APPLICANTS SIGNATURE ! �,_ DATE
Y�4�Ax SAA vt ... 1i
A I
loD
Pape No. 1 CASE HISTORY FOR CASE. NO.: ENG94-0025 K �
GEORGIA P WILLS MACK WARREN)
os/x4/98
09860 SW SERENA WAY
1 S
pi Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
} Code Sent Done Done Date By
....... ........ ........ ---- --- -------- ---
F.NGA010 APPLIL.."ION RELIEVED / / / / 05/02/94 JSH 05/17/94 JSH
ENGA040 Review inittated / / / / 05/03/94 JSH 05/17/94 JSH
ENGAOSO REVIEW COMPLETE / / 05/03/94 05/03/94 JSN 05/17/94 JSH
ENGA060 Constr docu prep initiated / / / / 05/03/94 JSH 05/57/94 JSH
ENGA070 Docu provided to applicant / / / / 05/03/94 APPLICANT (JACK WARREN) NOTIFIED VIA JSH 05/17/94 JSH
TELEPHONE, PERMIT IS READY.
ENGA080 Constr docu accepted by City / / 05/03/94 05/03/94 JSH 05/17/94 JSH
ENGA090 Fees/Depoe/Aasur remitted / / 05/03/94 05/03/94 JSH 05/17/94 JSH
ENGA110 (F) PERMIT ISSUED / / / / 05/03/94 JSH 05/17/94 JSH
ENGA120 Constr notice received / / / / 05/10/94 LT 05/25/94 LT
ENGA130 Initial insp performed / / / / 05/10/94 LT 05/25/94 LT
ENGA150 Field-check (LAST) / / / / 05/18/94
LT 05/25/94 LT
ENGA170 CONSTR COMPL t SATISFACTORY / / 05/18/94 05/18/94 LT 05/25/94 LT
ENGA180 Assurance released / / / / 05/26/94 JSH 05/26/94 JSH
ENGA190 RECORD CLOSED / / / / 05/26/94 FILE ROUTED TO "RE-,ORDS", FOR STORAGE. JSH 05/26/94 JSII
I
r
I
I
I�
f
I
"1!' Atr*.,., ��"�'' •�,,.'jM'_ s+ ".•.•� e! iPIF/Ir.`+.v '.MY w1 ••�. vy.L�,,*��+. s-
Y
;k
•
CITY OF TI
GARS
Code Enforcement
13125 SW Hall Blvd. CITY OF TIGARD
fi39-4171 W/�Cf v OREGON
NOTICE: PROPERTY LOCATED AT
is in violation of Tigard Municipal Codey�;
Section�.,,�
i ' oi' ��v,l4✓r1 t-is c ,
Pff
in order to avoid a citation and summons,the
A62�
must be removed/abated wi" eT-0 0
If ten (10) days is not sufficien ) �Y�receipt of this notice.
Please call regarding the signing o far,compliance tion,
for an extension. Failure to abate the violation may Initiatethereement
Issuance of both a Citation and a Summons.
If you have any questions
please contact the Code Enforcement
Officer named below at 639.4171.
TAX LOT# o �ioo
OWNER:*'N.L-`,P ------_--_ F
T A�•/� t
Officer:
Signature , te:-4