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PFI2021-00123 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12021-00123 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 04/08/2021 Parcel: 2S 111 CC 12900 Jurisdiction: Tigard Site address: 10335 SW HIGHLAND DR Subdivision: SUMMERFIELD NOA Lot: 180 Project: Place Encroachment Permit Project Description: Temporary encroachment permit for moving PODs Class of Work: FEES Type 2-Sidewalk/Driveway Approach Description Date Amount Encroachment Permit 04/08/2021 S25.00 Owner: Total S25.00 REQUIRED INSPECTIONS Call 503-639-4175 for the IVR inspection request line or visit the City of PHONE: Tigard website at www.tigard-or.gov to schedule inspections online. Contractor: PHONE: Applicant: DANIEL PLACE 2358 SE DIVISION ST PORTLAND, OR 97202 PHONE: 7342393316 Please sign below to indicate acceptance of conditions and return a copy with the proposed work schedule along with names and contact information of responsible parties before beginning work. Permittee/Applicant Signature: See application__001Inn Issued By: Special Conditions(See Attached)' Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12021-00123 Type: Condition Name: Status: Severity: PFI_Sidewalk/[ 01 -WORK SITE REQUIREMENTS Applied Notice Applicant must comply with all applicable provisions of federal and state law,the Tigard Municipal Code,and the terms of any agreement with the City of Tigard regarding work to be done pursuant to this permit. PFI—Sidewalk/1 02-WORK SITE AREA Applied Notice The work area and approach roads shall be maintained in a clean condition,free from obstructions and hazards. The spreading of mud or debris or storage of materials or equipment of any kind upon any public roadway is strictly prohibited and violation shall be cause for immediate cancellation of the permit. The City may at any time order immediate clean-up and suspension of work to accomplish clean-up. PFI_Sidewalk/[ 03-WORK SITE EROSION CONTROL Applied Notice Prior to starting work, effective and approved erosion control devices must be installed and maintained meeting the Clean Water Services and DEQ requirements. The City may at any time order corrective action and suspension of work to accomplish effective erosion control. PFI_Sidewalk/[ 04-WORK SITE REPAIRS Applied Notice Disturbed landscaped areas shall be restored or replaced. Existing signs,pavement markings,mailboxes,etc.shall be reinstalled or replaced,with like kind of material.Obtain City approval of restoration work. PFI_Sidewalk/[ 05-TRAFFIC CONTROL SPECIFICATIONS Applied Notice Applicant shall provide traffic control according to the current edition of the"Manual on Uniform Traffic Control Devices [MUTCD]for Streets and Highways", U.S. Dept. of Transportation, FHWA,current edition,American Traffic Safety Services Association[ATSSA], and Oregon Temporary Traffic Control Handbook[OTTCH]. PFI_Sidewalk/[ 06-TRAFFIC CONTROL PLAN Applied Notice Submit a job specific traffic control plan. A copy of the approved traffic control plan shall be readily available at the work area.Traffic control devices,flag persons,etc., shall be in place prior to initiation of construction work and shall be effectively maintained. PFI_Sidewalk/[ 07-TRAFFIC CONTROL ROAD CLOSURE Applied Notice Public roadway shall not be closed to traffic,at any time,without obtaining written approval from the City Engineer. The applicant is responsible to provide 48 hour advance notice of traffic flow disruptions to affected businesses, residents and area wide Emergency Services: 503-629-0111 (Tigard Police Dept.,Tualatin Fire&Rescue)and to 503-962-8140(Tri-Met) and 503-431-2345(Tigard School District)and other service providers impacted by such closure. PFI_Sidewalk/[ 08-TRAFFIC CONTROL ADVANCE WARNING Applied Notice Advance warning of traffic disruption shall be provided to the public by placement of an approved advance notification sign at each end of the construction area 72 hours(min.)before initiation of construction work. PFI_Sidewalk/[ 09-TRAFFIC CONTROL PROPERTY ACCESS Applied Notice Access to existing properties shall be maintained at all times, including normal delivery service and mail service. Obtain City approval of any access closures. PFI_Sidewalk/[ 10-TRAFFIC CONTROL WORK HOURS Applied Notice Work is permitted in daylight between the hours of 7:00 a.m.to 7:00 p.m. Mon-Fri unless otherwise authorized by the City. PFI_Sidewalk/[ 11 -TRAFFIC CONTROL LIMITED WORK HOURS Applied Notice Hours of construction work on collector and arterial roads will be limited to 9:00 a.m.to 3:00 p.m. unless authorized by the City Engineer. Work will not be permitted on collector and arterial roads between 3:00 p.m.to 9:00 a.m. unless authorized by the City Engineer. PFI_Sidewalk/[ 12-TRAFFIC CONTROL MODIFICATION Applied Notice The City reserves the right to add to or modify traffic control requirements as necessary to effectively control traffic and to assure public safety. PFI_Sidewalk/[ 13-DRAINAGE CONTROL Applied Notice Drainage shall be controlled within the work site and shall not adversely affect adjacent private property,public property and the receiving system. The City may at any time order corrective action and suspension of work to accomplish effective drainage control. PFI_Sidewalk/[ 14-UTILITY NOTIFICATION Applied Notice Oregon law requires following the rules adopted by the Oregon Utility Notification Center. Said rules are set forth in OAR 952-001-0100 through OAR 952-001-0080.Copies of said rules may be obtained from the Center by calling 503-246-1987. If you have any question about the rules, contact the Center. NOTE: Damage to utilities shall be corrected at the permit holder's expense PFI_Sidewalk/[ 15-UTILITY LOCATION CONFLICT Applied Notice Applicant must verify all existing utilities for both vertical elevation and horizontal location prior to start of work(pothole before digging if necessary). Should conflicts arise and redesign or relocation of facilities be necessary, it shall be done at the applicant's expense. Changes must be approved by the City in advance of work.Applicant shall coordinate the work with affected utility agencies. PFI_Sidewalk/[ 16-TEMPORARY PATCH Applied Notice A temporary hard-surface patch shall be placed on trenches within roadways at the end of each work shift. Obtain advance approval of patching method. No trench shall be left at any time in an un-safe condition. Applicant is responsible for and is liable for hazards or damage resulting from the prosecution of the work. PFI_Sidewalk/[ 17-REPAIR OF EXISTING FACILITIES Applied Notice Work under this permit shall include repair of existing facilities(roads, ditches, etc.)as may be necessary, as determined by the Inspector, to overcome deterioration or damage which occurred in conjunction with the work authorized by the permit. Corrective work shall be done at the applicant's expense. PFI—Sidewalk/1 18-SEWER SYSTEM TEST Applied Notice A sewer system air-test and/or DVD T.V. test report and one set of"As-Builts"shall be provided for review and approval. PFI_Sidewalk/[ 19-PRECONSTRUCTION MEETING Applied Notice Before initiating any construction activity,the applicant shall coordinate with the City's inspector, <Insert Name>at<Insert Phone#>,to establish a preconstruction meeting. PFI_Sidewalk/[ 20-NOTICE TO COMMENCE WORK Applied Notice The applicant shall notify the City's Inspector twenty-four(24) hours prior to commencing work, prior to any staged inspection, and after completing work covered by the permit. PFI_Sidewalk/[ 21 -PERMIT/PLAN ON SITE Applied Notice A copy of the permit including a Certificate of Insurance,and all attachments, and a copy of the approved construction plan and all amendments shall be readily available at the work area. All work shall conform to the permit terms, conditions and provisions and to the City approved permit plans, and approved plan amendments and to the City's standards and specifications and to these General Conditions. Changes to any of these must be approved by the City, in advance of work performance. PFI_Sidewalk/L 22-DAILY INSPECTION REPORTS Applied Notice Applicant shall submit daily inspection reports,on a weekly basis,to the City's Inspector. PFI_Sidewalk/[ 23-MONUMENT PROTECTION Applied Notice Existing monuments, property corners, and survey markers shall be protected. Replacement shall be at the permit holder's expense. PFI_Sidewalk/[ 24-VALIDATION OF MATERIAL/CONSTRUCTION Applied Notice The City's Inspector may, at his discretion, require tests and or reports from the applicant to validate claims of material or construction adequacy/compliance. Such tests/reports shall be provided at the applicants expense. PFI_Sidewalk/[ 25-EMERGENCY CONTACTS Applied Notice Provide to the City inspector, in writing, the names and 24 hour emergency telephone number of two(2)persons who have authority to resolve problems,take corrective action and, in general,will be responsible in case of any emergency. The applicant shall notify the City Inspector, in writing, of any/all assignment changes. PFI—Sidewalk/1 26-RIGHT OF ENTRY/EASEMENTS Applied Notice Applicant to obtain proper right-of-entry and/or easements prior to starting work. Proof of right-of-entry or properly executed easements, shall be provided to the City. The City shall in no way be construed to be liable for the applicant's failure to obtain or provide for proof of right-of-entry or easements. PFI—Sidewalk/1 27-PRIVATE PROPERTY AGREEMENTS Applied Notice Provide the City a copy of an executed agreement[s]from the owner for each private property disturbed by construction activity. PFI—Sidewalk/1 28-AS-BUILT DRAWING Applied Notice One as-built drawing showing all new public improvements, including any revision made to the previously approved construction plans and,also, any improvement which may impact an existing public system or facility, shall be provided to the City by a registered civil engineer along with an engineer's certification of installation compliance (Certificate of Compliance). PFI—Sidewalk/1 31 -OTHER Applied Notice Other City of Tigard E 072021 V Permit#: `2W ENGINEERING I PUBLIC WOR k Temporary EncroadaJEU, iit for Furnishings An Encroachment Permit is required anytime a private party wants to put something in the City's right-of-way, such as placing tables and chaos on a City sidewalk. Prior to placing the encroachment, a permit must be obtained from the City. Upon receiving an application for temporary encroachment, the city will issue a tentative temporary permit.The tentative status will allow the applicant to place the encroachments in the ROW pending review by the City. If the City determines that the applicant has not complied with TMC 15.16,the City will contact the applicant to make changes.The applicant agrees to respond to requests by the City for additional information and to make any changes requested by the City. Failure to respond to a follow-up request by the City within a timely manner will mean denial of the application.The City will contact OLCC to inform the agency of any application denials.The Citv will base its review on ensuring the safety of all users. BUSINESS NAME: REQUIRED INFORMATION _X_Narrative regarding proposed use and encroachment into public right-of-way. Narrative must include number and size of tables,chairs,benches,stools,etc. Also explain how ADA accessible route will be maintained through right-of-way.The ADA route shall be a barrier free 5'wide area.This area cannot be used for furnishings or patron queuing/waiting areas. _Site plan / sketch showing encroachment,ADA accessible route,patron queuing and waiting areas, and furnishings with dimensions. _Site photos of right-of-way showing area of proposed encroachment. APPLICANT / PROPERTY OWNER INFORMATION I Is Applicant Same as Property Owner? ❑ Yes Z No Applicant Name: Daniel Place Property Owner Name: Susan Place Applicant Address:2358 SE Division St. Property Address: 10335 SW Highland Dr. City:Portland State: OR Zip: 97202 City:Tigard State: OR Zip: 97224 Phone: 734-239-3316 Phone: 734-239-2655 Email:danielwplace@gmail com Email: place.susan@gmai.com THIS ENCROACHMENT PERMIT IS SUBJECT TO THE PROVISIONS OF Tigard Municipal Code Chapter 15.16. I certify that tete info ation provide 'n this application is true and correct to the best of my knowledge. I a ree t bound by Tigard Municipal Code Chapter 15.16. L Applicant Signator Print Name of Applicant: Daniel Place Property Owner Signature: Print Name of Property Owner.Susan Place STAFF USE ONLY Received by: FIR. Per rut I-cc: _SU-W - Reviewed by: Additional Fees: Approved by: Permit Expires: December 31,2020 City of Tigard • 13125 SW Hall Blvd. - Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 CVV1ALW - At April 7", 2021 My mom is moving into her newly purchased house at 10335 SW Highland Dr. She has two 16' PODS which will be delivered on Saturday April 101", 2021 and will be picked up on Monday April 12", 2021. They will both be placed on the street in front of her house for this time. They will not block or be near any fire hydrant or other municipal feature. The Summerfield community has advised us that they do not have any internal restrictions on PODS placements. We are seeking approval for this temporary placement. Thanks, Dan Place for Susan Place