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PFI2013-00007 a CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT _ COMMUNITY DEVELOPMENT Permit#: PF12013-00007 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 03/21/2013 Parcel: 2S 104AD02000 Jurisdiction: Tigard Site address: 12605 SW 128TH AVE Subdivision: BELLWOOD Lot: 47 Project: Bellwood Subdivision Sidewalk Repairs Project Description: Remove and replace sidewalks.This permit approves work at the following addresses 12605 SW 128th Ave., 12600 SW 128th Ave , 11665 SW Sheffield Circle, 12665 SW 127th Ave., 12320 SW 127th Ave., and 12785 SW Marie Ct. Owner: FEES Description Date Amount PFI Permit Fee 03/21/2013 $300.00 PHONE: Contractor: PHONE: FAX Applicant: ERIC O'MALLEY P O. BOX 1627 LAKE OSWEGO, OR 97035 PHONE: 503-684-6688 Total S300.00 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. A�1.ar Permittee/Applicant Signature: Issued By: 4//1'Z1Z/ L �✓� Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY r a CITY OF TIGARD RECEIPT 8 -13125 SAN Hall Blvd.,Tigard OR 97223 `503.639.41.71 Receipt Number: 190715 - 03/21/2013 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PF12013-00007 PFI Permit Fee 100-0000-43114 $300.00 Total: $300.00 PAYMENT METHOD CHECK'# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 11,034 TLEHRBACH 03/21/2013 $30.0.00 Payor: Diamond Concrete Inc.-Eric O'Malley Total Payments: $300.00 Balance Due: $0.00 Pagel of 1 City of Tigard Public Facility Improvement (PFI) Permit General Information: '). /o u)o Srw` O jam,- FOR STAFF USE ONLY Property Address/Location(s):y, 19(o(o `J 5,0, 1 ?7 1h A-vJt Engineerin S' a 3.2 a St LSI° (9 7 t` f�� Case No.: F Zed l 00C)0:1 1 1 795 5,w, lyl� (fa,f� Receipt No.: Date: Z *Applicant's Name: �' I r Application Accepted By: VF z Address: -7 Revised 7/1/10 City/State: L6te 1 c>_5�,xi QL Zip: cl 703 Primary Contact. jrrc-L i t REQUIRED SUBMITTAL c�/ / c/ l INFORMATION Phone:50> SOS I— 00 �_6 Fax: j nj 1� D `7 /— 0(09 Professional Engineered Plans are required _ for: Contractor's Name: ' • Street Widening CCB# r .^ Expiration: a Subdivision Infrastructure Address: • ;Main utility line extension: 0 Storm Drain,Sanitary—Tigard Cit)/State: Zip: 0 Water—Tigard Water Service Area Phone: Fax: (includes Durham,King Cit}-and a portion of unincorporated Washington County) Plans By: "Note:See Engineered Plan Address: Submittal Checklist attached. City/State: Zip: For all other work:Submit scaled sketch of the Phone: Fax: work to be done.(see attached minimum sketch requirements and provided sketch area). l ,�� l:curpin\master\land use application\131`1 app.docx Description of work: � �` Estimated value of work(within the public right-of-way): $ q, 5 0o oU Is work related to a LAND-USE DECISION? YES ❑ NO ❑ If so,please specify(MLP,SDR,SUB,etc.) case#: Is the work related to a BUILDING PERMIT? YES❑ NO ❑ If so,please specify (BUILDING PERMIT) case#: NOTE:Person specified as"Applicant"shall be designated"Permittee"and shall provide financial assurance for the work. City of Tigard 1 13125 SW Hall Blvd.,Tigard,OR 97223 1 503-718-2464 1 www.tigard-or.gov I Page 1 of 4 f , DEVELOPMENT ENGINEERING FEES 1. Public Facility Improvement(PFI) Permit: Part 1: All non-water system improvements Engineer's estimate X 5% (less$300.00 submittal fee) Engineer's estimate X 2%Plan Review Part 2: All public water system improvements Engineer's estimate X 12% 'Total Permit Fee Part 1+ Part2 PFI Permit Fee Exemptions: There will be no permit fee charged,or assurance required for the following types of work: • Sidewalk or driveway repair (less than 20 lineal feet) • Relocate or replace mailbox • Ditch cleaning that does not involve regrading. • Weephole'repair • Curb repair or replacement(less than 20 lineal feet) • Lawn sprinklersystem installation or repair • Street tree pruning or planting o Planter strip landscape.maintenance • Test wells 2. Addressing Fee: The fee for this service is$50.00 per address. SAMPLE Minimum Sketch Requirements NorthArrow Property Lines&.Dimension Slope.of Property Street& Street Name(s) Existing Building,Structures Utility& Street Light.Poles , Proposed Work Existing Curb or Edge of Pavement Trees Existing.S/W or D/W Apron Existing Utility Locations(sewer,water,storm) City of Tigard 1 13125 SW Hall Blvd.,Tigard,OR 97223 1 503-718-2464 ,vww.tigard-or.gov Page 2 of 4 Bruce & Karla Ruffin 11665 SW Sheffield Circle (FIX NEEDED ON 135th—behind house) ? PSC. 11Z.EES V/ennifer DeChane (daughter)and Juanita Bode (mother) 12600 SW 128th Avenue Samuel & Margaret(Jo) Cromwell 12665 SW 127`h Avenue E Lt S Orna & Randy Lu 12605 SW 128`h Avenue `Dennis&Carol Bonnono 12320 SW 127th Avenue l�j Richard Rohr4 12785 SW Marie Court 5°3 - 3 _4 to-j 00` 5 ofoot 2ZbL) �.. . pV ��. 3001 Thanks. Will wait to hear from Diamond Concrete on the bid this week. We are going to have the tree's removed in the next couple of months for sure. It doesn't sound like this will be an issue to have the concrete taken care of first, then the tree's. I am still hoping that Diamond concrete will be able to concrete grind the one area and remove and replace the other area. Hopefully this will keep the cost down. We have had that suggested since the one area is low enough to grind. Can you mention that to the guy. We are not concerned about how it looks as it is behind our house and behind the fence...we never see it or utitize the area. Just want to take care of the trip hazard. Karla :) Add 6aw 11a a. - r T �07Vi. as P ' a Page 41 of 90 s M!c 1196} 120OZ-13165.1314-1 11983 1199 1s1w33 iSiW34 HrYI O 13087 13045 11980 11975 pen 1312= . 12955 1302! 12765 12725 12705 12685 12645 11985 space -- 12925 12845 12 B1S 12785 12745 12715 12695 12665 12625 1249-12495 12085 13335 11995 Address 12085 12o3n KATHERINE S 12085 12005 1204. 13178 12085 12050 13315 1313, 13111 13355 1208E 12610 12101 { 208512085 W 13295 12075 130111 12940 129011 127911 12750 127211 12140 I C 12065. 1323513169 12135 127711 127311 12155 12085 H/ 13125 12149 12670 Map Q 13350 d1NF" 1314" 13101 1309_ _ 1265012630 1211_ RlD 12165 121511 12725 12176 12160 20x8 � 1343. 13330 GE CI CHIMNEY 1216[ 12715 12103 13425 133111 .. RIDGE SI 12735 12133 134C_ 12130 13172 1218, 12185 12170 12745 121811 12165 1216x1 - w- f;'i 13437 1329013270 12085 WILLS P 12185 1336" 131541313E 13099 1215! 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However,an notification of errors is appreciated, 135311 127811 128611 12840 3' Y pP 13230 > 12765 - m 13320 12856 < 1284. 1299E Q 127911 127311 - 12880 O x.12840 � 12826 1260x! 125711 12775`. � [55211 12810 13353 Z = (/' ]2885 12785 ! lry L�' 128713 f- 12829 _ 12895 13570 - 128911 13350 1 13075 13055 ry 1286x1 12800 12849 12805 12860 DOE L 1 12891 12845 HAMPTON C I FI) 1308(1 1307013060 W 128811 /1, 12810 j 12861 1,29W 12880 j 12890 1340x1 13350 W 12901 � 12976 ¢ 12860 129051rj ~ 12885 d' g 1288. 12540 - Q 0 1293. 12900 Q 129IX7 12820 w 1289E 12475 F "A Place f o Call Home" 12959 Q [29511 12901 n 12919 ¢ 12945 .L 12925 12930 127011 12932 City Of T i g a r d 1297E �...� 129511 12999 1295, ! 13 T g a dW O R 5 S 19 762 2 3 = N 12980 TRANQUIL L! 12985 12996 129911 12975 12997 5 0 3 6 3 9-4 1 7 1 12996 ,, .___ www.tigard-or.gov Page 16 of 90Quart er Section: 4` '�1102h- ( 13456 1345G-;�456'—.1345G—HANKS.BEARE).ST .•_ •1102G•� 134SG 13456 1345E 13456 .-1" ..----•- - - —. --' S''N 4 13456 k345G 11010'12660 \'` '15 •W33ri� 1.146: i1036 i 1345G 1345E - 13456 1345E a= 11012 1100_I :11010 1298i29N19�92012881128 O1S , '1261, 125or1. 1104! 13456 11039 ,'TL5� :11032 .-= -�_,_._);'_'_.�: 11020 12644 x410 ,'12607•.�1115L 11143 1249n1 1, . 13456 1345E 1345613456 1345E _ __r _ 1263G� Ly � ,'�-; _ Z "13565„ j 11345G 1345E 13456 13456. 13456 1345E +•13056 I 11115 3-3052-I \ `�� 1248 �-] 1345G" _ '1104-i �1z97o•lions ✓11030; .1262; -"�;111zn- AU�YeSS 13456 _ 1107E `'•� ,12612+ G' +13559 11' 13456 13456' •1345G` - --- 11074 I - iihn\, '12x10; -- 1 13456 13456 13456 11067 - "-- l 12960,•, %, •73040 -1-• '•N', j 12490 = -=. 13543%I .13456 13456 13456 ._._- 1345E < r'. 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Tigard Cit Boundary ti /� �' 1 /'`• - __-3-_q, •�-12665 12635"• 12575 g y ry _ .12765; .12705 1-' ' 1'---! -•12560 ,,1.114011' SW 135th / I 1291 1'"1- - !- �I �I_R. __ �_. _ -:4 Quarter Sections z_.." /`� '�. f 12880 G J+C1ER _ i 12570 �1 \ 128211 T-i12630126 �1258n•+' 1.1130' 135th Ave and Schblls - a �; l > "\11223+,� / !'�in9n'1z76nii• '-1700 -266111' _.J ?Y % 32730 "]lis9<1 ,iliac. Unimproved Right of Way __..._ 13495- 1131"z3 11245 '" I -'i__ I 1� I'1['1195 134951349''t \ Jit- X3145.y '`1310" -'•'M� 1321_ ' / + /� / 3448'_` 1348- �'_�- �.....� 131SG! 13490 ti 13475--1�w 13219 1321!' •_ '1 � _ I`' 1399! 1346=� t-1•'375 ,1,1� QR. ',313,;;• / w'/� i138S 1137;. ��, 1338! pOD; _7 1-•. •' 12A9L ! 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Q,Q;i --_.11725 13711 { 1173"= 1-: + - ,-' - E 13054 I _�__. ¢t" 1172[ + + This map was derived from several databases. . -'1344S� I 113307;' 1133U1'-,�13322 '` •e"-.,.1330L.1309n.�;! 13031 ,_:�� r� r-----{- H:-_: --r-L—,�+"-. i._` 11736 r- The City cannot accept responsibility for any error; 1346-,: i�, 1340">. n:,: /;•_02 13267,•'Y _\1313.-- 1-'--'i - =-I 1174-" 1173. 1 11735(1 I I {11720) + "T 1338----;-- : •+ 131.4.•, {130_4. - =J 1279712771275' 1272_ 12655' 32595 1 11756 Therefore,there are no warranties for this product I- I •� %'-;\ I. , ., ,1331.., ,. . . - , "-- 12745, I' .1264! 12577 _- 4336! �'*.,• =2.:--. ='-� / "13174. �" :1308_ "� 1 `11756 I 11757'' �•"- i•- However,any notification of errors is appreciated. 1174•' 13487 -L_" I .--_-__.._ - 11324 --1314i� 1 1 767 :_ .._...._.."_.._ ...I'_..` :._) 1177., L.-1 26 1 1 133 328' -,` a ONrC1 - f,11744 != ._. _. -._ .. 9 1 -_......__.. , _....._. - --- -'--- (AURM- f •, 131 -AUR...ON 6S •130 1178' �7y\k7 1178 "1i79G 11781 1179. 1179- -:7— I x 13781 - t,1 ! _:f.',{ I' 13341 '13334 LAURMONT D� 13o9r13075G'J'L78_': I 11821 12809 11276, .G :_'...( IU -- ! 113474'''_ 1336- �s..-292 13174 ' -` ,71797 \34790 -�.,_,-: 12786 - I _ ., --. ....!'N 11802 x'117;L 13486' f=-' _ I. �, i i 1341Y-'--_- 13236 -.� _] 1-183. 1161-- 11831 11815 11736 •13254 1319. 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