PFI2015-00059 1
CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
a COMMUNITY DEVELOPMENT Permit#: PFI2015-00059
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 05/05/2015Parcel: SEG912
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: Zarr New Driveway
Project Description: New driveway adjacent to 12010 SW Ann St.
Owner: FEES
Description Date Amount
PFI Permit Fee 05/05/2015 $300.00
PHONE:
Contractor:
PHONE:
FAX:
Applicant:
JAMES ZARR
12010 SW ANN ST
TIGARD, OR 97223
PHONE: 503-823-8856
Total $300.00
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.
Permittee/Applicant
Signature:
Issued By:
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for PF12015-00059
Type: Condition Name: Status: Severity:
PFI—Sidewalk/1 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-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/[ 06-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/[ 07-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/[ 08-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/[ 09-OTHER Applied Notice
City of Tigard RECEIVED
IsPUBLIC FORKS—ENGINEERING MAY 0 5 2015
Public Facility Improvement (PF!LPMSJM*ER1NG
DESCRIPTION OF WORK(in the right-of-way) REQUIRED SUBMITTAL
Check one: ❑ Utilities—IK
Side drivewa• proach ❑ Street improvements ELEMENTS
Detailed description:
❑ Minor work in right-of-way
(sidewalk repair,curb cut,street
opening,etc.)requires:
•Application form,completed
and signed
•Submit one(1)copy of scaled sketch
Property address/location(s): �zQ/���(,� ���([ � of the proposed work to be done
•Submit one(1)copy of traffic
control plan
–OR–
Applicant's name: 7 E] Substantial project work requires
� above items and professional
Address: 2Oi ee,.z • .e��/ �'� engineered plans for:
Street widening
City/state: �iG,4lt Z�! ZiP: •Subdivision infrastructure
Ph Email: •Main utility line extension:
- Storm Drain,Sanitary-—Tigard
- Water—Tigard Water Service
Contractor's name: 44 r' area(includes Durham,King Citi•
G
CCB#• and a portion of unincorporated
1���__
Washington County)
Address:
Citv/state: Zip: DELIVER APPLICATION TO:
City of Tigard
Phone: Email: Planning/Engineering
13125 SW Hall Blvd.
Engineer's name:
Tigard,OR 97223
� �� .
Applications for"minor work in right-of-way"
Address: only may be emailed to:
City/state: Zip: hermits .tigud�or.gov
Phone: Email:
FOR STAFF USE ON I.)
Case No.
Estimated value of work (within the public right-of-way): '
Application submittal fee:
Is work related to a LAND-USE DECISION? ❑ Yes ❑ No Application accepted:
If so,please specify (NILP,SDR,SUB, etc.) case #: By 1-S Date-
Ap `oa, �ewed;
Is work related to a BUILDING PER�T'IIT? ❑ Yes ❑ No
If so,please specify(BUILDING PERMIT)case#: By
Applicant notified
By: Date: a�
I:\CURPLN\Masterst�'.Use Applications Rev.07/16/2014
City of Tigard 13125 SW Hall Blvd. Tigard,Oregon 97223 www.tigard-or.gov • 543-718-2421 • Page 1 of 4
RECEIVED
MAY 0 5 2015
EXISTING DRIVEWAY -
MATCH WIDTH & GRADE CITY OFTIGARD
A PLANNING/ENGINEERING
R/W LINE
SEE NOTE 3
6"
S
5' MIN 2% EE NOTE 4 SI EWALK
SEE
LANDSCAP NOTE 3 LANDSCAPE
STRIP SEE NOTE 2 STRIP
A
3sL3
6' 6'
10' MIN
PLAN R/W �c
P
PROJECTED TOP
3/4' OF CURL; 27. MAX
STREET 1°i—II ° II _ 111-111-11 ��'�lr��
' . �. ° _ °II 11-11' qY
0 o0 �o a
0 0 0 oop o peO°>oea.oe 80°.•0°���o::o.e;0;°�11 SEE NOTE N0. 4
00 °p I I 1=1 11=1 I hi 1-11 i=i —I
o O o 0 0
2" OF AGGREGATE
SECTION A—A (3/4"-0") COMPACTED
NOTES:
1. CONCRETE COMPRESSIVE STRENGTH SHALL BE A MINUMUM OF 3000 PSI AFTER 28 DAYS.
2. CURB JOINT SHALL BE TROWELED WITH A MIN 1/2" RADIUS ALONG BACK OF CURB.
3. EXPANSION & CONTRACTION JOINTS SHALL BE 1/2" PREMOLDED ASPHALT IMPREGNATED
MATERIAL OR EQUAL EXTENDING FROM SUBGRADE TO FINISH GRADE.
4. DEFORMED #3 REBAR AT 12" EACH WAY. PLACE 3" CLEAR OF AGGREGATE. TIE ALL BARS.
(FOR COMMERCIAL DIRVEWAYS ONLY)
pCITY OF TIGARD APPROVED BY: NO SCALE
OREGON MICHAEL A. STONE, P.E.
q
ENGINEE RING DIVISION CITYaaN� COMMERCIAL DWG. No.
PUBLIC WORKS DEPARTMENT
13125 TIGA D,ORId-BLVD. DRIVEWAY 1 43
TIGARD,OREGON 97223 JANUARY 2013 7
VOICE:(503)639-4171
FAX: (503)684-7297 APPROVAL DATE
CONSTRUCT 1/2" TO RECEIVED
3/4" RADIUS LIP
CONSTRUCT DRIVEWAIM&RQ)h 2015
MIN. 3" SAWCUT AND . ITY OF TIGARD
VERTICAL BREAK 4
• • , PLA ING/ENGINEERING
EXISTING `
PAVEMENT a GU'TTE1�•. :. .. a .. a '.
SECTION / p •� p I
�2" OF 3/4"-0" COMPACTED AGGREGATE
CURB AND GUTTER
SEE NOTE 4
CONSTRUCT 1/2" TO
SAWCUT MIN 2' 3/4" RADIUS LIP
FROM FACE OF CURB
CONSTRUCT DRIVEWAY APRON
EXISTING
PAVEMENT
SECTION �' p
X\\-2" OF 3/4"-0" COMPACTED AGGREGATE
op STANDARD CURB
NOTES:
1 . SAWCUT THROUGH GUTTER PLATE SHALL BE MADE AS CLOSE
TO CURB FACE AS POSSIBLE.
2. COMPLETE CURB AND GUTTER SHALL NOT BE REMOVED UNLESS
DIRECTED BY THE ENGINEER.
3. WHEN STRAIGHT CURBS ARE REMOVED, A MINIMUM OF 2 FEET
OF PAVEMENT FROM THE FACE OF CURB SHALL BE REMOVED
AND REPLACED.
4. WHEN ENTIRE GUTTER PLATE IS REMOVED THE EXISTING
PAVEMENT SHALL BE CUT BACK AND A NEW 6" MONOLITHIC CONCRETE
GUTTER CONSTRUCTED.
5. AFTER CONCRETE HAS CURED, REPLACE REMOVED ASPHALT AND SEAL JOINT.
CITY OF TIGARD APPROVED BY. NO SCALE
OREGON MICHAEL A. STONE, P.E.
ENGINEERING DIVISION CITY ENGINEER CURB KNOCKOUT DWG. NO.
PUBLIC WORKS DEPARTMENT
13125 S.W.HALL BLVD.
TIGARD,OREGON 97=3 JANUARY 2013 FOR DRIVEWAYS 145
VOICE:(503)639-4171 F=
FAX: (503)684-7297 APPROVAL DATE