PFI2018-00171 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
COMMUNITY DEVELOPMENT Permit#: PF12018-00171
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 07/12/2018
Parcel: 1 S134DD02400
Jurisdiction: Tigard
Site address:
Subdivision: None Lot: None
Project: Dirksen Nature Park
Project Description: Adjacent to 11130 SW Tigard Street. Perform 2 waterline taps on the 8"water main in Tigard Street for
water services into Dirksen Nature Park.
Owner: FEES
Description Date Amount
PHONE:
Contractor:
COLUMBIA CONSTRUCTION INC
28170 BOBERG RD
WILSONVILLE, OR 97070
PHONE: 503-427-0304
FAX:
Applicant:
JEFF PECK
131 SW HALL BLVD
TIGARD, OR 97223
PHONE: 503-718-2466
Total $0.00
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 PF12018-00171
Type: Condition Name: Status: Severi :
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/[ 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/1 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/1 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 RECE
PUBLIC WORKS — ENGINEERING JUL 0 9 2018
Public Facihty Improvement PFI Pe�..�.r.L t
�I,AIVIVING'
TYPE OF WORD
DESCRIPTION OF WORD(in the right-of-way)
❑ TYPE 1-Franchise Utilit<7 Work
Check one: XUdlities ❑ Sidewalk/driveway-approach ❑ Street improvements performed by NWN, PGE
Detailed description: -peCrIV-1
and/or utility agency.
OVI s� VV'PtrPj"Al AJ' Iv% I iq Otrd S4
A TYPE 2-Sidewalk/Driveway/Sewer
• ..��rp n Work performed for the purpose of:
wo-g1-t'r • Sidewalk installation or repair.
5 -�-� �� • Driveway approach installation
Property address/location(s): t 113® ��° and/or repair
Z--Z,3 • Sanitary sewer lateral installation
and/or main line tap
A lit: C ITY Q� r-^1&fit`''0( ❑ TYPE 3-Full scale Development
ppe 1 Work performed with Land use
Address: 9'`�11_� SW �-�t' �1V� approval which includes any of
City/state: Zip: 9 -7 7_23 the following:
Phone:S®3•`118-7-44L Email: •� aA --Or, v • Subdivisions or Partitions
Contact name: .9�..`� Gk- Phone: So3• 1-8 •7A , • Street widening
• Mainline installation for Sanitary
Contractor: C OW M 66L C()A_S+-V1tALA4Cw% sewer, Storm sewer, Tigard water
and/or Tigard Water Service Area
CCB#: ���01�05Expiration:
Address: 1014 9 0Jk-K- :S-r• " SUBMIT COMPLETED APPLICATION TO:
City/state: DO"AA- ®9-- " Zip: C�`702,0 City of Tigard
Phone: 5 63• %27•03*Email: 1 Ca I%A rv%{®[o.t,t r1^ Planning/Engineering
13125 SW Hall Blvd.
Contact name: .--r� "DI*A4:9 Phone: 9-? - -SU Tigard,OR 97223
�p�g� Applications for"minor work in right-of-way"
En 'neer: �V•� 8 �i� _ only may be emailed to:
g
'360 yr f4 iS �� • Sy d`-F- rowpermits�tigard-or.gov
Address: R1 SS SW R k
CitjT/state: t9�1'�./��� , ®� Zip: 9-T2.29
� � •
Phone: 5®3• GZ 6.04337 Email: M V%6 g� O w V1 Fdkc-AC.C 6W Case No.: ?T;0` I�° ���
Contact name: ®y-%�C- 14 lel lice— Application submittal fee(.07°/ of
Engineer's Estimate) $
Estimated value of work is required(if over$5,000):$ 1511 -72-0-00 Additional fees: $
(within the public right-of-way) Application accepted:
N � ®
Is work related to a LAND-USE DECISION? [A Yes [I No By: Date: E
If so,please specify (MLP, SDR, SUB, etc.) case#: CUP 2013'� 0 Application reviewed: *7/1
By�6;�SL,_ Date: 0
Is work related to a BUILDING PERMIT? 9 Yes ❑ No Applicant.potified:
If so,please specify(BUILDING PERMIT) case#: By: Dater q%
I:\ENG\PermitApplications\pfi—application Effective 10/16/2017
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 of 4
APPLICANTS
NOTE: Person specified as "Applicant" shall be designated "Permittee" and shall provide financial assurance for work,if
required by the city pursuant to TMC 15.041.140.
* With the exception of a utility operating pursuant to a valid franchise with the C.;ity of Tigard,when the owner and the applicant are different
people,the applicant must be the purchaser of record or a lessee in possession with written authorization from the owner or an agent of the
owner. The owner(s) must sign this application in the space provided or submit a written authorization with this application. Franchised
Utilities are not required to obtain the owner's signature on the application
BY SIGNING BELOW,THE APPLICANT(S) SMALL CERTIFY THAT:
• The above request does not violate ani,recorded deed restrictions that mai,be attached to or imposed upon the subject
proper �.
• If the application is granted,the applicant will exercise the rights granted in accordance with the terms and subject to all the
conditions and limitations of the approval.
• All of the above statements and the statements in any plot plan,attachments,and exhibits transrnitted herewith,are true;and
the applicants so acknowledge that any permit issued,based on this application,may be revoked if it is found that any such
statements are false.
• The applicant has read the entire contents of the application,including the policies and criteria,and understands the
requirements for approving or denying the application.
—J-E F F F t. �- - 1 /9
Applicant/Authorized Agent's signature Print name Date
SIGNATURES of each owner of the subject property, if required.
Owner's signature Print name Date
Owner's signature Print name Date
Owner's signature Print name Date
PUBLIC FACILITY IMPROVEMENT PERMIT
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 • Page 2 of 4
DEVELOPMENT ENGINEERING PEES FOR STAFF USE ONLY
Public Facility Improvement(PFI)Permit:
DETAILED SUBMITTAL
REQUIREMENTS
APPLICATION FEE
Part 1: Required submittal fee$300.00
FRANCHISE UTILITY AND SIDEWALK/
PERMIT FEE DRIVEWAY AND UTILITY
Part 2: All non-water system improvements CONNECTIONS,ETC.
Engineer's estimate X 5% (less$300.00 submittal fee) (wort;in the right of way)
Engineer's estimate X 2%Plan Review Sketch
(including information below)
WATER SYSTEM FEE
Dimensions
Part 3: All public water system improvements �-Street Name
Engineer's estimate X 12% Site Address
PFI Permit Fee Exemptions: FULL SCALE DEVELOPMENT
There will be no permit fee charged,or assurance required
for the following types of work: (Subdivisions/Partitions and Street Impro>>ements)
• Sidewalk repair(less than 20 lineal feet)
• Relocate or replace mailbox Design Plans
• Ditch cleaning that does not involve regrading. (6 sets,24x36 or 22x34)
• Weep hole repair ❑ Cover—Site,Vicinity,Abbreviation,Legend
• Curb repair or replacement(less than 20 lineal feet) ❑ General Notes (City,Water,Sewer,etc.)
• Lawn sprinkler system installation or repair ❑ Street(Plan,Profile)
• Street tree pruning or planting
El Water,Storm and Sanitary(Plan Profile)
• Planter strip landscape maintenance ❑ Water Quality Facilities
• Test wells El Grading
❑ Landscaping/Tree Plan
❑ Composite Utility Plan(Electrical,Phone,Gas,
Note: A cash assurance may be required per Storm,Sanitary,Water,Signage,Street Lights,etc)
TMC 15.04.140. customer deposit) ❑ Details
❑ Traffic Sight Distance
❑ Signing and Striping
❑ Street Light Plan and Photometric
❑ Engineers seal/signature
❑ Sheet label(project land use name,revision and
plan log block,dates and sheet numbers.)
Additional Submittals
(per Land Use conditions)
❑ Traffic Report
❑ Storm water Drainage Calculations
❑ Geotechnical Report
❑ Preliminary Access Report(Sight Distance)
❑ Proposed Plat
❑ Pathway Design(if applicable)
❑ Water Department Approval
❑ Engineers Construction Estimate
PUBLIC FACILITY IMPROVEMENT PERMIT
City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 3 of 4
SAMPLE SKETCH:
q• _ q a
I
Edge of Pavement
® I
1T p reet} it I ®` Ditch � p
Streetlight ' .!■i■i■!■!.!■i■i�!■i
PlAinrTOdn
E=1 1
I I a
T� 71ojDoS dSevWei'rMnF"
Mr I 1
ON ° Existing Hous
�� I Existing
>i e Driveway �
aI 01
C 1 ■� •
01
I I
1"U
,
s I '
>
" I 1
I e
°, I Ecisting.Shop;
1
c9r °J
Powerpole /--�
i IJ ° O ■
I I� ,
Tl
95■®_®___® —._a®.®a®_
a I � rrop�rty L ni e�
I I i
■ Fire Hydrant(FH)
I I �
I ■
Scale: -1"-30'
I � �
■
I I
I I
I � �
MINIMUM SKETCH REQUIREMENTS (Put"N/A" if Not Applicable):
North arrow Property lines &dimension Slope of propeMT
Street &street name(s) Existing building, structures Utility&street light poles
Proposed work Existing curb or edge Trees
Existing S/W or of pavement Existing utility locations
D/W apron (sewer,water,storm)
PUBLIC FACILITY IMPROVEMENT PERMIT
City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 4 of 4
INDEX OF SHEETS CITY OF T
X1 Typical Sections
R1 Tigard Street-Construction Plan and Profile OREGON
F
.,yyyp
R2 Tigard Street-Construction Plan and Profile
R3 Tigard Street-Construction Plan and Profile PLANS FOR PROPOSED PROJECT `(
R4 Tigard Street-Construction Plan and Profile GRADING DRAINAGE PAVING SIGNING ILLUMINATION _ �7
R5 Tigard Street-Construction Plan and Profile > > > >
R6 Tigard Street-Construction Plan and Profile AND ROADSIDE DEVELOPMENT
R7 Multi-Use Path-Construction Plan and Profile
R8 Multi-Use Path-Construction Plan and Profile EC
R9 Multi-Use Path-Construction Plan and Profile TIGARDSTREET IMPR®VEMEI
T
R10 Multi-Use Path-Construction Plan and Profile h
AGARD ST.
EC1 Erosion Control Plan (DIRKSEN NATURE PARK FRONTAGE) r
TCi Traffic Control Plan '�• •'? R '
�'•. _
D1 Details-Curb Extensions 1.••, .1•'
D2 Details-Curb Extensions ' G `.
T r.
D3 Details-Standard Details WASHINGTON COUNTY
D4 Details-Standard Details
D5 Details-Standard Details&Embankment MARCH 2017 .
D6 Details-Infiltration Planters
D7 Details-Infiltration Planters&lIDASwale BEGINNING OF PROJECT END OF PROJECT VICINITY MAP
D8 Details-Infiltration Planters
D9 Details-Infiltration Planter&Utility Trench STA. "T" 28+1 l STA. "T" 4fi+fi0 SCALE- N.T.S
D10 Details-Retaining Wall Plan&Elevation LENGTH: 0.38 MILES
D11 Details-Education Building Driveway
D12 Details-Stairs&Accessible Route W C
D13 I Details-Boulder Walls C �-
o b✓
P1 Landscape Plan
P2 Landscape Plan �
F
P3 Landscape Planx� T
r�..� L==Li- - - - - -
P4 Landscape Plan — -- — SW-ROAR&-'.rte — — —
P5 Landscape Plant Materials List
P6 Landscape Plant.Materials List&Details
IR1 Irrigation Plan n
IR2 Irrigation Plan
E�
IR3 Irrigation Plan
#O
IR4 Irrigation Plan P�
F
IR5 Irrigation Details
IR6 Irrigation Details
IR7 Irrigation Details LOCATION MAP
SCALE: N.T.S.
SSl Signing and Striping Plan
SS2 Signing and Striping Plan
SS3 Signing and Striping Plan
i
SS4 Striping Details
555 Signing Details
SS6 Signing Details ATTENTION.
NOTIFY NW NATURAL AT(503)220-2415 WHEN EXCAVA71NO
IL1 Illumination Legend and Details WITHIN 5'OF THE DOSIING HIGH PRESSURE GAS MAIN.
IL2 Illumination Plan ATTENTION: OREGON LAW REQUIRES YOU To FOLLOW RULES
ADOPTED BY THE OREGON UTILITY N077FICATION CENTER. THOSE 21-hn- y
IL3 Illumination Plan RULES ARE SETFORTH IN OAR 952-001-0010 THROUGH OAR VR
952-001-0090 YOU MAY OBTAIN COPIES OF THE RULES BYm JUG C
IL4 Illumination Plan CALLING THE.OREGON UTIUT�Y NOT1f7CA7iON CENTER TELEPHONENOTF_ THE 3)N232BER FOR THE-198 CALL � C1,�GtN�Eip /�j�
WHr
UPI Utility Plan BEFORE YOU DIG 1-600-332-2344.: 9
57 0 EA 0755 SW Baffm Rd,Sine 300
UP2 Utility Plan / /t/ 503486 OR 9Fax
50��6228-D455 F�cb0352611T/5
Nww.whpadf WM is
i,
UP3 Utility Plan OREGON
CALL BEFORE YOU DIG �G o°° KIM MCMILLAN, P.E. ENGINEERING DIVISION
1-800-332-2344 `SO 1' 2 �O ENGINEERING MANAGL�R PUBLIC WORKS DEPARTMENT
T R2017 13125 S.W. HALL BLVD.
MARCH 6, .. 77GARD, OREGON 97223
503-09-4171
EXPIRES: 06/30/2018 DAIS FAX. 503-624-0752
C1P 92016 ® WWW.77G4RD-OR.GOV
PRaECT NUMBER
P:\CITY OF 71GARD\035975\DESIGN\DRAWNGS\OWL\35975-C-CSOI.DNG
tt
ii
v'' � -� i 0SI 1 5?77 - - CONSTRUCTION--NOTES: _
t0 r,N --,6795 h- O Ur,'1H 6,7 Pi
SPS i 796 RIP,1=173.16' o + (:IPS-i68,69' Const. std. curb
0
R11•0175121' IF_((�;)8'PVC=iu7,11' o CB P6971 1E(N)1,2"PVc 157.3;` IE(f4)�3"FVC=162.t�9` (For detail, see sht. D3)
r v 4" VC=1.68.96' ,, o u) I'.IPi=1i� ,77' IE( I)1.2"CMP=167,14' I;(V;!)8"1PVC=152.59'
. � IE(��}� �vc=167.15 � �-- � �"
3E(';V)�;"P1�C=168.76' IE(E)g'FVC=:L 67.05'- _ �� r� r=1C,� �7'-- _ �F E117_"Ci1P=1�77.1�i' 1f=fF13"€=QVC-162-40' - - i 7 1 Const. multi-use path
„( =1F>3.E�t;'-_ (For details, see shts. XJ, R9, & R10)
I 0
Const. commercial driveway
f S S S 7 S -I - � S j-�___- i- cS S--R - SS S
T Y ti -�_ c T_ _ �_�._�___� ST ST--._ or details, see s s D D
ST-�� �,,5T I i- k-,-,. __ -- ST-----�- ST- ST ST (F d t ls, s shts. 2 & 3)
{� , G--. G ,_�0 1_ _ G - G G-- G - �� G-� ti, G--- G --G -4
POLI ' \. '� \6 10 "T" LINE 14 r��
JS -_ _ [S�\ S S- J�� tip \
�` 10 ID O4 Sta. 38+50 to Sta. 39+50
W ��, � +o Const. infiltration planter
f-- i S88'19 25'W \ - , - -
-� -h �� L _ _-_-_ -=z _- (For details, see sht. D6)
N
Extg. RO.w. -'SW TiGARD STREET
CA
g'� f ��/ }.I ! 5 Const. PB inlet, type A
_ 8 _ _ _ o
� � .�. �,,,�.� _ _ _--`-�----- r-;�=.-.-.: - _.. _- - Spa
-- .r -->. r _ .-� �—-`r j n +� ��� L - ( f ��`� — fi= `'y�L TRS OH �-
-�, �-- - Space a intervals
t -i� (For details, see sht. D8)
i�'I .�--�_ U `�'- r }I{- O' - J- H- O-i�-'`-,-1- r �U H f
rn -
+''Y:1r�: f!i;Yi%l.f�'ri! %ljl+: '�ifrr Wil.-!';i3i: :'f,I�i. •�` 'r`it���Slij`c'.<f:li1- /
;;:,• ";.W! :''f:f.:.� l.,u i
HLL'F.0DUCT ,
••��t��-•�•- r� �'•f• _ •��� � a Sta. 39+47 23.25'f'`_� F1 11p .ice'+. t�/+ �•.�.-'. 'l(� r
- ...'•, '.-, .. •' _ �• •.. ,�' 1n!• .i.`-'- /.' '•�. ' 3.W17• •l7• ',�. VV•• �V'.•.s � �
M -�� � �. �,���: 4l• - �" � Const. overflow drain (beehive inlet)
•_`� 16 166 Inst. 10 storm sewer pipe - 49
' =•' .',.:;i s :' d d - Rim 174.07
`` I.E. out - 171.28
W / _�- / :f•,. ::�'., f� Slope - 1.009'
l R.O.W. Ln
-
10 _.r,' dedication l.E. outfall J70.79
4r 5 2 9 16 7 11 12 13 3 line 1
17 ,fir.` �: I ';'•,M e f N (For details, see sht. D9)
' P LINE C;' O Const. P.C. conc. sidewalk
SEE SHEETS (For details, see sht. D3)
/
Extg. wetland R9' & R10 y <•;:';. :' r�. og Const. joint utility trench under storm sewer pip
/ boundary f0'-49'-j ®� r`' c f ' Approx. 10" IE = 171.20
' ' :...:' ' 16 Landscape planter ,
% Wetland ` NOTE: Provide 1 min. clear
15 buffer " �' " ' ' _(See landscape plans)
�- .- A1l storm materia! O Relocate overhead utilities underground
- SW TIGARD STREET PLAN to be HDPE or PVC 17 last. accessible route sign (See utility plans)
2 a ,f 1 03034 SDR 35. (For details, see sht. D12)
a o SCALE: HORIZONTAL 1 =30 Const. joint utility trench
x
.........�+^.................:...................:.......................................:...................:...... .... ... . ................... ................... ....------- --- - (For detail, see sht. D9)
-----
R)
? 200.00' VC 10 Inst. light pole - 3
19180 .............................c`-n t� ...................:.................o�..............-.._........... :...................:...................:...... ..-............... 180 (See illumination plans)
-4.57q: = o co PVI Stu:41+00.00
' ``1 = o :PVI Elev:167.60: 11 Inst, 1" water service connection and meter box
Y : '- r ....... ...:...................:...................:.... K.9�97....:...................:. .. :.............-.... - City install meter.
..............................�. ---..............-------- -----. ............. ..
UJI
r• � /tP
11 m ........... ...... . .. .. ........ .. . ................... ----- -- - --- - 175 12 Ae t irrigation meter box
" ...
............:... ...m
75 _ _ �5 00� SEE SHT. D2 FOR CURB EXTENSION GRADES O Inst. removable bollard - 2
00
_ 1
s - Cum�grade ® - 5' spacing
...................:...................:.. . . .. . .....:............. . ......... .... �...:... 4 09�. ... ----- (0......:..................................................................... ...... (For details, see sht. D4)
fJo '
q &1g. ground ®
Foca of curd "� 14 Remove utility pole - 1
_ _
_... ....:............. .....: . :- ---- .``.---. .�....-.. :...........`M......:....----- ----- : .......... ... :-............................ a...... 17 Contact PGE of ��OFt(f
70 18+5D ~1�-~� 0 503-323-6700 or
<11
1-800-542-8818
LEGEND: : ---�_� : for coordination.
...................:.......................................:...................:...................:.....�.....-.... r____.
5779 E
15 Const. riprap basin OREGON
n —c Cut grading limits : : !� :-- '
00
—F Fill grading limits -- 7.0'W x 8.0'L x 1.5 T �� Opp i.
Class 50 S 11 Z O
39+00 39+50 40+00 40+50 41+00 41+50
Proposed joint Inst. riprap geofextile, O� r
—UG— Protrench SCALE: 1" = 30' type 1
utility SW TIGARD STREET — "T" LINE CURB PROFILE Protect extg. wetlands EXPIRES: 06/30/2018
Proposed light pole SCALE: HORIZONTAL 1"=30' 30 15 0 30
a Revisions and Addendums Date o. B ENGINEERING DIVISION D I R f\S E N NATURE PARK SHEET
f;
Description PUBLIC WORKS DEPARTMENT R4WH
;+
C 6 '
® 13125 S.W. HALL BLVD. SW TIGARD STREET IMPROVEMENTSf
77GARD, OREGON 97223 OF
a 9755 SW Bames Rd,Suite 300 VOICE. 503-639-4171
f
E 50 -626,OR 97225 FAX 4R0_O4-0752 TIGARD S TREE T _ CONSTRUCTION PLAN & PROFILE 53
a� 503-626-0455 Fax 503-526-0775 � WWW.TIGARD—OR.GDV
FILE No #,
www.wt,pacific.com STA 38+25 TO STA 41+75
DESIGN: JAJ I DRAWN: JMQ CHECK: KSR PROJECT NO: 92016
fi