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PFI2020-00453 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT sIII COMMUNITY DEVELOPMENT Permit#: PFI2020-00453 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 11/24/2020 Parcel: SEG674 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: City of Tigard-storm system replacement on 90th Ave Project Description: Storm system replacement. Installing 2 new catch basins and manholes, and replacing 35D037C with a G2. Installing pipe to each structure. Outfalling to ditch north of 11245 SW 90th Ave. Class of Work: FEES Type 2-Sidewalk/Driveway Approach Description Date Amount Owner: Total REQUIRED INSPECTIONS Call 503-639-4175 for the IVR inspection request line or visit the City of PHONE: Tigard website at www.ligard-or.gov to schedule inspections online. Contractor: PHONE: Applicant: JOE COULTER PHONE: • • 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 Issued By:, —1 Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PFI2020-00453 Tvoe: Condition Name: Status: Severity: PFI_Sidewalk/C 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-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_Sidewaik/[ 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_Sidewalkl[ 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/[ 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/1 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/[ 22-DAILY INSPECTION REPORTS Applied Notice Applicant shall submit daily inspection reports,on a weekly basis,to the City's Inspector. PFI_Sidewalkl[ 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 applicant's 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/[ 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/[ 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/[ 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/[ 31 -OTHER Applied Notice Other City ofTigard NOV 1 9 2020 1111 RI PUBLIC WORKS I,NGINEERING CITY 01-: PGARD iv . "-''VEERING TlGi�l�D Public Facility Improvement (PFI,`Fermit TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) ' ❑ TYPE 1—Franchise Utility Work Check one: x❑ Utilities ❑ Sidewalk/driveway approach 0 Streetimprovements performed by NWN, PGE Detailed description: Storm system replacement. Installing two new and/or utility agency. Catch basins, two new manholes, and replacing 35D073C with a G2. ❑ xTYPE 2— Sidewalk/Driveway/Sewer Work Installing pipe to each structure. Outfalling to the ditch north of 11245 90 ' performed for the purpose of: • Sidewalk installation or repair. Property address/location(s): 11325. 11275, 115 SW 90;Ave • Driveway approach installation S,v. 6'9- and/or repair • Sanitary sewer lateral installation and/or main line tap Applicant: Joe Coulter ❑ TYPE 3—Full scale Development Address: 8777 SW Brunham Work performed with Land use City/state: Tigard, OR Zip: 97223 approval which includes any of the following: Phone: 971-255-7723 Email: joec@tigard-or.gov • Subdivisions or Partitions • Street widening Contact name: Phone: • Mainline installation for Sanitary sewer, Storm sewer, Tigard water and/or Tigard'Water Service Area SUBMIT COMPLETED APPLICATION TO: Contractor City of Tigard CCB#: Expiration: Planning/Engineering 13125 SW Hall Blvd. Address: Tigard,OR 97223 Applications for"minor work in right-of-way" City/state: Zip: only may be emailed to: towpermits@tigard-or.gov Phone: Email: Contact name: Phone: Engineer: Address: City/state: Zip: / *FOR STAFFg_ USE ONLY � Case No.: /`1 O"'0�03 Phone: Email: Application submittal fee(.007%of Contact name: Engineei s Estimate) $ Additional fees: $ Estimated value of work is required(if over$5,000):$ y: l� B Application) accepted: t I By: Date: ii//`'24/2-0 (within the public right-of-way) Application reviewed: By: 7-, Date: !//2340?-0 City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard- Applica t notified: / By: I 0 Date: j42--1/L Is work related to a LAND-USE DECISION? ❑ Yes x❑ No If so,please specify (MLP,SDR,SUB,etc.) case #: Is work related to a BUILDING PERMIT? ❑ Yes x❑ No If so,please specify(BUILDING PERMIT)case#: City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 2 of 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 City 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) SHALL CERTIFY THAT: • The above request does not violate any recorded deed restrictions that may be attached to or imposed upon the subject property. • 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 transmitted 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. Applicant/Authorized Agent's signature Print name Joe Coulter Date 11-19-20 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 ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 2 of 4 DEVELOPMENT ENGINEERING FEES FOR STAFF USE ONLY Public Facility Improvement(PFI)Permit: DETAILED SUBMITTAL APPLICATION FEE REQUIREMENTS Part 1: Required submittal fee$300.00 (minimum) FRANCHISE UTILITY AND SIDEWALK/ DRIVEWAY AND UTILITY PERMIT FEE CONNECTIONS,ETC. Part 2: All non-water system improvements (work in the right of way) Engineer's estimate X 5%(less$300.00 minimum submittal fee) Sketch Engineer's estimate X 2%Plan Review (including information below) ❑ Dimensions WATER SYSTEM FEE ❑ Street Name Part 3: All public water system improvements ❑ Site Address Engineer's estimate X 12% FULL SCALE DEVELOPMENT PFI Permit Fee Exemptions: (Subdivisions/Partitions and Street Improvements) There will be no permit fee charged,or assurance required for the following types of work: Design Plans • Sidewalk repair(less than 20 lineal feet) (4 sets,24x36 or 22x34) • Relocate or replace mailbox 0 Cover-Site,Vicinity,Abbreviation,Legend • Ditch cleaning that does not involve regrading. 0 General Notes(City,Water,Sewer,etc.) • Weep hole repair ❑ Street(Plan,Profile) • Curb repair or replacement (less than 20 lineal feet) ❑ Water,Storm and Sanitary(Plan Profile) • Lawn sprinkler system installation or repair ❑ Water Quality Facilities • Street tree pruning or planting ❑ Grading • Planter strip landscape maintenance ❑ Landscaping/Tree Plan • Test wells ❑ Composite Utility Plan(Electrical,Phone,Gas, Storm,Sanitary,Water,Signage,Street Lights,etc) ❑ Details Note: A cash/bond assurance may be ❑ Traffic Sight Distance required per TMC 15.04.140. 0 Signing and Striping (customer deposit) ❑ Street Tight Plan and Photometric ❑ Engineers seal/signature ❑ Sheet label(project land use name,revision and plan log block,dates and sheet numbers.) ❑ Engineer's Construction Estimate 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 Provider Approval PUBLIC FACILITY IMPROVEMENT PERMIT City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 3 of4 SAMPLE SKETCH: SW " )1.- " SI Edge of Pavement Streetlight - Ditch --• •— •• RJaat Draut -'2'1(`j- i f - •- X -.. 4. ' T—�roraTtiirSel�w'erriiicr-- 1 I j • . r.= 1 dExisting House 1 I , • Existing �� >>i • Driveway 1 1 I CI .21 . ' - ! iI I r1 3 of 6I i os1 1 W. I I I Existing Shop I J i L Powerpole . I = I el .. ) I 1--------�"roP95ne-------�--- I I j IN F i re Hyd ra nt(FH) I I II Scale: 'I"=30' i I I I I I I • MINIMUM SKETCH REQUIREMENTS(Put"N/A"if Not Applicable): North arrow Property lines & dimension Slope of property 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 ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 4 of 4 ( 4e., ,44$4.4 ikt 4.44.- @Oil f I - .„ ----s '' 4. - *V' MiTtiaqn i .,#. ' r ._, 'NW •• Q4411/4 "Ill Op' : .., 't r • 1 i -...06. ..‘s ‘- „ .. , - _•1 , •,_,,, ,( w i I ,...4 ' _ . . 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I, ,. .. 1 _ t Me ,'..gr lisai.ft,}11 ....1416.. 04, ' i F1SE 5 I 1 I ai tr. ,1 _ . ' _ • .,_.... , A r- . -;7 •-.4 • -• '*44',4; ,•%,4 - • v .. ._ __ - , fict: ,, ,... . . _. .. . ,i .. ki ••,- ..144 ikik ,“ ,, .,_ .. ...... 0* *gor•--- s _,., ,"'• : •-• t-if-LOCISf:3=IsTA 1- 1 't U',:/:•• tEl '-,:o e_ZOUS. ...ot '1 40-, It'. ' -'i- -;707 . '' ' S t./.1. 0 >1 V i i I I ON — . . •t,.11.MH-GSS , , • „. zh ,„ OTUtP,',._'• , 41 4 ,.. a ; . ,.. .. . - 1 .-1 . ' j ' i. - A:4; - ---*.y.i- - - tit i I ' . s6C•b . _ LEGEND EXISTING EXISTING PROPOSED EXISTING PROPOSED DECIDUOUS TREE STORM DRAIN CLEAN OUT RIGHT-OF-WAY LINE —--—--—--—--— ':.,.. STORM DRAIN CATCH BASIN BOUNDARY LINE CONIFEROUS TREE # STORM DRAIN AREA DRAIN I ' PROPERTY LINE FIRE HYDRANT STORM DRAIN MANHOLE ` CENTERLINE ------------------- WATER BLOWOFF GAS METER WATER METER GAS VALVE DITCH ----'----'----'----'- WATER VALVE GUY W1RE ANCHOR CURB DOUBLE CHECX VALVE _ UTILITY POLE EDGE OF PAVEMENT -_— AIR RELEASE VALVE POWER VAULT © EASEMENT SANITARY SEWER CLEAN OUT POWER ,UNCTION BOX g° FENCE UNE SANITARY SEWER MANHOLE POWER PEDESTAL SIGN : COMMUNICATIONS VAULT GRAVEL EDGE © STREET LIGHT COMMUNICATIONS JUNCTION BOX POWER UNE --- -- -- --- MAILBOX .. COMMUNICATIONS RISER t::r OVERHEAD WIRE ----------------- COMMUNICATIONS LINE -------------------- FIBER OPTIC LINE --------------------- GAS LINE -------------------- STORM DRAIN LINE --------------------- SANITARY SEWER LINE --------------------- WATER LINE --------------------- ROLLED CURB - - STORM DRAIN AREA DRAIN DATA„/tg2) 10 SrCr/CENIDN ER�SIR ANO aS1R A1LE3 AREtC'Af:CTURE AD-1 AREA DRAIN STA.0+27.90 7.441 RT RIM-205.5 -204.0 IE 00.204.05(12"N'/) 63213PE AD-2 AREA DRAIN STA 1h2100 9.75'Rr RIY.215.60 K42...._REGON IE W-214.20 MT) IE WIlt.00(!1Y) 14.IE 0117W13.00(IOY) W PLEAD:5.7.OM ID*C900Alm RENEWS: 12/31/2020 Revisions ono Addendum's SHEET ENONEERIRUMM51ON 90TH AVE Description Dote �14 By' PUBLIC MORNS DEPARTMENT 53 Manhole Removal '°'z° I CDZ °,121nS...,o<WM STORMLINE REPLACEMENT 3 �, IT.GRD,OREGON 97113 OF FAX: Sn1-639-4 2 II FAR: SO3 614 01'.1 "�ICiA$b MMW. DA.OW FILE NO PLAN AND PROFILE 7T •DESIGN:COI DRAWN:CDZI CHECK APN PROJECT NO: 94001 •94001 • 11 I• m00 � _ O 41_ :wf.M.+wv-.w I 1 0 i.� F t i r 4 rise.= t41.e �� .. t S �� it` e e i , STORM PLAN 'SCALE: = 20. scALE: l=zo' Z D L� 235 20' 10. 0 20' K CLASS a BACKFILL -1_ SEE CWS DETAIL SW ON SHEET 230 e o �o=� 225 Ei Stwm pee CAS GAS MAT CGMW t aO 006 l� GAS HSxi 220 jFN + r� CT � i�iz� N3O I Nr,aWW1 z rc = tin no ry r og ` oo g"sl Sn"4n• E1 e.g nn O GAS m w u-EiiE22a Sn'Ofi�a Q{on4 = a 2,0 „�� tery„� wAr �� S��a R 3� 8 W NCWWW 1 t: ER HHri au� ` 6N¢W a W ow 205 "I O LF 12'C_900 CAN 200 f101t,2,C_g,0 195 3+00 2+60 2+60 2+40 2+20 2+00 1+80 1+60 1+40 1+20 1+00 0+80 0+60 0+40 0+20 0+00 STORM PROFILE icpp SCALE: 1"=20' HORIZONTAL, 1"=10' VERTICAL �v�ot - ONSTRcN:TION NOT c /-0 5.Install ore dean. See slam drain data on sheet Si and CWS Detail 380 on 9. Remove existing area drain. CT e sheet D5. 7. connect nee storm pips to existing area drain. 10. Retain and protect existing CuArort. 63213PE 1 6. Install 12-C-900 culvert with plunge pool. See Detail on sheet D6. 2. Retain and protect existing eons drain. } 71. Cop and abandon existing 8'ID stern pipe. Plug ends with grout. R ORECON p l Z Cot and connect existing 6'DI storm pipe of STA 1)23.00, 9.75'RI'to Y Y}sj �,,p 3. Install 18''fondant manhole. See CWS Detail 010 on sheet DI. AD-2. (12. Retain and protect existing ID"ID sterns pipe.) v .14,'L" I. Sanest line. & Cannel to existing e'CPP and extend to A0-2. 13. Install 4'asphalt rolled curb. w'AIA. ' _._._ ____ ..- .-__._._,.r,_.__ _..N. G� RENEWS: 12 / SHEET Revisions anal Addendums � --- FNr�NEERwc DIVISION - 31 2020 Description _: �a[eJo. B PUBLIC WORKS DEPARTMENT 90TH AVEA V 34 Manhole Removal 7010 , COI ��,,,,,sw..M({♦LYa STORMLINE REPLACEMENT 1 � IILUD.O3EGOI'9711J FAX; 3-629-1171 y x� FAX. Spa-6I1-0732 II clxiJ• wwwLG%1 �'aw PLAN AND PROFILE 1 _ ALE NO DESIGN:CDZ DRAWN:COI CHECK.APN"PROJECT NO: 94001 ' ,940011