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PFI2016-00206 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12016-00206 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 09/20/2016 Parcel: 1 S133CC70011 Jurisdiction: Tigard Site address: 14100 SW BARROWS RD 1 Subdivision: SCHOLLS VILLAGE CONDO STAGE 6 Lot: 1-1 Project: Pebblecreek HOA Project Description: Replacement of one 5x10 section of sidewalk on Barrows Road,at front entrance to Pebblecreek Subdivision. Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: VALERIE JOLIE 13873 SW ASH BURY LANE TIGARD, OR 97223 PHONE: 503-750-9143 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. Perm ittee/Applicant Not Present Signature: Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12016-00206 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/1 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. call ken Fisher 503-816-6146 or Kenny@tigard-or.gov PFI—Sidewalk/1 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 "s City o and RECEIVE© .� Tigard PUBLIC WORKS — ENGINEERING SEP 20 2016 Public Facility ImproPFI) Permit PLANNING/ENGINEERI G DESCRIPTION OF WORK(in the right-of-way) REQUIRED SUBMITTAL Check one: ❑ Public utilities(gas line,electric,data cable) ELEMENTS PqSidewalk/driveway approach and utilities only ;Minor work in right-of-way ❑ Street improvements (sidewalk repair,curb cut,street Detailed description: �� F Q�6 5X 10 opening,etc.) requires: P •Application form,completed (Q� F e 0A.2– rro We> and signed or Ftwo r (2e;I � ��'����/ 'Submit two(2)copy of scaled sketch ` ww � of the proposed work to be done �fJ ��(�f ©/�-� •Submit two (2)copy of traffic Property address/location(s): ttyD t9iS kip APO, control plan S012—ft Y-3 Qw K__ 0 'T Mac O -OR- ❑ Substantial project work requires t��J Ho lq1510611? above items and professional Applicant's name: W (ene_� IT60 c- engineered plans for: �\ ` •Street widening Address: �'��5 trt�r, lz q Lcw e, •Subdivision infrastructure City/state: T_CL f �' Zip: 0/7,� •Main utility line extension: Phone I Email: Lie 6_04 (M Water—Tigard rC U - Storm Drain,Sanitary Tigard- Water Service Area Contact person: 1, k?06 `TDbe Phone: Contractor's name: Q ) (;ArV _ cvt w CCB#: 02 _ J Expiration: D ( DELIVER APPLICATION TO: b Address: G City of Tigard /_ Planning/Engineering City/state: �o pp Zip: 7 2- 13125 SW Hall Blvd. Phonu 440 Email: 6 t4t n L Tigard,OR 97223 I CorM ;\pplications for"minor work in right-of-way" only may be emailed to: Engineer's name: rowPermits tiQard-ot.Qov Address: City/state: Zip: Phone: Email: Pr"Ec ��� �Q6/ Case No. 0 � ( Application submittal fee: Estimated value of work is required(if over$5,000):$ Application accepted: (within the publicright-of-way) By: !__S; Date: Is work related to a LAND-USE DECISION? ElYes El No reviewed:No I By: (�- Date: If so, please specify (MLP, SDR, SUB, etc.) case #: Applicant notified: Is work related to a BUILDING PERMIT? ❑ Yes ❑ No By: Date: c If so,please specify(BUILDING PERMIT)case#: l:\CURPLN\Mastem\LandUse Applications Rev.07/16/2014 City of Tigard • 13125 SAX'Hall Blvd. • Tigard,Oregon 97223 • www.tigard-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. *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 owners)must sign this application in the space provided or submit a written authorization with this application. BY SIGNING BELOW,THE APPLICANTS) SHALL CERTIFY THAT: • The above request does not violate any deed restrictions that may 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 the 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. SIGNATURES of each owner of the subject property required. App ' nt/Authorized Agent's signature Print name Date t ner's ature Print name I Date O er's signature Print name Date Owners signature Print nam Date PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 0 Page 2 of 4 CURB JOINT SEE STD DETAIL N0. 146 5' MIN. SEE NOTE 5 ROW t-2% uN T ROAD — _ r = rIII1-' T 11 I I-1 t=1 11=1 = =1 11=1 I I-l III=1 I ' 2" OF 3/4"-0" BASEROCK COMPACTED SUBGRADE SIDEWALK ADJACENT TO CURB PLANTER 5' MIN. ROW STRIP 6" �— 2% ROAD ; �' ~.. I 1 �I11=. -i 11=1 11=i� 1-' I=1 i I- I i=-1 1-111=1 _ 2" OF 3/4"-0" COMPACTED SUBGRADE BASEROCK SIDEWALK AWAY FROM CURB 1. CONCRETE SHALL BE 3000 P.S.I. AFTER 28 DAYS. 2. PANELS TO BE 5 FEET LONG UNLESS OTHERWISE SPECIFIED. 3. EXPANSION JOINTS & CONTRACTION JOINTS SHALL BE 1/2" PREMOLDED ASPHALT IMPREGNATED MATERIAL OR EQUAL EXTENDING FROM SUBRADE TO FINISH GRADE AND PLACED AT SIDES OF DRIVEWAY APPROACHES, UTILITY VAULTS, WHEELCHAIR RAMPS AND AT SPACING NOT TO EXCEED 45 FEET. 4. FOR SIDEWALK ADJACENT TO THE CURB AND POURED AT THE SAME TIME AS THE CURB, THE JOINT BETWEEN THEM SHALL BE A TROWELED JOINT WITH A MIN. 1/2" RADIUS. 5. SIDEWALK SHALL HAVE A MINIMUM THICKNESS OF 6 INCHES IF MOUNTABLE CURB IS USED OR IF SIDEWALK IS INTENDED AS PORTION OF DRIVEWAY. OTHERWISE SIDEWALK SHALL HAVE A MINIMUM THICKNESS OF 4 INCHES. 6. DRAIN BLOCKOUTS IN CURBS SHALL BE EXTENDED TO BACK OF SIDEWALK WITH 3" DIAMETER SCHEDULE 40 DWV (ABS OR PVC) PIPE AT 2% SLOPE. CONTRACTION JOINT TO BE PLACED OVER PIPE. 7. CONCRETE SHALL HAVE A MEDIUM BROOM FINISH AND TROWELED ON ALL FOUR SIDES CITY Ol'TIGARD APPROVED BY: NO SCALE OREGON MICHAEL A. STONE, P.E. ENGINEERING DIVISION aTY ENGINEER CONCRETE DWG. NO. PUBLIC WORKS DEPARTMENT 13MS.W. REGOLVD. TIG SIDEWALK � 20 TIGARD,OREGON 97223 JANUARY 2013 VOICE:(303)639-4171 FAX: (503)684-7297 1APPROVAL DATE Section 300—Work on 2-Lane, 2-Way Roads Minor Road Encroachment Diagram 300 This diagram covers work which will extend into a travel lane not on a freeway or expressway. When the work area including cones will leave at least a 10 foot lane, this diagram may be used. Use the appropriate lane closure diagram when traffic can't safely pass by in both lanes simultaneously. 1. Use truck-mounted high-intensity rotating, flashing, oscillating, or strobe lights. 2. If a 10-foot minimum travel lane can't be maintained, use the appropriate lane closure diagram. 3. If the posted speed is 45 MPH or higher, opposing traffic lanes must be separated by a line of cones or tubular markers. Consider channelization for opposing traffic whenever traffic volumes are high or the travel path is curved. 4. Place cones along the length of the work area. 5. For work in place an hour or less, the taper and tangent devices may be omitted if a protection vehicle with activated high-intensity rotating, flashing, oscillating, or strobe lights is used. 6. Use BICYCLES ON ROADWAY warning signs after the initial warning signs when cyclists can be expected. 7. An arrow panel in caution mode or truck-mounted PCMS with SHOULDER WORK or other appropriate message is recommended for higher visibility. 8. For night operations, it is essential that workers on foot are visible to approaching traffic and work vehicles and equipment involved in the operation. Work lighting should be placed and aimed so that it does not result in glare that interferes with the driving or work tasks. Note: A lane closure may be needed for other conditions as well, such as high traffic volumes, not enough approach sight distance at one or both ends of the work area, or the impact of heavy vehicles near an excavation with workers. Page 56 of 142