PFI2018-00323 rCity of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT 3`�y/Zc9
Request for Permit Action
• 13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503-718-2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPennits@dgard-or.gov
FROM: ❑ Owner NrApplicant ❑ Contractor ❑ City Staff
Check(�/)one
REFUND OR Name:
INVOICE TO: (Business orIndividu4
Mailing Address:
City/State/Zip:
Phone No.:
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
CANCEL/VOID PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
Permit#: RF120119 - 00323
Site Address or Parcel #: 5Z&- 100,,'
Project Name: cA��"
Subdivision Name: Lot#:
EXPLANATION: {�Gt�pY1l� Yl0 �OYYC� I�oal��( .
Signature: TAWS iie-tq , Date: 1 122,I W
Print Name:
Refund PghcU
L The city's Community Development Director,Building Official or City Engineer may authorize the refund of.
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
• ' OFFICE USE •
Route to Sys Admin: Date B Route to Records: Date 3 /9B
Refund Processed: Date Invoice Processed: I Date B
Permit Canceled: Date3 2d B Parcel Ta Added: Date B
L\Building\Forms\RegPemiitAction_20 8.doc
Agnes Lindor
From: Conner, Dave <Dave_Conner@comcast.com>
Sent: Thursday, January 9, 2020 1:37 PM
To: Agnes Lindor
Subject: RE: PF12018-00323
Caution! This message was sent from outside your organization. Allow sender I Block sender
Hi Agnes,
I finally got some information on this permit. Per our contractor,there was existing fiber in the building and therefore
no need for a permit. Can it be cancelled? Do we need to send a check to cover the cost? Also, if you have any other
outstanding permits that you need resolved, could you send them to me and I will work the list for you? In order for me
to look up the permit in our system I will need an address. One of my goals this year is to get our contractor's to be
better at closing out permits properly.
Thanks,
DAVE CONNER
PERMIT COORDINATOR
OFFICE HOURS: 6:30 AM — 3:00 PM
OREGON & SW WASHINGTON
1 1308 SW 68TH PARKWAY
TIGARD, OR 97223
DESK # 503-596-381 1
CEL-L_ # 971 -777-091 1
I
From:Agnes Lindor<agnesl@tigard-or.gov>
Sent:Tuesday,January 7, 2020 7:02 AM
To: Conner, Dave<Dave_Conner@comcast.com>
Subject: [EXTERNAL] RE: PF12018-00323
Thanks Dave-
1
Appreciate the response. Have a great day!
Agnes Lindor I Associate Planner
City of Tigard I Community Development
13125 SW Hall Boulevard
Tigard, Oregon 97223
Phone: 503.718.2429
Email: AgnesL@tigard-or.gov
From: Conner, Dave<Dave Conner@comcast.com>
Sent:Tuesday,January 7,2020 6:52 AM
To:Graham, Daniel <Daniel Graham@comcast.com>
Cc:Agnes Lindor<agnesl@tigard-or.gov>
Subject:RE: PF12018-00323
Good morning Daniel,
I will get K&B on this today and see what needs to be needs to be done for this to be completed out in their system.
Note to Agnes: Good morning Agnes, my name is Dave Conner, I am the Permit Coordinator for Comcast. You can
feel free to email me directly with questions or concerns and I will take care of the situation for you.
Thanks,
DAVE CONNER
PERMIT COORDINATOR
OFFICE HOURS: 6:30 AM - 3:00 PM
OREGON & SW WASHINGTON
1 1308 SW 68TH PARKWAY
TIGARD, OR 97223
DESK # 503-596-381 1
CELL # 971 -777-091 1
r
Dave
From: Graham, Daniel<Daniel Graham@cable.comcast.com>
Sent: Monday,January 6, 20204:41 PM
To:Conner, Dave<Dave Conner@comcast.com>
2
Cc: Agnes Lindor<agnesl@tiaard-or.gov>
Subject: FW: PF12018-00323
Dave,
Can you look into this permit for Agnes at Tigard please.
Thanks
daniel
From:Agnes Lindor<asnesl@tigard-or.gov>
Sent:Tuesday, December 31, 2019 4:56 PM
To:Graham, Daniel <Daniel Graham@cable.comcast.com>
Subject: [EXTERNAL] PF12018-00323
Hi Daniel-
The City received a PFI permit for Comcast last year on November 29, 2018 for work at 12447 SW 69`"Ave in Tigard. The
proposed work includes to overlash a total of 697' and rod/rope through existing underground facilities for a total of
162' and bore to place (1)-2" conduit for a total of 54'within the City of Tigard ROW.
This permit has been approved, but has been unpaid and therefore not issued. If you are no longer doing this we, please
let me know and we can cancel this permit. If the work has been done, it was done without a permit and a permit it
required. Please let me know either way,thanks.
Agnes Lindor Associate Planner
City of Tigard Community Development
13125 SW Hall Boulevard
Tigard, Oregon 97223
Phone: 503.718.2429
Email:AgnesL@tigard-or.Rov
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule."
3
Ni ECEIVED
V.
City of Tigard 3 /zo NOV 29 2018
PUBLIC WORKS—ENGINEERING iGARD
a
Public Facility Improvement (PFI)'Permit``IVEERING
TYPE OF WORK
DESCRIPTION OF WORK(in the right-of-way)
❑ TYPE 1—Franchise Utility Work
Check one: ❑ Utilities 13 Sidewalk/driveway approach ❑Streetimprovements performed by NWN, PGE
Detailed description: Comcast proposes to overlash a total of 69T and and/or utility agency.
rod/rope through existing underground facilities for a total of 162'and bore to ❑ TYPE 2—Sidewalk/Driveway/Sewer
place(1)-2"conduit for a total of 54'within City of Tigard ROW. Work performed for the purpose of-
-
£e Sidewalk installation or repair.
a Driveway approach installation
12447 SW 69th Ave, Tigard, OR 97223
Property address/location(s): 9 and/or repair
SFr71 ob i e Sanitary sewer lateral installation
and/or main line tap
Comcast ❑ TYPE 3—Full scale Development
Applicant: Work performed with Land use
Address: 11308 SW 68th Parkway approval which includes any of
City/state: Tigard, OR Zip: 97223 the following.
Phone: 503-522-1017 Email: Daniel_Graham@comcast.com a Subdivisions or Partitions
Daniel Graham a Street widening
Contact name: Phone:
e Mainline installation for Sanitary
Contractor: Texstar Enterprises sewer, Storm sewer, Tigard water
CCB#: 178798 Expiration: 10/10!19 and/or Tigard Water Service Area
Address: 14122 Arndt Rd SUBMIT COMPLETED APPLICATION TO:
City/state: Aurora,OR Zip: 97002 City of Tigard
Phone: (503) 776-5049 Email:jim.minert@texstarenterprises.com Planning/Engineering
13125 SW Hall Blvd.
Contact name: Jim Miner Phone: (503)793-3109 Tigard,OR 97223
Applications for"minor work in right-of-way"
Engineer. K&B Technical Solutions only may be emailed to:
Address: PO Box 2529
rowpermits @tigard-or,M
City/state: Clackamas/OR Lip: 97015
Phone: (971)678-3079 Email: lan_Reed@kbmail.net Case No,: Prz101�-oo323
Contact name: Ian Reed Application submittal fee(007%of
Engineers Estimate) $ 300• or,
Estimated value of work is required(if over$5,000):$ Additional fees: $
(within the public right-of-way) Application accepted:
�L
Is work related to a LAND-USE DECISION? ❑ Yes ❑ No By: Date:
If so,please specify(MLP,SDR,SUB,etc.) case #: Application reviewed:
By:ti(• �S Datc:
Is work related to a BUILDING PERMIT? ❑ Yes ❑ No Applicant notified.-
If
otified:If so,please specify(BUILDING PERMIT)case#: By: 74V - Date: �- 3
I:\ENG\PermitAppliotions\pri_appliotion Rev.10/16/2017
City ofTigard e 13125 SW Hall Blvd. a Tigard,Oregon 97223 a www.tigard-or.gov e 503-718-2421 a Page 1 of4
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 APPLICANTS)SHALL CERTIFY THAT:
• The above request does not violate any recorded deed restrictions that may be attached to or imposed upon the subject
prop
• 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.
11/27/2018
Applicant/Authorized Agent's signature Print name Date
SIGNATURES of each owner of the subject property, if required.
Ownei s signature Print name Date
Owner's signature Print name Daw
Owner's signature Print name Date
PUBLIC FACILITY IMPROVEMENT PERMIT
CityofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 2 of4
RECEIVE®
NOV 2 9 2018
APPLICANTS CITY CI- ;a 3AR
NOTE: Person specified as`Applicant"shall be designated"Permittee and shall provide finant iRIAMWlti+f0i' I,q1`BING
required by the city pursuant to TMC 15.041.140.
* With die 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 die owner or au 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 ownces signature on the application
BY SIGNING BELOW,THE APPLICANTS) SHALL CERTIFY THAT:
• The above request does not violate any ecorded deed restrictions that may be attached to or unposed upon the subject
Prop
• 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.
Zhic the entire contents of the application,including the policies and criteria,and understands the
oving or denying the application.
�ti Dn�►£c � > 11/27/2018
Applicant/Authorized Agent's signature Print name Date
SIGNATURES of each owner of the subject property,if required.
Owners signature Print name Date
Owner's signature Print name Date
Owners signature Print name Date
1
i
PUBLIC FACILITY IMPROVEMENT PERMIT j
City ofTigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-orgov 503-718-2421 PVe2of'4
I
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) (6 sets,24x36 or 2204)
• Relocate or replace mailbox Cover—Site,Vicinity,Abbreviation,Legend
• Ditch cleaning that does not involve regrading. 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
requiredper TMC15.04.140. Signing and Striping
(customer deposit) Street Light Plan and Photometric
Engineers seal/signature
❑ Sheet label(project land use name,revision and
plan log block,dates and sheet numbers.)
Addirional Submittals
(per 1And Use conditions)
❑ Traffic Report
2ro'Storm water Drainage Calculations
❑ Geotechnical Report
❑ Preliminary Access Report(Sight Distance)
❑ Proposed Plat
❑ Pathway Design(if applicable)
❑ Water Department Approval
❑ Engineees Construction Estimate
PUBLIC FACILITY IMPROVEMENT PERMIT
CityofTigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 3 of4
SAMPLE SKETCH:
Edge of'Pavement
I -d*— Ditch
Streetlight 1 -- ----------- —
StrC---
—/• a R=I r�
• i D
' T—�r�'RS3' �erTine" 1
•
1 n� I1
1 NI Existing House
I 1 ri 1 Existing 1
_">� • Driveway
ro
el I
Q-1 1 ��
0I 1 .
a°
I I cr,b 1
of
1 Existing Shop 1
J
Power` I I 1
0 0
1�-------�oP95ne—-—-—-—-—-
i
I1 Fire Hydrant(FH)
' i I
1 Scale: l"=30'
� I I
I � I
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� � 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 - www.tigard-or.gov - 503-718-2421 - Page 4 of4
Page 108 2011 Edition
5.5 Multi-Lane Roads
Right Lane Closure, Multi-Lane Non-Freeway Diag. 500
Diagram 500 covers work which closes the right lane of a multi-lane non-
freeway road.
If closing more than one lane on a multi-lane road, provide a minimum
tangent distance of 2L between the end of the first lane closure taper and the
beginning of the second lane closure taper.
1. Use truck-mounted flashing warning lights on work and protection
vehicles. See Section 4.3—Lights and Lighted Signs for exceptions.
2. For added visibility, a truck-mounted arrow board or PCMS in caution
mode may be used.
• 3. When the posted speed is 40 mph or less, the RIGHT LANE CLOSED
AHEAD signs may be omitted.
4. Placement of signs in a non traversable median or other median that is
not a two-way left turn lane is required for lane closures any time there
is room for a truck to be parked on the left, out of the travel lane.
When there is no room for a truck to be parked on the left an additional
RIGHT LANE CLOSED AHEAD sign should be placed on the right side
and placement of signs in the median is optional.
5. If flagging is needed for work vehicle ingresslegress, use Flagger
Layout Detail (see Inset).
Sign Spacing and Buffer Lengths(feet)
Posted Spacing Between Signs "Buffer.,
Speed A 8 C Space
20 50
25 100 100 100 75
30 100
35 350 350 350 125
40 150
45 180
50 500 500 500 210
55 250
60285
65 700 700 700 325
70 365
Chapter 5 September 2016
2011 Edition Page 109
Right Lane Closure, Multi-Lane Non-Freeway Diag. 500
1 4 t t
• Protection Vehicle
• w1r1AA(both Optlone[)
• See Chapter 4
• i
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September 2016 Chapter 6
Page 84 2011 Edition
Stationary Lane Closure with Flagging Diagram 320
Diagram 320 covers total closure of one lane of a two-lane, two-way
roadway. See the detail inset for the layout if using a single flagger to control
both directions of traffic on low volume roads (less than 400 ADT)with good
sight distance as discussed below.
1. Use truck-mounted flashing warning lights on work and protection
vehicles. See Section 4.3—Lights and Lighted Signs for exceptions.
2. For added visibility, a truck-mounted arrow board or PCMS in caution
mode may be used.
3. Flaggers at each approach are required if any of the following
conditions exist:
a. Night Operations.
b. Work space is over 200 feet in length.
c. Sight distance is less than 750 feet from each approach
through the lane closure.
d. Traffic volumes are greater than 400 ADT.
4. The length between the Flagger Ahead signs shall not exceed one
mile. Use Diagram 340— Lane Closure with Pilot Car if exceeding one
mile.
5. Cones should be used to outline the work space when curves or other
roadway alignments prevent clear direction for the motorists to pass
the work space safely.
6. Cones along the work space are recommended when posted speeds
are 45 mph or greater, when working under heavy traffic or when travel
lanes are narrower than 11 feet.
7. Extended queue signing (see Diagram 5-4) should be used when
traffic queues extend beyond the initial advance warning sign.
8. When flagging near an intersection, the"Flagger Ahead" (CW23-2)
sign should be visible to traffic entering from any side road. Additional
advance warning and Flagger Ahead symbol signs may be placed on
the side road(s).
9. Sign set-up and Flagger placement shown may be used for intermittent
full road closures of 20 minutes or less.
10. The "ONE LANE ROAD AHEAD" (W20-4) sign is optional and should
be considered on high volume or high speed roads, or when extended
queues are expected.
Chapter 5 September 2016
°ot� 0_
Single Flagger Operation j m
for Low Volumes //�����\ _ /� (Opft" O Q
(ADT<400) c �) ro em.
n� \_�\ BE ' o
rn 8 ' d F--r-I--� j- PREPARED ONE LANE .0 3
m ` I � t1lia> TO STOP AHEAD r-
8 o S m I '�'•, ♦ W
— — • • — — — • ROAD
m ( ~ r••••' ♦ i WORK
�1 1 49 40 I AHEAD 0
qq pp yy I Warr N
ON W O !1 0 0 0 1Ii O Y R � I � M4�r•
N
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_ 1 mile _ -1
f max. y
—• • • T • • • — — Q
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Buffer
Protection Vehicle
9/4
w/TMA(both Optional)
See Chapter 4 _�
SroP Two Flagger Operation m
a W �
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Page 52 2011 Edition
Bicycle and Pedestrian Accommodation Diagrams
The following practices and details address the accommodation of bicycles
and pedestrians within work zones. The following detail drawings should be
incorporated, where appropriate, into the traffic control plan for any short
term work.
1. See Section 1.6—Bicycle and Pedestrian Considerations for additional
guidance.
2. Stay alert for pedestrians and bicycle traffic and accommodate safe
passage for them, as needed.
3. The work space should be protected from bicycle and pedestrian
intrusion by using barricades or closely-spaced channelizing devices.
4. Maintain access to transit stops or clearly close a transit stop using
barricades or channelizing devices.
Bicycle Accommodation Diagram 5-6
Bicycle Accommodation Principles:
1. If a significant volume of bicycles can be expected and work closes a
marked bicycle facility, or requires bicycles to share a travel lane,
install a"(Bicycle) ON ROADWAY" sign (CW11-1) or the Bicycle
symbol (W11-1) sign with an "ON ROADWAY" (OBW1-5) rider, in
advance of the work area.
2. Install temporary signing off the paved shoulder, within the planter
(buffer) strip, or share the width needed between the shoulder and the
sidewalk, as available.
3. Signs are to remain in place until the surface is restored and the width
made available for bicycle use. See Diagram 5-6 for typical bicycle
signing placement.
Sign Spacing and Buffer Lengths(feet)
Posted Spadne Between Signs "Buffer"
S ed A B C Span
20 50
25 100 100 100 75
30 100
35 350 350 350 125
40 150
45 180
50 500 500 500 210
55 250
60 285
65 700 700 700 325
70 365
Chapter 5 September 2016
2011 Edition Page 53
Bicycle Accommodation Diagram 5-6
I i
I
NOTES:
• Bicycles on Roadway(CW11-1)sign should not
interrupt standard sequences. For example:
o BE PREPARED TO STOP/Flagger Symbol
o J LANE CLOSED AHEAD/Lane Ends
Symbol
Bicycles on Roadway sign typically follows ROAD
I
WORK AHEAD sign and used as general warning.
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DESCRIPTION' CIAMPLIE DESCRIPTIfN: ExAllake IC p
BOREIDRSI —_.—__—___ JOINT USE POLE ® HF TK
TRENCHJ01lf USE POLE WI TRARStFORMER ® m O
RME
EXISTING CONDUIT POWER POLE W/TRANSFORMER
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STRAND POWER POLE X
RIGHT OF WAY w CARIE POLE
PROPERTY LINE —————— TELEPHOIE FOIE
PUBLIC UTILITY EASEMENT ne PEDESTAL,VAULT m In .
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CENTERLINE CM1 MANHOLE ■
FACE OF CURB CATCH BASIN
EDGE OF PAVEMENT VALVE(WATER.GAS,ETC) RM
EDGE OF GRAVEL see METER(WATER,GAS,ETC) m B
EDGE OF MOEWALK FIRE HYDRANT V iJYy
EDGE OF DRIVEWAY —<h—
REMOVE A REPLACE LIMITS, 2
BORE PR
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STORM
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POWER 6fy
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TRAFFIC CONDUIT
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FENCE LINE —. ,— Q 0
GUARD RAIL o o a UIE
RAILROAD TRACKS {}}}H}H+H} f- , A
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