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ROW2011-00039 APPLICATION FOR WORK IN RIGHT -OF -WAY (ROW) PERMIT ment Engineering TIGARD Develo p 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 624 -0752 FOR STAFF USE ONLY General Information: WR 641571 Right -of -Way Property Address /Location(s): 15300 SW Pacific Hwy —Wit �" Case No.: .../a' vd03©j SI //? /5 Sig Receipt No.: *Applicant's Name: Portland General Electric Date: i0( /) I Address: 9480 SW Boeckman Rd A A Q... REQUIRED SUBMITTAL INFORMATION City /State: Wilsonville OR Zip: 97070 = [i 3oto_ Primary Contact: Linda Parrish ° 2 '. r ( -k r Phone: (503) 570 -4491 Fax: (503) 570 -4420 1.0 Submit a scaled sketch etch of the proposed work to be done Contractor's Name: N/A CCB# Expiration: Professional Engineered Plans are Address: required for: City /State: Zip: • Street Widening Phone: Fax: • Subdivision Infrastructure • Main utility line extension: Plans By: Address: City /State: Zip: Phone: Fax: Description of work: PGE to install new 1 phase 200 amp service Estimated value of work (within the public right -of -way): $ Is work related to a LAND -USE DECISION? YES ® NO If so, please specify (MLP, SDR, SUB, etc.) case #: Is the work related to a BUILDING PERMIT? YES NO If so, please specify (BUILDING PERMIT) case #: *NOTE: Person specified as "Applicant" shall be designated "Permitee" and shall provide financial assurance for the work. • c.\ users \shirley \appdata\local\microsoft \windows \temporary Internet files \co ntent. o utlook \rkfdOgku \city of tgard wr 641571.docx WR CHECKLIST NEW PGE FACILITIES TO BE INSTALLED ITEM YES COMMENT (UNLESS OTHERWISE SPECIFIED) ! I H OLEDIGGER ( \ BOOM INSTALL - O4 /0 AL - T% SECONDARY IN 3" PVC CONDUIT 1 /` GREW TO '(A& GUST BACKHOE PROVIDED & INSTALLED BY CUSTOMER. 1 \� QWNt%0 W (ZE I N UT - 124 PGE TRENCH PGE 1730 SECONDARY VAULT �, `\ - \ GUST W I IZE BECAU PROVIDED & INSTALLED BY CUSTOMER 3 � � \ / - -N0 EASEMENT EXISTS. PGE TO INSTALL 3 -AWAY SEC INS BUS � 2 0 / z LOCATES NOTE: CC 1 .-- 400 698/ '. / \ STAKING IF EXISTING CONDUIT IS UNUSABLE FOR ANY REASON 0-000098 \ FLAGGING IT I5 THE CUSTOMER'S RESPONSIBILITY TO • \ --� �/ \ TREE TRIM PROVIDE 8 INSTALL A REPLACEMENT 1--.. , \ 4DDA LANDSCAPE Nil '1 / _ ____ EASEMENT CONSTRUCTION NOTES: SFEXT -N �01 844 - 350 OX \ I PERMITS X TIGARD 00699/ C 25 x12588 PL00099 ‘-/ ( ) I N EA OF 2 - 4" PVC CUTSHEET I. CUSTOMER TO PROVIDE ALL TRENCHING AND BACKFILLING. TRENCH TO BE (� 2.4 , 6 K W EST UG CIR. VER. 36 INCHES DEEP AND 24 INCHES WIDE. MEASURED FROM FINAL GRADE. O �7 ^' \ '(Q 'f Al- QMQ 0, TRANSMISSION , V / ■ P0 00097 SHUTDOWN 2. CONDUIT (IF NECESSARY) WILL BE GRAY, SCHEDULE 40. ELECTRICAL GRADE. [ r CUSTOMER PVC CONDUIT WITH NYLON PULL STRINGS (MIN. 500 LBS. TEST). Ae C C I/6'- �•� \/ in ABC 75 12573 SHUTDOWN PGE TO DETERMINE THE SIZE AND NUMBER OF CONDUITS REQUIRED. N � , DOOR HANGER MAINTAIN 12 VERTICAL INCHES AND 24 HORIZONTAL INCHES CLEARANCE BETWEEN GAS AND OTHER UTILITIES. ALL ELBOWS TO BE 36 INCH (MIN) RADIUS. 996 2 Nth qC Si. / CONTACT ALL BENDS MUST BE FACTORY MADE. RIGID STEEL OR PGE APPROVED FIBERGLASS `SR �` 00100 1 00 COMPANY BENDS ARE REQUIRED FOR RUNS OF 151 FEET OR LONGER, OR FOR ANY LENGTH RUN WITH MORE THAN 180 DECREES IN BENDS. PVC SCHEDULE 40 BENDS ARE ACCEPTABLE 02(]388\ : �� ` ^J 1999-25 PH' C FOR RUNS OF (50 FEET OR LESS. THE MAXIMUM TOTAL BENDS IN ANY CONDUIT RUN IS 1 958 -40 �� 1 1 '1 p DATE TIME 270 DEGREES VI"- 00 24 q(' T X, p 3. CUSTOMER RESPONSIBLE FOR ROAD CROSSINGS. USE ONLY GRAY. SCHEDULE 40, 200A - ( � 42 —4 ELECTRICAL GRADE. PVC CONDUIT WITH NYLON PULL STRINGS (MIN. 500 LBS. TESTI. -1_ - 40 - 0L TX = �Q - T - O 4. SINGLE PRIMARY INSTALLATIONS CONDUIT TO EXTEND 4 MINIMUM OF 10' FROM 3 - — g'- 0 - X- TRANSFORMER PAD. _ PL 02038 r _ _ \ \ 1 L 5. ALL PGE TRANSFORMERS TO BE INSTALLED 8 FEET (MINI FROM ANY COMBUSTIBLE - \'\ - �\ I 01844- I BUILDING, WALL OR OVERHANG AND 4 FEET (MINI FROM ANY FIRE HYDRANT. \ 1 � 00316/ PGE TRANSFORMERS MUST BE WITHIN 15 FEET OF A DRIVEABLE AREA. j I I I J� I�\ PLDDD 75 ALWAYS MAINTAIN 10 FEET CLEARANCE IN FRONT OF ALL TRANSFORMERS. V �. 120/2 I 6. CUSTOMER TRENCH AND ELBOW CONFIGURATIONS MUST BE INSPECTED BY PGE PRIOR / \ 2006 TO BACKFILLING. PLEASE CALL 503-736 -5450 TWO 0455 PRIOR TO INSPECTION. J DG 7. DESIGN 15 BASED ON STANDARD UNDERGROUND EQUIPMENT. NON STANDARD UNERGROUND \ (� \ \\ /'-' / EQUIPMENT MAY BE AN OPTION AT AN ADDITIONAL COST TO THE CUSTOMER, \c 1 6/17/11 CUSTOMER TO INSTALL J-BOX & GUST OWNED WIRE \ NSTALL REV° DATE DESCRIPTION REVISIONS 3" POLE CONDUIT UNIT THINK AS - BUILT VERIFICATION This document accurately VICINITY MAP & NESC VIOLATIONS CORRECTED represents FIELD construction. 3 �� ()) ON EXISTING BRACKETS SAFETY Foreman: Date: ( �c6) / ~w � FIRST! SDG£ngineer: Date: R ,.. 1 ,,, , -- - R,.. _O (n �OF ✓ O O¢ - - Designer: Date: ca O - E J O B SITE_ www.PortlandGeneral.com www PortlandGeneral.biz www.EorthAdvontoge.com �' E _ 1 ��^ ? \� P TITLE JOB NO. �j� , \ I 3 �•5 *��� CALL BEFORE YOU DIG: OREGON LAW REOUIRES YOU TO REOUEST UTILITY LOCATION BLACK ROCK COFFEE 641571 9`i/� i r ` C ' 41 1 2 BUSINESS DAYS PRIOR TO EXCAVATION. FOR LOCATES CALL THE OREGON UTILITY CIRCUIT SIZE 3 I��� t/F K ING CITY NORTH 24 IIx17 �7k Z . tiT 1 I I Sr NOTIFICATION CENTER AT 8 PGE _ _ DESCRIPTION SCALE \ r- U CONTACT GENERAL FOREMAN AND /OR CONDUIT INSPECTOR 7 TO 10 INSTALL NEW 1 PHASE 200A SERVICE I' - 50' 0-v V (, D '� WORKING DAY'S PRIOR TO EXCAVATION. �' _ ✓�� 1 CONDUIT INSPECTION REQUIRED PRIOR TO BACKFILL. LOCATION �, O ti PGE WILL NOT INSTALL WIRE UNTIL TRENCH IS 100% BACKFILLED. � N. 15300 SW PACIFIC HWY, TIGARD; WASH CO �� DATE SECTION(SI 6 DEAN GILKEY \ Q L 'y!," WICREWVILLE 5/6/2011 C21 -10D WORK WITH SHEET ■ S .� / ff 4.. - / \ PHONE: (5031 612 -5604 CELL: 849 - 7064 / \ - Know what's below. .,.' LINE CREW CENTER 1 OF '�_ / DESIGN BY 9480 sw BOECKMAN RD LINDA PARRISH PHONE (5031 DRAWN BY 570 -4491 BRIGANTE ,... wa \ r � /., _� ./j . ��R \% STREETLIGHT SPECIALIST: JEFF STEIGLEDER WILSONVILLE, OR 97070 1 655 - C7 PHONE: (503) 570 -4404 CELL: 849 - 6548 CaII before you dig. © PORTLAND GENERAL ELECTRIC CO. - ALL RIGHTS RESERVED