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ROW2014-00018 CITY OF TIGARD RIGHT OF WAY PERMIT s COMMUNITY DEVELOPMENT Permit#: ROW2014-00018 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 02/25/2014 Parcel: SEG3628 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: PGE Project Description: Replace bad order underground primary cable. SEG 3624/3628. Owner: FEES Description Date Amount ROW Permit Fee 02/25/2014 $300.00 PHONE: Contractor: PHONE: FAX: Applicant: WAYNE HAGAN 3700 SE 17TH AVE PORTLANT, OR 97202 PHONE: 503-736-5411 Total $300.00 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: '� 1' 04— 1) rCSX\� ())Issued By: 1 WA ���''-"�`�` G ) Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY RECEIVED FEB 18 2014 City of Tigard CITY OF TIGARD P . Application For Work In The Right- - ROW Permit Property Address/Location(s): V ..4-Ck J 3\1 _11- FOR STAFF USE ONLY --A (I Q,r d v 6C 't W ' —1355001 3c02q/ Right-of-Way rJ(/20 Case No.: PLIA2..01 —00012 *Applicant's Name: /�ecbf 1 (�� Application Accepted'By:� Address: 3`1 Dl) L>�_ 1� a kip_ Application Reviewed:2. 1.0'/'14 /Y� By: j1, 3� (emu City/State:`_ `, t rc ^ Zip:e11 7 ��? Application Fee Due: Primary Contact: `N , $ 1 CA U�. Phone:✓' J W H' a Applicant Notified:ted: 24 2 )1 1 q „_a pY L3 Receipt No.: Email: e,.. tTna)1r•Vo REQUIRED SUBMITTAL '191 INFORMATION Contractor's Name: • Application form,completed and signed CCB# Expiration: • Submit one(1)copy of scaled sketch of the proposed work to be done Address: • Submit one(1)copy of traffic control City/State: Zip: plan Phone: Fax: Professional Engineered Plans are required Email: for: �) �{� • Street Widening Plans By: ‘2) ti) k ' )` Q� • Subdivision Infrastructure Address: - 1( t. 5? n /� • Main utility line extension City/State: / 1 OP Zip: l 2�1L2 Deliver application to jowpennit tt'tirard-or.gov or to City of Tigard Planning/Engineering,13125 SW Hall Phone: t' y� �y/�/� (���.�Fax: Blvd.Tigard,OR 97223. Email: Ke V t.r, •tilt OVID 6) •QLJ� Rev.12/10/2013 I:\CURPLI4\Masters\Land Use Appliuwons\Right of way Permit r n n�- Applicetion.docx Description ofwork:Rt *()IC aC. _ bark �l.l une cirounci prlma,r9 Cab1Q_, Estimated value of work(within the public right-of-way): $ Is work related to a LAND-USE DECISION? YES NO 0 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#: K, Hendrix FEB 13 2014 Signature of Applicant/Permittee: \--"\.hd.XLc 0.8547 Date: _. Print Name: r't S t ` tle.n6 Title:-Trcf Nx,ppbrt �v City of Tigard I 13125 SW Hall Blvd.,Tigard,OR 97223 I 503-718-2464 I www.tigard-or.gov N Northwest Traffic Control • W E Portland (503)262-6500 Stopping/Sight Distance Vancouver(360)604-5655 Buffer Space S Fax (503)262-0357 Toll Free (800)783-9733 Speed(mph) Distance(ft) 25 75 30 100 35 125 40 150 45 180 50 1 210 ■ 1 © © 0 55 I 250 I ' 4 SW Katherine St. (> Posted Sign + 4 Speed Spacing(rt) ' — (Mehl A B C Oq ii (or less) 100' 100' 100' a s .e O 4. 35-40 350' 350' 350' N 0 45-55 500' 500' 500' 3 y _ O A= Road Work Ahead x3 B= Be Prepared to Stop x3 C= Flagger Ahead x3 Owner n*ctibb Number #735509 a2191W Katherine St.Tigard.OR PGE tom, Northwest Traffic Control All signs and devices SHALL conform to the MUTCD/OTTCH. 103)963-69;1 �0#„,20„ wA c.n,E1.V3�0„ lithan Burris 04509 007445 Will adjust to field conditions. Nathan @NWfCl.com Plan NOT to scale. File date: 02/14/2014 WR CHECKLIST LEGEND TENSION. 524 O A 75 6975 ITEM YES COMMENT 000lODY TENSION: '27•r VT 063 M"ER NEW PGE FACILITIES TO BE INSTALLED TL0'ZSI °rel,s7,- BACKNOE (UNLESS OTHERWISE SPECIFIED) \ _____ •I 20�I e23.20 PGE TRENCH MN FACILITIES TO BE INS7ALL!u ABC-2 AL-DB LOURS T I• FACILITIES TO BE ABANDONED SW KATHERINE ST FALAT • E STRING _ INSTALL 3-#2 AL-ELP JET PRIMARY IN 4"PVC CONDUIT 51621. 7 FLAGGING X PROVIDED & INSTALLED BY PGE-APPROVED CONTRACOOE PLOI450 4)0' 4(' 7REETRIM 2012-20 •I N N LANDSCAPE ABANDON PRIMARY CONDUCTOR EASEMENT PERMITS X CM OF TIGARD PR In -77 µ1 TRAFFIC PLAN T ALL CONDUIT TO BE INSTALLED 36 INCHES(MIN)BELOW FINAL GRADE. .. /• 01:• 20 CUOSPRET ALL PGE CONDUCTORS TO BE INSTALLED IN GRAY,SCHEDULE 40,ELECTRICAL GRADE, N K 0.54 W CA AR PVC CONDUIT WITH NYLON PULL STRINGS(MIN.500 LBS.TEST).PGE TO DETERMINE \ Ew /RAILSRU$SION THE SIZE AND NUMBER OF CONDUITS REQUIRED MAINTAIN 12 VERTICAL INCHES AND VT 06342 H SHUTDOWN 24 HORIZONTAL INCHES CLEARANCE BETWEEN GAS AND OTHER UTILITIES.ALL ELBOWS •INCH 8 SMALLER TO BE 36 INCH RADIUS ALL BENDS MUST BE FACTORY MADE C 100 2948 CUSTOMER ALL ELBOWS LARGER THAN 4 INCH TO BE 60 INCH RADIUS RIGID STEEL OR PGE LO men- SHUTDOWN APPROVED.FIBERGLASS BENDS ARE REQUIRED FOR RUNS OF 151 FEET OR LONGER. 00510/ DOOR HANGER 3 OR FOR ANY LENGTH RUN WITH MORE THAN 180 DEGREES IN BENDS.PVC SCHEDULE 005105 40 RENDS ARE ACCEPTABLE FOR RUNS OF 150 FEET OR LESS.TFIE MAXIMUM TOTAL 2012 M B 75 3760 CONTACT BENDS IN ANY CONDUIT RUN IS 270 DEGREES. li 4 COMPANY is- ., -n:HOPE(HIGH DENSm'POLYETHYLENE)DUCT E. OR SCHEDULE 40 P C WITH A MECHANICAL CONNECTION(CERTA-LOX OR LIKE MECHANICAL Si PNt (J CONNECTION PRODUCT)AS AN ALTERNATIVE TO HOPE DUCT.HDPE SHALL MEET THE VT 06340 REQUIREMENTS OF PGE SPECIFICATION L22501(AVAILABLE ON REQUEST FROM POE PROJECT 4 111.11. ■ DATE TIME MANAGER).FOR SAFETY REASONS THE DUCT SHALL BE BLACK WITH THREE EQUALLY SPACE y EXTRUDED RED STRIPES(WHICH IS A SPECIFICATION REQUIREMENT).MANDREL TEST OF V05,1 P ' HOPE PIPE IS REQUIRED AFTER INSTALLATION WITH PGE INSPECTOR PRESENT Q EL ORBS 1 I�/ POE TO NE NOTIFIED AND INSPECT ALL COND(1/T,VAULT AND PAD R/STALLATIONS IN , BEFORE BRCRFRL. ALL NEW VAULT 8 PAD LOCATIONS TO BE FIELD VERIFIED •A WITH PGE AND CUSTOMER REPRESENTATIVE. U 00 1II -10 Cu-OK REFER TO POE UIREM NTS SERVICE REQUIREMENTS BOOK FOR FURTHER DETAILS &SPECIFIC REQUIREMENTS.LINK TO • •• • • ' -10 Cu- DESIGN IS BASED ON STANDARD UNDERGROUND EQUIPMENT.NONSTANDARD UNDERGROUND EQUIPMENT MAY BE AN OPTION AT AN ADDITIONAL COST TO D00Y235- .Ii I THE CUSTOMER.- Fs0Mwe THINK �12_� SAFETY FIRST! RIGHT-0F-WAY PERMIT NOTICE: ANY DEVIATION FROM THIS DESIGN MUST BE APPROVED BY PGE PROJECT MANAGER A PERMIT FROM THE LOCAL JURISDICTION IS REQUIRED BEFORE ANY ______ WORK IN THE RIGHT-OF-WAY MAY RE PERFORMED. ONLY PGE APPROVED CONTRACTORS AND CONTRACTORS WHO HAVE MADE OTHER SPECIAL AGREEMENTS WITH PGE WILL BE ALLOWED TO WORK UNDER PGE'S PERMIT. THE CONTRACTOR MUST NOTIFY THE LOCAL JURISDICTION 48 HOURS BEFORE WORK IS TO BEGIN.A COPY OF THE PERMIT MUST BE ON SITE PGE CONSTRUCTION DRAWING AS—BUILT VERIFICATION & NESC VIOLATIONS CORRECTED +� This document occurDRely represents FIELD Construction. :` war • �yvV.1111p.. Foreman: Date: • Y CONTACT SERVICE COORDINATOR General Foreman: Date:Mir POB TRENCH AND CONDUIT INSPECTION PRIOR •H+. _ r, I 10 BACHcnL POE Ma 501 INSTALL WIRE (Signature only required for field construction changes.) -(. - UNTIL TRENCH Is Ino_B CRRLIFD SDPMENG REVIEW: IASBUILT BY DESIGNER: i _j i - SERVICE COORDINATOR _ J l 503-736-5450 DA', I2/JN3 - 1":100' 'ACCOUNT: 1170001 IAW°- 0000014628 1108 No.735509 '� -�f •' 'a _{ ` TITLE 80 UG PRIMARY CABLE - R-T +sL� eBeeun SIZE ' J T ` , � ^E 1ICATION 3362 11x17 iv\�\�\ 1 JI V LouTRxr 1;� f ATTENnoN: CALL 811 BEFORE YOU DIG `/ 12490 SW KATHERINE S7,TIGARD k�11 I OREGON Uw REWIRE$YOU TO FOLLOW RULES ADOPTED DESCRIPTION Ro a BY THE OREGON UTILITY NOTIFICATION CENTER. 811 REPLACE 8O UG PRIMARY CABLE T'--) I� 1 THOSE RULES ARE SET FORTH IN OAR CENTER. ��vl •+ THROUGH 952-001-00M YOU MAY OBTAIN COPIES OF I COUNTY ECTION(S) WORK WITH SHEET 11\{^ �'7 THE RULES BY CALLMG THE OREGON UTILITY WASHINGTON �C21-ITC BEAVERTON I OF I M NOTIFICATION CENTER ADANN6TRATION 0 (303-2324987) LINE CREW CENTER DESIGN BY PHONE(4251 DRAWN BY THOMAS GLADE R r TO REQUEST UTILITY LOCATES CALL THE OREGON bone A ees below. 2n3 10(SORB 06 WAYNE HAGAN 864-7213 I K MIERAS fw�R��RrR UTILITY NOTIFICATION CENTER BIT AT LEAST RA•TRTOH,CA 97006 655-84 A V FCFR\F 6 F MAP I 1 BUSINESS DAYS PRIOR TO EXCAVATION. ca byre you dig. 0 PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED ■ q CITY OF TIGARD RECEIPT ■ 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 195004 - 02/25/2014 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID R0W2014-00018 ROW Permit Fee 100-0000-43114 $300.00 Total: $300.00 PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 093291 BGALICIA 02/25/2014 $300.00 Payor: Linda M. Miller/PGE Total Payments: $300.00 Balance Due: $0.00 Page 1 of 1