PFI2015-00194 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
a COMMUNITY DEVELOPMENT Permit#: PFI2015-00194
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 12/22/2015
Parcel: SEG1629
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: Comcast
Project Description: Adjacent to 14050 SW Pacific Hwy.Comcast proposes to overlash(1)-48ct fiber optic cable to existing
strand in City of Tigard ROW.
Owner: FEES
Description Date Amount
PHONE:
Contractor:
PHONE:
FAX:
Applicant:
SCOTT SARBER
11308 SW 68TH PKWY
TIGARD,OR 97223
PHONE: 503-596-3819
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.
Permittee/Applicant
Signature: Not Present
Issued By:
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for PF12015-00194
Type: Condition Name: Status: Severity:
PFI_Utilities 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_Utilities 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_Utilities 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_Utilities 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_Utilities 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_Utilities 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_Utilities 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_Utilities 08-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_Utilities 09-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_Utilities 10-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_Utilities 11 -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_Utilities 12-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_Utilities 13-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 Utilities 14-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_Utilities 15-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_Utilities 16-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_Utilities 17-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_Utilities 18-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_Utilities 19-MONUMENT PROTECTION Applied Notice
Existing monuments, property corners, and survey markers shall be protected. Replacement shall be at the permit holder's
expense.
PFI_Utilities 20-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_Utilities 21 -OTHER Applied Notice
RECEIVED
City of Tigard
DEC 18 2015
CITY OF T lGIARD
PUBLIC WORKS— ENGINEERING PLANNING,/ENGINEERING
Public Facility Improvement (PFI) Permit
DESCRIPTION OF WORK(in the right-of-way) REQUIRED SUBMITTAL
Check one: 8 Utilities ❑ Sidewalk/driveway approach ❑ Street improvements ELEMENTS
Detailed description: Comcast proposes to overlash (1)-48ct N Minor work in right-of-way
fiber optic cable to existing strand in City of Tigard ROW. (sidewalk repair,curb cut,streetopening,etc.)requires:
•Application form,completed
and signed
•Submit one(1)copy of scaled sketch
Property address/location(s): 14050 SW Pacific Hwy of the proposed work to be done
Tigard, OR 97224 •Submit one(1)copy of traffic
I� control plan
–OR–
Comcast ATTN: Scott Sarber ❑ Substantial project work requires
Applicant's name: above items and professional
Address: 11308 SW 68th Parkway engineered plans for:
�,/ Tigard, OR Zi 97223
Ci state: 9 p: •Street widening
•Subdivision infrastructure
Phone: (503) 596-3819 Email: Scott_Sarber@cable.comcast.com •Main utility line extension:
- Storm Drain,Sanitary—Tigard
Contractor's name: Texstar Enterprises ATTN: Jim Miner - Water—Tigard Water ServiceArea(includes Durham,King City
CCB#: 178798 Expiration: 10/10/2017 and a portion of unincorporated
Address:
14122 Arndt Rd Washington County)
Zip:
City/state:
Aurora, OR 97002 DELIVER APPLICATION TO:
City of Tigard
Phone: (503) 793-3109 Email: Jimminer@texstarenterprises.com Planning/Engineering
13125 SW Hall Blvd.
Engineer's name: KCB Technical Solutions ATTN: Glen Williams Tigard,OR 97223
6566 SE Lake Rd Applications for"minor work in right-of-way"
e
Address: only may be emailed to:
City/state: Milwaukie, OR Zip: 97222 rospermitsgtigard-orm
Phone: (503)650-6041 Ext.tis Email: Glen_Williams@kbmail.net
imm
Estimated value of work (within the public right-of-way): $
500 Case No.: lj S
Application submittal fee:
Is work related to a LAND-USE DECISION? ❑ Yes p No Application accepted:
If so,please specify (MLP,SDR,SUB,etc.) case#: By: _L Date: W/,qhs
App�fi�'
T
Is work related to a BUILDING PERMIT? ❑ Yes NJ No n Vewed:
If so,please specify(BUILDING PERMI case#: B5' _ Dare:
ZZ Z.oIS�
Applicant notified:
`L� (y,�►�w By: L_J Dare:
S�t,n.vt. bk I4�t GC�7L� d/
I:\CURPIN\Masters\find Use Applications Rev.07/16/2014
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 www.tigard-or.gov • 503-718-2421 • Page I of 4
APPLICANTS
NOTE: Person specified as"Applicant"shall be designated"Permittee"and shall provide financial assurance for,,vork.
\\hen the owner and the applicant are different people,the applicant must be the purchaser of record or a lessee ui possession with writren
authorization from the owner or an agent of the owner. The owwur(s)must sign this application in the space provided or submit a written
authorization with this application.
i
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BY SIGNING BELOW,THE APPLICANT(S) SHALL CERTIFY THAT:
• The above reQnest does not violate any deed restrictions that may be-attached to or imposed upon the su iecLp olL'.
• If the application is granted,the applicant will exercise the rights granted ui 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.
?Y11- 91111, /'�791
Scott Sarber 12/18/15
Afp-plicant/Aur ri ed Agent's signature Print name Date
Owner's signature Print name Date
Owner's signature Print name Date
Owner's signature Print name Date
PUBLIC FACILITY IMPROVEMENT PERMIT
Cityof Tigard 13125 SN Hall Blvd. • Tigard,Oregon 97223 • ,v\v\vtigard-or.gov 503-718-2421 ° Page 2 of 4
1
DEVELOPMENT ENGINEERING FEES
1. Public Facility Improvement(PFI) Permit:
Part 1: Required submittal fee$300.00
Part 2: All non-water system improvements
Engineer's estimate X 5% (less $300.00 subinittal fee)
Engineer's estimate X 2%Plan Review
Part 3: All public water system improvements
Engineer's estimate X 12%
Total Permit Fee = Part 2 + Part 3
PFI Permit Fee Exemptions:
There will be no permit fee charged,or assurance required for the following types of work:
• Sidewalk or driveway repair(less than 20 lineal feet)
• Relocate or replace mailbox
• Ditch cleaning that does not involve regrading.
• Weephole repair
• Curb repair or replacement(less than 20 lineal feet)
• Lawn sprinkler system installation or repair
• Street tree pruning or planting
• Planter strip landscape maintenance
• 'Test wells
PUBLIC FACILITY IMPROVEMENT PERMIT
City of Tigard 13125 SSV Hall Blvd. • Tigard,Oregon 97223 • ,,'\vwtigard-or.gov 503-718-2421 Page 3 of 4
SAMPLE SKETCH:
Edge of Pavement
Ditch —�
Streetlight ICjW
--•---•-------•—t
S ---
Raaf arta.ffr-- i
rn� Existing House
W� I Existing
�� Driveway
CI � •
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1
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a I u
06
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ct
;I I �
o Existing Shop
,
Powerpole I I o l o
95,
-------FiopertyLine—-—-—-—-—-
I
II Fire Hydrant(FH)
I � I
Scale: 1"=30'
� I I
I I I
' I I
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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 of Tigard 9 13125 SW Hall Blvd. - Tigard,Oregon 97223 - www.tigard-or.gov - 503-718-2421 - Page 4 of 4
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Contact Scott Sheer PO BOX 2529.CMetlu .OR 97015 r - 18177
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Phone:(503)598-3819 �-(503)650-ao41EXL2 FIBER ENHANCEMENT '
Scott Sarber@cable.comcast.com ema9:ci-_wur SNeknmal.�s1 - CITY OF TIGARD ROW PERMIT DRAWING
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Page 80 - - - 2011 Edition-
5.3 Two-Lane, Two-Way Roads
Shoulder Work w/ Minor Road Encroachment Diag. 3001
Use this detail for non-freeway work which extends into a travel lane and
maintains a minimum 10 foot-travel lane. If a minimum 10 foot travel lane
can not be maintained, or when traffic can not safely pass by in both lanes
simultaneously, use the appropriate lane closure diagrams—for example,
Diagrams 310 through 350.
A lane closure may be appropriate for conditions such as high traffic
volumes, high speeds, and inadequate approach sight distance to the work
space, or heavy equipment adjacent to the travel lane.
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. Cones shall be placed along the entire length of the work space. If a
protection vehicle is used and work is in place one hour or less, the
taper and tangent devices may be omitted.
4. If the speed is 45 mph or higher, volumes exceed 2000 ADT, or there
is limited sight distance, consider placing cones or tubular markers on
centerline.
5. An arrow board in caution mode or truck-mounted PCMS with
"SHOULDER WORK" or other appropriate message may be used for
higher visibility.
Sign Spacing and Buffer Lengths(feet)
Posted Spacing Between Signs Buffer
Speed A B C Space
20 50
25 100 100 100 75
30 100
35 40 350 350 350 125
150
45 180
50 500 500 500 210
55 250
Chapter 5 December 2011
i
-- 2011-Edition - - —- Page 81 -
Shoulder Work w/ Minor Road Encroachment Diac -3-07
ROAD
WORK to
AHEAD
•
Initial
Warning A •
Sign
•
•
(Optional) •
IL
•
Protection Vehicle •
w/TMA(both Optional)
See Chapter 4 •
Buffer
10' •
minimum • U3
•
•I
•
i
A ROAD
M NARROWS
(Optional)
B
l ,ROAD
WORK
`. AHEAD
Initial
Warning
Sign
December 2011 Chapter 5
Page 118 2011 Edition
Lane Closure at Intersection with Flagging Diagram 620
Diagram 620 covers work within an intersection when normal traffic control
must be interrupted. Work vehicles may or may not be in the work space.
1. During flagging, traffic signals shall be turned off. Contact the road
jurisdiction for approval and assistance(see Chapter 3).
2. For multi-lane facilities, traffic approaching the intersection shall be
reduced to a single lane on each approach. See Chapter 3 for
information on flagging through intersections.
3. There should be one flagger for each approach. One flagger may
control two adjacent approaches if sight distance, low volumes on side
roads, and flagger position allows for safe operation and clear direction
to motorists. For low traffic volume intersections (fewer than 400
entering vehicles per day), one flagger may be used.
4. 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 may be expected.
Sign Spacing and Buffer Lengths(feet)
Posted Spacing Between Signs Buffer
Speed A B C Space
20 50
25 100 100 100 75
30 100
35 40 350 350 350 125
150
45 180
50 500 500 500 210
55 250
Chapter 5 December 2011
r
2011 Edition Page 119
Lane Closure at Intersection with Flagging Diagram 620
ROAD
WORK
AHEAD
(gym, �L 1 1
AHEAD
B
BE
PREPARED
TO BSM
B
A tDp�o
—'— • RDAD
BE LAN
E
100 R.Mex. PREPARED ROAD
• TO STOP WORK
�— AHEAD
� A B B CI
Bunter :� .1 i
F 4—
o�
r t00R.Max.+l
C B B A
ROAD BE
WORK PREPARED look Mex.
AHEAD TO STOP -- e
HE IANE
AHEAD • �T
(Opnanan I A A
—A B BE
PREPARED
TO STOP
B (OptlonaQ
1 ONE UN
1 1 1 ROAD
AHEAD
C
,�
AHEAD
December 2011 Chapter 5