PFI2016-00044 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
COMMUNITY DEVELOPMENT Permit#: PF12016-00044
i 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 03/07/2016
Parcel: SEG2168
Jurisdiction: Tigard
Site address: 15535 SW Pacific
Subdivision: Lot:
Project: Comcast Cable PFI
Project Description: Directional bore at a min of 36"below grade and install 1, 2"conduit with CATV
Owner: FEES
Description Date Amount
PFI Permit Fee 03/07/2016 $300.00
PHONE:
Contractor:
TEXSTAR ENTERPRISE
PHONE: 503-776-5049
FAX:
Applicant:
KEN PARRIS
11308 SW 68TH PKWY
TIGARD, OR 97223
PHONE:
Tota 1 $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 Not Present
Signature:
i
Issued By: ---.__ oe _
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for PF12016-00044
Type: Condition Name: Status: Severity:
PFI_Utilities 01 -WORK SITE REQUIREMENTS 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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
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.
Kenny Fisher @ 503-816-6146
PFI_Utilities 18-PERMIT/PLAN ON SITE 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 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 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 Notice
RECEIVED
Ci o f Tigard MAR 01 2016
ry ✓ g CITY OF TIGARD
PUBLIC FORKS — RNGINEERING PLANNING/ENGINEERING
Public Facility Improvement (PFI) Permit
DESCRIPTION OF WORK (in the right-of-way) REQUIRED SUBMITTAL
Check one: Utilities ❑ Sidewalk/driveway a )roach ELEMENTS
® pl El improvements
Detailed description: Directional Bore at a min of ❑ 'Minor work intight-of-way
(sidewalk repair,curb cut,street
36" below grade and install (1 ) - 2" opening,etc.)requires:
conduit with CATV. •Application form,completed
-- --- ---- and silmed
•Submit one(1)comp of scaled sketch
Property address/location(s): 15532 SW Pacific Hwy of the proposed work-to be done
•Submit one(1)copy of traffic
Work being performed along and across SW control plan
Royalty Pkwy G--I2� (p
-OR-
Comcast Cable - Ken Parris ❑ Substantial project work requires
Applicant's name: above items and professional
Address: 11308 SW 68th Pkwy engineered plans for:
•Street widening
City/state: Tigard, OR 'Lip: 97223 •Subdivision infrastructure
Phone: 971-801-5699 Email: Kenneth—Parris @cable.comcast.com •A lain utility lint extension:
Storm Drain,Sanitary—Tigard
\Cater—Tigard Water Service
Contractor's name:Texstar Enterprises, Inc Area(includes Durham,King City
CCB#: 17 8 7 9 8 Expiration: 10/10/2 017 and a portion of unincorporated
Address:
14 122 Arndt Rd NE Washington County)
City/state:Aurora, OR Zip: 97002 DELIVER APPLICATION TO:
City of Tigard
Phone: 503-776-5049 L-'.mail: uriahstewart@texstarenterprise.corr Planning/Engineering
13125 SW Hall Blvd.
Engineers name: Uriah Stewart Tigard,OR 97223
1412 2 Arndt Rd NE \pplicarirms for"mtnor avork In right-of-
Address: nnl%-mat•be emailed to:
City/state: Aurora, OR Zip: 97002 ron ermitsa)tigard-or.gov
Phone: 503-969-6161 Email. uriahstewart@texstarerlterprise.com
Case No.: E-1 2-0
Estimated
—�y V�y
Estimated value of work(within the public right-of-way): $_2 j-9 7 7
application submittal fee:
Is work related to a LAND-USE DECISION? ❑ Yes ❑ No Application accepted:
If so,please specit,(I ITY,SDR, SUB, etc.) case #: By: /at' f a Date
Is work related to a BUILDING PERMIT? ❑ Yes p No
rru
Appficatit svcd:
If so,please specify(BUILDING PERMIT)case#: By` � DAICC
Applicant notified:
By: b Date:
t.\CURPLN\M,stenWnd Us,AppUc dwt Rev.07/16/2014
City of Tigard • 13125 SXf'Hall Blvd. • Tigard,Oregon 97223 • \vRwtigard-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 ace different people,the applicant must be the pucchas"of record or a lessee io possession with written
audinrintiati from the owner or ana
gcii t of die owner. The owner(s)must sign this application in the space provided or submit a written
authorization with this application.
BY SIGNING BELOW,THE APPLICANT(S) 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 tights 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,inay 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.
SIGNAT RES each owne of the subject property required.
Uriah Stewart 03/01/2016
ApphcanthAutfiorized Agent's signature Print name Date
Owners signature Print name Date
Owner's signature Print name Date
Owner's signature Print name Date
PUBLIC FACILITY IMPROVEMENT PERMIT
City of Tigard 13125 SW Hall Blvd. Tigard,Oregon 97223 www.tlgard-or.gov 503-718-2421 Page 2 of 4
A
Page 106 2011 Edition
-
-
Diagram 430 shows work in the travel lane(s)next to a continuous two-way
left turn lane with one direction of traffic diverted into the continuous two-way
left tum 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. When two or more travel lanes are reduced to a single lane before the
diversion,each lane shall be closed separately. Layout traffic control
according to ODOT Standard Drawing TM 852 for 5-lane sections.
4. A shifting taper(U2)may be added in the diverted traffic direction
across the continuous two-way left turn lane(as shown). This option is
recommended when the speed is 45 mph or greater.
Sign Spacing and Buffer Lengths(feet)
>P steel
_'00_4 Ow fBe#iye�i3n 5)g6 ��Bi�ffA"REKA
1
20 50 ERRATA:
25 100 100 100 75
30 100 Supplement Table
35 350 350 350 125
40 150 Updated:Teb uery12,
45 180 2016
By:OWTTraIBt-Ruad�y 1
50 500 500 500 210 Section
55 250 3
Y
3
Sign Spacing and Buffer Lengths(feet)Supplement
PA ted;;: : °S aciq'':`Eetvusen Vii`ns:„ ;"Buffer"i.
60 285
65 700 700 700 325
70 365
9
A
5
C
Chapter 5 December 2011
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2011 Edition Page 107
Ne
ROAD
WORK
AHIW
CeflER
LME
CLOSED
AHM
Bulfer
Protection Vehicle
wfl-MA(both Optional)
See Chapter 4
Buffer
ROAD
WORK
AHEAD
December 2011 Chapter
i
N Date:03-01-16 Author:Uriah Stewart Project:Sunsup Tanning Centers 97224
Proposed New Comcast Facilities Comcast Pro'ect#:42285 Contractor:Texstar Enterprises Contractor Contact:Uriah Stewart 503-969-6161
1 _.._.._.._._. Comments:
Restore all work areas to like or better condition.
7oe*TnEES ATTENTION:Oregon law requires you to follow rules adopted
by the Oregon Utility Notification Center.Those rules are set
forth in OAR 952-001-0010 through 952-001-0090.You may obtain
copies of the rules by calling the center.(Note:the telephone
number for the Oregon Utility Notification Center is(503)-232-1987).
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