PFI2016-00110 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
a COMMUNITY DEVELOPMENT Permit#: PF12016-00110
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 05/25/2016
Parcel: SEG2074
Jurisdiction: Tigard
Site address: 8705 SW Sattler
Subdivision: Lot:
Project: PGE PFI
Project Description: Replace UG Term Kit at Pole PFI and traffic signal shut down at Hall blvd and Sattler
Owner: FEES
Description Date Amount
PHONE:
Contractor:
PGE
10800 SW AVERY ST
PHONE: 503-464-7777
FAX:
Applicant:
TOD SHATTUCK
10800 SW AVERY ST
TUALATIN, OR 97062
PHONE: 503-672-5466
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 PF12016-00110
Type: Condition Name: Status: Severi :
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. Contact Ken Fisher at 503-816-6146 or kenny@tigard-or.gov.
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
Sattler St. is a no asphalt cut street until the year 2017.
RECEIVED
City of Tigard MAY ? 5 2016
PUBLIC WORKS —ENGINEERING PGE WORK ORDER#M�$ TGARD
= N N INEERING
Public Facility Improvement (PFI)PT epi i
DESCRIPTION OF WORK(in the right-of-way) REQUIRED SUBMITTAL
Check one: R Utilities ❑ Sidewalk/driveway approach ❑ Street improvements ELEMENTS
Detailed description: At property 8705 replace UG Term Kit at pole#1486 ❑ Minor work in right-of-way
(sidewalk repair,curb cut,street
and Traffic Signal shut down at Hall Blvd and Sattler St opening,etc.)requires:
•Application form,completed
and signed
`IR,.ViV-4 •Submit one(1)copy of scaled sketch
Property address/location(s): 8705 SW Reiling St, Tigard of the proposed work to be done
Crew work on SW Sattler St •Submit one(1)copy of traffic
C-1 'L O, control plan
—OR—
Tod Shattk/Kath n Vanderzanden ❑ Substantial project work requires
Applicant's name: ry above items and professional
Address: 10800 SW Avery St engineered plans for:
•Street widening
Ci /state: Tualatin, OR Zip: 97062 •Subdivision infrastructure
Phone: 503-672-5466 Email: T&DSupportAvery@pgn.com •iviain utility line extension:
Storm Drain,Sanitary—Tigard
- Water—Tigard Water Service
Contractor's name: Portland General Electric Area(includes Durham,Icing City
CCB#: 103663 Expiration: Active and a portion of unincorporated
Address: 10800 SW Avery St Washington County)
City/state: Hillsboro, OR Zip: 97062 DELIVER APPLICATION TO:
503-464-7777 T&DSu ortAve n.com City of Tigard
Phone: Email: PP rY@P9 Planning/Engineering
13125 SW Hall Blvd.
Engineer's name: NA
Tigard,OR 97223
Applications for"minor work in right-of-way"
Address: only may be emailed to:
City/state: Zip: rip re mitR&tigard-or.=
Phone: Email:
Case No.: I ` � 2,016 — 00 1f
Estimated value of work (within the public right-of-way): $TBD
Application submittal fee: -et
Is work related to a LAND-USE DECISION? ❑ Yes 1W No Application accepted:
If so, please specify (MLP, SDR,SUB,etc.) case #: By: / -1 -0 Date:
Is work related to a BUILDING PERMIT? ❑ Yes R No Application reviewed:
If so,please specify(BUILDING PERMIT)case#: By: K,K Date:
Applicant otified:
S,gnrt�•.c t S A >R1�, �•� ST .�rf-t ( ;LO1-7 By: S Date: �
lACURPLN\Masten\land Use Applications Rev.07/16/2014
City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov e 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 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.
BY SIGNING BELOW,THE APPLICANT(S) SHALL CERTIFY THAT:
• The above request does not violate any deed restrictions that maybe attached to or imposed upon the subject propert�.
• 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 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.
Dg,Wly eIQa byN dtl Vanden—n
Kathryn ..Us' ;: ,�P �� a Kathryn Vanderzanden 5/24/16
Vanderzanden
01b,
Dala10180514OB 28 48-0T(10'
Applicant/Authorized 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
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov 503-718-2421 Page 2 of 4
2011 Edition Page 29
3.7 Flagging Through Intersections
Flagging through intersections is especially hazardous for both road users
and workers. Other traffic control measures (e.g. full closures with detours)
that minimize impacts to the normal operation of the intersection should be
considered to accommodate the work.
Concepts applicable to all intersections:
1. Contact the road jurisdiction traffic office ahead of time for help in
determining what closures or detours can be set up. All closures
shall be approved by the road jurisdiction.
2. Avoid flagging, if possible, during peak traffic times, especially on
major commuter routes.
3. There should be one flagger for each approach (See Diagram 620).
One flagger may be used to control the entire intersection if the
intersection has an approach ADT of 400 vehicles per day or less.
4. With multiple flaggers, designate one as the lead flagger. Effective
means of communication, such as radio devices, should be used.
5. Approach lanes should be reduced to a single through lane.
Consider closing lanes that are not a major movement, such as right
turn lanes with only occasional use. Consider prohibiting left turns if
there is work or obstruction within the intersection.
6. Dedicated lanes may be provided for major turning movements with
appropriate regulatory signing such as"RIGHT TURN ONLY" (R3-5)
or"RIGHT LANE MUST TURN RIGHT" (R3-7) signs. Non-conflicting
turning movements may be combined with other movements.
7. Conflicting regulatory signs, such as STOP, YIELD or RIGHT TURN
ONLY, shall be covered.
3.8 Night Flagging
When flaggers and/or pilot cars are necessary during night operations,
flagger stations shall be illuminated, and shall be illuminated separately from
the work space. Consider using ANSI Class III high visibility safety apparel
during night operations.
Nighttime Flagger illumination strategies should include the following:
1. Locate lighting on the same side of the roadway as the flagger.
2. Flagger station lighting should meet the following criteria:
a. Locate lighting on the shoulder approximately 5-10 feet from
the edge of the traveled way at a 15 degree angle away from
the travel lane in advance of the flagger, without impacting
the flagger's escape route.
December 2011 Chapter 3
2011 Edition Page 119
,Lane Closure at Intersection with Flagging Diagram 620
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December 2011 Chapter 5
Kathryn Vanderzanden
From: Derek Walker
Sent: Friday, April 22, 2016 7:45 AM
To: Power Quality
Subject: Need a job
Categories: Blue Category
Need a primary fault job B/O term kit at pole 1486 C21-11D open in pad 7858 normal open
closed in pad 7859
II
t
Ti
A 10. 25025 Stinger on term kit is burnt off from
1►T� 4,,U Ty cutout. Run goes to pad 7858
bu
i
Cable is tied off
1
Derek Walker
Special Tester,WLC
derek.walker(@oan.com
(503)572-7364
2
Kenny Fisher
From: Kenny Fisher
Sent: Wednesday, May 25, 2016 11:03 AM
To: 'T&DSupportAvery'
Subject: PFI permit#2016-00110
Tod Shattuck or Katheryn Vanderzanden,
I am processing this permit for replacing a underground Term Kit at pole#1486 and shut down traffic signal.
You will need to contact ODOT as Hall BI. And this signal is in their right of way. Thank You.