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PFI2016-00147 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12016-00147 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 07/20/2016 Parcel: SEG2205 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Electric Lightwave, LLC Project Description: ELI will overpull infrastructure to provide fiber optic service to the customer at 7337 SW Kable Lane Owner: FEES Description Date Amount PFI Permit Fee 07/20/2016 $300.00 PHONE: Contractor: PHONE: FAX: Applicant: CHRISTINE GANOUNG 18110 SE 34TH ST BUILDING ONE SUITE 100 VANCOUVER,WA 98683 PHONE: 360-606-9280 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 '9 'J �� 91�� 114 Signature: f� Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12016-00147 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. Ken Fisher 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 RECEIVE® JUL 12 2016 City of Tigard 0,,, T!r- qD "a " pp Application For Work In e fight-Of--Way ROW Permit Property Address/Location(s): 7337 SW Kable Ln FOR STAFF USE ONLY Tigard, OR oC��J Right-of-Way -- - Case No: /1 3-� Cil *Applicant's Name: Electric Lightwave LLC Application Accepted: ) :—L19 Address:18110 SE 34th St Bldg ONE Suite 100 Application Reviewed-.771-4-14, By: City/State: Vancouver, WA zip, 98683 Application Fee Due: 8 30D.00 S Primary Contact: Christine Ganoung Applicant Notified: Phone: 360-606-9280 rax Receipt No. 40S0 5 Email• cmganoung@rccgllc.net REQUIRED SUBMITTAL INFORMATION Contractor's Name- Standard Utility Contractors • Application form,completed and signed 66948 • Submit one(1)copy of scaled sketch Of CCB# Expirarion: the proposed work to be done Address: 12094 NE Ehlem Rd • Submit one(1)copy of traffic control City/State: Aurora, OR Zip: 97002 Plan Phone: 503-849-4828 rax; Professional Engineered Plans are required Etnail: darrel@standardutility.com for. • Street Widening Plans By: Rock Creek Communications Group LLC • Subdivision Infrastructure • Main utility line extension ,lddress: 31116 NE 152nd Ave 'Deliver application to;r,w�x rnlu,ir.{;ji;;cru-�r.1��lulu or to City/State:Battle Ground WA Zip: 98604 _ City ofI'igardPlanning/L'Onecring,13125 SW Hall Phone: 360-606-9280 FkSlvd. rbard,OR 97223. ait: -- Rev-12/10/2D13 Email: emGanoung(arccgl le.net 17,U tvl rt\Udxscrn\t and Uw.+1 neo^"\R> or-n•=� 'cnn c App"tioa.d�x Description of work: ELI will overpull existing infrastructure to provide fiber ottic service to the customer at the above referenced address per attached plan. Estimated value of work(within the public right-of-way): $---- Is work related to a LAND-USE DECISION? YES ❑ NO E] If so, please specify(NILP,SDR,SUB,etc.)case#: Is the work related to a BUILDING PERMIT? YES NO LX If so, please specify(BUILDING PERMITT #: Signature of Applicant/Permittee � f Date: Jul 12, 2016 Print Name: Christine Ganoung Title: OSP Engineer _ _ — City of Tigard 1 13125 SW Hall Blvd.,Tigard,OR 97223 1�503-718-2464 1 www.tigatd-or.gov �� VERIZON POR METZGER 7337 SW KABLE LN, TIGARD, OR C30102.OSP.16.ND.12JM.SUC SHEET INDEX WTI NAME OESLRIPIIDN 1-COIR SREET/9M LoCAMIw wr. YtZrrF1tI1 Nor ERAL Noms RECEIV S-GENERAL ROTES a. --4NOICT a EET(1) yS J JUL 12 2016 swRwrrnAto CITY OF TIGARD PLANNING/ENGINEERING CUSTOMER IrezoN_aGR wurz Im,ew I(AeIL EARS.ncum.aw ' cawrAcr.u rr roueB OWNER vcszw newswr uwwArrB �V: ffidnl G E S S APP I ANT (i s 1.11oRA Rl£ retro 5E NTH sr.x0&nrDWC DNE 4� swTE Tao �,� vANCIX/vETr,ter weal aTKr:sos-dSJ-e000 meat: E- x0- cars VICINITY MAP SCOPE OF WORK E-warAK:rBM DAA�TWArEEF .OW INTEGRA WILL OVERPULL EXISTING INFRASTRUCTURE TO PROVIDE FIBER OPTIC SERVICE TO CONSULTANTS ENGINEERS THE CUSTOMER AT 7337 SW KABLE LN. ROCK uEE GwaApna mN5 GROW LLCN.Ts. INTEGRA WILL LOCATE EXISTING SPLICE CASE IN 25-TA ON SOUTH SIDE OF SW KABLE LN.FROM WILL vmUraD.WA,veew 25-TA,INTEGRA WILL OVERPULL EXISTING 2"CONDUIT 205'WEST TO HANDHOLE.CONTINUE DEar:rso-ee1-6511 OVERPULL AN ADDITIONAL 102'CROSSING SW KABLE LN AND PLACE NEW (1)-17X30 INTERCEPT To s6t EeaG�Wd»IL HANDHOLE. E-YAL:a'roA WNOWMCGUC"ET NEW UNDERGROUND BUILD:OPEN TRENCH 6'TO VERIZON PROVIDED MEET POINT,PLACING NEW (1)-2"CONDUIT AND FIBER OPTIC CABLE. G Int���\//�E��� DESIGNED BY Rccc uc APfWWD BY. Bo INTEGRA TELECOM �r CHECKED BY: INTEO4A 7Er ECOM DRAWN BY.' GANDIMG • PERMIT SET 7/12 2016 egra an VERIZON POR BLEMETZGER RENSIONS 7337 SW KABLE LN REV DESCRIPTION DATE BY APP TIGARD, OR 1 N.—.17'SET 07 12 2016 CMC - Nnow what's below. CBII before you dig. PE STAMP COUNT..WA I GTON DATE: SCALE. PRO„ECT CODE: SHEET 07 12 2016 1 50 C30102.0SR I6.14D.12JAI.SUC PERMIT SET SURFACE FEATURES/AERIAL U11LI11ES — LINETYPES do SYMBOLS fJ�Yi mBNgG EYSEw BNBIYD ms= ONE= CABLE CABLE PGLF ft" o PoNiER1Y cLiWHER —_ s1RANo —______S1RAN0 D OM]'IE FOIAVD YOAAEN I — — iRAiFIC SIGRK 9MK O 0lHER PolE O MAN COIdIr --------IT - - H SPIJQ �� SPLICE ® W.A TEF METER --------PLLIMAI NHERo1/CT PLENUM DNERWC! VAUL!/BULDR,G srmAQ YMAI ® /&,WdNa$TMAQ TAPE XYMANT —WA ICp ^^© ! 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