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PFI2016-00214 r CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT = COMMUNITY DEVELOPMENT Permit#: PF12016-00214 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 09/26/2016 Parcel: SEG911 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: PGE Project Description: Adjacent to 12260 SVV 106th Drive. Replace 60'13/0 1/0 SEC servicing 12230 SVV 106th Drive with 4/0 TX. PGE Job M2042525. SEG 911 Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: JOHN GUERRY 10800 SVV AVERY STREET TUALATIN, OR 97062 PHONE: 503-310-2885 Tota 1 $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 +/ � p , Signature: 9C4 ✓VIAJ Ina LA—,, Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12016-00214 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. 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 F(ECENED City of Tigard Sip 2 6 2016 PUBLIC WORKS — ENGINEERING CITY OF-IGARD • NGIENGINEERING Public Facility Improvement (PFI) Pef REQUIRED SUBMITTAL DESCRIPTION OF WORK(in the right-of-way) ELEMENTS Check one: Vpublic utilities(gas line,electric,data cable) Jll? Minor work in right-of-way ❑ Sidewalk/driveway approach and utilities only (side,,valk repair,curb cut,street ❑ Street improvements opening,etc.)requires: PGE JOB M2042525 •-application form,completed Detailed description: and signed REPLACE 60' B/O 1/0 SEC SRVG 12260 SW 106TH DR •Submit two(2)copies of scaled W/4/0 TX sketch of the proposed work to be done •Submit two(2)copies Property address/locadon(s): 12260 SW 106TH DR., of traffic control plan TIGARD, OR 97224 SFC � —OR— oil Substantial project work requires above items and professional Applicant's Portland General Electric engineered plans for: PP s name: •Street widening Address: 10800 SW Avery Street •Subdivision infrastructure City/state: Tualatin, OR Zip: 97062 •Main utility line extension: Storni Drain,Sanitary—Tigard- Phone. 503-310-2885 Email: PrereqCoord@pgn.com —Tigard Water Service Area Contactperson: John Guerry Phone: 503-310-2885 Contractors name: CCB#: Expiration: DELIVER APPLICATION TO: Address: City of Tigard City/state: Zip: PIanning/Engineering Phone: Email: 13125 SW Hall Blvd. Tigard,OR 97223 Applications for"minor work in right-of-way" Engineer's name: only may be entailed to: Address: mwnermitsl&tigard-or.gov City/state: Zip: Phone: Email: Case No.:PFI Wb-0021 y Application submittal fee: Estimated value of work is required(if over$5,000):$ Application accepted: (within the public right-of-way) By: 10 e— Date: q1?ll 11LO Is work related to a LAND-USE DECISION? VYes El No No reviewed: If so,please specify (MLP,SDR,SUB,etc.) case#: By:.�I•WDate: Applicant notified: Is work related to a BUILDING PERMIT? ❑ Yes NQ No By: Date: If so,please specify(BUILDING PERMIT)case#: l:\CURPLN\Masten\Land Use Applimbans Pev 07/16/2014 Cityof Tigard - 13125 SVi'Hall Blvd. - Tigard,Oregon 97223 • unawtigard-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,if required by the city pursuant to the TMC 15.041.140. * With the exception of a utility operating,pursuant to a valid franchise with the Citi, of Tigard,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 die owner.71te owner(s)must sign this application in the space provided or submit a written authorization with this application. Franchised Utilities are not required to obtain the owners signature on the application. BY SIGNING BELOW,THE APPLICANT(S) SHALL CERTIFY THAT: • The above request does not violate any recorded deed restrictions that may be attached to or unposed upon the subject property- • 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 any 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. Applicant/Authorized Agent's signature Print name Date SIGNATURES of each owner of the subject property, if required 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 • www.tigard-or.gov 503-718-2421 • Page 2 of 4 DEVELOPMENT ENGINEERING FEES 1. Public Facility Improvement(PFI)Permit: Part 1: Required submittal fee$300.00 Part 2: All lion-water system improvements Fngineer's estimate X 50%(less$300.00 submittal 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. • Weep hole 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 Cityof Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 Page 3 of 4 SAMPLE SKETCH: Edge of Pavement 1 '� ► Ditch — Streetlight 1 —-—-—-—-—-—-- -r--- ' T–"Frioj�'os d"Selwer'Cirie" I I - rntill Existing House 1 1 Existing 1 �i • Driveway �I vi I 1 I 10. 1 I rl "I I o� C 'I I I O i 1 Existing Shop i Powerpole 1 a 95' 1 ------- ------�--- • �roperiy'Line IFire Hydrant(FH) � � I 1 Scale: 'I"=30' I i 1 I 1 � � I I � I I 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 - 13125 S\X'Hall Blvd. - Tigard,Oregon 97223 - wwwtigard-or.gov - 503-718-2421 - Page 4 of 4 Page 84 2011 Edition Stationary Lane Closure with Flagging Diagram 320 Diagram 320 covers total closure of one lane of a two-lane, two-way roadway. See the detail inset for the layout if using a single flagger to control both directions of traffic on low volume roads (less than 400 ADT)with good sight distance as discussed below. 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. Flaggers at each approach are required if any of the following conditions exist: a. Night Operations. b. Work space is over 200 feet in length. c. Sight distance is less than 750 feet from each approach through the lane closure. d. Traffic volumes are greater than 400 ADT. 4. The length between the Flagger Ahead signs shall not exceed one mile. Use Diagram 340—Lane Closure with Pilot Car if exceeding one mile. 5. Cones should be used to outline the work space when curves or other roadway alignments prevent clear direction for the motorists to pass the work space safely. 6. Cones along the work space are recommended when posted speeds are 45 mph or greater, when working under heavy traffic or when travel lanes are narrower than 11 feet. 7. Extended queue signing (see Diagram 5-4) should be used when traffic queues extend beyond the initial advance warning sign. 8. When flagging near an intersection, the"Flagger Ahead" (CW23-2) sign should be visible to traffic entering from any side road. Additional advance warning and Flagger Ahead symbol signs may be placed on the side road(s). 9. Sign set-up and flagger placement shown may be used for intermittent full road closures of 20 minutes or less. 10. 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 are expected. Chapter 5 December 2011 2011 Edition Page 85 Stationary Lane Closure with Flagging Diagram 320 oCc C z CL C Q p o ]02< O v� rn wa � O W l t 3 Qo I H a c -- ——————— ————— I �• • t oa •� >OR • atl I ` L I I I � o�v I a R 4 t o • a. J � I I • ; I o :� � •• t�� � • I aE I I O 0 v �.. I �o�r CO o� I I LL` �: r w a CM-2Y. I mai I c llt I U I Sign Spacing and Buffer Lengths(feet) J W 9 c ERRATA: — Posted Spacing Between Signs Buffer w 2 uy o rL Speed A B c Space zz 0 20 50 Supplement Table 25 100 100 100 75 30 100 updated:Fabnmy 12, 35 125 Q0Q Q 2016 40 350 350 350 150 O O By:OOaF n'M'tk-k-y 45 180 3 kilion 50 500 500 500 210 55 1 250 Si tn S acin it and Buffer Lengths feet Supplement December 2011 Posted Simcint Between Signs "Buffer" Chapter 5 Speed A B C Space 60 285 65 700 700 700 325 70 365 ,- WR CHECKLIST OVERHEAD LEGEND ITEM YES COMMENT WL 1-2 Span: 6515 HOLEDIGGER REMOVE/ABANDON FACILITIES_ INSTALL FACILITIES Install: WL 2 MIR 12260 1061 H DR. BOOM (62') 1-RUN OF 4/0 AL URD TX Install: BACKHOE X *1-3"PVC CONDUIT (3) SU3481 -SLEEVE, 7/8", PINK-RED INSTALL ADDITIONAL FACILITIES/MODIFY FACILITIES Abandon: 2 PGE TRENCH 2230 (62') 1-RUN OF 1/O AL TRIPLEX X 65' 12240 BORE 12250 LOCATES X CONDUCTORS } STAKING X INSTALL B-PHASE 410 TX AL EPR JKT-D SECONDARY a FLAGGING *PROVIDED&INSTALLED BY PGE 71 TREETRIM 1-3"CONDUIT 20'-Unknown 12260 LANDSCAPE X POST PROVIDED&INSTALLED BY PGE APPROVED CONTRACTOR 2011 54992 EASEMENT • VT-68 PERMITS X TIGARD ABANDON NSECONDARY CABLE 2270 E PER LC24010-3 1 7128 TRAFFIC PLA X 20'- own CUTSHEET 8-(J11 EQUIPMENT UG CIR.VER. VT 74 1 TRANSMISSION SHUTDOWN JUNCTION BOX 1730 UNFUSED CUSTOMER X 14 ACCOUNTS SHUTDOWN SIv rQs�, DOOR HANGAR CONTACT Q COMPANY PH# C# LU DATE TIME WL 1 VT 740(NEW VT): 10525 12233 (�j Install: JUNCTION BOX 1730 UNFUSED 12255 (3) BUS, SUBMERSIBLE 6 POSITION Remove:UNCTION BOX, 1324 UNFUSED -10 LANDSCAPING NOTES 0 5 30 60 Feet cG+ LANDSCAOPE REPAIR 12285 PGE Vicinity Map ANY DEVL477ON FROM THIS DESIGN MUST BE APPROVED BY THE PGE PROJECT MANAGER J�. PGE CONSTRUCTION DRAWING AS-BUILT VERIFICATION&NESC VIOLATIONS CORRECTED �P This document accurately represents FIELD Construction Foreman: Date: THINK General Foreman: Date: SAFETY (Signature only required for field construction changes J SDPM/ENG REVIEW ASBUILT BY DESIGNER: sW FIRST DATE SCALE, A UNT. W JOB N clrDesrntF 7/19/2016 1 : 30 ft 5940001 3000000658 IO M2042525 PL TITLE REPLACE 60' B/O 1/0 SEC SRVG CALL 811 BEFORE YOU DIG CIRCUIT -13361 s1 G ATTENTION: TIGARD-13361 11 X 17 ,"S' OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED , PGE LOCATION BY THE OREGON UTILITY NOTIFICATION CENTER. / 12250 SW 106TH DR,TIGARD _7'14THOSE RULES ARE SET FORTH IN OAR 952-001-0010 DESCRIPTION hh i�ic THROUGH 952-001-0090 YOU MAY OBTAIN COPIES OF COUNTY SECTIONS 60' B/O 1/0 SEC SRVG 12260 SW 106TH DR WK W/0 TX SHEET vrS� THE RULES BY CALLING THE OREGON UTILITY NOTIFICATION CENTER ADMINISTRATION @(502-232-1987) WASHINGTON C21 -03A 1 OF 1 TO REQUEST UTILITY LOCATES CALL THE OREGON KIIOW hat`�s�below. BEAVERTON DESIGN BY PHONE DRAWNBY UTILITY NOTIFICATION CENTER, 811 AT LEAST Call�oreyou dig. UNE CREW CENTER JOHN GUERRY 503-310-2885 Nathan Falke ��� PGE N 2 BUSINESS DAYS PRIOR TO EXCAVATION BEAVER ON,OR 97006 ©PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED71