PFI2017-00116 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
= COMMUNITY DEVELOPMENT Permit#: PF12017-00116
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 07/13/2017
Parcel: SEG2468
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: Comcast
Project Description: Adjacent to 7632 SW Durham Road and SW 74th Ave. Comcast proposes to overlash 1,125'of(1)-2"
conduit from pole#62/NT to pole#2910/108343 and to push/pull 86'of(1)-2"conduit to upgrade vault.
SEG 2468/2469/2445.
Owner: FEES
Description Date Amount
PFI Permit Fee 07/10/2017 $300.00
PHONE:
Contractor:
NX UTILITIES LLC
1150 FIRST AVE
SUITE 600
KING OF PRUSSIA, PA 19406
PHONE: 484-804-4500
FAX:
Applicant:
JASON MCDONALD
11308 SW 68TH PARKWAY
TIGARD, OR 97223
PHONE: 503-924-9120
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
Signature: See e-t •C�/ ,C�h
Issued By:
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for PF12017-00116
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. Kenny Fisher 503-8'6-6146 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
RECEIVED
City of Tigard JUL 0 6 2017
■
PUBLIC WORKS — ENGINEERING CITY OF TIGARD
Public Facility Improvement � 'e�
TYPE OF WORK
DESCRIPTION OF WORK(in the right-of-way)
W TYPE 1—Franchise Unlit}•Work
Check one: @ Utilities ❑Sidewalk/driveway approach ❑Stree tunprovements performed by NT\VN, PGE
Detailed description: Comcast proposes to overlash 1,125'of(1)-2"conduit and/orutilityagency.
from pole#62/NT to pole#2910/108343. ❑ TYPE 2—SidcwaLk/Driveway/Sewer
Comcast proposes to push/pull 86'of(1)-2"conduit to upgraded vault. Work performed for the purpose of:
• Sidewalk installation or repair.
• Driveway approach installation
7632 SW Durham RD,Ste 115,Tigard,OR 97224
Property address/loc tion{s): and/or repair
• Sanitary sewer lateral installation
and/or main line tap
Applicant: Comcast El TYPE 3—Pull scale Development
PP Work performed with land use
Address: 11308 SW 68th Parkway approval which includes any of
City/state: Tigard Zip: 97223 the following:
Phone: (503)924-9120 Emad: Jason_McDon00Qcoincast.wrnIMaHoney_McKeon@kbmai net • Subdivisions or Partitions
Contact name: Jason McDonald Phone: (503)924-9120
• Street widening
• 1\lairdine installation for Sanitary
Contractor: NX Utilities sewer, Storm sewer,Tigard water
E
CCB#: xp
200986 9/20/2017 and/or Tigard Water Service Area
iation:
Address: 1947 Claxter Rd NE SUBMIT COMPLETED APPLICATION TO:
City/state: Salem,OR Zip: 97301 City of Tigard
484 804-4570 comcasteamas@nxutilities.com P1anning/Engineeting
Phone: ( ) T[nail: �° 13125 SW Halt Blvd.
Contact name: Sergio Medel Phone: (503)910-7396 Tigard,OR 97223
Applications for"minor work in right-of-way"
Engineer: K&B Technical Solutions truly maty he emailed to:
Address:
6566 SF Lake Rd Suite F ronTP mits@tigard-g-G=
Cite/state: Milwaukie,OR. Zip: 97222 FOR STAFF ITSE. ONLY
503 650-6041 MaHone McKeon kbmail.net ?-F\� 11-to lel
Phone: Email: Y— @ Case No.:
Contact name: MaHoney McKeon Application submittal fee:
Additional fees: $
Estimated value of work is required(if over$5,000):$ Application accepted:
(within the public right-of-way) By: 2b— Date:
Application reviewed:
Is work related to a LAND-USE DECISION? ❑ Yes R No
If so,please specify (MIT,SDR,SUB,etc.) case#: By: (4h S)#4bate: 7 ' 10 ^/
Applicant notified:
Is work related to a BUILDING PERMIT? ❑ Yes 9 No By: 't'� Darr: _
If so,please specify(BUILDING PERMIT)case#: 1:\ENG\permitApplic•tions\pti•ppkcation Rev.12/16/2016
I
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 wwwtigard-or.gov • 503-718-2421 • Page 1 of 4
I
APPLICANTS
NOTE: Person specified as"Applicant"sliall be designated"Permittee"and shall provide financial assurance for work,if
required by the city pursuant to TMC 15.041.140.
: With die exception of a utility operating pursuant to a valid fnmclute wide the City 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 the
owner. The owner(s)must silm this application in die space provided or submit a written authorization nidi this application. Franchised
Utilities are not required to obtain the owners signature on die application
BY SIGNING BELOW,THE APPLICANTS)SHALL CERTIFY THAT:
• The above request does not violate any recorded deed restrictions that may be attached to or imposed upon the subject
propem,
• 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,arc 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.
Jason McDonald 06/23/17
App • ant/Auto ed Agent's signature Print name Date
I
SIGNATURES of each owner of the subject property,if required.
I
Owner's signature Print name Date
Owner's signature Print name Date
Owner's signature Print name Date
i
PUBLIC FACILITY IMPROVEMENT PERMIT
Cityof Tigard 13125 SAX/HallI3hvc1. • Tigard,Oregon 97223 • ww%v tigard-or.gov 503-718-2421 Page 2 of 4
DEVELOPMENT ENGINEERING FEES
Public Facility Improvement(PFI)Permit: DETAILED St 13NIH-17 AL
APPLICATION FEE
Part 1: Required submittal fee$300.00
FRANCHISE UTILITY AND SIDEWALK/
PERMIT FEE DRIVEWAY AND UTILITY
CONNECTIONS,ETC.
Part 2: All non-water system improvements (work in the right of way)
Engineer's estimate X 5%(less$300.00 submittal fee)
Engineer's estimate X 2%Plan Review Sketch
(including information below)
WATER SYSTEM FEE
❑ Dimensions
Part 3: All public water system improvements ❑ Street Name
Engineer's estimate X 12% ❑ Site Address
PFI Permit Fee Exemptions: FULL SCALE DEVELOPMENT
There will be no permit fee charged,or assurance required
(Subdivisions/Partitions and Street Improvements)
for the following types of work:
• Sidewalk repair(less than 20 lineal feet)
• Relocate or replace mailbox Design Plans
• Ditch cleaning that does not involve regrading. (G sets,24x36 or 22x34)
• Weep hole repair ❑ Cover—Site,Vicinity,Abbreviation,Legend
• Curb repair or replacement(less than 20 lineal feet) ❑ General Notes(City,Water,Sewer,etc.)
• Lawn sprinkler system installation or repair ❑ Street(Plan,Profile)
• Street tree pruning or planting ❑ Water,Storm and Sanitary(Plan Profile)
• Planter strip landscape maintenance ❑ Water Quality Facilities
• Test wells ❑ Grading
❑ Landscaping/Tree Plan
❑ Composite Utility Plan(Electrical,Phone,Gas,
Note. A cash assurance may be required per Storm,Sanitary,Water,Signage,Street Lights,etc)
TMC 15.04.140.(customer deposit) ❑ Details
❑ Traffic Sight Distance
❑ Signing and Striping
❑ Street Light Plan and Photometric
❑ Engineers seal/signature
❑ Sheet label(project land use name,revision and
plan log block,dates and sheet numbers.)
Additional Submittals
(per Land Use conditions)
❑ Traffic Report
❑ Storm water Drainage Calculations
❑ Geotechnical Report
❑ Preliminary Access Report(Sight Distance)
❑ Proposed Plat
❑ Pathway Design(if applicable)
❑ Water Department Approval
PUBLIC FACILITY IMPROVEMENT PERMIT
City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 Page 3 of 4
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Page 78 2011 Edition
Work on Shoulder Diagram 210
Diagram 210 covers stationary work with work or parked equipment on the
shoulder. This diagram does not cover work on a freeway shoulder. See
Diagram 710 for Freeway Shoulder work.
1. Vehicles should be parked as far off the roadway as practical.
2. Use truck-mounted flashing warning lights on work and protection
vehicles. See Section 4.3—Lights and Lighted Signs for exceptions.
3. For added visibility, truck-mounted arrow boards or PCMS in caution
mode may be used.
4. Arrow panels in caution mode are recommended for work on roads
with posted speeds of 45 mph or greater and high traffic volumes,
greater than 2000 average daily traffic(ADT).
5. Requirements for signing and devices are shown in Table 5-2, below.
Table 5-2: Device and Signage Guidelines
Proximity to Edge of Traveled Way
More than 15 feet
or behind Barrier or Less than 15 feet
Guardrail
One advance warning sign is
Advance warning required and two signs are
Work in Place signs, devices, and recommended.
More than 1 Hour flashing warning Cone taper is required. Cones
lights are optional. along the edge of traveled way
are optional.
Work in Place Advance warning signs and devices are optional.
Less than 1 Hour
Sign Spacing and Buffer Lengths(feet)
Ported SpednBBetween Signs "Buffer"
Speed A B C Spam
20 50
25 100 100 100 75
30 100
35 350 350 350 125
40 150
45 180
50 S00 S00 500 210
55 250
60 285
65 700 700 700 325
70 365
Chapter 5 September 2016
2011 Edition Page 79
Work on Shoulder Diagram 210
11
(Optional)
•
• ` Protection Vehicle
% w/TMA(both Optional)
See Chapter 4
•
•
Buffer
•
•
•
•
A
— ROAD SHOULDER
WORK OR WORK
AHEAD AHEAD
Initial Warning Sign
1 t *Use as appropriate-see Table 5-2
September 2016 Chapter 5
Page 106 2011 Edition
Diversion into a Continuous Left Turn Lane Diagram 430
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 turn 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(L/2)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)
Posted Spacing Between Signs "Buffer"
Speed A B C Spam
20 50
25 100 100 100 75
30 100
35 350 350 350 125
40 150
45 180
50 500 500 500 210
55 250
60 285
65 700 700 700 325
70 365
Chapter 5 September 2016
2011 Edition Page 107
Diversion into a Continuous Left Turn Lane Diagram 430
ROAD
WORK A
AHEAD
1 �yl
B t
CEWMR
u�
I
CLOM
MW
A
II
U2 I • I
Buffer
Protection Vehicle
Wnw(both Optional)
/See Chapter 4
Buffer
•
• U2
I '
•
U2 I• I A
I
lyt B
ROAD
WORK
AHEAD
September 2016 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 Spam
20 50
25 100 100 100 75
30 100
35 350 350 350 125
40 150
45 180
50 500 500 500 210
55 250
60 285
65 700 700 700 325
70 365
Chapter 5 September 2016
2011 Edition Page 119
Lane Closure at Intersection with Flagging Diagram 620
fGB
C 1 1
(00--D
B
(OPOoreo
RMD
100 R.Mex PREPARED MEM MMD
TO STOP WO11K
MEAD
A B B C
Buffer.
H H
I
1OO1L M—
C B B A
ROAD BE
WORK PREP
MIFM TO STOP • 100 fL Melt
uNE 1 _
ROAD
AIEAO
(am«wo �A
B
BE
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ro sroP
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1 t
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C
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WORK
AHEAD
September 2016 Chapter 5