PFI2017-00199 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
Sri COMMUNITY DEVELOPMENT Permit#: PF12017-00199
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 10/10/2017
Parcel: SEG2378
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: Comcast
Project Description: Pull new fiber in ROW
Owner: FEES
Description Date Amount
PHONE:
Contractor:
PHONE:
FAX:
Applicant:
JASON MCDONALD
11308 SW 68TH PARKWAY
PHONE: 503-596-3965
P
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: r
Issued By: kjr_��
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for PF12017-00199
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
ermit.PFIUtilities 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. Call 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
RECEIVED
SEP 2a �o��
City o,f Tigard CITY O TIGARD
i
a PUBLIC; WIORI�S — ENGINEERING PLANNING/ENGINEEFIING
C
Public Facility m�Irovement PFI) Permit
TYPE OF WORK
DESCRIPTION OF WORK(in the right-of-Nvay) ❑ 'TYPE 1—Franchise Utilih-Work
Check one: ] Utilities ❑Side%%';tlk/clrivewa}-approacli ❑Street improvements performed by N1\'N, PGE
Comcast proposes to pull new fiber through existing and/or utilityagency.
Detailed description: P P P 9 9
conduit and construct new conduit in the Cit of Tigard ROW. ❑ TYPE 2—Side«atk/Drive��a}/Sewer
Work performed for the purpose of:
• Sidewalk installation or repair.
11354 SW Durham Rd,Tigard OR,97224 • Drivewa}•appro.ich installation
Property address/locatiofi(s): and/or repair
• Sanitary serer lateral installation
and/or main line tap
Comcast ❑ TYPE 3—Full scale Development
Applicant: \Fork performed with Land use
Address: 11308 SW 68th Parkway approval vdhich includes any of
CitA'/state: Tigard,OR Gip: 97223 the following:
Plione: (503)596-3965 Email: Jason_McDonald3@Comcast.com • Subdivisions or Partitions
Jason McDonald 503 596-3965 • Street widening
Contact name: Phone: { )
• llaililine installation for Sanitary
NX Utilites serer, Storm serer, Tigard water
Contractor: and/or Tigard Water Sen-ice Arca
CCIi#: 200986 Etipiratioii: 9/20/2017
Address: 1947 Claxter Rd NE stir3MITCOMPLETEDAPPLICATION TO:
Cit<-/state: Salem,OR Zip: 97301 City of Tigard
0 - snxutilities. m Plmtrrlug/Eligiueeri�rg
Phone: 53)9107396 Email: medel @ co13125 SW Hall Bled.
Contact name: Sergio Medel Phone: (503)910-7396 Tigard,OR 97223
Applications for"minor%%'ork in right-of-u•ay"
K&B Technical Solutions only may be emailed to:
Engitleel•: rowpermi ts([l).tig_a rd-o r.gor
Address: 6566 SE Lake Rd Suite F
City/state: Milwaukie,OR Zip: 97222 rr��
Phone: (503)650-7615 Email: Shane_Langley@KBMail.net Case No.: �F�-��, � 0 0 � cl '1
Contact name: Shane Langley Application submittal fee: S
Additional fees: $ Py.
Estimated value of work is required(if over x$'5,000):$ Application
,,accepted: J
(within the public right-of-way) By: V I' 6 Date: 10 r —1
Application reviewed:
Is work related to a LAND-USE DECISION? ❑ Yes ® No
If so,please specify(\ILP,SDR,SUB,etc.) case#:
Applicant notified:
Is work related to a BUILDING PERMIT? ❑ Yes 9 No By: ✓yl Y3 Date: JD 7
If so,please specify(BUILDING PERMIT)case#: I:\ENG\PermltApptications\pfi applicatbn Rev.12/16/2016
•xi th a�,,, a-A t 5 �,-� Avti-M4' I II v to, g� �q'.yD�� O(L A-Pr�,2.3',
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 %N,-\ .tigard-or.gox- 503-718-2421 • Page I of 4
I
APPLICANTS
NOTE: Person specified as"Applicant"shill be designated"Permittee"and shall provide financial assurance for work,if
required by the city pursuant to TNTC 15.041.140.
* W\rdi the exception of a utility opersttuig pursusuit to a\-Ad franchise with the Citi•of Tigard,when the owner and the applioutt are different
people,the applicant,nust he the piu-chaser of record or a lessee in possession cvith written authorization firm the ownei or aii agent of the
owner. The owners)must sign this applicatiost iu the space provided or submit a written authorization with this application. Fniticltised
Utilities are not required to obtain the ou'llei's signature ou the application
BY SIGNING BELOW,THE APPLICANTS) SHALL CERTIFY THAT:
• j7ie abo-ve recluest does not violate a"recorded deed restrictions that may he attached to or imposed upon thC subject
• r ,
• If the application is granted,die applicant will exercise the rights granted in accordance with the terms and subject to all die
conditions and limitations of the approval.
• All of the above statements and the statements in any plot plan,attachments,and exhibits transmitted here\vitlh,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.
• T1hc applicant has read the entire contents of the application,including the policies and criteria,and understands the
requirements for approving or deny=ing the application.
S�.�ne �,� /� 9/19/2017
Applicant/Audi gent'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 SNXI Hall Blvd. • Tigard,Oregon 97223 • t«vwtigard-or.gov 503-718-2421 Page 2 of 4
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BEGIN UNDERGROUND CONSTRUCTION AT
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A MIN.OF 36'BELOW GRADE. ITE
(TYPICAL)
EXIT CITY OF TIGARD ROW AND CONTINUE
CONSTRUCTION ON PRIVATE PROPERTY
1.ALL WORK AREAS TO BE
RESTORED TO LIKE OR BETTER
CONDITION.
-28T TO SW 113TH AVE — - 2.ALL OTHER UTILITIES ARE BASED
OFF EXISTING LOCATES OR UTILITY
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M TIGARD,OR 97224
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TECHNICAL SOLUTIONS '
' $ VContact:Jason McDonald Z 55541
PO BOX 2529,Clackamas,OR 97015 3 FIBER ENHANCEMENT
N Phone:(503 957-4791 Office-(503)650-6041 Ext.212
Jason_tvlcDonald3@comcast.com Email:Share Langley(akbmad.nel 4 CITY OF TIGARD ROW PERMIT DRAWING
2011 Edition Page 107
Diversion into a Continuous Left Turn Lane Diagram 430
ROAD
WORK
AHEAD
Ihl
B 1yt
CENTER
LANE
CWSM
AHEAD
A
II
U2 I ;I
Buffer
Protection Vehicle
w/TMA(both Optional)
See Chapter 4
Buffer
•
• U2
I '
U2 lei A
II
t B
y I ROAD
WORK
AHEAD
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 Spadng Between Signs "Buffer"
Speed A B C Space
20 SO
25 100 100 100 75
30 100
35 350 350 350 125
40 150
45 180
50 S00 S00 500 210
55 1-250
60 285
65 700 700 700 325
70 365
Chapter 5 September 2016
r
2011 Edition Page 109
Right Lane Closure, Multi-Lane Non-Freeway Diag. 500
1 1 t t
I I .'
• ProWWon VMUe
• w/TMA(both 00oW
• BW CMpW 4
•
--i-- ---------i
I
II •
' e„rte� •
t + I I 1Buffm
I IA I T
� I
I e
•� sE I
� PREPARED
I� TO STOP
—1 --1---- --� I (OpfionaQ
Flagger Layout ••
Detail
A
JB
See Note 4 111 tIt
September 2016 Chapter 5
Page 108 2011 Edition
5.5 Multi-Lane Roads
Right Lane Closure, Multi-Lane Non-Freeway Diag. 500
Diagram 500 covers work which closes the right lane of a multi-lane non-
freeway road.
If closing more than one lane on a multi-lane road, provide a minimum
tangent distance of 2L between the end of the first lane closure taper and the
beginning of the second lane closure taper.
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 the posted speed is 40 mph or less, the RIGHT LANE CLOSED
AHEAD signs may be omitted.
4. Placement of signs in a non traversable median or other median that is
not a two-way left turn lane is required for lane closures any time there
is room for a truck to be parked on the left, out of the travel lane.
When there is no room for a truck to be parked on the left an additional
RIGHT LANE CLOSED AHEAD sign should be placed on the right side
and placement of signs in the median is optional.
5. If flagging is needed for work vehicle ingress/egress, use Flagger
Layout Detail (see Inset).
Sign Spacing and Buffer Lengths(feet)
Posted Spacing Between Signs "Buffer"
Speed A B C Space
20 SO
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