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PFI2017-00245
CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12017-00245 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 11/06/2017 Parcel: SEG2496 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Frontier Communications Project Description: Adjacent to 16325 SW Upper Boones Ferry Road. Replace defective Frontier pole 40c2 with 45c2 3rd pole west of SW Upper Boones Ferry Road by RR tracks on south side of road. Taller pole needed for separation from power, place new pole directly west from existing. Frontier Project number: 51338-5219271. SEG 2496. Owner: FEES Description Date Amount PHONE: Contractor: ROBINSON BROS CONSTRUCTION INC 13619 NE 10TH AVE VANCOUVER,WA 98685 PHONE: 503-647-5567 FAX: Applicant: ROSALIE SIMS 4155 SW CEDAR HILLS BLVD BEAVERTON, OR 97075 PHONE: 503-319-7787 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: Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12017-00245 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. 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 NOV 0 6 2017 City of Tigard PUBLIC WORKS — ENGINEERING CITY OF T ICARD PLANNING/ENGINEERING Public Facility Improvement (PFI) Permit TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) X TYPE 1—Franchise Utility Work Check one: X Utilities ❑ Sidewalk/driveway approach ❑ Streetimprovements performed by NWN, PGE Detailed description: Replace defective frontier pole 40c2 with 45c2 and/or utility agency. 3rd pole west of SW Upper Boones Ferry RD by RR Tracks ❑ TYPE 2—Sidewalk/Driveway/Sewer on south side of road. Taller Dole needed for separation from Work performed for the purpose of: power place new pole directly west from existing. • Sidewalk installation or repair. ' • Driveway approach installation Propertyaddress/location(s): North side of address and/or repair 16325 SW Upper Boones Ferry RD on SW Durham RD • Sanitary sewer lateral installation Frontier proiect#51338-5219271 : 24-1 tQ and/or main line tap Applicant: Frontier Communications ❑ TYPE 3—Full scale Development Work performed with Land use Address: 4155 SW Cedar Hills Blvd approval which includes any of City/state: _Tigard, OR Zip: 97075 the following: Phone: 503-319-7787 Email: rosalie.h.sims(d)ftr.eom • Subdivisions or Partitions Rosalie Sims 503-319-7787 • Street widening Contact name: Phone: • Mainline installation for Sanitary Contractor: Robinson Brothers Construction sewer, Storm sewer, Tigard water CCB#: 5742 Expiration: 1/2/18 and/or Tigard Water Service Area Address: 6150 NE 137th Ave SUBMIT COMPLETED APPLICATION TO: City/state: Vancouver, WA Zip: 98682 City of Tigard Phone: 360-576-5359 Email: misbell(d)..rbc-utilitv.com Planning/Engineering 13125 SW Hall Blvd. Contact name: Mike Isbell Phone: 541-260-6009 Tigard,OR 97223 Applications for"minor work in right-of-way" Engineer: only may be emailed to: rowpermits[}a tigard-orgov Address: Mi City/state: Zip: x l[ Phone: Email: Case No.:i I Contact name: Application submittal fee: $ Additional fees: $ Estimated value of work is required(if over$5,000):$ Application accepted: (within the public right-of-way) By: Date: 10 1& 1 � Is work related to a LAND-USE DECISION? ElYes X No Applica' n re d: By: eDate: If so,please specify (MLP,SDR,SUB,etc.) case#: V2Applicant notified: Is work related to a BUILDING PERMIT? ❑ Yes X No By: Date: If so,please specify(BUILDING PERMIT)case#: 1:\ENG\PermitApplications\pfl_application Rev.12/16/2016 City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-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 TMC 15.041.140. * With the exception of a utility operating pursuant to a valid franchise with 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 sign this application in the space provided or submit a written authorization with this application. Franchised Utilities are not required to obtain the owner's 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 imposed upon the subject propeiu- • 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. R O S A L I E S I M S ON:cnly signed SIMS, SIMS ON:cn=ROSALIE SIMS,o=FRONTIER COMMUNICATIONS,ou,email=rhsims@hr.com,c=US Date:2017.11.031554:04-07'00' Rosalie Sims 11-03-17 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 FOR STAFF USE' ONLY Public Facility Improvement(PFI)Permit: DETAILED SUBMITTAL APPLICATION FEE Part 1: Required submittal fee$300.00 FRANCHISE UTILITY AND SIDEWALK/ PERMIT FEE DRIVEWAY AND UTILITY Part 2: All non-water system improvements CONNECTIONS,ETC. Engineer's estimate X 5%(less$300.00 submittal fee) (work in the right of way) 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. (6 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 SAMPLESKETCH: ,' Yt Edge of Pavement I Ditch ---- StreeStreetlight tlight I .�..—.—.—.—.�.—.—r—.— • Rain Drain I I ` ' T lMrIWP os' d'�elnnr'e rTi ii e" � I T jNI Existing House a� I Existing ` 1 I 21 Driveway 1 3'01 I L: I I rl 0, 1 I �; Existing Shop I I Powerpole 1 I I a �. M • a I Ica- 95' I �-------7roper -Lni e----------- 1 I 1 Fire Hydrant(FH) I I I , I . Scale: 'I"=30' � I I I I I ' I I � I . 1 I I MINIMUM SKETCH REQUIREMENTS(Put"N/A"if Not Applicable): _X _ North arrow X Property lines & dimension N/A Slope of property X Street &street name(s) N/A Existing building, structures _X_Utility&street light poles -X_ Proposed work X Existing curb or edge N/A Trees -X_ Existing S/W or of pavement N/A Existing utility locations D/W apron (sewer,water,storm) PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard - 13125 SW Hall Blvd. - Tigard,Oregon 97223 - www.tigard-or.gov - 503-718-2421 0 Page 4 of 4 2011 Edition Page 85 Page 84 2011 Edition Stationary Lane Closure with Flagging Diagram 320 Stationary Lane Closure with Flagging Diagram 320 Diagram 320 covers total closure of one lane of a two-lane, two-way o Y o <a: C roadway. See the detail inset for the layout if using a single flagger to control 0 O¢ o both directions of traffic on low volume roads(less than 400 AD7)with good _ m L sight distance as discussed below. i L o -� 0- < O CL Zed - 1. Use truck-mounted flashing warning lights on work and protection -_. o o N vehicles. See Section 4.3--Lights and Lighted Signs for exceptions. m i 2. For added visibility,a truck-mounted arrow board or PCMS in cautionof /�- -� ,,`, o mode may be used. m a- m 1+1 3. Flaggers at each approach are required if any of the following a Q 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 --_ --_ --------`j • s a� I •• through the lane closure. I � c >0 d. Traffic volumes are greater than 400 ADT. I o V� I j I •E l ��� m I w • �'Q ami 4. The length between the Flagger Ahead signs shall not exceed one m 1 1 I mile. Use Diagram 340-Lane Closure with Pilot Car if exceeding one i 1` i " E 3 mile. I -T 5. Cones should be used to outline the works ace when curves or other I' lit roadway alignments prevent clear direction or the motorists to pass Q �>.� , I •• CO the work space safely. ` Q -E: g • G. Cones along the work space are recommended when posted speeds I 0 o o I'. • a) are 45 mph or greater,when working under heavv traffic or when travel I o,>V •� I _L iC lanes are narrower than 11 feet. i J 7. Extended queue signing (see Diagram 5-4)should be used when m traffic queues extend beyond the initial advance warning sign. 1 T a o 8. When flagging near an intersection, the Flagger Ahead (CW23-2) sign should be visible to traffic entering from any side road.Additional I t advance warning and Flagger Ahead symbol signs may be placed on Z o p c the side road(s). 5� ZX , a Sign Spacing and Buffer Lengths(feet) ` O 0 9. Sign set-up and flagger placement shown may be used for intermittent Posted Spacing Between Signs softer full road closures of 20 minutes or less. speed a B C space 20 50 o r Q 10. The"ONE LANE ROAD AHEAD"(W20-4)sign is optional and should zs ,00 1011 100 100 a be considered on high volume or high speed roads,or when extended 3301z5 queues are expected. 40 350 3511 350 150 45 180 50 Soo 500 500 210 55 250 Chapter 5 December 2011 December 2011 Chapter 5 \\O\ CONSTRUCTION NOTE FRONTTO REPLACE ER 500 09.2010 #3fi 9614 0C2 WITH 5C2.BOP 4825 01.2001 O FTTP PIGTAIL 50OFT 4 EXISTING POLE IS HOLLOW AT YGD 240 TGRDORXA H3020,285-288 TOP OF POLE.PLACE TALLER TGRDORXA FT1 TGRDORXA FT29171 6,1-944 POLE TO GET SEPERATION FROM 525 09.2010 POWER DRIP LOOP.UNABLE TO RBN \N 5 / © 72a 01.2006 LOWER AND KEEP VERTICLE G� TGRDORXA FC2040,565-570+ o N YGD xD,7-24 CLEARANCE OVER DRIVEWAY. \ / O cn TGRDORXA FC2040,1-624+ WORK WITH PT3288962 PGE TO 10 XD,625-648+ O PAY FOR ADDITIONAL 5'FT. xD,sa9-8sa C YGD 0 10.2008 "p YGD CABLE TV AND FRONTIER � YGD \\ / OH 1499 01.1988 TGRDORXA T76,1-24 TO TRANSFER TO NEW POLE. co PLACE NEW POLE TOWARDS YGD 24 Op 211210.2008 ANCHORS BEHIND EXISTING F TGRDORXA T76,1-24 YGD POLE TO TRANSFER FRONTIER TGRDORXA T1010,1-12+ `� A \ 500802 RISER TO NEW POLE.PLACE C2113A2914 TGRDORXA FT451,1-2+ \ TGRDORXA T144,1-24+ STAND OFF BRACKET ON NEW PORTLAND GENERAL ELECTRIC\ TGRDORXA T1010,15-24 POLE. REPLACE OLECALL FOR LOCATES DUE TO �\ 500801 C2113A2918 BURIED RISERS. 36296 2113A8686 PORTLAND GENERAL ELECTRIC OE 780 07.2010 (40-2)(01.1996) RBN 24 s�A ''!� SEE SHEET 2 FOR POLE DETAIL 45-2 XD,1-24 AND R/W INFO. DATE �2! 200' SEE SHEET 3 FOR VICINITY MAP.`�, � AE-IM 25 19 FRONTIER TAG �Q BBRIV 4R1,1951-1975 / -/ PERMIT REQUIRED PER 500800 C2113A2919 LATITUDE ./ CITY OF TIGARD. , Q- LONGITUDE PORTLAND GENERAL ELECTRI FTR HOA CAN HOA POWER HOA ,/ SS FS ? �3�2� 511562 C2113A19 \ 36297'X6297 PORTLAND GENERAL ELECTR FRONTIER, fier� PRo O AE 25 24 GjERM25pR } TGRDORXA 1S1 / \� G� T D NESC REPL BOP FTR 36296 IN FR NT BBRIV 4R1,1976-1985+ gL gEt\V 3651 96,1985 FRONTIER �/" \ �� OF 16325 SW UPPER BOONES FERRY RD g1, NUMBER: EXCH.CODE�nu XD,86-100 ggFtN aRp / / ROSALIE SIM WASHINGTON DRAWN DATE: ENGR: NTY: XO a6-1p / PHONE: FILE: / / , / SCALE: __ TAX DISTRICT: DWG 1 OF TWNSHP:2, RNG: w I SEC: HAND DIG AND MOVE / FRONTIER RISER TO NEW RR TRACKS / POLE ON STAND OFF BRACKET. / FRONTIER RI ER / RNV , / EW POLE / N o POLE DETAIL / 6' SIDEWALK 0 36296 59' POWER 61611 74' RISER � 70' v FTR 36296 SW DURHAM RD C2113A8686 69' (40C2) ('1981) 7'S" \RNV 45C2 v CONSTRUCTION NOTE PLACE NEW POLE, EXISTING POLE IS HOLLOW AT 20' 6' SIDEWALK TOP OF POLE, MAY NEED TO PLACE TALLER POLE FTR 511562 7-27' TO GET SEPERATION FROM POWER DRIP LOOP. C2113A19 51 'A UNABLE TO LOWER AND KEEP VERTICLE 35C3 '1966 \ v- CLEARANCE OVER DRIVEWAY. PGE SLT AT 30'2", �1 PGE PDLP IS 283". PGE TO RAISE ON NEW POLE. AIRGAS EXISTING POLE TOP IS HOLLOW. FTR 36297 16325 SW UPPER WORK WITH PT3288962, PGE, FRONTIER AND BOONES FERRY RD, 30C2 '1981 CABLE TV TO TRANSFER TO NEW POLE. EXISTING TIGARD RISERS WILL NEED TO TRANSFER TO NEW POLE. O UPPER B SEE POLE DETAIL. ONES FERRY RD SEE SHEET 1 FOR ALL CABLE & COUNTS. POLE ATTACHMENTS 51351-5219864 PGE SLT 30'2" SEE SHEET 3 FOR VICINITY MAP. PGE PDLP 28'3" 5460-TIGARD PGE TO PAY FOR ADDITIONAL 2S 1 W 13A 57T THROUGH NJUNS N PERMIT REQUIRED PER CITY OF TIGARD. PROCESS, ADDITIONAL $439.45 WP2 OF 3 Y FOR ADDITIONAL 5'FT. VICINITY MAP ,... ""'fold hford St 3 a� CL o Harrington IV R � SW Langtree St Hamlet St Cn �a m � N c� =r > D N e n a QQo SW Seville Rd n � J�Q� p� co En coo 0 = SW Band St S`, G G_ A < a SW Alder St ti T SW Durham Rd SW Durham Ro, ? Washington Ct n m rP Ln *G A Tigard High School > m CL Frosr Ln 4 v s Oregon Business Park I Clean Water Services Durham Fac a o ® o cn 7 < CL Gof7,gie Mao data'2017 Google United States Terns Send feedback 500 R t WORK AREA IS 3RD POLE WEST ON SW DURHAM RD 51351-5219864 ON NORTH SIDE OF AIRGAS, ADDRESS OF 5460-TIGARD 16325 SW UPPER BOONES FERRY RD, TIGARD 2S1W13A WP3 OF 3 N