PFI2017-00150 City of Tigard e COMMUNITY DEVELOPMENT DEPARTMENT
•
Request for Permit Actionq1111 /
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • w%vvv.ti and-or.LYON,
TO: CITY OF TIGARD
Building Division
13125 SW Hall Blvd.,Tigard, OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor ® City Staff
Check(✓)one
REFUND OR Name: N/A
INVOICE TO: (Business or Individual)
Mailing Address: N/A
City/State/Zip: N/A
Phone No.: N/A
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (✓):
® CANCEL/VOID PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit #: PFI2017-00150
Site Address or Parcel #: SEG841
Project Name: PGE
Subdivision Name: N/A Lot #: N/A
EXPLANATION: Per Engineering, permit is not required for this work because it's already
covered under PFI2017-00034.
Date: 8/9/17
Signature: --�_
Print Name: Lina Smith
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
FOR OFFICE USE ONLY
Route to S,s Admin: Date By Route to Records: Date W7Y / B
Refund Processed: Date B Invoice Processed: Date By
Permit Canceled: Date /y / B Parcel Tag madded: Date By
1:\Building\Forms\RegPermit:Nction_. 2314.doc
City o V k Tigard V � �y 11-7
a PL1BLIC WORKS — ENGINEERING ,
r
•
Public Fadhty Improvement (PFI) Permit
TYPE OF WORK
DESCRIPTION OF WORK(in the right-of-way)
TYPE 1—Franchise Utility Work
Check one: X Utilities ❑Sidewalk/driveway approach ❑Street improvements performed by N'lWN, PGE
Detailed description: SVC to New 12 Lot Subdivision and/or utility agency.
Progress Landing ❑ TYPE 2—Sidewalk/Driveway/Sewer
Work performed for the purpose of:
• Sidewalk installation or repair.
SW135th Ave between SW Morning Hill • Driveway approach installation
Property- address/location(s): g and/or repair
Dr and Walnut St anitary sewer lateral installation
and/or main line tap
Applicant: Portland General Electric El TYPE 3—Full scale Development
pp Work performed with Land use
Address: 10800 SW Avery St approval which includes any of
City/state: Tualatin,OR Zip: 97062 the following:
Phone: 503-672-5481 Email: preregcoord@pgn.com • Subdivisions or Partitions
Contact name: Chris Jewett Phone: 503-672-5481
• Street widening
• Mainline installation for Sanitary
Contractor: sewer, Storm sewer, Tigard water
and/or Tigard Water Service area
CCB#: Expiration:
Address: SUBMIT COMPLETED APPLICATION TO:
City/state: Zip: City of Tigard
Phone: Email: Planning/Engineering
13125 SW Hall Blvd.
Contact name: Phone: Tigard,OR 97223
Applications for"minor work in right-of-way"
Engineer: only may be emailed to:
ro=e rmitsatigard- r.tov
Address:
City/state: Zip:
Phone: Email: Case No.:
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: S W Date: �' 7ZI
Is work related to a LAND-USE DECISION? ElYes 54 No Application reviewed:
B Date.
If so,please specify (AlLP,SDR,SUB,etc.) case#: .
Applicant notified:
Is work related to a BUILDING PERA7IT? ❑ 1-es S1 No By: Date:
If so,please specify(BUILDING PERIVH fI case#: 1:\ENG\Permit4plications\pfi_appRcation Rev.12/16/2016
City of Tigard • 13125 Stiff'Hall Blvd. Tigard,Oregon 97223 • ww tigard-or.gov 503-718-2421 Page I of 4
APPLICANTS
NOTE: Person specified as`Applicant"shall be designated"Pertuittee"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 lwtth the City of'l igard,when the owner and the applicant are different
people,the applicant must be the purchaser of record or a lessee in possession with written atithorization from the owner or an agent of the
owner. The owner(s)must sight this application in the space provided or submit a written authorization.with this application. Vranchiscd
Utilities are not required to obtain the owners sigmature ou the application
BY SIGNING BELOW,THE APPLICANT(S) SHALL CERTIFY THAT:
• The above request does not violate ani-recorded deed restrictions that mai,be attached to or imposed upon the subject
r0 em.
• 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.
e N-A t-A+rS
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 Datc
Owner's signature Print name Date
PUBLIC FACILITY IMPROVEMENT PERMIT
City of Tigard • 13125 SW'Hall Blvd. • Tigard,Oregon 97223 • vvw-"tigard-or.gov 503-718-2421 • Page 2 of 4
6><1R1 VAULT WITH 3'TERMI-04.0CTS
SUBDIVISION LEGEND
wrrwsrouar
25
25'4 NEW PGE FACILITIES TO BE INSTALLED
A,.AwAI OrAAwce n1DN Arn cLa.BusTRv
5T42TIAR°'aqN sqn AHo"°`°' 1988
o Iwml R DEAR sPAa..naHr (UNLESS OTHERWISE SPECIFIED)
MA. ��»,RN a— D-7921
A HYO LAEA T 376 ACIL,
1 2_ 11935 PROVIDED&INSTALLED BCH VAULT,Y�CUSTOMER�E TOP
905 JU 644-PGE PADMOUNT VAULT,WTTH 64-332P-2125-PGE TOP
J PROVIDED d INSTALLED BY CUSTOMER
nrayM.y ycO.q,u. Q FAULT INDICATOR
LRXTs rbrh 1730 SECONDARY VAULT.
S.- Q Q PROVIDED d INSTALLED BY CUSTOMER
�. O 1 co.+lrm („) _ - ------, INSTALL 3-20 AL-XLP OF PRIMARY IN 4 PVC CONDUIT
Q - ------------- PROVIDED S INSTALLED BY CUSTOMER
PAD #163
--'--- '----' ----�---•INSTALL 1-F2 AL-EPR JK7 PRIMARY IN 1-2"PVC CONDUI'
E"iuP+JS CBWl4e
aoeer"wn = INSTALL 7200V i - PROVIDED b INSTALLED BY CUSTOMER
• Q
10 PAD MT 50 A(rJ 12W40V - - - INSTALL 1-F350 AL-TX SECONDARY IN 1-3"PVC CONDUIT
Q --- --- _-_-. PROVIDED 6 INSTALLED BY CUSTOMER
PD 163VT 168 CUSTOMER 70 INSTAL[3"PVC CONDUIT d STUB-IJP
45.
10
_ FOR FUTURE 1-40 AL-TX SERVICE
A 50
DO WITH SLCST WO#
IM40V 30'AA
200AMP ��' ��\\ I PGE H-1730-1a CARSON BOX
18797 <MFU(R Vr 169 Ar ►L
35'$ 7,791A AFC
VT-18829 1982 T—_ `;:ER, FIFA RK
' 2-A4/0
NA AL AT4 CO �'\ i!t!140' 8TIRNaI MN FED`°PK
PD-18792-Q 1 T20'\\ �i sr LT
NA MPVLW
A 15 40941 I 11 "L
1 VT 167 . MWA
•nTco1PACTLD
1 waru
Vr 170 ;215' #'
1 i 7 ''.c;REPc� To u.LL
1 ; wvP
205'
01 133, CONSTRUCTION NOTES: RSDEV
25' 3 12 1 A 50
n P1' 198 PAD #162 1. CLISTOMER TO PROVIDE ALL TRENCHING AND BACKFBLMG.JOINT USE TRENCH
` 1 PD 162 WITH GAS,TRENCH TO BE 48 INCHES DEEP AND 30 INCHES WOE,MEASURED FROM
' INSTALL 7200V FnN,u GRADE.
2.ALL LGE CONDUCTORS TO BE 04TALLED IN GRAY,SCHEDULE 40.EIEMACAL
GRADE.PVC CONDUIT WITH NYLON PULL STRINGS(MIN.500 LBS.TEST).
ME TO 1206 ;'LL 1¢ PAD Mr 50 A�6 12a24Dv MINE_SIZE_
'w 45' b`
MAINTAIN I2VERT"INCHES AND 224 HORIZONTAL INCHES CL A ANCE BETWEEN
1 GAS AND OTHER UTIUM.ALL ELBOWS 4 INCH 6 SMALLER TO BE 36 MCH RADRJS.
BE
C A-ORO 1 �_ 11 1 60 MCH ALL SMUST RADIUS OGID STEEL FACTORY MADE.
EPGE LELBOWS LARGER THAN 4 INCH APPROVED.FIBERGLASS BENDS AREREOURED
L I 'Y L3 1 li 5 FOR RUNS Of 151 FEET OR LONGER,OR FOR ANY LENGTH RUN WITH MORE MAN
1 K 311 180 DEGREES IN BENDS.PVC SCHEDULE 40 BENDS ARE ACCEPTABLE FOR RUNS OF
GR •" EL 1�166 150 FEET OR LESS THE MAXIMUM TOTAL BENDS M ANY CONDUIT RUN R 270 DEGREES
B! 3.CUSTOMER RESPONSIBLE FOR ROAD CROSSINGS.ALL CROSSINGS MUST EXTEND
{q E!!
FROM PROPERTY LME TO PROPERTY LME USE ONLY GRAY,SCHEDULE 40,
E 164 �F! �E f] /{ ELECTRICAL GRME,M CONDUIT.CROSSINGS TO BE 48 INCHES DEEP,MEASURED
A 275 CZ /-x/4A FROM F0
4
1L GRADE.
1 _ ,
♦Ai .3O'-Cl 4.DIRECTIONAL L BORING REQUIREMENTS:BLACK HDPE/HIGH DENSITY POLYETHYLENE)DUCT
VT I6 �I��i OR SCHEDULE 40 NC WITH A MECHANICAL CONNECTION(CERTAIOK OR LIKE MECHANICAL
VT 260 ) _ - 4' IOOa 1971_. 1335 CONNECTION PRODUCT]AS AN ALTERNATW TO HDPE DUCT,HDPE SHALL MEET THE
/ __ REOUIREMEMS OF PGE SPECIFICATION LC205I5(AVAILABLE ON REUEST FROM PGE PROJECT
(♦ 185 _ MANAGER).FOR SAFETY REASONS THE DUCT SHALL BE BLACK WITH THREE EQUALLY SPACE
VO 1201740VEXTRUDED RED STRIPES(WHICH IS A SPECIFICATION REQUWN
EMEn MADREL TEST OF
5 HOPE PIPE IS REOUIRED AFTER INSTALLATION WITH PGE INSPECTOR PRESENT
200AMP 5
5.CUSTOMER TO PWVW AND INSTALL 0664-PGE VAULT W11H 064-32P-2125 COVEk
? V S 1.22%VD UTRrrr VAULT MODEL OR EOWALENT FOR LGE PAD MOUNT TRANSFORMERS.
V PADVAULT TO BE SET AT FINAL GRADE fSEE DETAIL ON 5KETCH).
g-, P L 5,827 A A.ALL PGE TRANSFORMERS TO BE MSTAUED 8 FEET(MIN)FROM AM COMBUSTIRIE
/AV v- L 5,627A AFC �. BIRLOMG.WALL OR OVFRNMK AND 4 FEET f=1 FR)M ANY FILE HYDRANT.
C 75 8381 PD-9169 § �v ALWAYSME MAINTAIN 10 UST BE WIT.FEET CLEARANCE FRONT
INPEFRONT OF ALLLL TRANSFORMERS
7.STEEL BARRIER 1'0575 ARf REWRED AROUND TRANSFORMERS THAT ARE DEPOSED
' r5 �O TO VEHICLES.
T F
WITH
04CH GRAVEL L43E AND
C 2 AL Q 1 274 2 3 B (SEE DETAIL KETCH ENTER ALI SWYYCH VAULTS TO BE SET ATHE VAULT EEO LOWER 6KNOCKOUTSS(TEV"-WKTS).
30'-6 _ -('f- 9.FROM LOT PUBLIC UTILITY EASEMENT I1.U1J TO BE B FEET(MINI).
O e n 1971 K)FEET(PREFERRED)
25'8 U G40 4 10 ESTIMATED AMPS MOTOR STARING CURRENT FOR FUCKER CALCULAtroNs.
33�j(I TRANSFORMER LOADING AND VOLTAGE DROP CALCULATIONS BASED ON KW
1958 N PER RESIDENCE.
9592 H.CONSULTWYTW ACEEKS E STARTING�roNG FOR A PRECNTRJCTION CONFERENCE MCLUDEOICONFERENCE
35-4 WILL BE EXCAVATOR PGE,TELCO,CAW,AND GAS.
1989
M.DESUNDERGROUNDEDEOIXPMEW MAY!ON STANDARD�RGROUND OPTION AT ADDITIONAL,STC D
To TELE CUSTOMER
C 25 50393 P -9594 PGE CONSTRUCTION DRAWING
2-C 4/0 AS-BUILT VERIFICATION & NESC VIOLATIONS CORRECTED
AL-C 4 CUA This document otturalely represents FIELD COns1n than.
9593 Foreman: Date:
35'-4 General Foreman: Dote:
1988 Si nahJre only required for field conshuction chap es.
SDPMENG REVIEW JASSUILT BY DESIGNER:
*Yr
ti T_ CONTACT SERVICE COORDINATOR DATE 5112016 SCALE: ACCOUNT 1070001 AWO: 1000001596 NO.M2310344c.... "- ME PA—,; FOR rNcH AND COProLFr MPEcrroN nlo>
Me OP TR
s C" TO RAC014U PCE WU NOT MSTA WRE TITLE
Thee
1—Do. UNTIL TRENCH S iW%BACOCLED. "OGRESS LANDING
•r.le CATV SERVICER 800_542-8878
00_542-887 / CIRCUIT SIZE
®B.eMxn 503-323700 OR 800-547-RBTB(SALEMI / MURRYHILL-MURRYHILL 17x22
ATTENTION CALL 811 BEFORE YOU DIG PGE LOCATION
Lt BLIP O .M.a> SR.I.Y.P BOREGON LAW REQUIRES YOU TO Y THE OREGON QUIRTS NOTIFICATION A ALES ADOPTED , ` DSW R 735TH TO BETWEEN SW MORNING HILL DR&WALNUT ST
Ir+tT—h TNOSE RULES ARE SET FORTH IN OAR 952-MI-D010 I RESIDENTIAL SUBDMSION SERVICE
THROUGH 952-001-0090.YOU MAY OBTAIN CORES OF COUNTY FCTION(S) WORK wml SHEET
THE RULES BY CALLING THE OREGON UTILITY _ BEAVERTON WASHINGTON C21-04R&C21-0"
ANY DEVIATION FROM THIS DESIGN MUST NOTIFICATION CONnat ADAW STRATION® (sm-2324987) LINE CREW CENTER 1 OFF
:O REQUEST UTILRY LOCATES CALL THE OREGON DESIGN BY MI-5 (503) DRAWN BY
BE APPROVED BY PGE PROJECT MANAGER uncrrr NonFlr.AnoN CENTER BII A7 LEAST K.WAw.below, Iu�EnoNna�, CHRIS JEWETT 672�4Rr LANE WHITNEY
2 BUSINESS DAYS PRIOR TO EXCAVATION Call belefe YDU c19. O PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED
CD yT I 1Cl) rj
n 'U
o
(D A A3 Single Flagger Operation
I �
for Low Volumes (Optional) o' a
o I (ADT<400) ,o
0 0 0 o Dm I BE 0) o
v 1 e e c 1 PREPARED FUMMM0 ROAD E Q
W :3 I Tt H H R H r
I TO STOP AHEAD
0 0 o W W I I """ -' 4—
I — — :• •r• — — — I • ROAD
I ♦ ® •• ♦ I WORK
'° I I c K e K 6 K A I---J I AHEAD
o co f7:03
O ? I sAl.rnur.�w+ar I N
O O N
e..ana..
�W I ro I
N;�, �,��,�C _, I
pow
MCD(T
0000cno • A B B
1
I------------------------i
I 1 mile _1 -n
r' max.
—• • • �• • • — — — — CQ
FIB 5,
B
Buffer
Protection Vehicle
ROAD T• w/TMA(both Optionaq
WORK See Chapter 4
AHEAD W
BE
ONE LANE PREPARE 2)
AHEAD TO STOP Two Flagger Operation
w CD
(Optional) p00
Page 52 2011 Edition
Bicycle and Pedestrian Accommodation Diagrams
The following practices and details address the accommodation of bicycles
and pedestrians within work zones. The following detail drawings should be
incorporated, where appropriate, into the traffic control plan for any short
term work.
1. See Section 1.6—Bicycle and Pedestrian Considerations for additional
guidance.
2. Stay alert for pedestrians and bicycle traffic and accommodate safe
passage for them, as needed.
3. The work space should be protected from bicycle and pedestrian
intrusion by using barricades or closely-spaced channelizing devices.
4. Maintain access to transit stops or clearly close a transit stop using
barricades or channelizing devices.
Bicycle Accommodation Diagram 5-6
Bicycle Accommodation Principles:
1. If a significant volume of bicycles can be expected and work closes a
marked bicycle facility, or requires bicycles to share a travel lane,
install a"(Bicycle) ON ROADWAY" sign (CW11-1) or the Bicycle
symbol (W11-1) sign with an "ON ROADWAY" (OBW1-5) rider, in
advance of the work area.
2. Install temporary signing off the paved shoulder, within the planter
(buffer) strip, or share the width needed between the shoulder and the
sidewalk, as available.
3. Signs are to remain in place until the surface is restored and the width
made available for bicycle use. See Diagram 5-6 for typical bicycle
signing placement.
Sign Spacing and Buffer Lengths(feet)
' Posted Spacing Between Signs "Buffer"
Speed A 8 C Specs
20 SO
25 100 100 100 75
30 100
35 350 350 350 125
40 150
45 180
50 500 S00 500 210
55 250
60L32
65 700 700 70070
Chapter 5 September 2016
2011 Edition Page 53
Bicycle Accommodation Diagram 5-6
I I
I
NOTES:
• Bicycles on Roadway(CW11-1)sign should not
interrupt standard sequences. For example:
I
o BE PREPARED TO STOP/Flagger Symbol
o LANE CLOSED AHEAD/Lane Ends
I Symbol
• Bicycles on Roadway sign typically follows ROAD
I
WORK AHEAD sign and used as general warning.
I
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September 2016 Chapter 5