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PFI2018-00028 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12018-00028 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 02/12/2018 Parcel: SEG989 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: PGE Project Description: SEG989, associated with address 12332 SW 72nd Ave. 2016 OH Fitnes-3 man crew to move jumper out of climbing space. Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: AMY SWEANY 10800 SW AVERY ST TUALATIN, OR 97062 PHONE: 503-612-2935 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: J Issued By: L/ kJ Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12018-00028 Type: Condition Name: Status: Severity: 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 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. RECEIVED City of Tigard FEB 0 5 2018 PUBLIC WORKS —ENGINEERING CIN OF '"GARD PLANN 1 NGS ENGINEERING Public Facility Improvement (PFI) Permit TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) TYPE 1—Franchise Utility Work Check one: dUtilities ❑Sidewalk/driveway approach ❑Street improvements performed by NWN, PGE Detailed description: 20160H FITNES -3 MAN CREW TO MOVE and/or utility agency. JUMPER OUT OF CLIMBING SPACE Ll TYPE 2–Sidewalk/Driveway/Sewer Work performed for the purpose of- - Sidewalk installation or repair. Property address/location(s): 12332 SW 72nd Avenue - Driveway approach installation and/or repair Portland, OR 97223 - Sanitary sewer lateral installation Gr II'l i and/or main line tap Portland General Electric Submitted b Am Swean ❑ TYPE 3—Full scale Development Applicant: � Y Y Y� Work performed with Land use Address: 10800 5W Avery Street approval which includes any of City/state: Tualatin, OR Zip: 97062 the following: 503-612-2935 rere coord n.com - Subdivisions or Partitions Phone: Email: p q ord@pgn.com name: Y Y Am Swean on behalf of C 503-612-2935 - Street widening �� - Mainline installation for Sanitary Contractor: N/A sewer, Storm sewer,Tigard water and/or Tigard Water Service Area CCB#: Expiration: Address: SUBMIT COMPLETED APPLICATION TO: City/state: Zip: City of Tigard Planning/Engineering Phone: Email: 13125 SW Hall Blvd. Contact name: Phone: Tigard,OR 97223 Applications for"minor work in right-of-way" Engineer: N/A only may be emailed to: Address: rowpermitsCati_gard-or.gov City/state: Zip: I Phone: Email: Case No.: rZZ61 B 0 UO�:- Contact name: Application submittal fee: $ Additional fees: $ Estimated value of work is required(if over$5,000):$ 1 00 Application accepted: (within the public right-of-way) By: sc Date: Is work related to a LAND-USE DECISION? ElYes Lf No Application reviewed: By: Date: If so,please specif r (MLI,SDR,SUB,etc.) case#: Applicant notified: Is work related to a BUILDING PERMIT? ❑ Yes [�f No By: Date: If so,please specif,(BUILDING PERMIT)case#: 1:\ENG\PermltApplIca tlans\p(i_application Rev.12/16/2016 City of Tigard - 13125 SSV Hall Blvd. - Tigard,Oregon 97223 - unvwtigard-or.gov - 503-718-2421 - Page 1 of 4 APPLICANTS NOTE: Person specified as"Applicant"shall be designated"Perinittee"and shall provide financial assurance for work,if required by the city pursuant to TMC 15.041.140. * \X1ith 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 he the purchaser of record ora lessee hi 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 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 imposed upon the subject 12rel . • 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. pplicant/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 naive Date Owner's signature Print name Date PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov 503-718-2421 • Page 2 of 4 1426 9299 15170 12332 Southwest 12215 0 sW He mole w 172nd Avenue WR CHECKLIST VT-10 45'-4 45'-4 Y -__ 2014 2014 Well&Good A ITEM YES COMMENT r VT 12 A 10 55874 J Coffee House T a HOLEDIGGER BOOM V - 3 BACKHOE SW ELMHURST ST t" SW RevP w n S1 PGE TRENCH 12260 Lowe sHome Oin Improvement LOCATES V W N STAKING Qn '�G°nragR s1 FLOGGING p Georg( TREETRIM ZLANDSCAPE N VT-409 7130 7100 EASEMENT PERMITS MOVE WIRE TRAFFIC PLAN cursHEEr VT-100� 12280 JUMPER ON UG CIR.VER. IN = TRANSMISSION 9 POLE SHUTDOWN CUSTOMER 2 SHUTDOWN .3489 ,ff� 31 .-. 1 (-. _._...__ --- , --.��- DOOR HANGER 45'4 ---- CONTACT 195 4 — --- ----- COMPANY T-99DATE TIME B 25 99024 060 A50-33124._. — 3-142 100 198 'O-21 SW HERMOS0 WAY 14225 ATTENTION: CALL 811 BEFORE YOU DIG OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED , THINK BY THE OREGON UTILITY NOTIFICATION CENTER- THOSE RULES ARE SET FORTH IN OAR 952-001-0010 Q SAFETY r THROUGH 952-=-0090,YOU MAY OBTAIN COPIES OF --- I THE RULES BY CALLING THE OREGON UTILITY L c ---' _ ~ '^ +� FIRSTI NOTIFICATION CENTER ADMINISTRATION @ (503-232-1987) -.._ ) TO REQUEST UTILITY LOCATES CALL THE OREGON � �, U I Know whaYs below. you V � m � UTILITY NOTIFICATION CENTER,811 AT LEAST Call before C 2 BUSINESS DAYS PRIOR TO EXCAVATION Y 9• PGE CONSTRUCTION DRAWING 7 SDPMENG REVIEW: JASBUILT BY DESIGNER: AS—BUILT VERIFICATION & NESC VIOLATIONS CORRECTED This document accurately represents FIELD construction Foreman: Date: GF: Dote: DATE: 1,6/2018 SCALE: wA ACCOUNT: 5930001 AWO: 1000001400 JOB NO M2401358 TITLE PGE / CIRCUIT SIZE or 1 1x" PGE LOCATION 12332 SW 72ND AVE, TIGARD DESCRIPTION MOVE JUMPER OUT OF CLIMBING SPACE RIGHT-OF-WAY PERMITNOTICE: e A PERMIT TROM TME UXAt tURISUCTrON tS REQUIRED BEFORE ANr COUNTY CTION(S) WORK WITH SHEET WVRAMINERIGHT-Of-WAYMAYREPf RfORMED. ONLYI'Gf APPRQVFO BE4VERTON WASHINGTON C2101A CCRrTRAC TUtS AND CONTRACTORS WMO MAVE MADE OTHER SPECIAL I OF 1 AGREEMENTS WfrH PGE WILL RE ALLOWED TO WORK UNDER PGVS PERMIT. LINE CREW CENTER DESIGN BY PHONE(503) DRAWN BY THE CONTRACrOR MUST NOTPY TME LOCAL JURISDICTION U MOM 2213 SW I53RD DR STEVE HURSH 503-672-5409 STEVE HURSH BFTCIRf WORK b TO REGIN A COPY Of THF PERAw T MUST of ON Sill BEAVERTON,OR 97008 O PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED 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 September 2016 ---------------- — I a i Single Flagger Operation °* —• l a I for Low VolumesB I (Optional) 3 6- (ADT<400) or POW I =' O 0 0 S DBE = I FLAGOM A e e c PREPARED ONE LANE °O ROAD a I � H H TO STOP r 0 0 0 0 °° I 1... ma — — — — — I ROAD `—^ WORK fD 0 8 0 0 " ' K c K B K e K A I--� I AHEAD Bun. � SMl I Q ��ft,vwa +w nuOO"N 4 y �D I t A B C i------------------- —I ? 1 mile h max. • • �� B B Buffer Protection Vehicle ROAD w/TMA(both Optional) WORK See Chapter 4 0 AHEAD BE �Q ZONANE PREPARED 0 R 4 AHEAD TO STOP Two Flagger Operation W m � , (Optional) p Cn 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 Sign "Buffer" —Speed A B C Space 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 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 I I I I Tt I I I I I I A I I I I I I I I�I I I I I I I I A I I I I I I I I� I I I I I I I I I I B I I I I I I 1 I� ON I ROADWAY I I I I I C I I I I I I i ROAD I� WORK I I AHEAD September 2016 Chapter 5