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PFI2018-00027 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12018-00027 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 02/12/2018 Parcel: SEG879 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: PGE Project Description: SEG 8791 12145 SW Lincoln Ave. Install bridle to raise service. M2334310. Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: BRANDON HADLEY 10800 SW AVERY STREET TUALATIN, OR 97062 PHONE: 503-844-5412 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: Af _ � c.CG _T�I'1'�►� r Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12018-00027 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 City of Tigard FEB 0 5 2018 PUBLIC WORI,,7_S —ENGINEERING CITY OF TIGARD RLAINGIENG•INEERING Public Facihty Improvement (PFI) Vernet TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) ,_,,( � TYPE 1—Franchise Utility`York Check one: CJ Utilities ❑ Sidewalk/driveway approach ❑Streetimprovements performed by NWN, PGE Detailed description: PGE Job M2334310 and/or utility agency. Install bridle to raise service. ❑ TYPE 2—Sidewalk/Drivexay/Sewer Work performed for the purpose of: • Sidewalk installation or repair. Property address/locations): 12145 SW Lincoln Ave • Driveway approach installation and/or repair SFTigard, OR 97223 • Sanitary sewer lateral installation and/or main lune tap .Applicant: Portland General Electric[Submitted by Amy Sweany] ❑ TYPE 3—Full scale Development Work performed with band use Address: 10800 SW Avery Street approval wlich includes any of City/state: Tualatin, OR Zip: 97062 the following: Phone: 503-844-5412 Email: preregcoord@pgn.com • Subdivisions or Partitions Contact name: SDPM Brandon Hadley Phone: _ 503-844-5412 • Street widening • Mainhhe 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" N/A only may be enruled to: Engineer: ro emits tigard-or. ov �lp� g Address: City/state: Zip: Omni }�- Phone: Email: Case No.: �T I 2-pr i— oo2-7 Contact name: Application submittal fee(007%of Engineer's Estimate Estimated value of work is required(if over$5,000):$ N/A Additional fees:I (within the public right-of-way) Application accepted: Date:�" � �g Is work related to a LAND-USE DECISION? [I Yes r4 No By: If so,please specify (MLP,SDR,SUB, etc.) case#: Application reviewed: By: Date: Is work related to a BUILDING PERMIT? ❑ Yes E� No Applicant notified: If so,please specify(BUILDING PERMIT)case#: By: Date: I2' I:\ENG\PermitAppllcations\pfl_applkation Rev.10/16/2017 City of Tigard 13125 SW Hall Blvd. Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 of4 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 crust 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 maybe attached to or imposed upon the subject 1210129M. . • 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. V-skn z 2c�t Applicant/Authorized Agent's signature Print name Date SIGNATURES of each owner of the subject property, if required. Owner's signature Print naive Date Owner's signature Print name Date Owner's signature Punt naive Date PUBLIC FACILITY IMPROVEMENT PERMIT City ofTigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www tigard-or.gov 503-718-2421 • Page 2 of4 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 December 2011 Q a Single Flagger Operation (otl for Low Volumes (Optional) O CL NW v (ADT<400) ' ,n sroP s= Cn 0 o 0 o a= BE MAQOER PREPARED ONE LANE TtA a 9 c ROAD a k H TO STOP AHEAD a twit o W W �' - t mae - ♦- 0 0 0 ML — . . —I As ♦— • ROAD WORK C) twit o n I c K s K e K A AHEAD O Q O w 3 • &uft Prut9cdm VWtkle 0 w( Bee Moth 4 PWAM N _ to tiTOP "Z cn'� M 0000 �oui0n v A m� I { • A B B C IAD i------------------------' �+ s I_ 1 mileTI _I � max. sy —� , , -4F--, , • — — — to • [Q B B A Buffer Protection Vehicle ROAD • w/TMA(both Optional) WORK See Chapter 4 _0 AHEAD BE ONE LANE PREPARED A EAD TO STOP Two Flagger Operation Ncro (Optional) p co � WL 1 PL 1600: 083 OVERHEAD LEGEND Install: REMOVEIABANOON FACILITIES_INSTALL FACILITIES 142 C/O F6T OH XFMR -INSTALL ADDITIONAL FACILITIES/MODIFYFACILITIES FTR OWNED POLE 12075 12055 1 WORK LOCArMS NOTE:INSTALL BRIDLE SERVICE FROM PL 1600 TO vy CONDUCTORS LOT12190TO MEET VERTICAL CLEARANCECG REMOVE I.02AL-TX OHSECONDARY OVER ROAD . MfiTALL f•p AL-TX ON iECOII1Dd1RY 94K 34 45' 53 9400 12099 A GJ 1599 POGN 2 12115 45'-4 1953 1989 12127 q �qC�T X �rF 12145 GJ P OI` P� 9445 } Q' P� 0� 60D P ? 4 195 y� 1' 154 78 12.1,3 11' J 80' � 100' 60 9270 fV qN !2 ?qC sq 678 12190 40'� 1994 S'4 C 6az`Tx 1514109 9305 3 25 T �q� S�, C'04% QC r t� �C336 �C sy, sT qeC • h336 �C, 9380 \qA 68 PROGRESS-WEST PORTLAND 0 25 C 100�eSt, 795KCMACSR115 kV .I',:`A 7/OALNQNAACOPI4 q?qC.T N1.1 POE CONSTRUCTION DRAWMY9 AS-BUILT VERIFICATION 8 NESC VIOLATIONS CORRECTED inn An,umena: ..,eh ep sr. -- Foreman: Date: THINK INK General Foreman: Date: SAFETY (Signature onlyrequired/or Geld consbuctoon changes) SDPM/ENG REVIEW: SBUILT BY DESIGNER: ,ANYDEKA770NFROMTHNDE9GNMUST FIRST 10/27/2017 1 in 50 ft 1070W1 0TE SCALE ACCOUNT 000017443 M2334310 REAPPROVED BY THE PGE PROJECT MANAGER TITLE 2016 OH FITNES-INSTALL BRIDLE TO RAISE SERVICE CALL 811 BEFORE YOU DIG CIs ATTENTION: �� w TIGARD-13336 1 17 7 x 11 OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED , PGE LOCATION BY THE OREGON UTILITY NOTIFICATION CENTER_ 12145 SW LINCOLN AVE,TIGARD,OR,97223 THOSE RULES ARE SET FORTH IN OAR 951-001-0010 DESCRIPTION THROUGH 952.001-0090 YOU MAY OBTAIN COPIES OF INSTALL BRIDLE TO FIX CLEARANCE ISSUE SHEET THE RULES BY CALLING THE OREGON UTILITY COUNTY SECTIONS WORK WITH NOTIFICATION CENTER ADMINISTRATION @(502-131-1987) WASHINGTON C2102A 1 OF 1 TO REQUEST UTILITY LOCATES CALL THE OREGON K•GW*hnft below. suveR�ow DESIGN BY PHONE DRAWN BY UTILITY NOTIFICATION CENTER,811 AT LEAST Call before you d1g. uwecAtwc[wnR BRANDON HADLEY 503-758-6436 CHRISTIAN CANON 2 BUSINESS DAYS PRIOR TO EXCAVATION 2213 SW 153RD DR ®PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED