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PFI2018-00045 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12018-00045 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 03/06/2018 Parcel: SEG666 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: PGE Project Description: SEG 666/758. Repair underground cable failure underneath street, adjacent to 11615 SW Tigard Drive. M2480766 Owner: FEES Description Date Amount PFI Permit Fee 03/06/2018 $300.00 PHONE: Contractor: PORTLAND GENERAL ELECTRIC CO 121 SW SALMON ST C/O LEGAL DEPT PORTLAND, OR 97204 PHONE: 503-464-8852 FAX: Applicant: STEVE HURSH 10800 SW AVERY STREET TUALATIN, OR 97062 PHONE: 503-612-2935 Tota 1 $300.00 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 SSignature: ( 1��(}��r-�� O�,vr te�t— Issued By: c4rz&�� Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12018-00045 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 afety.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 2 6 2018 PUBLIC WORKS—ENGINEERING CITY OF Tt GARD PL_'"lFPa1fffflt Public Fadhty Improvement PFT) ERtNG TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) Ef TYPE 1—Franchise Utility Work Check one: gUtilities ❑Sidewalk/driveway ap roach ❑Streetimprovements performed by NWN, PGE A Detailed description: :r' 1 N �Q and/or utility agency."Y 0►.1 y Y'�'- V�+ a Pr' CN 41p,CAS N'e e�" ❑ TYPE 2—Sidewalk/Driveway/Sewer PGEJob M2480766 Work performed for the purpose of - Sidewalk installation or repair. - Driveway approach installation 11615 SW Tigard Street Property address/location(s): 9 and/or repair Tigard, OR 97223 - Sanitary sewer lateral installation and/or main line tap Applicant: Portland General Electric[Submitted by Amy Sweany] ❑ TYPE 3—Full scale Development pp Work performed with Land use Address: 10800 SW Avery Street approval which includes any of City/state: Tualatin,OR Zip: 97062 the following. Phone: 503-612-2935 Email: preregcoord@pgn.com - Subdivisions or Partitions Steve Hursh 503-672-5409 - Street widening Contact name: Phone: - Mainline installation for Sanitary Contractor: Portland General Electric sewer, Storm sewer,Tigard water and/or Tigard Water Service Area CCB#: 103663 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: ro ermits .ti4 d-or.gov Address: City/state: Zip: Phone: Email: Case No.: F-W 1 6—0-0245- Contact name: Application submittal fee(.007%of Engineer's Estimate) $ Estimated value of work is required(if over$5,000): tj Additional fees:$ (within the public right-of-way) Application accepted: By: AL Date: Is work related to a LAND-USE DECISION? ❑ Yes YNo If so,please specify(MLP,SDR,SUB,etc.) case#: Application reviewed: r By: V Date: Is work related to a BUILDING PERMIT? ❑ Yes No Applicant notified: If so,please specify(BUILDING PERMIT)case#: By: At- Date: I:\ENG\PermltAppliations\pfl application 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 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 unposed upon the subject $ropes'- • 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 die 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 die application,including the policies and criteria,and understands the requirements for approving or denying the application. J�� rZIEl:Z*� SA-e e �A k-A fs�, 2 201 -2 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 naive Date PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 5013-718-2421 • Page 2 of 4 AWL WW A rion.com Lane Closure at lritersedlon with Fiaggit g Diagrarh 6.20 ROAD WORK EA ONE AN 1 t (Oplbna9 ROAD AHEAD BE PREPAY TO STOP • B A (opunal) o ONE ROAD 100 R.Max. OO PRRPAJlSD AHEAD WROAD ORK =STOP O A B B C But* 0 0 ♦" 0000 4— o ♦ o o —. 0 ,I T Ili's I00fLWmx C B B A TTI ROAD o I WORK K o PREPARED 100 fl Max. TO STl3P • 0 ONE LANE ROAD O AHEAD (Optional) A IN,;B aE PREPARED TO STOP B (Opllonal) ONI LAME 1 t AHEAD ROAD WCRX www.invarion.com 11-ane Closure at Intersection with Flagging iolagram iza Diagram 620 covers work within an intersection when normal traffic control must be interrupted.Work vehicles may or may not be in the work space. 1. During flagging, traffic signals shall be turned off. Contact the road jurisdiction for approval and assistance (see Chapter 3). 2. For multi-lane facilities, traffic approaching the intersection shall be reduced to a single lane on each approach. See Chapter 3 for information on flagging through intersections. 3.There should be one flagger for each approach. One flagger may control two adjacent approaches if sight distance, low volumes on side roads, and flagger position allows for safe operation and clear direction to motorists. For low traffic volume intersections (fewer than 400 entering vehicles per day), one flagger may be used. 4.The uONE LANE ROAD AHEAD"(W20-4)sign is optional and should be considered on high volume or high speed roads,or when extended queues may be expected. Sign Spacing and Buffer Lengths(feet) *ate d pdC!"D BGtWWM Sight Buffer Speed A $ C Space ERRATA: 20 50 25 100 100 100 75 Supplement Table 30 100 35 350 350 350 125 Updated:February 12, 40 150 2016 45 180 By:ODOT Traffic-Raodmy 50 500 500 500 210 Section 55 250 Signs Spacing and Buffer Lengths(feet) Supplement Posted specl . :Betvme 'S ns "Buffer" 3p+sed A. . . g C Bpac*. 60 285 65 700 700 700 325 70 365 ov Single Flagger Operation i C ,opr,ar+r) a i for Low Volumes .. (Optional) 3 o i (ADT<400) .To n > ! FLAG" BE ONE LANE 7 I T A 6 a c ! PREPARED ROAD o o _ 'rte — TO STOP AHEAD 4- 4— y o� o ® ♦ ` • ROAD t WORK ^' ic s Is w H � M I Y.rr�+Ate.w opoawl 8t 8w CJrpkr 00o np I i AB B Fo 1 mile J m to max. 5 0 0 0 0 ter-0 woo0 ► °0 000, ® °°° ■■ r C B Buffer Protection Vehicle >; w/TMA(both Optional) ,. ROAD WORK See Chapter 4 ONE LANE BE . ROAD PREPARM Two Flagger Operation 3 AHEAD TO STOP W► (Optlonal) 0 0 3 www.invarion.com ["lonary Lane Closure wlth flagging Diagram 120 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 I 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. S. When flagging near an intersection,the"Flagger Ahead" (CW23-2) sign should be visible to traffic entering from any side road.Additional advance waming 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. ,O 11615 3 9 01 10 CrPs� WR CHECKLIST ITEM YES COMMENT HOLEDIGGER 020 BOOM BACKHOE X 116 - ;Ll[ m PGE TRENCH et Cie y `Q\ rD VAC TRUCK X 0e LOCATES X 11615 Southwest STAKING FLAGGINTigard Street 7 EETRIMG R S LANDSCAPE REPAIRASPHALi EASEMENT (..wZ �ac�t �� PERMSX CITYOF TIGARD TRAFFIC PLAN CUTSHEET 5 1640 D UG CIR.VER. TRANSMISSION !D SHUTDOWN 11 CUSTOMER SHUTDOWN DOOR HANGER CONTACT COMPANY PH* C* 0 50 7 19 DATE TIME 670 PQ 2022 ATTENTION: CALL 811 BEFORE YOU DIG OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED , THINK BY THE OREGON UTILITY NOTIFICATION CENTER. 11 THOSE RULES ARE SET FORTH IN OAR 952-001-0010 SAFETY THROUGH 952-001-0090.YOU MAY OBTAIN COPIES OF THE RULES BY CALLING THE OREGON UTILITY FIRST! NOTIFICATION CENTER ADMINISTRATION Cc (503-232-1987) 0 ?O REQUEST UTILITY LOCATES CALL THE OREGON �F what's below. UTILITY NOTIFICATION CENTER,811 AT LEAST Call before oud{ /�� 2 BUSINESS DAYS PRIOR TO EXCAVATION ore Y 9• �`V PGE CONSTRUCTION DRAWING SDP"ENG REVIEW: ASBUILT BY DESIGNER: a AS—BUILT VERIFICATION & NESC VIOLATIONS CORRECTED 1 1 7 his document accurately represents FIELD construction 0 Foreman: Date: GF: Date: DATE: 2124.2018 SCALE: WA ACCOUNT:5940007 AWO:3000000656 JOB NO.M2480766 (/� c+ TITLE PGE REPAIR UNDERGROUND CIRCUIT PROGRESS-GREENB URG SIZE ]1x17 CABLE FAILURE UNDERNEATH PGE LOCATION 11615 SW TIGARD DR, TIGARD STREET `RIGHT•OF.WAY PERMIT NOTICE DESCRIPTION REPAIR UNDERGROUND CABLE FAILURE A PERMIT rROM THE LOCAL ILIRIS&CTION IS REOUIRED BEFORE AHr COUNTYECTION(SJ WORK WITH SHEET WORK IN THF RIGHF OF-WAY MAY M PERFORAffD. ONLY PGF APPROVED BEAVERTON WASHINGTON C 11340 COW TRACTORS AND CONTRACTORS WFIO HAVE MAGE OTHER SPECIAL1 OF 1 AGREEMENTS WITH PGE MU PE ALLOWED TO WORK U1YDEIL PGE•5 KRMfr LINE CREW CENTER DESIGN BY PHONE(503) DRAWN BY THE CONTRACTOR MUST NOTIFY THE LOCAL JURISDICTION 68 HOURS 2213 SW 153RD DR STEVE HURSH 503-672-5409 STEVE NURSH BEFORF WORk t5 TO 8EGfW A COPY Or TNF PERT"MUST RF ON SI FF. BEAVERTON,OR 97006 O PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED