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PFI2018-00013 n CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12018-00013 .- 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 09/12/2018 Parcel: SEG1218 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Portland General Electric Project Description: SEG1218, associated with address 13030 SW 115th Ave. Provide service to 2-lot partition, underground service to existing house and remove overhead service. Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: CHRIS JEWETT 10800 SW AVERY ST TUALATIN, OR 97062 PHONE: 503-464-7777 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: ✓�L Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12018-00013 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. Call Ken Fisher at 503 816 6146 or Kenny@tigard-or.gov 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 NECEIVED JAN 23 2018 City of Tigard CITE:' ()F T!GNARD PUBLIC WOR S — ENGII`�II ERING PLANI�II� ��;�:;'t:;= �� .�vEERiNG acility Inaprovemen PublicF t (P FI) Pernut ..,... <. •,M' � Via.,.. ...;- t0,.��,:;:..rwea9a�.,..:.- ..,".fix....;;• �.,;��:§�:w >..e.N•.. .:��W�2.�•.�s'.lwa�'Ma W. 4-`aS�..�. DESCRIPTION OF WORK(in the right-of-way) TYPE 1—Franchise Utility Work- Check orkCheck one: 0 Utilities ❑ Sidewalk/dtiveway approach ❑S tree t improvements performed by NWN, PGE Detailed description: Provide service to 2-lot partition, underground and/or utility agency. service to existing house and remove overhead service. ❑ TYPE 2—Sidewalk/Driveway/Sewer Work performed for the purpose of Sidewallr installation or.repair. 13030 SW 115TH AVE ° Driveway approach installation Property address/location{s): and/or repair Tigard, OR 97224 ^� S� 2 Ig Sanitary sewer lateral installation and/or main line tap Portland General Electric El TYPE 3—Full scale Development Applicant: Work performed with Land use Address: 10800 5W Avery St. approval which includes any of City/sta.te: Tualatin, ORZIP: 97062 the following: Phone: 503-464-7777 Email: preregcoord a@pgn.com Subdivisions or Partitions Contact name: Chris Jewett Phone: 503-672-5481 ° Street widening • Mainline installation for Sanitary Contractor: TBD sewer, Storm sewer, Tigard water and/or Tigard Water Service Area CCB#: Expiration: Address: SUBMIT COMPLETED APPLICATION TO- City 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: NSA only may be emailed to: rowPerin its&tigard-or.gov Address: F City/state. Zip: Phone: Email: Case No.: P�?I Zo I q —coo 3 Contact name: Application submittal f66:'$ Additional fees:$ Estimated value of work is required(if over$5,000):$ Application accepted; (within the public right-of-way) ley: Kc Date: Application' reviewed Is work related to a LAND-USE DECISION? Yes O No By: ��$ .Date: If so,please specify (MLP,SDR,SUB,etc.) case#: Applicant notified. Is work related to a BUILDING PERMIT? ❑ Yes ❑ No BY: Dater 1:\ENG\PerniitAppllcations\pfl_application Rev.12/16/2016 If so,please specify(BUILDING PERMIT)case#: -a,. n:t� u. � :.._c:..:• ,:. a• ..:.::< �.:nr».... �._": ..• �i.,�w,��`�,.;:`_5�.:..,Ca.',:fi"Sw:��.....-....:.e ?b:,:a ,."Mk...w�'a'3.,,..�5",a.�6,<.ti,....�.a"`43:1.,i,::,w.:..�".w,;�:�..�: �_. T...u.`�.: F: City of'Tigard 13125 SW Hall Blvd. ° Tigard,Oregon 97223 wwwtigard-or.gov 503-718-2421 a Page 1 of 4 APPLIcAmrs NOTE: Person specified as "Applicant"shall be designated"Permittee"and shah provide financial assurance for work,if required by the city pursuant to TMC 15-041,140. \Xrltb the exception of a utility operating pursvmt to a,valid franchise with tine City of Tigard,when flic owner and the applicant are different people,the applicant must be the purchaser of record or a lessee in possession with written authorization froni the owner or an agent of the owner. The owner(s)must sign thus application in the space provided or submit a written authorization vrith this appl1C,-ttJGT1. 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 an;T recorded deed restrictions that may be attached to orunposed upon the subject prope - 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 die 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. 10/10/2017 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 ofTigard 13125SWHall Blvd. Tigard,Oregon 97223 www.tigard-o.t.gov a 503-718-2421 Page 2of4 rage 118 2011 Edition eMT. �n ars'.... � h F� ram 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. i 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"ONE 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 Po e�i spadng B tw�en Signs.. u&tFf�r' Speed 20 s0 25 100 100 100 75 30 100 �� 350 .350 350 i 50 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 119 topnpn�o oN&ONE ROAD 8E AHPaD PREPAR ROAD TO STOP WORK AHEAD A B B C V'JOAQ ,occ; _cj i3uftw • 4 ' T. look Mex. C B B A ROAD BE • WORK PREP o AHEAO Tp STOP ® 100 R Max.NEIANE ROM a AHEM Tt A B BE PREPARED TD$TOP B �oP ONE LANE ROAD AHEAD C ROAD WORK AHEAD September 2016 Chapter 5 n ii 129 '21-03 ___ 12999 - SINGLE FAMILY LEGEND - r NEW PGE FACILITIES TO BE INSTALLED � II - - ------_— THINKC2 1-03A (UNLESS OTHERWISE SPECIFIED) p SAFET 1(�/ INSTALL FACILITIES 1.,85 1 FIRST REMOVE FACILITIES U <( I, 12980 I' —•'"-'" _______ INSTALL 142 AL-EPR JKT PRIMARY IN 2"PVC CONDUIT C)U c y I 11550 j PROVIDED B INSTALLED BY CUSTOMER 1 ______- INSTALL 1-419 AL-TX SECONDARYIN 1-3"PVC CONDUIT PROVIDED&INSTALLED BY CUSTOMER I----- ---- -- s------- CONTACT SERVICE COORDINATOR C 2 AL— —————___,. _ PD 16 M] INSTALL 644-3 TRANSFORMER VAULT, -- FOR TRENCH AND CONDUIT INSPECTION PRIOR PROVIDED d INSTALLED BYCUSTOMER 14 T 180' \ C 25 TO BACKFILL PGE WILL NOT INSTALL WIRE UNTIL TRENCH IS 100%BACKFILLED. FAULT INDICATOR 160,C d10 SERVICE COORDINATOR -- -- 503-323-6700 OR 1-800-542-8818 _______ REMOVE#2•AL SECONDARY UNDERBUILD AND -_— 1156 SERVICE DROP TO HOUSE _ _--- _— @2qL------—�------ 11375 CONSTRUCTION NOTES: SFEXT 1.CUSTOMER TO PROVIDE ALLTRENCHING AND BACKFILLING.JOINT USE TRENCH I OATH GAS,TRENCH TO BE 48 INCHES DEEP AND 30 INCHES VIDE,MEASURED FROM FINAL GRADE. 2.CONDUIT OF NECESSARY)WILL BE GRAY,SCHEDULE 40,ELECTRICAL GRADE, PVC CONDUIT WITH NYLON PULL STRINGS PAIN.500 LBS.TEST). —__—.13030 PGE TO DETERMINE THE SIZE AND M.MBER OF CONDUITS REQUIRED. MAINTAIN 12 VERTICAL INCHES AND 24 HORIZONTAL INCHES CLEARANCE 41 BETWEEN GAS AND OTHER UTILITIES,ALL ELBOWS TO BE 36 INCH(MIN)RADIUS. -- -- ALL BENDS MUST BE FACTORY MADE.RIGID STEEL OR PGE APPROVED FIBERGLASS Q BENDS ARE REQUIRED FOR RUNS OF 151 FEETOR LONGER,OR FOR ANY LENGTH RUN WITH MORE THAN 180 DEGREES IN BENDS.PVC SCHEDULE 40 BENDS ARE \\ ACCEPTABLE FOR RUNS OF 150 FEET OR LESS,THE MAXIMUM TOTAL BENDS INANY C21-030 CONDUIT RUN IS 270 DEGREES. U U X 3.CUSTOMER RESPONSIBLE FOR ROAD CROSSINGS-USE ONLY GRAY.SCHEDULE 40, Q F ELECTRICAL GRADE,PVC CONDUIT WITH NYLON PULL STRINGS(MIN.500 LBS.TEST). N�U`J co 4.DIRECTIONAL BORING REQUIREMENTS:BLACK HDPE(HIGH DENSITY POLYETHELINE)DUCT QZ m N _ OR SCHEDULE 40 PVC WITH A MECHANICAL CONNECTION(CERTA-LOK OR LIKE MECHANICAL CONNECTION PRODUCT)AS AN ALTERNITNE TO HDPE DUCT.HDPE SHALL MEET THE 131 5 U 1 REOUIREMENTS OF PGE SPECIFICATION LC20515(AVAILABLE ON REQUEST FROM PGE PROJECT EXTRUDED RED STRIPES(NMICH IS A SPECIFICATION REQUIREMENT).MANDREL TEST OF -_--- ---'--- + HDPE PIPE IS REQUIRED REDAFT R INSTALLATION NTH PGE INSPECTOR PRESENT. 11 85 S.SINGLE PRIMARY INSTALLATIONSCONDUITTO EXTEND AMINMUM OF IO FROM TRANSFORMER PAD. _.� 6,ALL POE TRANSFORMERS TO BE INSTALLED S FEET(MIN)FROM ANY COMBUSTIBLE ! — - BUILDING.WALL OR OVERHANG AND 4 FEET(MM)FROM ANY FIRE HYDRANT. PGE TRANSFORMERS MUST BE W FTKN 15 FEET OF A DRIVEABLE AREA. ALNAYS MAINTAIN 10 FEET CLEARANCE IN FRONT OF ALL TRANSFORMERS. 11470 \ 7.CUSTOMER TRENCH AND ELBOW CONFIGURATIONS MUST BE INSPECTED BY PGE PRIOR TO '\ --- -. BACKFILLING.WHEN YOU ARE READY FOR PGE TO INSPECT(AFTER INSTALLATION IS COMPLETE) 11480 PLEASE CALL 8OD-SC4818 OR 503-323-670D IN THE PORTLAND AREA. 11475 '� ALLOW UP TO WORKING DAYS FOR INSPECTION TO OCCUR. S.DESIGN IS BASED ON STANDARD UNDERGROUND EQUIPMENT NONSTANDARD j l 9 UNDERGROUND EQUIPMENT MAYBE AN OPTION AT AN ADDITIONAL COST TO THE CUSTOMER. 11395 IIc- 28154 _----------- : G �t ��NY DEVIATION FROM THIS DESIGN MUST BE APPROVED BY THE PGE PROJECT MANAGER RIGHT-OF-WAY PERMIT NOTICE: - A Typl`°I B80-PGE SWITCH VAULT A PERMIT FROM THE LOCAL JURISDICTION IS REQUIRED BEFORE ANY PGE CONSTRUCTION DRAWING NOTES: WORK IN THE RIGHT-OF-WAY MAYBE PERFORMED. ONLY PGE APPROVED LEGEND 4-e ,!y!T_ 6-6" AS-BUILT VERT CATION B NESC VIOLATIONS CORRECTS POB PN I—T-+-r-+-r CONTRACTORS AND CONTRACTORS WHO HAVE MADE OTHER SPECIAL TT):acs =+.==�nrdv r<c«s<<r.FIELD Cogs r—. ^�Y I I—+_I—r—r 1,VAULTS TO BE O —1_I-1_,_,_ Mtn insi ft my Ca6N r_,—, ,_T�Tr,_ SET AT LOCATIONS AGREEMENTS WITH PGE WILL 8E ALLOWED TO WORK UNDER AGE'S PERMIT. -` IrISMe Duct —+— 1—r_I—+_I_ Mm Cowr —�TTIT,T,_I_ APPROVED BY PGE THE CONTRACTOR MUST NOTIFY THE LOCALJURISDICTION48HOURS Foreman: Date: TM'°^ :,',. ...' o TH.ICATV -STI- 1.TOP DO TO BEFORE WORK IS TO BEGIN.A COPY OF THE PERMIT MUST BE ON SITE. General Foreman: Date: - to ®BacIQ10 SE SET AT FINAL Si 9tum mly required for field construction changes.) 0 hr• GRADE &4.4 VAULT WITH 3^Ter9vv/eucrs 0 .�BoeM® • APPROVED BY PGE "°� O/E r G N PAMSfM�r n AY S M=e SDPMIENG REVIEW ASBUILT BY DESIGNER: .,3 U„dryd cawusnrcE ATE: SCALE: ACCOUNT OB NO. 1T MIT) °�' �•-�FaRh Jif � a.DO NOTCROSS ucrurh mrarox groes uo 5:6 T �pR PVC BSTHEEN wn^a'=�^� Cep Rte^ 8/23/2017 1 in:42 ft 1070001 1000004594 M2369224 TITLE Joint Use TrwwhWMGm i 4.INSTALL 500ILE �Krr�e„o�e Pacific Evergreen Homes 6 Iwo TESTPULL crRCUr SIZE ® CALL 8II BEFORE YOU DLG 0 m ®® STRING IN EACH PVC. TIGARD-13362 11 x 17 ATTENTION: 0 0 0 b LOCATION OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED 10. O 00rBY THE OREGON UTILITY NOTIFICATION CENTER 6 ,T �O�eC / �� „ten Pv �V� 13030 SW 115TH AVE,TIGARD,97224 THOSE RU LES qRE SET FORTH IN OAR 952.001-00]0 3A1'M/NUS 4' HI OJ ! DESCRIPTION THROUGH952-001-0090 YOU MAY OBTAIN COPIES OF CRUSHED ROC "� `"-� � w ` PROVIDE SVC TO 2-LOT PARTITION THE RULESSYCALLING THE OREGON UTILITY 6-DEEP(MINI O —�,r,,K,av-aero sroe ornn SHEET NOTIFICATION CENTER ADMINISTRATION X61(502-232-1987) COUNTYSECTION S WORK IMTH TO REQUEST UTILITY LOCATES CALL THE OREGON K—tid ntE6@IOYY. / WASHINGTON C21 O3C,C2103B,C2103A,C2103D 1 OF_ UTILITY NOTIFICATION CENTER,811 AT LEAST' CWI�B YOU ftoeF°+'�^� DESIGNBY PHONE(503f DRA WN BY 2 BUSINESS DAYS PRIOR TO EXCAVATION Chris Jewett 672-5481 Sam Morland 0 PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED rs<coru�e..s.accr n