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PFI2018-00268 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12018-00268 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 10/04/2018 Parcel: SEG2058 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: PGE Job M2564380 Project Description: SEG2058 associated with 15105 SW 98th Ave. Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: SCOTT ALLEN 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: See application Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12018-00268 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 OCT n3 2018 City of Tigard CITY OF Ti GAR© a PUBLIC WORKS —ENGINEERING PLANNING/ENGINEERING Public FacilityImprovement (PFI) Permit TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) TYPE 1—Franchise Utility Work Check one: V Utilities ❑ Sidewalk/driveway approach ❑Street improvements performed by NWN, PGE Detailed description: Overhead work- Install trip Saver/Avian protection and/or utility agency. ❑ TYPE 2—Sidewalk/Driveway/Sewer PGE Job M2564380 Work performed for the purpose of: • Sidewalk installation or repair. • Driveway approach installation 15186 SW 98th Ave Property address/location(s): and/or repair Tigard, OR 97224 • Sanitary sewer lateral installation 5' 'L}S j 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, ORZip: 97062 the following: Phone: 503-464-7777 Email: preregcoord@pgn.com • Subdivisions or Partitions Contact name: Scott Allen Phone: 503-718-6339 Partitions- Street widening • 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 riglit-of-way" Engineer: roonly may be emailed to: wpermits&jgard-or.gov Address: City/state: Zip: Phone: Email: Case No.: PF17-AU V(' Contact name: Application submittal fee(.007%of Engineers Estimate) $ Estimated value of work is required(if over$5,000):$ Additional fees:$ (within the public right-of-way) Application accepted: FF�� q �� Is work related to a LAND-USE DECISION? El Yes 61 No By: Date: 1H -`3 If so,please specify (MLP,SDR,SUB, etc.) case #: Application reviewed: �'ll By: $$ Date: 10 Is work related to a BUILDING PERMIT? ❑ Yes 9f No Applict notified: If so,please specify(BUILDING PERMIT)case#: By: S Date: 4! I:\ENG\PermitApplications\pfi_application Rev.10/16/2017 City ofTigard 13125 SW Hall Blvd. Tigard,Oregon 97223 • www.tigard-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 APPLICANTS) SHALL CERTIFY THAT: • The above reQuest does not violate any recorded deed restrictions that may be attached to or imposed 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 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. Digitally signed by Vinh D Vinh D Nguyen, PE Nguyen,PE Date:2018.09.28 07:21:52-07'00' 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 • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 Page 2 of4 DEVELOPMENT ENGINEERING FEESFOR STAFF VSL' ONLY Public Facility Improvement(PFI)Permit: DETAILED StIBMITTAL APPLICATION FEE REQUIREMENTS Part 1: Required submittal fee$300.00 (minimum) FRANCHISE UTILITY AND SIDEWALK/ DRIVEWAY AND UTILITY PERMIT FEE CONNECTIONS,ETC. Part 2: All non-water system improvements (work in the right of way) Engineer's estimate X 5%(less$300.00 minimum submittal fee) Sketch Engineer's estimate X 2%Plan Review (including information below) ❑ Dimensions WATER SYSTEM FEE ❑ Street Name Part 3: All public water system improvements ❑ Site Address Engineer's estimate X 12% FULL SCALE DEVELOPMENT PFI Permit Fee Exemptions: (Subdivisions/Partitions and Street Improvements) There will be no permit fee charged,or assurance required for the following types of work: Design Plans • Sidewalk repair(less than 20 lineal feet) (6 sets,24x36 or 22x34) • Relocate or replace mailbox ❑ Cover—Site,Vicinity,Abbreviation,Legend • Ditch cleaning that does not involve regrading. ❑ General Notes(City,Water,Sewer,etc.) • Weep hole repair ❑ Street(Plan,Profile) • Curb repair or replacement(less than 20 lineal feet) ❑ Water,Storm and Sanitary(Plan Profile) • Lawn sprinkler system installation or repair ❑ Water Quality Facilities • Street tree pruning or planting ❑ Grading • Planter strip landscape maintenance ❑ Landscaping/Tree Plan • Test wells ❑ Composite Utility Plan(Electrical,Phone,Gas, Storm,Sanitary,Water,Signage,Street Lights,etc) ❑ Details Note: A cash/bond assurance maybe ❑ Traffic Sight Distance required per TMC 15.04.140. ❑ Signing and Striping (customer deposit) ❑ Street Light Plan and Photometric ❑ Engineers seal/signature ❑ Sheet label(project land use name,revision and plan log block,dates and sheet numbers.) Additional Submittals (per Land Use conditions) ❑ Traffic Report ❑ Storm water Drainage Calculations ❑ Geotechnical Report ❑ Preliminary access Report(Sight Distance) ❑ Proposed Plat ❑ Pathway Design(if applicable) ❑ Water Department Approval ❑ Engineers Construction Estimate PUBLIC FACILITY IMPROVEMENT PERMIT City ofT igard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 Page 3 of 4 SAMPLE SKETCH: Edge of Pavement I 1 Ditch StreetlightRijn I -!•—•—•---•--•—•—r--- 1 �• r�.. I>ram N : ' Tl r0 0Sc1�5el+wle rTi Hee a r I u ! Existing House ! I r I Existing 1 zi i Driveway 3� 1 a 4U ! 1 QICL I • a 0+ Existing Shop C" kN J Powerpole I m I a I ! 95' r I � -------- PrapeityLni s----------- 0 � I . Fire Hydrant(FH) I � I I Scale: 'I"=30' � I I � I I ' I I � I . � I I MINIMUM SKETCH REQUIREMENTS(Put"N/A"if Not Applicable): North arrow Property lines &dimension Slope of property Street &street name(s) Existing building, structures Utility&street light poles Proposed work Existing curb or edge Trees Existing S/W or of pavement Existing utility locations D/W apron (sewer,water,storm) PUBLIC FACILITY IMPROVEMENT PERMIT City ofTigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tlgard-or.gov • 503-718-2421 • Page 4 of4 www.invarion.com Lane Closure at intersection with Flagging Diagram 6 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 "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) Pasted Spacing Between Signs Buffer ERRATA: Speed A B C Space 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-Raodway 50 500 500 500 210 Section 55 1 A 250 Signs Spacing and Buffer Lengths (feet) Supplement Posted- S acrog Between Signs "Buffer'" Speed, A g Space 60 285 65 700 700 700 325 70 1365 www.invarion.com 11-ane Closure at Intersection with Flagging Diagram 620 ROAD WORK HEA l t (Optional) ONE LANEROAD AHEAD B BE PREPARED TO STOP • B A (Optional) • p ONE LANE ROAD BE 140 ft,Max, O PREPARED AHEAD ROAD O TO STOP AWHEA O A B B C Buffer p U 0000 4 O MM 0 O O IF2� M+ k%= O O 1 QO ft.Max.- { C B B A I ROAD O 9E WORK PREPARED O 100 ft.Max. HEA TO STOP • O ONE LANE ROAD O AHEAD (Optional) A • B BE PREPARED TO STOP B (Optional) ONE LANE t ROAD AHEAD C ROAD WORK HEA 9876 1 1 15060 15065 -4 Q 5 14379 196 970 N 9670 9644 4 5 4134 3-A4 5 4271% < WL1 PL-1290: 35' 1 40'-4(J 45'-4() 142 6 Install; 195 1994 1990 TRIPSAVER 65T 15100 A•2/0 AL-TX AVIAN PROTECTION � CNI Z Q m 9885 9955 9845 15105 U O� N 00 j9685 9 45 Z y Q 9825 Q 9725 y 9765 114 1148 1290 3724 45 4 89 45'-4(]o45'-4 1989 1989 1956 ABC 795 AAC I 872 CZ 1-11 C 143 100 T 45'-4 ` N 4/0 AAC 972 89 148 65 T 142 6 T ABC 795 AAP--,,, 1541034 C 2 AL-TX N 4/0 AAC rl C 25 52785' SW SATTLER ST All)CU DX V t Z a 47 O +I 9880 ¢ 151 25'-4 9749 v 500 I N 1991 9765 30 4 ? ¢ 9741 U 1991 M 9900 C 4/0 q4`r 5505 9650 9596 -�- 30'-4 1967 v2 A L x 9884 A 25 97520 9787 9733 D-72 15213 15201 U 9773 j 9717 0 48 I 0 25 50 100 Feet 20'-4 15225 1991 I I PGE CONSTRUCTION DRAWING OVERHEAD LEGEND AS-BUILT VERIFICATION 8 NESC VIOLATIONS CORRECTED This document accurately represents FIELD Construction INSTALL FUSE 65T Foreman: Date: _ REMOVE/ABANDON FACILITIES_INSTALL FACILITIES XBOX General Foreman: Date: (Signature only required for field construction changes) ITEM YES COMMENT SDPM/ENG REVIEW ASBUILT BY DESIGNER: DATE: ALE: ACCOUNT AWO: JOB NO. 8/15/2018 1 in = 60 ft 1 1070001 11000007719 1 M2564380 BARRICADES TITLE TRIPSAVER INSTALL TREE CIRCUIT slzE DURHAM-SATTLER 11 x 17 LANDSCAPE PGE LOCATION 15186 SW 98TH AVE,Tigard THINK PERMIT X Cit Of Tigard DESCRIPTION SAFETY INSTALL TRIP SAVER II SHEET TRAFFIC PLAN X OTTC COUNTY SECTIONS WORK WITH FIRST WASHINGTON C2111 C 1 OF 1 ANY DEVL47YON FROM THIS DESIGN MUST WILSONVILLE DESIGN BY PHONE DRAWN BY LINE CREW CENTER JOSH DORNON 971.338.3703 MISTY MESAGA N BE APPROVED BY THE PGE PROJECT MANAGER 9480 SW BOECKMAN RD WILSONVILLE OR 97070 O PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED