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PFI2018-00313 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT lis COMMUNITY DEVELOPMENT Permit#: PF12018-00313 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 12/27/2018 Parcel: SEG642 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: PGE Project Description: SEG 642.Replace underground cable. PGE Job M2500549 Owner: FEES Description Date Amount PFI Permit Fee 12/26/2018 $300.00 PHONE: Contractor: PHONE: FAX: Applicant: TOM COX 10800 SW AVERY STREET TUALATIN, OR 97062 PHONE: 503-464-7777 Total $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 Signature: Issued By: 1 Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12018-00313 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 N 0 V 19 2018 PUBLIC WORKS —ENGINEERING i� `- '''`nD � „{;ua Vii:ERENG Public FacihtyImprovement PFI Permit TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) TYPE 1—Franchise Utility Work Check one: 0 Utilities ❑Sidewalk/driveway approach ❑Street improvements performed by NWN, PGE Detailed description: Replace undergrond cable and/or utility agency. ❑ TYPE 2—Sidewalk/Driveway/Sewer PGE Job M2500249 Work performed for the purpose of: • Sidewalk installation or repair. Property address/location(s): 11585 SW Tigard St • Driveway approach installation _ and/or repair Tigard, OR 97223 • Sanitary sewer lateral installation and/or main line tap Applicant: Portland General Electric ❑ TYPE 3—Full scale Development Work performed with Land use Address: 10800 SW Avery St Tualatin, OR 97062 approval which includes any of City/state: Tualatin, OR Zip: 97062 the following: Phone: 503-464-7777 Email: preregcoord@pgn.com • Subdivisions or Partitions Contact name: Tom Cox Phone: 503-736-5419 • Street widening • Mainline installation for Sanitary Contractor: TBD— Permit needed for bid walk 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: only may be emailed to: ro ermits_,tigard-or.gov Address: pil City/state: Zip: ��MEW Phone: Email: Case No.: E 1 W1S'oda l3 Contact name: Application submittal fee(.007%of Engineer's Estimate) $ Estimated value of work is required(if over$5,000):$ 22,809.63 Additional fees: $ M (within the public right-of-way) Application accepted: Is work related to a LAND-USE DECISION? ❑ Yes V No By: Date: It Iq Applicati we If so,please specify (MLP,SDR,SUB,etc.) case #: Z 01 By: Date: Is work related to a BUILDING PERMIT? ❑ Yes No Applicant notified: If so,please specify(BUILDING PERMIT)case#: By: Date: 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 I 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 ani recorded deed restrictions that may be attached to or imposed upon the subject 12ropeiu- • 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. .00� Steve Hursh 11/19/2018 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 FEES FOR STAFT I'SE' ONLY Public Facility Improvement(PFI)Permit: DETAILED SUBMITTAL 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 ofTigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 Page 3 of4 SAMPLE SKETCH: Edge of Pavement I I � Ditch Streetlight I •—.—•—•�•:.—.�•—r—.— • Rikin nr4dn g / ' T— ropos dM98WeF Me Existing House Existing ZI i Driveway 01 Loi al �1 ., I O 1 al I a 6. w� I 'I 0, Existing Shop CM Powerpole I - a f �'•,�, a • I 95' 1 •------- —-—-—-—-—- 0 -�roperi�+L ni e' I I . 1 ' 1 I Fire Hydrant(FH) I I � I Scale: 1"=30' � I I I � � 1 1 � � 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.tigard-or.gov 503-718-2421 • Page 4 of4 UNDERGROUNDLEGEND { 49 ` HEMOVE ABANDON FACILITIES_INSTALL FACILITIES _w�� j w INSTALL ADDITIONAL FA CILITIES/MODIFY FACILITIES 16845 1 WORK LOCATIONS 35'-4 .......• SURVEY GRID BOUNDARY 1966 11865 U a N m 114 CONDUCTORS a INSTALL BCO#2 AL EPR JKT-D PRIMARY 'PROVIDED 6 INSTALLED BY PGE 14'"CONDUIT Lu 'PROVIDED 6 INSTALLED BY WL 1 VT-22: Q PGE APPROVED CONTRACTOR Install: 11855 (2)ELBOW KIT-JKTD CABLE-#2AL ti INSTALL B0#2 AL EPR JKT-D PRIMARY h 'PROVIDED d INSTALLED BY PGE ——————— 1-2"CONDUIT PROVIDED 6 INSTALLED BY 1 I. h PGE APPROVED CONTRACTOR WL 2 VT-12020' 11"5= Install: SU90010100-GRATE VLT LID,VENTED,40"x40"x6" 687 I 142 65 T POLES (3)ELBOW KIT-JKTD CABLE-#2AL 40'A POLE CLASS(1,2,3,4,H1,H2,S) Rem- 19671 Do Not SU90010100-GRATE VLT LID,VENTED,40"x40"x6" Close Hot I 1645 POLE HEIGHT 1Iss5 I 1 �y EQUIPMENT 116# INS T.SMALL FAULT INDICATOR(S)VAR TRIP 200 A Lg TENSA O:135# SW T! RD S TENURE B 10 12014"PGE NSTALL SLT. 1/900f0}00-GRATE VLT LID,VENTED,10`xI0'x6 W1 L � 1 � 1 2 1`GP�O 1 C 60 39601 `"VT-12 FrX- oJ I1635a LANDSCAPING NOTES G'L�• 11530 { cc 1-34C m WL 3 VT-12022: ` I PRE CLEAR 3'AROUND VAULT 64� % 1 1 11610 ` 1 a `%\ �% 1164'_ � I ' 11640 1 w 1 I 11625 +� i i 1 Q ' 11665 C11-34D 3 I B 60 78 1 h 11670 -12022 1 1 I t 1 11685 I I i 1 1 11700 1 1 I WL 3 VT-12022: 11715 Install: ELBOW KIT-JKTD CABLE-#2AL 1730 1 { 0 25 50 100 Feet 1 l I I I I I I I I 1 11735 N PGE CONSTRUCTION DRAWING AS-BUILT VERIFICATION e NESC VIOLATIONS CORRECTED Foreman: Date: THINK General Foreman Date: SAFETY (Signature only required for field construction changes) SDPMIENG REVIEW: ASBUILT BY DESIGNER: JJOB NO ��NYDEM77ONFROMTMSDF.SIGNMUST FIRST 8/21/2018 1 TE in=50 ft 1070001E ACCOUNT 000001462AI 8 M2500249 BE APPROVED BY THE PGE PROJECT MANAGER TITLE REPLACE BIO UG PRI CALL 811 BEFORE YOU DIG clRculT SIZE ATTENTION.. PROGRESS-GREEN BURG 17 x 11 OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED , -PGE LOCATION BY THE OREGON UTILITY NOTIFICATION CENTER. ` 11585 SWTIGARD STREET,TIGARD,OR,97223 THOSE RULES ARE SET FORTH IN OAR 952-001-0010 1 DESCRIPTION REPLACE B/O UG PRI IN RD X-ING VT 22-12022 THROUGH 952-001-0090 YOU MAY OBTAIN COPIES OF RESTORE N/O AT PD 6929 Cll-34C SHEET THE RULES BY CALLING THE OREGON UTILITY COUNTY SECTIONS WORK WITH NOTIFICATION CENTER ADMINISTRATION @(502-232-1987) ..ate. MSI WASHINGTON C1134C 1 OF 2 TO REQUEST UTILITY LOCATES CALL THE OREGON K1101NMhet'below' BEAVERTON DESIGN BY PHONE DRAWN BY UTILITY NOTIFICATION CENTER,811 AT LEAST CMI bdomyou dig. LAVE CREW CENTER TOM COX 503.867.0414 KYLE LEMPINEN 2 BUSINESS DAYS PRIOR TO EXCAVATION 7713 SW 153RDOR ©PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED 1-LINE DIAGRAM -- I , �y► -pt>-ssss � 1 \ / 137 / 0No n No AL WWI 134 Ix", yr 97 No S070057 B 50 1050 PL-6641 C B - B 6 / B 50 88889If \ �_ / i i f Open i- C" VT-8998 ! I I PL-16845 ' 0 \ I C f _�-- Vr-1z -� L-8370 o Not Glnee Hot B 25 96980 PD-6929 \ = ,. - - / , C1 1-34D ANY DEVL47TON FROM THIS DESIGN MUST eryp, ` % I BE APPROVED BY THE PGE PROJECT MANAGER 1 010128189 CALL 811 BEFORE YOU DIG 4785 ATTENTION: � OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED , THINK BY THE OREGON UTILITY NOTIFICATION CENTER. VT-12020 IT _ THOSE RULES ARE SET FORTH IN OAR 951-001-0010/ C 60 3%01 `C j 1 � SAFETY THROUGH 952-001-0090 YOU MAY OBTAIN COPIES OF - 1 THE RULES BY CALLING THE OREGON UTILITY i FIRST NOTIFICATION CENTER ADMINISTRATION @(502-132-1987) O REQUEST UTILITY LOCATES CALL THE OREGON below. L 1 UTILITY NOTIFICATION CENTER,811 AT LEAST Call befoM YOU dig. ` r 2 BUSINESS DAYS PRIOR To FXralrn TION Y I POE CONSTRUCTION DRAWING AS-BUILT VE 1,l AT' ONS CORRECTED vrao \ `t. Foreman. Date: B so 14133( \�J/ General Foreman: Date: y^ O� �\ (Signature on regwred for field construction ch es) g SDP"ENG REVIEW JASBUILTBYDESIGNER, ��- 825215 VT-12000 \ DATE C U - O -�-?� 8/21/2018 1 in=50 ft 1070001 0000014628 M2500249 REPLACE B/O UG PRI ' CIRCU! SIZE PROGRESS-GREEN BURG 11 x 17 C LOCATION 1 ME 11585 SW TIGARD STREET,TIGARD,OR,97223 - I / DESCRIPTION REPLACE BIO UG PRI IN RD X4NG VT 22-12022 { RESTORE N/O AT PD 6929 Cl l-34C SHEET i'' I Y•,1 COUNTY SECTIONS WORK WITH WASHINGTON C1134C 2 OF 2 0 37.5 75 150 Feet \\ II I BEAVERIM DESIGN BY PHONE DRAWN BY j I Ln.....cer_ TOM By 503.867.0414 KYLE LEMPINEN PGE N AvERr+ssxooa - ee�vEarou on uxae 0 PORTLAND GENERAL EL CTRIC CO.-ALL RIGHTS RESERVED www.invaHon.com Lane Closure at Intersection with Flagging :_, <`� Diagram 620 ROAD WORK HEA C j t ONE LANE (Optional) ROAD AHEAD B BE PREPARED TO STOP • B A (Optional) • O ONE UNE ROAD 100 fl,Max, O BE PREPARED AHEAD ROAD OWORK O TO STOP AREA A e B G Buffer p C? 0000 4 O MM p O RM O O 00 of ON 1 D7mex 4-1 C C B I B A ROAD O 9E WORK PREPARED O 10L)ft.Max. HEA TO STOP • U ONE LANE ROAD O AHEAD (Optional) A • B BE PREPARED TO STOP B (Optional) ONELANE I t ROAD AHEAD G ROAD WORK HEA www.invarion.com Lane Closure at Intersection with Flagging ., ,_. Diagram 620 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) Posted Spacing Between Signs Buffer Speed A B 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:OQOT Traffic-Raodway 50 500 500 500 210 Section 55 1 A 250 Signs Spacing and Buffer Lengths (feet) Supplement Posted S acing Between Signs "suffer" Speed . A B C Space 60 285 65 700 700 700 325 70 365