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PFI2020-00203 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT gu 114 t COMMUNITY DEVELOPMENT Permit#: PFI2020-00203 I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 06/17/2020 -f Parcel: SEG1947 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Ziply Fiber PFI Project Description: Cable Relocation Class of Work: FEES Description Date Amount Type 1 -Utilities(gas, electric, data) Total Owner: REQUIRED INSPECTIONS Call 503-639-4175 for the IVR inspection request line or visit the City of PHONE: Tigard website at www.tigard-or.gov to schedule inspections online. Contractor: PHONE: Applicant: RUSSELL WELLS 4155 SW CEDAR HILLS BLVD BEAVERTON, OR 97005 PHONE: 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. PermitteelApplicant Signature: See- a,ppi.t CGS�-- Issued By: Special Conditions(See Attached) llllll Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PFI2020-00203 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 ADVANCE WARNING Applied Notice Advance warning of traffic disruption shall be provided to the public by placement of an approved advance notification sign at each end of the construction area 72 hours(min.)before initiation of construction work. PFI_Utilities 09-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 10-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 11 -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 12-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 13-DRAINAGE CONTROL Applied Notice Drainage shall be controlled within the work site and shall not adversely affect adjacent private property, public property and the receiving system. The City may at any time order corrective action and suspension of work to accomplish effective drainage control. PFI_Utilities 14-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 15 -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 16-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 17-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 19-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 20-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 21 -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 22- DAILY INSPECTION REPORTS Applied Notice Applicant shall submit daily inspection reports, on a weekly basis,to the City's Inspector. PFI_Utilities 23 - 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 24 -VALIDATION OF MATERIAL/CONSTRUCTION Applied Notice The City's Inspector may, at his discretion, require tests and or reports from the applicant to validate claims of material or construction adequacy/compliance. Such tests/reports shall be provided at the applicant's expense. PFI_Utilities 25 -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 26-RIGHT OF ENTRY/EASEMENTS Applied Notice Applicant to obtain proper right-of-entry and/or easements prior to starting work. Proof of right-of-entry or properly executed easements,shall be provided to the City. The City shall in no way be construed to be liable for the applicant's failure to obtain or provide for proof of right-of-entry or easements. PFI_Utilities 27-PRIVATE PROPERTY AGREEMENTS Applied Notice Provide the City a copy of an executed agreement[s]from the owner for each private property disturbed by construction activity. PFIUtilities 28-AS-BUILT DRAWING Applied Notice 1,2,3,4,5 28-AS-BUILT DRAWING One as-built drawing showing all new public improvements, including any revision made to the previously approved construction plans and,also, any improvement which may impact an existing public system or facility, shall be provided to the City by a registered civil engineer along with an engineer's certification of installation compliance(Certificate of Compliance). 1,2,3,4,5 28-AS-BUILT DRAWING One as-built drawing showing all new public improvements, including any revision made to the previously approved construction plans and, also, any improvement which may impact an existing public system or facility,shall be provided to the City by a registered civil engineer along with an engineer's certification of installation compliance(Certificate of Compliance). One as-built drawing showing all new public improvements, including any revision made to the previously approved construction plans and,also, any improvement which may impact an existing public system or facility, shall be provided to the City by a registered civil engineer along with an engineer's certification of installation compliance(Certificate of Compliance). PFI_Utilities 31 -OTHER Applied Notice Other RECEIVED 11 City of Tigard JUN 1 6 2020 RD ppI#: 2020-00203 ENGINEERING DEPAR Public Facilities'r .°rpm A nt (PH) Permit PROJECT INFORMATION TYPE OF WORK Project name: 51351-W0884020 ❑ TYPE I-Franchise Utility Work Brief description of project CABLE RFI()CATION- pe f m ea by VW v,pcE °`°m n agcm, SW MI IROOCK STREET 0 TYPE2-ROW Sidewalk/Driveway/Sewer Work perfomsed for the puipose or •Sidewalk installation or repair •Driveway approach ins allwon and repair SITE INFORMATION •Sanitary-sewer lateral installation and Location(address if available): 9715 SW MIIRDOCK ST nu n line ap SEG 1947 ❑ TYPE 3-Full Scale Development wok perfaemed with land use approval which indudes any of the following •Subdivisions or Parnions APPLICANT INFORMATION •Sneer widening Name: ZIPLY FIBER 'Mainline sisrallanon for unitary sewer, smnn sewer, Tigard wane and Tigard Mailing address: 4155 SW CEDAR HILLS BLVD water sconce area City/State:_tFOVFR TON , OR Zip: 970f15 0 7YPE4-Snaa Gel Technology Phone: 5fl -848-10n1 ❑ TYPES_'r�d'ruan�r Email: Phone: 5034643-1001 NOTE: Typetand 2 applications may he Contact name: RUSSFI I f:WFI I S. ma led top,wpr m sfQpQa d„r we. Phone: 503-312-7330 Email: russell.wells@ziply.corn CONTRACTOR INFORMATION 0 Same as applicant Name: NORTHSKY COMMUNICATIONS CCB Number: 208747 Mailing address 11818 SE MILL PLAIN BLVD City/state: VANCOUVER,WA zip: 88884 Phone: WO-254-6920 Erna: notthskycomm.com ENGINEER INFORMATION Name: NA Mailing address: City/State: 'Zip: P Phone: Email: ADDITIONAL INFORMATION Estimated value of work is required(if over$5,000):$ N/A (wallet the public r ht-of-u ay) Is work related to a LAND USE DECISION? O Yes 0 No Case number. City ofTigard • 13125 SW Hill Bhd. • Tigard,Oregon 97223 • wwuetigard-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 15.04.140. • V 4th the exception of a utility operating pursuant to a valid franchise or beaus with the City of Tyctnt what the owner and the applicant ea afferent people,the appbcmt must be the putch set of record or a lessee in possession with watten authonzahrnt from the owner or an agent of the owner. The owner must ngp this application in the space provided or submit a written authoneanon with this application. Franchised or Licensed tltiliues arc not required to obtain the owners signature on the application. 1,the applicant,certify that: • To the best of my knowledge,all the information provided within this application package is complete and accurate. • The above request does not violate any recorded deed restrictions that may be attached to or imposed upon the subject property. • If the application is granted.I will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. 4p �J ...- ('uzSFll C1/034.5 A r authorized agent's signature Print name llat Property owner's signature(if required) Print name Date I I .I 'NI:, Case No: FFI2020-002203 Permit fee: '�� Received by: MB Date: 6/16/20 Approved by: 771111.471 8 D (ate: u//t /707 p 0 Notified by: ►'" Date: i7 ZO City of Tigard • I Tl2 r 5VA hall Blvd. • Trpanl,I trapin 07223 • wAcn.tgnrd cpsis • 'it II 718 2.421 • Page 2 el 4 DEVELOPMENT ENGINEERING FEES Public Facility Improvement(PFI)Permit: INITIAL PFI PERMIT FEE Part I: Required submittal fees 1(P/o of the Net PFI Permit Fee See below for calculations.Minimum of$300. NET PFI PERMIT FEE Part 2: All non-water system improvements engineer's estivate X 7%(less the initial PH Permit Fee). WATER LINE CONSTRUCTION FEE Pan 3: All public water system improvements engineer's estimate X 12a/o. t�n<VAPP TSL ONLY t,ae •i i.� TYPE 4:SMALL WIRELESS FACILITY TYPE I—3:DETAILED SIBMITTAI. CHECKLIST REQUIREMENTS Does applicant have a right-of-way license- l l l es 0 No TYPE I AND TYPE 2-Must include a sketch showing: Under the wireless facilities standards,is the proposal ❑ Dimrnsirau considered?(check all that apply): 0 Small Cell 0 Macro 0 Street Name Bow many install sites are proposed as part of this permit ❑ Site Address application? TYPE 3-Must provide 4 sets of plans(sized 24 x 36 or 22 at 34)and an electronic version of all submittal The proposed equipment is located on which of the following items. The plans must that include: ❑Public Right-of-Way 0 Private Property Vicinity,❑ Cover—Site,Vicinity,Abbreviation,Legend • If equipment is to be located on private property,describe the 0 General Notes(City,Water,Sewer,etc.) type&use. 0 Street(Plan,Profse) ❑ Water,Storm and Sanitary(Plan Profile) ❑ Water Quality Facilities ❑ Grading ❑ Landscaping/Tree Plan ❑ Composite Utility Plan(Electrical,Phone,Gas,Storm, Sanitary,Water,Swage,Street lights,etc.) ❑ Details ❑ 'Traffic Sight Distance ❑ Signing and Striping ❑ Street Light Plan and Photometric ❑ Engineers seal/signature ❑ Sheet label(project land use name,revision and plan log block,dates and sheet numbers.) ❑ Engineer's Construction Estimate Arlditiotref Submittah (per land use conditions,if applinbk) ❑ Traffic Report ❑ Storm water Drainage Calculations ❑ Geotechnical Report ❑ Preliminary Access Report(Sight Listance) ❑ Proposed Plat ❑ Pathway Design ❑ Water Provider Apprrn-al • City of Tigard • 13125 SW Hall Blvd. • Tigard,()rcgon 97223 • wwwtipardocgrry • 503-718-2421 • Page 3 of 4 SEE ATTACHED TRAFFIC PERMIT 1-W0884020-PERMIT 1 Cr) c11 „1_ •. Si Edg•of Pavement ? Sloeetlight f� Ditch�� � �•�• '�•� �'��'� 1 1 7-Tra$S0111f lt9197111i-j i I 7 &E i i E.ostrng House 1 1 ct Emeng iI ••Driv I eway r ',1 FI In il fl 1 co i �i I 1 i Engine Seep 1 i Power i I cn i i �le ` 95• i 1 7 I I I Sceie. 1-=30' I 1 I I I I 1 I 1'\l'1. 1 \\111' PL.': \II\It 11 SKETCH RIiQ1 II I:\11'.\TS(Put N/A if not applicable) X North arrow Property lines&dimensions lixisurlg utilities locations (sewer,storm,water) X Street&street names _All existing structures X Proposed work _Existing curb or edge of pavement _Utility&street light poles Existing S/W or 13/W apron _Slope of property Trees City of Tigard • 13125 SW thU Blvd. • Tigard,Oregon 97223 • www.tigardorgov • 503-718-2421 • Poge 4 of 4 JOINT POLE NOTE -NONE -....•„. ""^�.os..a.,"°°'^' s� �.� � G. ZIPLY CONTRACTOR REQUIREMENTS l: TOTAuµAITEU HOURS 94i �.W'Si25'".�"k"ldOPl '8�..>. Si, Z VICINITY MAP cuw c.r.CONSTRUCTION NOTE NOTE -WORK WITH BRADY BULLINGER LPLL1n a o N 1-CITY/TIGARD PERMIT REQUIRED CITY OF TIGARD-503-718-2611 tG " 'o..,.�.'l.`"m 2-ZIPLY FIBER CONTRACTOR Brady@tigard-or.gov B. g` ' TIT xI GIVEN L8E CAS CODES for City contractor ADA SIDEWALK SW MCDONALD ST ,x,,w' RAMP CONSTRUCTION SW BONITA RD m V ,,„,,,, O ,m___ aE.W aw Ee a° coNsmon,ox OPCEN NOTE E oocu.n me ""'STATION CONNECTION"` SW MURDOCK ST ''"JOB SITE o'w'u amountso o.v`,.ef O7+wrvxR 1-CITY/TIGARD PERMIT REQUIRED WORK ORDER 51351-5255398-49 TEMPLETON 2-ZIPLY FIBER CONTRACTOR ELEMENTARY REco envra PERMITS GIVEN LSE CAS CODES ivx,cuw::Lt7 rvn�wxo LABOR HOURS G 6,ANRET 0 noorEoOTCP/TSAF L 0 SEIAILES Mot MANESS CONSTRUCTION CONTACTS BPUCE-C-0/M-00(-0 0 xo esRNLt RPqu,REn CREW-C-O/M-0/x-0 .RUNT POLE DAVID CARNLEY-971-940-9000 FLAGGERS-38 HOURS • ,Ea.„..,R INSPECTOR-4 fiber F�,RMRE JAMES STAATS-503-756-3119 qxo TA uv:cwo ZIPLY FIBER CONTRACTOR-NORTHSKY pM@ m ram SCHEDULING CONTACT L&E CAS CODING CONTRACTOR TO o 0 o SOMA RYAN ROBERTS-503-643-3713 PROVIDE ANY MATERIALS o 0 o Es A+,E, FACILITIES CONTACT 6411.000 SHEET 1 OF 2 POINT OF CONTACT LAUREL KIELTY 425-263-4006 6423.010 NORTH PUSS 5422.020 R1.6I031 INSPECTION CONTACT -RESTORE LANDSCAPE TO ORIGINAL \ %%T VA'R�wvammre RON HAYHURST 503-292-3345 OR BETTER monism ROsswEus mom., Eosas,n> ENGINEERING CONTACT MATERIAL REQUIREMENTS mumsxI moTRPFus RUSS WELLS 503-312-7330 ZIPLY FIBER CONTRACTOR ---- -- .. PROVIDED MATERIALS } • fiber TGRD/ .BLE RELOCATION- 9715 SW MURDOCK ST 51351-W0864020 R,aE�. go..RU, NUNeer. VJ.7PF4f120 IE,n. GLVMM.E (NOT RU43NE'Lr [WATw 3a.7PITOT RE MATTOM m IIZdSTRK1., I"C I G > INN9HR-' TOO fiber SHEET 2 OF 2 • m�QM\ NORTH \ Q TGRDORXA 43893 TGRDORXA H3013,41-44 e TGRDORXA 43891 0 0 25 TGRDORXA H3013,45-48 c 500 07.2006 BBGTD 6596 FTTP PIGTAIL 500FT 4 BBGTD DAL,226-250 TGROORXA H3013,41-44 51351-W0864020 O 781 07,2006 ® 0 25 YJD TGRDORXA H3013.1-48 BBGTD 6597 ZI 315' BBGTD DAL,226-250 '� t AEF 50 26x XD,1-25+ Q O 25 9715 I K BBGTD DAL.226-250 BBGTD 6598 MURDOCK T ^©1f�,1- 3 Q 309' BBGTD DAL,226-250 f�U , a I�N AEF 25 26 A s AEF 2 DAL,351-375 III Flav i ZIPLY FIBER CONTRACTOR TO MOVE EXISTING CABLES 12"ADDITIONAL DEPTH TO ACCOMODATE CITY OF TIGARD NEW ADA RAMP CONSTRUCTION. IF NECESSARY WITH COPPER CABLE MAY F SW MURDOCK ST HAVE TO REDUCE RADIUS TO GET COPPER TO MOVE.EXPOSE;RELOCATE; H �\ RESTORE LANDSCAPE. • fiber B„ p,,, 9715 SW MURDOCK ST V )nsen,n I` ,°'% . DRAWN DATE. EN%WALE , ASH vT:„` TNJSro H�Ni. EL LANE CLOSURE AT T INTERSECTION WITH FLAGGING SIGN SPACING AND BUFFER LENGTHS PEDESTRIAN/BICYCLE SAFETY ESCORT REQUIRED AT WORK SITE WHILE CONSTRUCTION WORK IN PROGRESS POSTED SPACING BETWEEN SIGNS BUFFER ODOT DIAGRAM 820 SPEED A B C SPACE REFERENCE 20 50 25 100 100 100 75 30 100 36 40 350 350 350 125 150 45 180 e 50 500 500 500 21055 250 t /�NOTE-TRAFFIC CONTROL ORANGE CONES TO BE © t A SPACED PER TRAFFIC SAFETY GUIDELINES p A DEPENDING ON POSTED SPEED LIMIT AND TAPERED A PER POSTED SPEED LIMIT 100'MAX H �- A n J PEDESTRIAN �1,... 100 MAXASCHOO SCHOOTEMPL TON ELEMENTARY BICYCLE C B B A L TRAFFIC I I I I I ' \ / <> FLAGGER AHEAD SIGN SAFETY — ESCORT SW MURDOCK ST it A 100'MAX BE PREPARED TO G D STOP SIGNB O ONE LANE ROAD O O O O <F PERMIT SKETCH O AHEAD SIGN 1 B C OO W NORTH G 2 \ OROAD WORK S' AHEAD SIGN H=2IPLY FBER CONTRACTOR WORK AREA • A=ORANGE SAFETY CONE • fiber TRAFFIC FLAGGER fiber 9715 SW MURDOCK ST DIRECTION W!)RRAn7n�`R R ,,, SAFETY W0884D24PERMR 1 .' SIGN iwwxR w,E Russ neu ice'w� SCALE _m TFxw,,aCT. MO , OF , iVN61-1P. RNG. SC'.