ROW2014-00038 1111111 CITY OF TIGARD RIGHT OF WAY PERMIT
n Permit#: ROW2014-00038
COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 04/28/2014
TIGARD Parcel: SEH1828
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: PGE
Project Description: Adjacent to 9155 SW View Terrace,SW 92nd Avenue and SW Inez Street. Replace bad order
underground primary cable-vault 5723 to vault 5724. Bore/open trench, landscape work. SEG
1828/3608.
Owner: FEES
Description Date Amount
ROW Permit Fee 04/28/2014 $300.00
PHONE:
Contractor:
PHONE:
FAX:
Applicant:
HASSAN AMAN
2213 SW 153RD DRIVE
BEAVERTON,OR 972006
PHONE: 503-963-6926
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
Sign ature: l'A(k presolk
I
Issued By: 'I�'
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for ROW2014-00038
TVpe: Condition Name: Status: Severity:
ROW 01-CUSTOM CONDITION Applied Notice
<Custom Condition goes here>
ROW 02-PERMIT&PLAN REQ ON SITE Applied Notice
A copy of the permit and all attachments, and a copy of the approved construction plan and all amendments shall be
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 the aforesaid must be approved by the City, in advance of work performance.
ROW 03-TRAF CTRL-SPECIF(CITY) Applied Notice
The City's standard specification for traffic control is"Manual on Uniform Traffic Control Devices for Streets and Highways",
U.S. Dept. of Transportation, F.H.A., 1988 Ed.
ROW 04-TRAF CTRL-CONTR RESPON FOR Applied Notice
Traffic control shall be provided for by the contractor in accordance with the City's standard specification and, also, in
accordance with a City(job specific)approved traffic control plan.A copy of the approved traffic control plan shall be
available at the work area.
ROW 05-TRAF CTRL-ROAD CLOSURE Applied Notice
Public roadway shall not be closed to traffic,at any time,without having first obtained written approval from the City
Engineer.The permit holder is responsible for provision of timely notification of traffic flow disruptions to area wide
Emergency Services(Tigard Police Dept.,Tualatin Fire&Rescue)and to Tri-Met and Tigard School District.
ROW 06-TRAF CTRL-ADVANCE WARNING Applied Notice
Advance warning of imminent traffic disruption shall be provided to the general motoring public by placement of an advance
notification sign at each end of the construction area 72 hours(min.)before initiation of construction work.
ROW 07-TRAF CTRL-PRIV PROP ACCESS Applied Notice
Access to existing properties shall be maintained at all times, including normal delivery service and mail service and if not,
shall be cause for work stoppage until effective access is established.
ROW 08-TRAF CTRL-DEVICES IN PLACE Applied Notice
Traffic control devices,flagpersons,etc.,shall be in place prior to initiation of construction work and shall be effectively
maintained.
ROW 09-TRAF/NOISE CTRL-WORK HRS Applied Notice
No work will be permitted during the hours of darkness, nor between 9:00 p.m.to 7:00 a.m. Monday through Friday, nor
between 9:00 p.m.to 8:00 a.m. Saturday, nor between 9:00 p.m.to 9:00 a.m. Sunday.
ROW 10-TRAF CTRL-MIN LANE WIDTH Applied Notice
Minimum travel lane width shall be eleven(11)feet; pedestrian travel shall also be provided for.
ROW 11-TRAF CTRL-CITY CAN MODIFY Applied Notice
The City reserves the right to add to or modify traffic control requirements as may be necessary to effectively control traffic
and to assure public safety.
ROW 12-INSP 24 HR NOTICE REQUIRED Applied Notice
The permit holder or his contractor shall notify the City's inspector Kenny Fisher at 503-816-6146 or email at
kenny @tigard-or.gov,twenty-four(24)hours prior to commencing work,twenty-four(24)hours prior to any staged
inspection, and after completing work covered by the permit.
ROW 13-HAZARDS-CERT OF INS Applied Notice
Maintenance of the work area and approach roads is the responsibility of the permit holder.The work area and approach
roads shall be maintained in a clean condition,free from obstructions and hazards.A copy of the permit holders Certificate
of Insurance shall be available at the work area.
ROW 14-DEBRIS-MATERIALS Applied Notice
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
cleanup and stoppage of work to accomplish cleanup.
ROW 15-EROSION CTRL REQ Applied Notice
Effective erosion control is required. Erosion control devices must be installed and maintained meeting D.E.Q.
requirements.The City may at any time order corrective action and stoppage of work to accomplish effective erosion
control.
ROW 16-REPAIRS-LIKE MATERIALS REQ Applied Notice
Property disturbed by construction activity shall be seeded with a standard grass mix;shrubs,flowers, barkdust,existing
signs,pavement markings, mailboxes,etc.,shall be reestablished, reinstalled or replaced,with like kind and material.
ROW 17-DRAINAGE CONTROL REQ Applied Notice
Effective drainage control is required. Drainage shall be controlled within the work site and shall be so routed that adjacent
private property, public property and the receiving system is not adversely impacted.The City may,at any time,order
corrective action and stoppage of work to accomplish effective drainage control.
ROW 18-UTILITIES PRELOCATION REQ Applied Notice
Oregon law requires following the rules adopted by the Oregon Utility Notification Center. Said rules are set forth in OAR
952-001-0010 through OAR 952-001-0080.Copies of the rules may be obtained from the Center by calling(503)232-1987.
If you have questions about the rules, contact the Center.NOTE: Damage to utilities shall be corrected at the permit holders
expense.
ROW 19-UTILITY LOCATIONAL CONFLICT Applied Notice
Contractor 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 permit holders expense. Changes must be approved by the City in advance of work performance.Contractor shall
coordinate the work with affected utility agencies.
ROW 20-TRENCH-PATCH/SAFETY/LBILITY Applied Notice
A temporary hard-surface patch(Cold mix A.C. or Hot mix A.C. base paving) shall be placed on trenches within roadways
at the end of each day's work. No trench,on site or off site,shall be left at any time in an unsafe condition.The permit
holder is responsible for and is liable for hazards or damage resulting from the work.
ROW 21-REPAIRS REQ-INSPTR OPINION Applied Notice
Work provided for under the permit shall include repair of existing facilities(roads,ditches,etc.)as may be necessary, in the
City Inspectors opinion,to overcome deterioration or damage which occurred in conjunction with the work authorized by the
permit. Corrective work shall be done at the permit holders expense.
ROW 22-AS-BUILT/ENGR CERTIF REQ Applied Notice
At the end of each year,or an a mutually agreeable yearly date, any entity making changes to its facilities in the public
right-of-way shall submit complete"as-built"drawings 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 engineers certification of installation
compliance(form attached).
ROW 23-DAILY INSP REPORTS REQ Applied Notice
The permit holders Engineer/Inspector shall submit daily inspection reports, on a weekly basis,to the City's Inspector. (see
Developer-Engineer Agreement note#5).
ROW 24-TESTS/REPTS TO VALIDT CLMS Applied Notice
The City's Inspector may,at their discretion, require provision of tests and or reports from the permit holder, permit holder's
engineer or contractor to validate claims of material or construction adequacy/compliance. Such tests/reports shall be
provided at the permit holder's expense.
ROW 25-RELEASE-WAIVER REQ Applied Notice
The permit holder shall provide a copy of a properly executed Release&Waiver document to the City for each ownership
disturbed by construction activity, as evidence of disturbance resolution and owner satisfaction.
ROW 26-MONUMENT PROTECTION REQ Applied Notice
Existing monuments, property corners, and survey markers shall be protected. Replacement shall be at the permit holders
expense.
ROW 27-PROB SOLVING-RESPON PARTY Applied Notice
The permit holder shall 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 an
emergency.The permit holder shall notify the City Inspector, in writing,of any/all assignment changes.
ROW 28-CONSTR SAFETY-RESPON PARTY Applied Notice
The permit holder shall cause his contractor to provide to the City Inspector, in writing,the name and 24 hr emergency
telephone number of a designated"Competent Person"responsible for construction safety as per OR-OSHA, Chap.437,
Div. 3 Construction, Subdivision P-Excavations.The contractor shall notify the City Inspector of any/all assignment
changes.
ROW 29-ESMT/RT OF ENTRY-RESPON Applied Notice
It is the sole responsibility of the permit holder to provide for 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 permit holder's failure to obtain or provide for proof of right-of-entry or easements.
RECEIVED 1
APR 21 2014
City of Tigard
11 CITY A
- ' Application For Work In The R hf a O.: . arERING •TIGARD ROW Permit
Wes#' 9Y4 53c
Property Address/Location(s): alt 9155 Sc View Terrace. FOR STAFF USE ONLY
so 9 .-de A, n/D S in St. S —I IS2 / Right-of-Way,- ^nt�7,� 2/�
1y n Dd Case No.: "�-Vt 4 OC(A.`TJ
*Applicant's Name: PortIa-AA, ( eneca.( E1ectrtC,, lK O Application Accepted:4 24 By: 1
Address: 2 a1.3 S W 15 3 '41)4"1)4"t VG Application Reviewed:4.` GZ By:J1 Y1
City/State: 6 ect uB,c-tcsYI) 0 R Zip: 97006 Application Fee Due:..s 30fl
Applicant Notified: 4.22- 14
Primary Contact: 14 a.ss an 146,&ill x
Phone: 503— 9 4 3-4 i R 4 Fax:503- L 72-S516" Receipt No.: `-1 J (�-]
7
Email: TCP 3) S v ee O crt 84c- e psi,.de ., REQUIRED SUBMITTAL
INFORMATION
Contractor's Name: re lb a Clete- - r%i't.A - j a b • Application form,completed and signed
• Submit one(1) copy of scaled sketch of
CCB# 9�`�+q b� Expiration: the proposed work to be done
Address: • Submit one (1)copy of traffic control
City/State: Zip: plan
Phone: Fax: Professional Engineered Plans are required
Email: for:
• Street Widening
P a 6- • Subdivision Infrastructure
Plans By: • Main utility line extension
Address:
Deliver application to rowpel iiits(ltigard-or.;>ov or to
City/State: Lip: City of Tigard Planning/Engineering,13125 SW Hall
Phone: Fax: Blvd.Tigard,OR 97223.
Ree.12/10/2013
Email: I:\CURPLN\Masters\Land Use AppIkseons\Right-of-was Permit
Apphcation.docx
Description of work: IR eriace. bad oprJeic 13.4-ae.f'r0)- }. ?ct .tr c cdak V 4 .5"72..3 "to
Vcoat' 5"1 a Si. Qe re /apevt french 1 Lartetscaire. r.,e,rdc..
Estimated value of work(within the public right-of-way): $
Is work related to a LAND-USE DECISION? YES n NO 1-4---
If so, please specify(MLP,SDR,SUB,etc.)case#:
Is the work related to a BUILDING PERMIT? YES U NO Er-
If so, please specify(BUILDING PERMIT)case#: 1
Signature of Appliicjant/Permittee: •14 t cerc 1401st ck." A t+laan Date: Y� ig—ctml4
Print Name: 14 &SSA-' AInex-`n Title: C 'tYAtt Sb r ;4>c P 1..
City of Tigard I 13125 SW Hall Blvd.,Tigard,OR 97223 I 503-718-2464 I www.tigard-or.gov
WR CHECKLIST LEGEND
9- 9000 46 ITEM YES_ COMMENT
9150 HOLEDIGGER
9120 l-54 RT BOOM NEW PGE FACILITIES TO BE INSTALLED
PL00005 BACKHOE (UNLESS OTHERWISE SPECIFIED)
PGE TRENCH
BORETRENCH % [OMRLROR 171 FACILITIES TO BE INSTALLED
B 25 27946 9155 LOCATE) 0 B!♦ FACILITIES TO BE ABANDONED
9235
_ STAGING
AB RAGGING K INSTALL I-92 AL-XLP 1KT PRIMARY IN T"PVC CONDUIT
9205 —' PROVIDED & INSTALLED BY POE APPROVED CONTRACTOR
TREFTRIM
SW VIEW TERRACE VT 05724 9705 48 LANDSCAPE % POST ABANDON PRIMARY CONDUCTOR
AV EASEMENT GROUND PER LC22035-7
t-10 Cu-ax PERMITS % COY OF SOARS
01 845- I I•.�,• 14370 TRAFFIC PLAN %
C1115HEF7 ALL CONDUIT TO BE INSTALLED 36 INCHES(MIN)BELOW FINAL GRADE.
BR ALL PGE CONDUCTORS TO BE INSTALLED IN GRAY,SCHEDULE 40.ELECTRICAL GRADE.
366' RESTORE CONSTRUCTION US CUR.VEIL. PVC CONDUIT WITH NYLON PULL STRINGS(MIN.500 LAS.TEST).PGE TO DETERMINE
Aajj�p �.; AREA TO ORIGINAL TRANSMISSION THE SIZE AND NUMBER OF CONDUITS REQUIRED.MAINTAIN 12 VERTICAL INCHES AND
�' E}, 0 G CONDITION SHUTDOWN 14 HORIZONTAL INCHES CLEARANCE BEJWEEN GAS AND OTHER UTILITIES.ALL ELBOWS
CUSTOMER 4 INCH B SMALLER TO BE 36 INCH RADIUS ALL BENDS MUST BE FACTORY MADE.
ALL ELBOWS URGER THAN A INCH TO BE 60 INCH RADIUS.RIGID STEEL OR PGE
9230 9200 0'O I ALL APPROVED.FIBERGLASS BENDS ARE REQUIRED FOR RUNS OF 151 FEET OR LONGER
2 N DOOR ILANGER % OR FOR ANY LENGTH RUN WITH MORE THAN /BO DEGREES IN RUNS BENDS PVC SCHEDULE
14405 - 40 BENDS ARE ACCEPTABLE FOR NS OF 150 FEET OR LESS.THE MAXIMUM TOTAL
CONTACT BENDS IN AM CONDUIT RUN IS 270 DEGREES.
O O ~ W �-50'
COMPANY �IRFCTIONAL BORING REQUIREMENTS-BLACK HOPE(NIGH DENSITY POLYETHYLENE)DUCT
g >� 14400 PH: 1!SCHEDULE 40 PVC WITH A MECHANICAL CONNECTION (CERTAIOK OR LIKE MECHANICAL
01 Z Z C. ONNECTION PRODUCT)AS AN ALTERNATIVE TO HDPE DUCT.HOPE SHALL MEET THE
V.-) 7 p DATE TIME ,FOUIREMENTS OF PGE SPECIFICATION 122501(AVAILABLE ON REQUEST FROM PGE PROJECT
B 50 7567 Z CABLE TO BE ABANDONED - '+N,OEP.FOP SAFETY REASONS THE DUCT SHALL BE BUCK WITH THREE EQUALLY SPACE
N •�+ "' "CH IS A SPECIFICATION REQUIREMENT.MANDREL TEST OF
a CUT,CAP 8 GROUND AT ALL INSPECTOR
01lmY 9205 9165 'R INSTALLATION WITH PGE INSPECTO (RESENT.
O TERMINATION POINTS
Ka6761 9aS TO BE NOTIFIED AND INSPECT ALL LOCATIONS vAULT AND PAD INSTALLATIONS
pyy V'00098 e PE,,RE OM AEU. NEW ✓AUE7 5 PAD LOCATIONS TO BE FIELD VERIFIED
2013 A 44 CUSTOMER REPRESENTATIVE.
1� I 14435 THINK REFER 10 PGE ELECTRICAL SERVICE REQUIREMENTS BOOK FOR FURTHER DETAILS
A- - 11 9085 &SPECIFIC REQUIREMENTS.LINK TO WWW PORTIANISCINFRM TYMARPrxnnB
B-2 AL REP JKT-D U.. B•: SAFETY DESIGN IS BASED ON STANDARD UNDERGROUND EQUIPMENT.NON-STANDARD
W VT 05723 UNDERGROUND EQUIPMENT MAY BE AN OPTION AT AN ADDITIONAL COST TO
SW INEZ ST a FIRST! THE CUSTOMER
L] RO 'PROP LINE
14505 Z cm
D.
I-IB Lu-Orl 9100
74500 90BD ANY DEVIATION FROM THIS DESIGN MUST
BE APPROVED BY PGE PROJECT MANAGER
RIGHT-OF-WAY PERMIT NOTICE
A PERMIT FROM THE LOCAL JURISDICTION IS REQUIRED BEFORE ANY
WORK IN THE RIGHT-OF-WAY MAY BE PERFORMED. ONLY PGE APPROVED
CONTRACTORS AND CONTRACTORS WHO HAVE MADE OTHER SPECIAL
AGREEMENTS WITH PGE WILL BE ALLOWED TO WORK UNDER PGE'S PERMIT. PGE CONSTRUCTION DRAWING
THE CONTRACTOR MUST NOTIFY THE LOCAL JURISDICTION 48 HOURS
BEFORE WORK IS TO BEGIN.A COPY OF THE PERMIT MUST BE ON SITE AS-BUILT VERIFICATION & NESC VIOLATIONS CORRECTED
\\'' I This document accurately represents FIELD Construction.
1—, /r �v d �• X41 __ Foreman: Date:
�I /, d -- General Foreman: Date:
ai' W. • , _ jl (Signature only required for field construction changes.)
r , D � q SDPM ENG REVIEW: IASBUILT BY DESIGNER:
t
1: L--1 �� DATE. y7y74 SCALE. 1':100' 'ACCOUNT- 1070001 IAwo 0000014628 IJOe No 746535
. ( TITLE
/ �,�" .1..r.____ REPLACE BO UG PRIMARY CABLE
_ ` CIRCUIT SIZE
C4,t- DURHAM-SAT TIER 71577
.-1?,_... I . PGE/ LOCATION
J JOB `I E L ATTENTION' CALL 877 BEFORE YOU DIG 9755 SW VIEW TERRACE,TIGARD
_ .' OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED ` DESCRIPTION
__- , • BY S THE OREGON UTILITY FORTH NOTIFICATION CENTER. REPLACE 80 UG PRIMARY CABLE
THOSE RULES ARE SET FORTH IN OAR 952-001-0010
COUNTY CTION(S) WORK WITH SHEET
l^ t THROUGH 952-001-0090.YOU MAY LITIU COPIES OF BEAVFRTON WASHINGTON C21-11A 1 OF r
M 2 D THE RULES BY ULUNG THE OREGON Lamm,
N
NOTIFICATION CIDER ADMINISTRATION® (50J-73Z-MAT) UNf CREW CENTER DESIGN BY PHONE(425) DRAWN BY
nloMU cAJnE TO REQUEST UTILITY LOCATES CALL THE OREGON KIRSW y(gYs below. »q SW IWO Dt HASSAN AMAN 320-0379 I K MIERAS
L UTILITY NOTIFICATION CENTER,871 AT LEAST RRAYRTOH.OR RIBIA
655-E6 VICINITY MAP 1 BUSINESS DAYS PRIOR TO EXCAVATION. Call before you dig. O PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED