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PFI2014-00078 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12014-00078 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 09/23/2014 Parcel: SEG573 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Portland General Electric Project Description: Adjacent to 8530 SW Pfaffle St.,replace overloaded overhead transformer. SEG573 Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: RON SLATTERY 2133 SW 153RD DR. BEAVERTON, OR 97006 PHONE: 503-672-5471 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 y Signature: OL 1 COL+)PPn�T f eStXI J Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12014-00078 Type: Condition Name: Status: Severity: ROW 01-CUSTOM CONDITION Not Met Notice No street cuts are permitted. ROW 02-PERMIT&PLAN REQ ON SITE Not Met 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) Not Met 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 Not Met 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 Qob 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 Not Met 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 Not Met 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 09-TRAF/NOISE CTRL-WORK HRS Not Met 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 07-TRAF CTRL-PRIV PROP ACCESS Not Met 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 Not Met Notice Traffic control devices,flagpersons,etc., shall be in place prior to initiation of construction work and shall be effectively maintained. ROW 10-TRAF CTRL-MIN LANE WIDTH Not Met Notice Minimum travel lane width shall be eleven(11)feet; pedestrian travel shall also be provided for. ROW 11-TRAF CTRL-CITY CAN MODIFY Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met Notice Existing monuments, property corners, and survey markers shall be protected. Replacement shall be at the permit holders expense. ROW 29-ESMT/RT OF ENTRY-RESPON Not Met 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. ROW 27-PROB SOLVING-RESPON PARTY Not Met 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 Not Met 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. RECEIVED City of Tigard SEP 18 2014 Public Facihty Improvement CITY OF TIGARD `�' P PLANNING/ENGINEERING (PFI) Permit General Information: FOR STAFF USE ONLY Property \_A1dddr�ess/Loca/t�iony(Is):B' Si" E . Engineerit>�FIZo`y �` hL `V[. `T U- l SCV 3 Case No.: _ • Fee: - b (�_ rr� Receipt No.: R O - *Applicant's 2Name. OY'A turd C- Q nQ r� � OY-r j i 1�D� Date:9 q Address: �� .).l S�� ���Qi1 d Jf IUB Application Accepted: ` By: City/State:� `;VVQ-Y^(�1c1 4Q Zim C\-1 ij Primary Contact: REQUIRED SUBMITTAL U E_ INFORMATION Phone: b4_71 Fax: `JU 3 ' LD IZ.LD I ci-b E-Mail: ID1 . ����rt Q� ��Uff1 Professional Engineered Plans are rcquircd for: Contractor's Name: 'y i �P • Street Widening • Subdivision Infrastructure CC_B# Expiration: • Alain utility line extension: 0 Storm Drain,Sanitary-Tigard Address: 0 Watcr-Tigard Water Service Area City/State: Zip: (includes Durham,King City and a portion of unincorporated Washington Phone: Fax: County) "Note:See Engineered Plan Plans By: C1 1J Q51 C Submittal Checklist attached. Address: YYIt QS (N_bc),1e Wl[ fQSS For all other work:Submit scaled sketch of the City/State: 'Lip: work to be done.(see attached minimum sketch Phone: Fax: requirements and provided sketch area). Updated 6/24/2013 L\CURPLN\M16uicn\Land Use Applicami \Public Fanlity Description of work.- 4 L L C)J Q Y 1W d Pd Imptu�ement dcxs y v er hind -�MMAR.mer, Estimated value of work(within the public right-of-way): $ Is work related to a LAND-USE DECISION? YES F NO If so,please specify(MLP,SDR,SUB,etc.)case#: Is the work related to a BUILDING PERMIT? YES❑ NO If so,please specify (BUILDING PERMIT)case#: City of Tigard 1 1..3,125 SXR/Hall Blvd.,Tigard,OR 97223 1 503-718-2464 1 www.tigard-or.gov I Page 1 of 5 APPLI CANT'S: To consider an application complete,you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS as described on the front of this application in the"Required Submittal Elements"box. NOTE: Person specified as"Applicane'shall be designated"Permittee"and shall provide financial assurance for work. *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 on the back of this form or submit a written authorization with this application (Detailed Submittal Requirement Information sheets can be obtained,upon request,for all types of Land Use Applications.) BY SIGNING BELOW,THE APPLICANT(S)SHALL CERTIFY THAT: • The above request does not violate any deed restrictions that may be attached to or imposed upon the subject property. ♦ 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 the 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. SIGNATURES of each owner of the subject property. DATED this ' T�fY l day of 1 120 14 Applicant/Authorized Agent's Signature Owner's Signature Owner's Signature Owner's Signature City of Tigard 1 13125 SAY/Hall Blvd.,Tigard,OR 97223 1 503-718-2464 1 -,vww.tigard-or.gov I Page 2 of S DEVELOPMENT ENGINEERING FEES 1. Public Facility Improvement(PFI)Permit: Part 1: All non-water system improvements Engineer's estimate X 5%(less$300.00 submittal fee) Rngineer's estimate X 2%Plan Review Part 2: All public water system improvements Engineer's estimate X 12% Total Permit Fee=Part 1+Part 2 PFI Permit Fee Exemptions: There will be no permit fee charged,or assurance required for the following types of work: • Sidewalk or driveway repair(less than 20 lineal feet) • Relocate or replace mailbox • Ditch cleaning that does not involve regrading. • Weephole repair • Curb repair or replacement(less than 20 lineal feet) • Lawn sprinkler system installation or repair • Street tree pruning or planting • Planter strip landscape maintenance • Test wells 2. Addressing Fee: The fee for this service is$50.00 per address. SAMPLE Minimum Sketch Requirements North Arrow Property Lines&Dimension 4 Slope of Property Street&Street Name(s) Existing Building,Structures 4 Utility& Street Light Poles Proposed Work Existing Curb or Edge of Pavement 4 Trees Existing S/W or D/W Apron Existing Utility Locations(sewer,water,storm) City of Tigard 1 13125 SW Hall Blvd.,Tigard,OR 97223 1 503-718-2464 1 www.tigard-or.gov I Page 3 of 5 SAMPLE SKETCH: Edge of Pavement I +— Ditch —� Streetlight I •—•—•—•—•---•—•—r—•— I /• a Rata Drax► 1 I 4 ! r Trx 0--*, a I I I I I ►�. I Existing House IExM n �„g I g �. I �t • Driveway Iul cis I C I • . CL i JA rl 1 al � I I vim' 1 bj I Existing Shop t Powerpole I I = 1 m I a 95' I -------- ropertyLine---------- � I I I Fire ir Hydrant(FH) � � I I Scale: 1"=30' I I � I I I j 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 of Pavement Trees Existing S/W or D/W Apron Existing Utility Locations(sewer,water,storm) Cityof Tigard 1 13125 SW Hall Blvd.,Tigard,OR 97223 1 503-718-2464 1 www.tigard-or.gov I Page 4 of S SKETCH AREA: City of Tigard 13125 SW Hall Blvd.,Tigard,OR 97223 503-718-2464 www.tigard-or.gov Page 5 of 5 i i �'05926 11220 044 1124E a 200 2C 1.11-45 05945 O I -2 AL- 1124501! 44 o� i 9 PO ooaaz P�0 44 1125E WR CHECKLIST i LQ5 I 1 1259 I PD 0003e (TEM YES COMMENT HOIfDIGGER 8485 11262 loom X l 1-6 AL 7 BACKHOE j I PGE TRM -.42 11312 42- PC) 180 1 /B-2 AL-OB F6 T 8465 N -- - - � srr ;�;� I 01542- P 5139 m LOCATIS I Pq saUI AC- 00000 0545, 1- 42 1 PC00073 01545; y STAIM B-2 A G4 CU L05i a0 6T v i Pe��(>G RAW46 I 54 00043 1 � �01-20 0e540 9P Srr,. \ 1-4 �Ju I •9B9-a5 LANDSCAPE J---–-–-– – – - x-- - PFAFFLE ST ----- — –1--��--- – ---- -- - i�eray x Q � E:SEhtE1JT GTrar,�ery 1 I IM PEWS \ J -142 �' W PfafflGe• TRAFFIC PLMI ABC-2/0 CU I Q F 100T C � N 8888 1-2 L-r X �`� 7 e CUISHEEi N-4 = PL05925 !1221 I a1U TX 40 1961-30 ,, � \\ ; UD C1R.VER. 43597-94 ooa y Sabres atis. / a Ikgal Togwd 11 Corm. TRANSMISSION a Cid 41�i o sw"V V 5. SHODOwN \ �1 8 O 1-2/0 AL-7X r''� rOinCa Beds� f CUSTOMER X �o C 16 41917 11 SHUTDOWNF \ i m \ \ 8400 .coaoo?� >�k DOM Ha+cEll \ I \ 2-350 Tx '� r� Syu,,,z CONTACT COWM Y \ _ \ \ 8470 350 TX PH# Of N DATE TIME 1` 1-142 j \ F6T j . �'I j\• C 76 11 j \ CALL 811 BEFORE YOU DIG 3-142 \ PD 0 32 OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED F40T \ BY PLN302 06507 \ \ OF THOSE E ORES ARE SET FORTH TIN OTAR 952-0 CENTER. -MIO , PL00302 ��\• \ THROUGH 952-001-0090.YOU MAY OBTAIN COPIES OF a 00302 \ \,\ 350 TX NOTIFICATION CENTHE RULES BY TER ADMINISTRATION Q UTILITYING THE OREGON (503-232-1987) 2000-50 \ 2-350 T a I 019990340 . \ To REQUEST UTILITY LOCATES CALL THE OREGON VT 01099 Know whaYs below. UTILITY NOTIFICATION CENTER 811 AT LEAST 2 BUSINESS DAYS PRIOR TO EXCAVATION. fall before you dig. V,\ \\ PGE CONSTRUCTION DRAWING 00053 I 499-35 �.\ \ \• C-2 AL SDP/WENG REVIEW: JASBUILT BY DESIGNER: AS—BUILT VERIFICATION & NESC VIOLATIONS CORRECTED This document accurately represents FIELD construction. Foreman: Date: GF: Date: DATE: 9�g/2014 SLICE: WA ACCOUNT: 1070001 AWO= 1000002846 JOB NO. 774111 T"" Transformer Replacement aRculr West Portland-North slzE REPLACE 33 583 WITH 7200V / 1 1x17SO C 12C1240V PGE LOCATION 8530 SW Pfaffle St IPH, 3W DESCRIPTION Replace overloaded overhead Transformer Peak. 9 5 KW NG F uSe ke'red COUNTY SECTION(S) WORK WITH SHEET BEAVERTON Washington C 17-350 I OF) I LINE CREW CENTER DESIGN BY PHONE (503) VIRAWN BY VAI h 2213 SW 153RD DR CarterLassetter 503-672-5492 /1, BEAVERTON,OR 97006 0 PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RE64VED