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PFI2014-00117 zq CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12014-00117 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 12/22/2014 Parcel: SEG2468 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Electric Lightwave Project Description: Adjacent to 15865 SW 74th Ave.,directional bore and place 56'new 2"HDPE conduit crossing SW 74th Ave. at described address. Conduit with fiber optic cable to be minimum 36"depth (top of pipe). SEG2468. Owner: FEES Description Date Amount PHONE: PFI Permit Fee 12/22/2014 $300.00 Contractor: PHONE: FAX: Applicant: BRIAN DAVIDSON 18110 SE 34TH ST., BUILDING ONE, SUITE 100 VANCOUVER,WA 98683 PHONE: 360-558-4215 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: ',4_ �_/) Issued By: 14,014W, Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12014-00117 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 Kenny Fisher at 503-816-6146 or email at kenny@tigard-or.gov 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 I RECEIVE® NOV 2 0 2014 R City of Tigard CITY OF TIGARD NGINEEAING Public Facility Improvement (PF1 'ermit tio-hfrecl General Information: FOR STAFF USE ONLY r 15865 SW 74M AV9. g Property Address/Location(s): En neerin � _M117 Case No.• 00 Receipt No.: Date:12, 3, *Applicant's Name: G(6CM/C. 0G14 I wfiye 1 LSC• Application Accepted By: I Z Address: 12HO SE 34ryST , MUNdC7 ONE S(Jl X w Revised 7/1/10 City/state: A zip: g8683 Primary Contact: IM 1f3� ��D�� REQUIRED SUBMITTAL Phone: (3b0) S5$` '�'Z!S Fax: (360) 559-IV 700 FINFORMATION Professional Engineered Plans are required kz Contractors Name S714nlDAi20 t�77U7�1 Conl1'RAG7�fLS' ■ Street Widening CCB# bb9q8 Expiration: • Subdivision Infrastructure Address: 12-024 i511t'0V " NC • Main utility line extension: City/State: AU202ffi 02 Zip: 0 Storm Drain,Sanitary—Tigard 0 Water—Tigard Water Service Area Phone: (5-03) 55 9 - (5_o3) 678-Z721 (includes Durham,Icing city and a portion of unincorporated Washington County) Plans By: EL,45-CIV-1C- U6AT WH✓E , LLC "Note:See Engineered Plan Address: SAm e- Submittal Checklist attached. City/State: Zip: For all other work Submit scaled sketch of the Phone: Fax: " work to be done.(see attached minimum sketeb requirements and provided sketch area). Description of work: D/ EC:nD/Jl�L BD12LyL' � �7�i Ixurpin\muter\land use application\PFI app.doa Ntw 2" HDPE GonIDU1T G2oS5WC7 5tJ 74/vi 4VE. 4-r DtSC_R-+66-0 ,4�,0&_&S . C,WbU!T w/ F.O. C*bg ID 6-� 1ti'W, 3(," DlwrH - 1"�toP or PW Pe) Estimated value of work(within the public right-of-way): $ /68D- Is work related to a LAND-USE DECISION? YES ❑ NO If so,please specify(MLP,SDR,SUB,etc.) case#: Is the work related to a BUILDING PERMIT? YES❑ NO X If so,please specify (BUILDING PERMIT)case #: *NOTE:Person specified as"Applicant'shall be designated"Permittee"and shall provide financial assurance for the work. City of Tigard 1 13125 SW Hall Blvd.,Tigard,OR 97223 1 503-718-2464 1 www.dptd-or.gov I Page I of 4 CONSTRUCTION NOTES: i I I I ROAD PROFILE VIEW Facilities shown on this plan were obtained from records, visual surface inspection,and/or information obtained from i I I I SW 74th Ave. other utilities.Some facilities may be omitted,or shown at an incorrect location. Facilities shown are in assumed locations based on all information received,but exact locations must be II verified prior to start of construction. 2 - NEW 2"Riser on PGE j I I I I I pole#2998 Aerial facilities are to be bonded&grounded at all accessable PARKING II t NEW 17"X30" locations,with cable tags placed at each attachment. Inc I I I I I HH ON PRIV. 3 $ NEW 2" CONDUIT & F.O. PROPERTY SIDEWALK All aerial attachments are to be street-side unless otherwise IW I I I RAILROAD CABLE - 36" MIN. DEPTH noted.(FS)indicates"Field side". IA I N ;. , Primary method of conduit placement will be by Directional NEW 17"X30" HH ON PRIV. I I I I I 36 Min.pep ,k boring.Typical minimum conduit depth to be 36", however, u„ _ druing construction,depth may be adjusted deeper to avoid PROPERTY I T T T I I Row other existing utilities. j All materials,methods of placement,and restoration must RECEIVEPmeet the requirements of the City of Tigard. Contractor to contact Utility Notification Center prior to start of PGE C21-12D P.#2998 NOV 20 2014 work. /-800-424-5555 or 811. 85' - 2, X75 ,� CITY OF TIGARD _• =a —; � ELI HOA @ 2010 CITY OF to pothole all utility crossings prior to 0 � PL. NEWS RISER ON EXIST. excavation/drilling. PLAN I I I I 2 CATV BRKTS. Maintain minimum 1'vertical seperation from water,sanitary I I I and storm lines. I I Driveway to " I j U) 15865 SW 74th r j 0 _; I Ave.° — -t• I I r ► I l i i � o j I NOR"hH PLANTER I CITY P MIT PLAN Y I -I W � I -I ELECTRIC � Int rai.�HrwAVF I PARKINGI I 18110 SE 34th SL (360)558-6900 CORP.OFFICE Building One, 98100 WAA 98 Vancouver. 683 � �� I I kE;, ,,.�,Pr,,,,, E, D"E ,� Windstream-UNI-Cognex-15865 SW 74th Ave,Tigard,OR "I�`/—JII'/ � SHEET NC. 1 Or 1 I 1 ENC4NEER Brian Davidson ,„SNE (360)5584215 r J DATE 11/19/14 10 (360)5584703 PRWECTNO C20503.OSP.14.NQ.12JM.SUC FlE H4AE: S::nLL 20, 12D 90C r 71' D 1 SS 12D 027---y— r i I `i CL k 0 ` i � ■ 15776 ' f� oD a "'' r p � Q r 1 r � r 12 092C I SS12DO29 12 DO81 8 ' DIP SS120028 55 12DQ9 ]2D093C 12D0O 1 OQ169 F e,.. ±•moi J � �