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PFI2015-00035 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12015-00035 13125 SW Hall Blvd..Tigard OR 97223 503.718.2421 Date Issued: 04/01/2015 Parcel: SEG775 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Comcast Project Description: Adjacent to 7295 SW Dartmouth St.,trench and place(1)2"conduit a min.of 36"below grade. SEG775. Owner: FEES Description Date Amount PHONE: Contractor: TEXSTAR ENTERPRISES 14122 ARNDT RD. AURORA, OR 97002 PHONE: 503-776-5049 FAX: Applicant: KEN PARRIS 11308 SW 68TH PKWY. TIGARD, OR 97223 PHONE: 971-801-5699 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 Signature: _ (�a�1LL�i �/� -- Issued By: r Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12015-00035 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 City of Tigard Application For Work In The Right-Of-Way ROW Permit Property Address/Location(s):7295 SW Dartmouth St. Tigard, OR 97223 FOR STAFF USE ONLY Right-of-Wa �t 1 �O Case No. *Applicant's Name:Comcast Application Accepted: ?J �J V By: Address: 11308 SW 68th Pkwy. Application Reviewed: V_ By: City/State:Tigard, OR Zip:97223 Application Fee Due: "19- Primary Contact:Ken Parris Applicant Notified: 'l" Phone:(971)801-5699 Fax: Receipt No.: Email:Kenneth_Parris@cable.comcast.com REQUIRED SUBMITTAL INFORMATION Contractor's Name:Texstar Enterprises • Application form,completed and signed 178798 10/10/2015 • Submit one (1) copy of scaled sketch of CCB# Expiration: the proposed work to be done Address: 14122 Arndt Rd City/State:Aurora, OR Z • Submit one (1) copy of traffic control Z-97002 p: plan Phone:(503)776-5049 Fax:(503)776-5050 Professional Engineered Plans are required Email:limminer@texstarenterprises.com for: • Street Widening Plans By:K&B Technical Solution • Subdivision Infrastructure Address: 6566 SE Lake Rd Suite F • Main utility line extension Milwaukie 97222 Deliver application to ro ermitsaa tiord-or.gov or to City/State: Zip: City of Tigard Planning/Engineering,13125 SW Hall Phone:(503)650-6041 Fax:(503)650-7390 Blvd.Tigard,OR 97223. Email:KJ_Sprecher@kbmail.net Rev.12/10/2013 1ACURP1.N\Masters\Land Use Appi--ions\Right-of-w•ay Permit Apphcation.docx Description of work:Comcast proposes to trench and place (1)-2"conduit a min of 36" below grade with in the City of Tigard ROW. Estimated value of work(within the public right-of-way): $1000.00 Is work related to a LAND-USE DECISION? YES ❑ NO X❑ If so, please specify(MLP,SDR,SUB,etc.)case#: Is the work related to a BUILDING PERMIT? YES ❑ NOFX If so, please specify(BUILDING PERMIT)case#: Signature of Applicant/Permittee: Date:3/20/2015 Print Name:KJ Sprecher Title:Coax Ext/Node Seg Manager City of Tigard 1 13125 SW Hall Blvd.,Tigard,OR 97223 1 503-718-2464 1 www.tigard-or.gov CONSTRUCTION NOTES: N I{ 1. ALL WORK AREAS TO BE 1 I RESTORED TO LIKE OR BETTER 56' CONDITION. w E ; 2. ALL OTHER UTILITIES ARE BASED 12' - - r 32' N 12' OFF EXISTING LOCATES OR UTILITY STRUCTURES. s Q ` ` 3. IT IS THE CONSTRUCTION 0 0 I0 0 0 CONTRACTORS RESPONSIBILITY N I` 7175 TO CALL FOR LOCATES BEFORE \ DIGGING. C/) t 4. TRENCH - t \ ROW 11' 11626 ,1 `\�� �,. Contact: Ken Parris ` EOP— Title: Construction Technician 3 Mobile: (971)801-5699 Office: (503) 596-3811 Email: Kenneth_Parris@cable.comcast.com 24' 45' - - SW BAYLOR ST _ 8' FROM ROWa comcst, 16' FROM SEWERC! 13' 30/NT �� 11308 SW 68th Parkway *80�� , &25' E I Tigard, OR 97223 8 — ix TRENCH AND PLACE (1)2"CONDUIT — J & PO BOX 2529 97015 A MIN OF 36" BELOW GRADE ,� i Design By:K&B(503)650-6041 R&R 6'x6' FLAG OF SIDEWALK / i Email:KJ_Sprecher@kbmall.rlet SITE ADDRESS: 7295 SW Dartmouth St Tigard, OR 97223 1 S M36 I REV. DATE DESCRIPTION APPROVED i 1 03119/15 CITY OF TIGARD PERMIT DRAWING KJS 11680 SCALE: PROJECT NUMBER: 1"=15' 42613 SHEET NUMBER TITLE: x\ ATTENTION Oregon,ra requeas you to plow tieeadoptedbytheOregonUldnyN,�«p, COAX ENHANCEMENT Center Those rules are at forth o OM ftf- PERMIT D RAW I N G \� I 001-0010 through 952-001.0080 You may OOrt �. CApNa of the ndes by CaAnp the Cants 114101r.tM ISlepnone numbor for the Oregon Utility FILE NAME: j 1JotifxatlonCenterisl50372D2- -811. SHEET CMEX-4431-3237 — — _ -- — 1 1 Page 78 2011 Edition Work on Shoulder Diagram 210 Diagram 210 covers stationary work with work or parked equipment on the shoulder. This diagram does not cover work on a freeway shoulder. See Diagram 710 for Freeway Shoulder work. 1. Vehicles should be parked as far off the roadway as practical. 2. Use truck-mounted flashing warning lights on work and protection vehicles. See Section 4.3—Lights and Lighted Signs for exceptions. 3. For added visibility, truck-mounted arrow boards or PCMS in caution mode may be used. 4. Arrow panels in caution mode are recommended for work on roads with posted speeds of 45 mph or greater and high traffic volumes, greater than 2000 average daily traffic(ADT). 5. Requirements for signing and devices are shown in Table 5-2, below. Table 5-2: Device and Signage Guidelines Proximity to Edge of Traveled Way More than 15 feet or behind Barrier or Less than 15 feet Guardrail One advance warning sign is Advance warning required and two signs are Work in Place signs, devices, and recommended. More than 1 Hour flashing warning Cone taper is required. Cones lights are optional. along the edge of traveled way are optional. Work in Place Advance warning signs and devices are optional. Less than 1 Hour Sign Spacing and Buffer Lengths (feet) Posted Spacin Between Signs Buffer Speed A B C Space 20 50 25 100 100 100 75 30 100 35 40 350 350 350 125 150 45 180 50 500 500 500210 55 250 Chapter 5 December 2011 2011 Edition Page 79 Work on Shoulder Diagram 210 1t (Optional) ` Protection Vehicle w/TMA(both Optional) See Chapter 4 • Buffer • • • • U3 • A ROAD SHOULDER WORK ORWORK AHEAD AHEAD Initial Warning Sign t *Use as appropriate-see Table 5-2 December 2011 Chapter 5