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PFI2015-00070 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT = COMMUNITY DEVELOPMENT Permit#: PF12015-00070 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 06/03/2015 Parcel: SEG952 Jurisdiction: Site address: Subdivision: Lot: Project: PGE Project Description: Adjacent to 9369 SW Tigard St 100A 1 PH Commercial service for Comm Cabinet Astound-Wave Broadband. Owner: FEES Description Date Amount PFI Permit Fee 06/03/2015 $300.00 PHONE: Contractor: PHONE: FAX: Applicant: HAP ENGLISH 10800 SW AVERY ST TUALATIN, OR 97062 PHONE: 503-672-5489 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: Gl,pp�j GCLA e,-q Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12015-00070 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(Tn-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 503.816.6146(cell),503.718.2602(office),or 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_Utildies 21 -OTHER Applied Notice RECEIVED City of Tigard MAY 2 g 2015 ■ PGE WORK ORDER 9 M 1578130 PUBLIC WORKS — ENGINEERING CITY p-I IGMD Public Facility Improv 'ffG(M Permit DESCRIPTION OF WORK(in the right-of-way) REQUIRED SUBMITTAL Check one: N Utilities ❑ Sidewalk/driveway approach ❑ Street improvements ELEMENTS Detailed description: 100A 1 PH Commercial service for Comm Cabinet ❑ Minor work in right-of-way Astound-Wave Broadband (sidewalk repair,curb cut,street opening,etc.)requires: •Application form,completed and signed •Submit one(1)copy of scaled sketch Property address/location(s): 9369 SW Tigard St,Tigard 9S of the proposed work to be done •Submit one(1)copy of traffic control plan OR— Applicant's name: Laura Taylor for Hap English ❑ Substantial project work requires PP above items and professional Address: 10800 SW Avery St engineered plans for: Tualatin, OR 97062 •Street widening Ci /state: Zip: •Subdivision infrastructure Phone: 503-672-5489 Email: TBDSupportAvery@PGN.com -Main utility line extension: - Storm Drain,Sanitary-Tigard - Water-Tigard Water Service Contractor's name: NSA Area(includes Durham,King City and a portion of unincorporated CCB#: Expiration: Washington County) Address: City/state: Zip: DELIVER APPLICATION TO: City of Tigard Phone: Email: Planning/Engineering 13125 SW Hall Blvd. Engineer Tiand s name: N/A Tigard,OR 97223 Applications for"minor work in right-of-may" Address: only may be emailed to: City/state: Zip: �permlte up�v Phone: Email: Estimated value of work (within the public right-of-way): $4411.27 Case No.: Application submittal fee: �0 Is work related to a LAND-USE DECISION? ❑ Yes N No Applicatio accepted: If so,please specify (NfLP, SDR, SUB, etc.) case #: By:� Date: So�� Is work related to a BUILDING PERMIT? El Yes reviewed:Yes R No `s— By ate: If so,please specify(BUILDING PERMIT)case#: Applicant notified: By:-dam Date: 1:\CURPLN\Masten\Lend Ute Applkatlom Rev.07/16/2011 City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 - www.tigard-or.gov 503-718-2421 - Page 1 of 4 APPLICANTS NOTE: Person specified as`Applicant"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 or submit a written authorization with this application. 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 goon the subject propcm;. • 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 required. Laura Taylor Laura Taylor for Hap English 05/28/2015 Applicant/Authorized Agent's signature Print name Date Owner's signature Print name Date Owner's signature Print name Date Owners signature Print name Date PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-715-2421 • Page 2 of 4 LOAD SUMMARY 142 00 F6T COMMERCIAL LEGEND LOAD TYPE CONNECT DEMAND EST. KW FACTORSDEMAND INSTALL 7200V COOKING D 0.30 D A/� NEW PGE FACILITIES TO BE INSTALLED LIGHTING 0.3 0.90 0.77 OH �Jr I`►RJ 12Q240V \ RECEPTACLES 1.2 0.10 0.12 1PH, 3W \ (UNLESS OTHERWISE SPECIFIED) WATER HEATING 0 0.20 0 _ _ _ _ _ _ _ . INSTALL 1-#2 AL-TX OH SECONDARY ELECTRIC HEAT 1 0.75 0.75 AIR CONDITIONING 2.4 0.75 1.8 00679 EXISTING MESSENGER GUYING OK REFRIGERATION 0 0.75 0 1958-4 MOTORS 0.75 0.50 .375 ABC-336 AAC -2 AL-DB \ - - - - - - - • INSTALL 1-YD AL-TX SECONDARY IN 1-3"PVC CONDUIT COMPUTERS o 0.67 D THINK PROVIDED & INSTALLED BY CUSTOMER 26 WELDERS 0 0.10 D A 15 1 -1 4 3 ELEVATORS o 0.10 D t-25T SAFETY MiRIGATION o 0.75 o S� 2.6KW EST DEMA PL00679 FIRST! MISCELLANEOUS 0 0.50 0 T jC9'Q 190385 CONSTRUCTION NOTES: cMDEv TOTAL EST CONNECTED 4.65 TOTAL EST DEMAND T.565 ST 15 KV A -795 PORTR AND WR CHECKLIST ' CUSTOMER IS RESPONSIBLE FOR ALL TRENCH,CONDUIT,VAULTS,PADS AND ROAD CROSSINGS. ST ITEM YES COMMENT 2. ALL CONDUIT TO BE INSTALLED WITH 30 INCHES (MIN)COVER AT TOP OF CONDUIT Road Side 7A^ Spell PROGRESS FROM FINAL GRADE. ~-Typical \ HOLEDIGGER 3. ALL PGE CONDUCTORS TO BE INSTALLED IN GRAY,SCHEDULE 40,ELECTRICAL GRADE, \ PVC CONDUIT WITH NYLON PULL STRINGS MIN.500 LBS.TEST).PGE TO DETERMINE LEGEND \ BOOM THE 51ZE AND NUMBER OF CONDUITS REQUIRED.MAINTAIN 12 VERTICAL INCHES AND 24 HORIZONTAL INCHES CLEARANCE BETWEEN GAS AND OTHER UTILITIES.ALL ELBOWS 3„ C. PGE P te,/ \ BACKHOE 4 INCH & SMALLER TO BE 36 INCH RADIUS.ALL BENDS MUST BE FACTORY MADE. Min Secondary Cable \ ALL ELBOWS LARGER THAN 4 INCH TO BE 60 INCH RADIUS.RIGID STEEL OR PGE 36 Cover PGE TRENCH APPROVED.FIBERGLASS BENDS ARE REQUIRED FOR RUNS OF 151 FEET OR LONGER Min Inside O"cl \ OR FOR ANY LENGTH RUN WITH MORE THAN 180 DEGREES IN BENDS.PVC SCHEDULE Trench p Telco/CATV \ 40 BENDS ARE ACCEPTABLE FOR RUNS OF 150 FEET OR LESS.THE MAXIMUM TOTAL \ \ BENDS IN ANY CONDUIT RUN IS 270 DEGREES. ID" ®Backfill \ LOCATES 4. DIRECTIONAL BORING REQUIREMENTS:BLACK HDPE (HIGH DENSITY POLYETHYLENE)DUCT Select Backfill OR SCHEDULE 40 PVC WITH A MECHANICAL CONNECTION (CERTAAOK OR LIKE MECHANICAL 180' \ STAKING CONNECTION PRODUCT)AS AN ALTERNATIVE TO HDPE DUCT.HDPE SHALL MEET THE REQUIREMENTS OF PGE SPECIFICATION LC20575 (AVAILABLE ON REQUEST FROM PGE PROJECT 12" Min U•diourbed FLAGGING MANAGER).FOR SAFETY REASONS THE DUCT SHALL BE BLACK WITH THREE EQUALLY SPACE Earth 04450 00331 EXTRUDED RED STRIPES (WHICH IS A SPECIFICATION REQUIREMENT).MANDREL TEST OF y970'60 1941 _1 10 TREETRIM HDPE PIPE IS REQUIRED AFTER INSTALLATION WITH PGE INSPECTOR PRESENT Joie)Uee Trench WA Gm '� LANDSCAPE S. ALL PGE TRANSFORMERS TO BE (NAND 4 8 FEET IM (MIN)FROM ANY COMBUSTIBLE O � � BUILDING,WALL OR OVERHANG AND 4 FEET/AYN)FROM ANY FIRE HYDRANT. �7 PGE TRANSFORMERS MUST BE WITHIN 15 FEET OF A DRIVEABLE AREA. APC'-7 EASEMENT ALWAYS MAINTAIN 10 FEET CLEARANCE IN FRONT OF ALL TRANSFORMERS. N-336 A AAC 0 O PERMITS GOT 6. TRANSFORMER PADS ARE TO BE SET SO THAT THE TOP IS 2 INCHES ABOVE O FINAL GRADE.CONDUIT IS TO BE INSTALLED IN PAD AS INDICATED IN DETAIL TRAFFIC PLAN AND TO EXTEND 1 INCH ABOVE THE PAD. 00047 CUTSHEET 7. STEEL BARRIER POSTS ARE REQUIRED AROUND TRANSFORMERS THAT ARE EXPOSED TO VEHICLES. 1 998-25 UG CIR.VER, B. ALL SWITCH VAULTS TO BE SET AT FINAL GRADE WITH 6 INCH GRAVEL BASE AND TRANSMISSION CONDUITS ALIGNED TO ENTER THE VAULT END LOWER KNOCKOUTS (TERM-A-DUICTS). SHUTDOWN (SEE DETAILS ON SKETCH) V/ \\ B 25 26790 CUSTOMER 9. PGE To BE NOTIFIED AND WSPECT ALL CONDUIT,VAULT AND PAD INSTALLATIONS � PL-331 y �1.` 240SHUTDOWN BEFORE BACKFILL- ALL NEW VAULT& PAD LOCATIONS TO BE FIELD VERIFIED ��yy a / 50 28651 100AMP WITH PGE AND CUSTOMER REPRESENTATIVE DOOR HANGER SAFET SOCKET 10. REFER i0 PGE ELECTRICAL SERVICE REQUIREMENTS BOOK FOR FURTHER DETNLS B " PPL 2.6%VD CONTACT & SPECIFIC REQUIREMENTS.LINK TO WWWvnRYlaunr-cucou rnnwFnnnnr �` �ohPPG 2,060A AFC COMPANY n. DESIGN IS BASED ON STANDARD UNDERGROUND EQUIPMENT.NON-STANDARD UNDERGROUND EQUIPMENT MAY BE AN OPTION AT AN ADDITIONAL COST TO 3" THE CUSTOMER. CONDUIT ��\ A�/� I� Cit PHS C 12, THE POINT OF DELIVERY AND DIVISION OF OWNERSHIP BETWEEN THE CUSTOMER AND DATE TIME PGE WILL BE AT THE LINE SIDE OF THE NEW CUSTOMER PROVIDED SWITCH GEAR. PGE CONSTRUCTION DRAWING INSTALL 3" POLE CONDUIT UNIT AS-BUILT VERIFICATION & NESC VIOLATIONS CORRECTED W/12" BRACKETS & WEATHERHEAD 01661 \, This document accurately represents FIELD Construction. -85 Foreman: Date: m�. General Foreman: Date: S 9�F Signature only required for field construction changes. p� fro CONTACT GENERAL FOREMAN SDPMTENG REVIEW: ASBUILT BY DESIGNER: I �� J. AND'OR CONDUIT INSPECTOR 7 TO 10 WORKING DAYS PRIOR DATE SCALE: ACCOUNT: AWO: JOB NO. ti� �G TO EXCAVATION. CONDUIT INSPECTION REQUIRED PRIOR TO BACKFILL 4.27.2015 1"=60' 1070001 1000004599 M1578130 Ci,9 9� PGE WILL NOT INSTALL WIRE UNTIL TRENCH IS 100% BACKFILLED. TITLE 9l ERIC BIEREN ASTOUND - WAVE BROADBAND �� Q • ry GENERAL FOREMAN ` CIRCUIT SIZE ,y�1 CELL:503-849-7996 /PG TIGARD - 13361 11x17 0 > CALL 811 BEFORE YOU DIG LOCATION y m rrENnoN: 0 ` 9369 SW TIGARD ST OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED J DESCRIPTION BY THE OREGON UTILITY NOTIFICATION CENTER. , /✓ T ��F SC,O ? THOSE RULES ARE SET FORTH IN OAR 952-001-0010 100A LPH COMMERCIAL SVC FOR COMM CABINET ICq QP 11 THROUGH 952-001-0090.YOU MAY OBTAIN COPIES OF COUNTY SECTION(S) WORK WITH SHEET q0 t # THE RULES BY CALLING THE OREGON UTILITY cn BEAVERTON WASHINGTON C21- 026 I of I �S NOTIFICATION CENTER ADMINISTRATION g (503-232-1987) LINE CREW CENTER DESIGN BY PHONE(503) DRAWN BY 106 $ ST To REQUEST UTILITY LOCATES CALL THE OREGON Know what's below. 2213 sW 153RD DR HAP ENGLISH 672-5489 LANE WHITNEYiDB �\� UTILITY NOTIFICATION CENTER,811 A7 LEAST CallBEAVERTON,OR 97006 ITY VICINMAP 2 BUSINESS DAYS PRIOR TO EXCAVATION. before you dig. 0 PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT = COMMUNITY DEVELOPMENT Permit#: PF12015-00070 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 06/03/2015 Parcel: SEG952 Jurisdiction: Site address: Subdivision: Lot: Project: PGE Project Description: Adjacent to 9369 SW Tigard St 100A 1 PH Commercial service for Comm Cabinet Astound-Wave Broadband. Owner: FEES Description Date Amount PFI Permit Fee 06/03/2015 $300.00 PHONE: Contractor: PHONE: FAX: Applicant: HAP ENGLISH 10800 SW AVERY ST TUALATIN, OR 97062 PHONE: 503-672-5489 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: Gl,pp�j GCLA e,-q Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY