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PFI2016-00201
CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12016-00201 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 10/06/2016 Parcel: SEG2404 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Comcast Project Description: Directionally boring from the CATV approx. 145'to 15995 SW Hall Blvd. The power runs diagonal so we will be adjusting the running line because the other existing primary power lines. Owner: FEES Description Date Amount PFI Permit Fee 10/06/2016 $300.00 PHONE: Contractor: PHONE FAX Applicant: KENNETH PARRIS 11308 SW 68TH PKWY TIGARD, OR 97223 PHONE: 971-801-5699 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: 6'lbQ�t�ctrvl Tom• Issued By: L ` t Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12016-00201 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. Ken Fisher 503-816-6146 or Kenny@tigard-or.gov 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 RECEIVE® City of Tigard SEP 13 2016 111 BLIC kv,70RKS— ENGINEERING CITY OF TIGARD Public Facility Improvement (MW?nit DESCRIPTION OF WORK(in the right-of-way) TYPE OF WORK Check one: Q Utility Connection © TYPE 1—Franchise Utility Work ❑ Sidewalk/driveway approach W"nrk performed by NWTI,PGE ❑ Street improvements and/or utility agency. Detailed description: Directionally boring from the CATV approx 145' ❑ TYPE 2–Sidewalk/Driveway/Sewer to the 15995 SW Hall Blvd `the power runs diangnal so we will be Work performed for the purpose of- adjusting the running line because othe existing primary power lines. • Sidewalk installation or repair. • Driveway approach installation Property address/location(s): 15995 SW Hall Blvd, Tigard OR 97224 and/or repair • Sanitary sewer lateral installation and/or main line tap ❑ TYPE 3—Full scale Development Applicant: Comcast Work performed with land use Address: 11308 SW 68th Parkway approval which includes any of the following: City/state: Tigard,OR jih: 97223 a SubdiNisions or Partitions Phone: 971.801.5699 Email: kenneth_parris@cable.comcast.com • Street widening Contact name: Ken Parris Phone: 971.801.5699 • Mainline installation for Sanitary sewer,Storm sewer,Tigard water Contractor: Fisk Communication Inc and/or Tigard Water Service Area CCI3#: 185632 Expiration: SUBMIT COMPLETED APPLICATION TO: Address: 2705 NE 65th Ave City of Tigard City/state: Vancouver,WA Zip: 98661 Planning/Engineering Phone: 360.989.7285 Email: fcckris@gmail.com&feeheidi@gmail.com 13125 SW Hall Blvd. Tigard,OR 97223 Contact name: Kris Raimer Phone: 360.989.7285 Applications for"miner work in right-of-way" only may be emailed to: Engineer: romVermits ,tigard-or.gov Address: FOR STAFF USE ONLY City/state: Zip: Phone: Email: Case No. Contact name: Application submittal fee: Additional fees: Estimated value of work is required(if over$5,000):$ 600.00 Application accepted- (within the public right-of-way) By: Dare: Is work related to a LAND-USE DECISION? ❑ Yes Ej No Application reviewed: /p--V- rr If so,please specify WLP,SDR,SUB, etc.) case #: By: k-K5AF1Z Date: Applicant notified: LP Is work related to a BUILDING PERMIT? ❑ Yes n No By: 1�' Date: IL If so,please specify(BUILDING PERMIT)case#: t:\CUPPLN\Mastersiland Use AppHntlons Xev.07/09/2015 City of Tigard • 13125 SW Ifall Blvd. • Tigard,Oregon 97223 • ttr%m:tigard-or.gov • 503-718-2421 • Page I 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 am°deed restrictions that may he attached to or imposed upon the sub*�p�p��. • 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. Heidi Ramos-Medrano 09.13.16 Applicant/A horized A nt's signature Print name Date Owner's signature Print name Date Owner's signature Print name Date Owner's signature Print name Date PUBLIC FACILITY IMPROVEMENT PERMIT City of'Tigard • 13125 SNX'Hall I3Ivd. • Tigard,Oregon 97223 • wwwAgard-or.gov 503-718-2421 • Page 2 of 4 DEVELOPMENT ENGINEERING FEES FOR STAFF USE . NLY Public Facility Improvement(PFI)Permit: DETAILED SUBMITTAL REQUIREMENTS APPLICATION FEE Part 1: Required submittal fee$300.00 FRANCHISE UTILITY AND SIDEWALK/ PERMIT FEE DRIVEWAY AND UTILITY CONNECTIONS,ETC. Part 2: All non-water system improvements (work in the right of way) l:ngineer s estimate X 5%(less$300.00 submittal fee) Engineer's estimate X 2'Yo Plan Review Sketch (including information below) WATER SYSTEM FEE ❑ Dimensions Part 3: All public water system improvements ❑ Street Name Engineer's estimate X 12% ❑ Site Address PFI Permit Fee Exemptions: There will be no permit fee charged,or assurance required FULL SCALE DEVELOPMENT for the following t`pes of work: (Subdivisions/Partitions and Street Improvemcnts) • Sidewalk repair(less than 20 lineal feet) • Relocate or replace mailbox Design Plans • Ditch cleaning that does not involve regrading. (6 sets,2406 or 2204) • Weephole repair ❑ Cover—Site,Vicinity,Abbreviation,Legend • Curb repair or replacement(less than 20 lineal feet) ❑ General Notes(City,Water,Sewer,etc.) • Lawn sprinkler system installation or repair ❑ Street(Plan,Profile) • Street tree pruning or planting ❑ Water,Storm and Sanitary(Plan Profile) • Planter strip landscape maintenance ❑ Water Quality Facilities • Test wells ❑ Grading ❑ Landscaping/Trec Plan ❑ Composite Utility Plan(Electrical,Phone,Gas, Note: A cash assurance may be required per Storm,Sanitary,Water,Signage,Street lights,etc) TMC 15.04.140. (customer deposit) ❑ Details ❑ Traffic Sight Distance ❑ Signing and Striping ❑ Street Light Plan and Photometric ❑ Engineers seal/signature ❑ Sheet label(project land use name,revision and plan log block,dates and sheet numbers.) Additional Submittals (per Land Use conditions) ❑ Traffic Report ❑ Storm water Drainage Calculations ❑ Geotechnical Report ❑ Preliminary Access Report(Sight Distance) ❑ Proposed Plat ❑ Pathway Design(if applicable) ❑ \X'ater Department Approved PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard 13125 SW 1 lall Blk d. • Tigard,Oregon 97223 0 wwwtigard-or.gov • 503-718-2421 • Page 3 of 4 CC),; lgb b51 G OA r y ��f�svro.a� ��rovuS � bb�1 www.invarion.com 1491+1 1W F, „ Owner Project/Job Number Fisk Com. Project Name/Location UNITED 11 AF F IC CONTPOL a .R'VIC 159955W Hall Bled Tigard, OR Prime Contractor Traffic Control Contractor Fisk Comm. United Traffic Control Contact name/number E-mail aim Prepared By OR Cert#05357 wA Cert#010057 Steven Hill EXP.6/27/2019 EXP.11/30/2019 B E-mail Cell Phone Steveh @ unitedtrafficcontrolservices.com 971-330-0343 B A �i Posted speed Siv,spacing(hl./- 100 ft.Max. '� *4 (MPH) A B C less) 100' 100' 100' q B B i 35-40 350' 350' 35D' 45.55 500' 500' 500' � o j♦ "°ON Slapping. / Sight Distance Buffer Spacing 100ft.Max.� ed(MPH) Distance(ft) B B q I 15 75 T 30 100 35 125 40 150 N 100 ft.Max. 45 180 10210 s5 1 zso A Merging tapers=L Shifting taper=1/2€ Lane B Width 10' 11' 12' 20 mph 70' 75' 30' 25 mph 105' 115' 125' 30 mph ISO' 165' ISO, B 35 mph 205' 225' 245' 40 mph 270' 295' 320' ♦�♦ 45 mph 450' 495' 540' - SO mph SOO' 550' 600` 55 mph 550' 1 605' 660' All signs and devices SHALL conform to the MUTCDMIAC. Signs SHALL be 48"x 48"retro reflective(Black on Orange) will adjust to field conditions. Plan not to scale S