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PFI2016-00225 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12016-00225 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 10/28/2016 Parcel: SEG1458 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Comcast Project Description: Adjacent to 11550 SW Terrace Trails. Bore one 3/4"conduit from ped under Terrace Trails Dr. at min.of 30"and to power meter at house. SEG1458 Owner: FEES Description Date Amount PFI Permit Fee 10/13/2016 $300.00 PHONE: Contractor: LINESCAPE LLC 19100 SW 51 ST AVE TALILATIN, OR 97062 PHONE: 503-969-4409 FAX: Applicant: RANDY SHIELDS 11308 SW 68TH PARKWAY TIGARD,OR 97223 PHONE: 888-824-8264 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: Not Present Issued By: --�— Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12016-00225 Tv pe: Condition Name: Status: Severity: PFI_Utilities 01 -WORK SITE REQUIREMENTS Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met Notice Oregon law requires following the rules adopted by the Oregon Utility Notification Center. Said rules are set forth in OAR 952-001-0100 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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 Not Met 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. RECEIVE® City of Tigard OCT 10 2016 .4 Pt;BLIC 1\ OR11S — I�:NGII�I:1:R1NG c CITY OF TIGARD M=� Public Facility Improvement (PHY �EER'"� DESCRIPTION OF WORK (in the right-of-way) TYPE OF WORK Check unc: X Uufity Connection TYPE 1—Franchise Utility Work ❑ Sidem-alk/driveway approach &ork performed by N\X'N,PGI ❑ Street improvements and/or utility agency. Detailed"description: _T)©tyo, rslci e 3�� cave + /� ❑ TYPE 2—Sidewalk/Drivcwa}'/SCwG' JD N�t►tlJ� Work performed for the purpo"(1 0f: 1 • Sidewalk installation or repair. • Driveway approach installation Propern= address/location(s): !1.SSO S W`Ce.,rrct.C-e--T"raaIS D f• and/or repair - Sanitary sewer lateral installation and/or main line tap /� ❑ TYPE 3—Full scale Development Applicant: l t�M c s Work performed with Jatnd use Address: (-06i-h approval which includes any of the following: Cit1/state: -1 "Lip: �� � 1 • Sulxlivisu�ns or partitions Phone: aha L"mail: y u �1ti. sl' CAL If, C11 CCS ,u- Strcet widening Contact name: � 5 Ytti Phone: Jul _ • Mainline installation for Sanitary sewer,Sturm sewer,Tigard water Contractor: ���5 C G>Jp� LLC- and/or Tig-.ud Water Service Area ('CB#: I q j( Q A 7- SUBMIT COMPLETED APPLICATION TO: Address: 191 an cS W sf r91/�, City of Tigard Citi•/state:TVd-(,6L+1 Y) © R Lip. 93-0(p ;z— Planning/Engineering 13125 SW Hall Blvd. Phone: 5d3-(oJ.2-�`Jl-lEmail: �'r'"+-,cQIi'neSCecr�C.(Cc.Co.lL Tigard,OR 97223 Contact name: �P:�d(c S Q/��.t C Phone: 1�� -$d 'I Gl (p Applications fur"minor Work in right-of-way" only may be emailed to: Engineer: r�2ermits(grtj€Yard-or�ov Address: City/state: Lip: Phone: Email: Case No.: t ��f Contact name: Application submittal fee: 30c).a d Additional tees: Estimated value of W=ork is required (if over S5,000):S Application accepted- (within the public right-of-way-) By: 2y= Date: Application renewed: Is work related to a LAND-USE DI CISIC)N? El Yet; �No By: Datr: if so, please specify, (,MIT, SR, SUR, etc.) case #: Applicant norilied: 1 Is work related to a BUILDING PL RA41T% ❑ 1YIN Nes R o By: Date: �L If so,please specify(BU ILID ING PERMIT)case#: l:\CUROLN\Masten\Land Use Appl"Tiom A-07/09/2015 City of Tigard • 1312-5 SW Ball Blvd. • Tigard,Oregon 97223 0 ytlt wtigard-or.gov • 5t13-718-2421 1 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 arc different people,the applicant must be the purchaser of record or a lessor in possession with written authorization from the owner or an agent of the owner. The ovaer(s)must sign den application in the space provided or submit a wa ma authorization with this application BY SIGNING BELOW,THE APPLICANT(S) SHALL CERTIFY THAT: • The2hove request does not violate any deed restri bona that may be attar-h2ttar-hCd to or jmpus d upon the subjectpq , • 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,bash 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 cAd;h owner of the subject property required. kz ZOE Arz;��= Pelican orized Agent's signature Print name Date Own s' ature Print name // Date er' signature Print name o Date Owner's signature Print name Date PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard • 13125 SW Hall Blvd. - Tigard,Oregon 97223 - www.dgard-o gov 503-718-2421 • Page 2 of 4 DEVELOPMENT ENGINEERING FEES 17OR STAFF USE ONTA' Public Facility Improvement (PFI) Permit: DIC-TAILED SUBMITTAL REQUIREMENTS APPLICATION FEE Part 1: Required submittal fee S300.00 FRANCHISE UTILITY AND SIDEWALK/ PERMIT FEE DRIVEWAY AND UTILITY CONNECTIONS,ETC. Part 2: All non-water system improvements (work in the right of way) Engineers estimate\ 5% (less$300.00 submittal fee) Engineer's estimate\ 2%Plan Review Sketch (including information below) WATER SYSTEM FEE ❑ Dimensions Part 3: All public water system improvements ❑ Street Name Engineer's estimate X 12°4 ❑ Site Address PFI Permit Fee Exemptions: There will be no permit fee charged,or assurance required FULL SCALE DEVELOPMENT for the following types of work: (Subdivisions/Partitions and Street Improvements) • Sidewalk repair(less than 20 lineal feet) • Relocate or replace mailbox Design Plans • Ditch cleaning that does not involve regrading. (G secs,24x36 or 22x34) • \X'cephole repair ❑ Cover—Site,Vicinity,Abbreviation,Legend • Curb repair or replacement(less than 20 lineal feet) ❑ General Dotes(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 f=acilities • Test wells ❑ Grading ❑ Landscaping/Tree Plan ❑ Composite Utility Plan (Electrical,Phone,Gas, Note: A cash assurance maybe 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 scat/signature ❑ Sheet label(project land use name,revision and plan log block,dates and sheet numbers.) Additional Submittals (per Iand Use conditions) ❑ "Traffic Report ❑ Storm water Drainage Calculations ❑ Gcotechnical Report ❑ Preliminary Access Report(Sight Distance) ❑ Proposed Plat ❑ Pathway Design(if applicable) ❑ Water Department Approval PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard 13125 S\X' Hall Blvd. • Tigard,Oregon 97223 • %rw-w•.tigard-or.gov • 503-7118-2421 • Page 3 of 4 Q -�7 TNFLOVC.K STREET' w+� tntc3 ►� S t o e WA L K, X555 , 1 } I � atr11! -- - — - WA�IC FO I 60' i 311' S VV 7 c cLC 2.. —t-t--cu, l.S D r. R t:,.H T I F-Wig Fol: 4v vo AAeA i ,I X15(v0 ll �o ATTENTION:Oregon taw requires you to follow rules adopted by the Oregon Utllky Notification Center Those rules ere set forth In OAR 952-001.0010 . through 952-001-0090 You may obtain copies of the rules by calling the center.(Note.the telephone number for the Oregon Utility Notification Center Is(503)232-1987). Page tip: 2011 Edition 2011 Edition P,Iq�95 Stationary Lane Closure with Flagging Diagram 320 Stationary Lane Closure with Flagging Diagram 320 Diagram 320 covers total closure of one lane of a two-lane,two-way roadway. See the detail inset for the layout if using a single flagger to control 4 both directions of traffic on low volume roads(less than 400 ADT)with good o sight distance as discussed below. �� m 1. Use truck-mounted flashing warning lights on work and protection o _ ` I a O vehicles. See Section 4.3-Lights and Lighted Signs for exceptions. o $� 2. For added visibility,a truck-mounted arrow board or PCMS in caution _ro mode may be used. 9 4 ALL w 0 3. Flaggers at each approach are required if any of the following m g o - .�. I 1- conditions exist: a. Night Operations. b. Work space is over 200 feet in length. c. Sight distance is less than 750 feet from each approach through the lane closure. I I I •• �' 9 j I d tai I •• >o u d. Traffic volumes are greater than 400 ADT. I r Q�i Q It I rll� U 4. The length between the Flagger Ahead signs shall not exceed one `Er 1 1 I e a b mile. Use Diagram 340-Lane Closure with Pilot Car if exceeding one /�; i i E %0-t y mile. I < > t I • P I ��// �G I • � m' 5. Cones should be used to outline the works ace where curves or other c roadway alignments prevent clear direction for the motorists to pass o •® t( the work space safely. mf' f(t / �t i •' 6. Cones along the work space are recommended when posted speeds i I j•, .� are 45 mph or greater,when working under heavy traffic or when travel lanes are narrower than 11 feet. I 11 0 7. Extended queue signing(see Diagram 5-4)should be used when m$ Y I V.7. / u traffic queues extend beyond the initial advance warning sign. I �~ 1 I t ,r- 711 ° I �; m w o I CO Y" I V a B. When flagging near an intersection,the'Flagger Ahead-(CW23-2) sign should be visible to traffic entering from any side road. Additional advance warning and Flagger Ahead symbol signs may be placed on St,,,Sp•dng—dD.n-Lc ge„tn.» j P.M d V.1 n 6uMn .Y the side road(s). fFARATA: u� i SW.d AK a C' Spu. n U 9. Sign set-up and flagger placement shown may be used for intermittent s.prl,—T.161. z tn7 too ,m s I full road closures of 20 minutes or less. ao too Js Sst iso Tw t2s 2 10. The'ONE LANE ROAD AHEAD`(W20-4)sign is optional and should ^� 4s I'M be considered on high volume or high speed roads,or when extended So Son Soo w' 710 -__ ss ri gUCUeS are expected. s_ipn S acln It and Buffer tenxths(fpetl Su lenient_ ad_n Between Slns_"Buffer"S ace ;hipler 5 Dncnrntxm 2011 December 2011 Posted —5A B C Chnplpr 5 Speed 60 285 65 700 L 700 700 325 70 365