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PFI2017-00133 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT • COMMUNITY DEVELOPMENT Permit#: PF12017-00133 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 08/03/2017 Parcel: SEG925 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: OR99VV Corridor Safety and Access to Transit Project Description: Soil sampling for sidewalk and bike lane construction by City of Tigard and ODOT Owner: FEES Description Date Amount PFI Permit Fee 07/27/2017 $300.00 PHONE: Contractor: PHONE: FAX Applicant: CHRISTINA HEMBERRY PHONE: 360-619-8097 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: Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12017-00133 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. Mike White at 503 804 0658 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 JUL 2 7 2017 _ ° PUBLIC WORKS — ENGINEERING CITY OF TIGARD_ Public Facility Improvement (PFT�Tmlt "'"Gi TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) TYPE 1-Franchise Utility Work Check one: ❑ Utilities ❑ Sidewalk/driveway approach 5rStreetimprovements performed by NWN, PGE Detailed description: and/or utility agency. fi fl/.�laee etff-i /ODar 'k/�feAbe��44, / El TYPE Sidewalk/Driveway/Sewer f APOr ee�/ l8�%4�� Work pee rf(ormed for the purpose of: "7 Sidewalk installation or repair. - Driveway approach installation Property address/location(s): &.I&) 41N1We11_e1W 51 Ae", and/or repair rto • Sanitary sewer lateral installation and/or main line tap f� /� / / rYPE 3-Full scale Development Applicant: /1�/i�D 6/�P r 7�(�/r��/CQr L/l G Work performed with Land use Address: 'SSG/O /1,� �'�.�f dl cf1,4�7 /Zl/ approval which includes any of City/state: V44CO*Ve A t zip: 4 e06 z the following: Phone: (i(J-4,19-P9 Email: 4 A/IShik-, Al1`T `�"' Md Qie45 S •(O • Subdivisions or Partitions Contact name: 1'hlis1l;ir, Hew !/ Phone: 3&0-6/9-*N 7 • Streetwidening / L • Mainline installation for Sanitary Contractor: A>51e*'e 9!;zLleSy�0il �iJK0/1 2042X,,;?;I sewer, Storm sewer, Tigard water and/or Tigard Water Service Area CCB#: 1616 Z X Expiration: r Address: 3100 614P AA/ SUBMIT COMPLETED APPLICATION TO: City/state: Zip: 9.7Dz3 City of Tigard �J E Planning/Engineering Phone:5-05 -IOZ-/��Email: Le��S�tirt 4$; �4 <� �['oit�4�1/rl/ � 13125 SW Hall Bbd. Contact name: Aallf Z GVlfeI 1lP Phone: a5—97SZ- /7,21 Tigard,OR 97223 '/ ,// /J / Applications for"minor work in right-of-way" Engineer: F/Q/O,r/ f7 1_ �It-1561 14(A e4/S �rAc only may be emailed to: rowpermits[a�,ti�ard-or.gov Address: to S5 cSiJD.f!G'rtf cfit� ZDo City/state: % D/Z ip: ZD Z FOR STAFF USE ONLY Phone:15S ZZ/- &J/ Email: .�'4/Oit ��. Gw+ Case No.:� /y�- t J Contact name: /D/l _25�s".-fha/L- Application submittal fee: $ 360 Additional fees:$ Estimated value of work is required(if over$5,000):$ 5--00 Application accepted: (within the public right-of-way) By: k S Date: 02 Is work related to a LAND-USE DECISION? ❑ Yes V No Application reviewed: By: �111 �4 Date: If so,please specify (MLP,SDR,SUB,etc.) case#: Applicant notified: Is work related to a BUILDING PERMIT? ❑ Yes �i No By: 1A Date: 3 If so,please specify(BUILDING PERMIT)case#: 1:\ENG\Pe.mitApvllratfons\pfi_a,plicatro^ Rev.12/16/2016 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,if required by the city pursuant to TMC 15.041.140. * With the exception of a utility operating pursuant to a valid franchise with the City of'1'igard,when the owner and the applicant arc 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. Franchised Utilities are not required to obtain the owner's signature on the application BY SIGNING BELOW,THE APPLICANT(S) SHALL CERTIFY THAT: • The above request does not violate any recorded deed restrictions that may be attached to or imposed upon the subject prope • 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 any 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. 0-77 /2:7//-�7- Applicant/Authorized Agent's signature PriM name Date SIGNATURES of each owner of the subject property, if required. 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 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 • Page 2 of 4 _ aP " ��?Proposed work is under OR99W' i. .1 .._..�.... a .1 ONE LANE* SHOULDEF 71 6' WIDE SW CURB $0( CON` TRUCT TAiNING WALL -REPLACE ADA RAMP(S) BET'lEEN wa' T""cn'T AND B-1 ,3 j EW COLUMNS UNDER OR99W NEW ADA RA B 8B-12� flus sroa _ v N _ MAINTAIN EXISTING SW COMMERCIAL ST g_g B-10 B-11 TRIMET WESTS[DE EXPRESS/ SOUTHERN PACIFIC RAP ROAD LEGEND • TB18838-08 TEST AN SHOWNTHUS B_# BORING NUMBER AND APPROX. LOCATION 01199W: CORRIDOR SAFETY AND ACCESS TO TRANSIT PROJECT off, (PORTLAND/TIGARD) HHPR-2016-005 Vancouver, u 7711,rWashingtonSuite126 PACIFIC HIGHWAY- MULTNOMAH COUNTY OREGON ODOT KN18838 Vancouver,Wash�n�ton 98662 36a2W17311 FIGURE A3 DATE RhinoOne SITE 3 - COMMERCIAL STREET (TIGARD) JULY 2017 —NOTES— Eauinment list Rhino One-nn6218-1 Tra?c control de,v ices shallnot encnrach into the adjacent lase. .� 3 Road Work Ahead MaiDtxin In'miximam lane width at ail times I Road Closed Ahead \D Conc spxcing=NI'max(for,F ed limits leas than 45mph). I Detour Ahead c�G Adjust to field rnedianxa I Type 11 Barricade w/No Right Turn O p V J0'1-10 All traffic control shall adhere to entreat MUTCD Anidellnes, 4 Type it Barricades w/Detour(right arrow) Rnan Ram 2 Type ill Barricades(1 Road Closed Detour cr.asm woRK C Nodty readentsrhnsh.vc,in ad%ance. Left) NF.AD HEAD 45 28"Cones Q RosD V 4f w'ORK Y DfTOI�R HrAn < ' AHEAD ROAD Ln CLOSED B-8 R-9 Y R-ln a SW Commcrtial St -n�•-f.��-•-•.-.-.-..-�.-•��-�►r.�-r -�•• r.y�rt� y •� loo-± E ROAD ORK aeon j�jopose/ ,SCka�w(e b � D&H Greg LeMieax Flogging lagging Inc. 1621 SE Pardee S( 2,5 nr:TDnR Portland,OR 97202 Off:(503)232-2488 lax:(503)73a-J571SW,.f�E,rd greg(a�-bl7agging.com q _ Contractor:Rhino One Contact Person:Rajiv Ali Phone:(360)852-6367 Email:rajir(wrhiuooneeng.com h LEGEND Job Location:SW Conanercial St and S'W Lincoln Ave Additional Detour Detail Tigard rtrn.a*Platt nn SW Tigard Sta Y 4A":4R^Sign,,w/Dans Type of Mark:Borings SW Tiede—Ave • 28"Cann Duration:Pending erolm •Place nn SW Ticdeman Time:Pending Are o;SW Greenhar¢Rd ► Type 11 Barricade Date:Pending DEmnR *Place nn SW GrmnbarF pp � I Type III Barricade June 28,2017 D&H PLAN#6118-1 Rd rn,.M 99th Ave V ® Boring Intron