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PFI2017-00279 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT !is COMMUNITY DEVELOPMENT Permit#: PF12017-00279 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 01/03/2018 Parcel: SEG734 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: PGE Project Description: SEG734,Associated with address 11730 SW 95th Avenue. PGE Job M2409413. 2 Pole Set to fix VD/Flkr Issues and Aerial Crossing. Open Delta OH Service. Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: AMY SWEANY 10800 SW AVERY ST. TUALATIN, OR 97062 PHONE: 503-612-2935 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 II � Signature: Q Q , li l 1 b Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12017-00279 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. Call Ken Fisher at 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 RECEIVED DEC 2 6 2017 City of Tigard CITY OF TIGARD PLANNING/ENGINEERING PUBLIC WORKS —ENGINEERING Public Facility Improvement (PFI) Permit TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) TYPE 1—Franchise Utility Work Check one: gUtilides ❑ Sidewalk/driveway approach ❑Streetimprovements performed by NWN, PGE Detailed description: PGE Job M2409413 and/or utility agency. 2 Pole Set to fix VD/Flkr Issues and Aerial Crossing. ❑ TYPE 2–Sidewalk/Driveway/Sewer Open Delta OH Service Work performed for the purpose of: • Sidewalk installation or repair. • Driveway approach installation Property address/location(s): 11730 SW 95th Avenue and/or repair Tigard, OR 97223 • Sanitary sewer lateral installation and/or main line tap Applicant: Portland General Electric[Submitted by Amy Sweany] F-1TYPE3—Full scale Development pp Work performed with Land use Address: 10800 SW Avery St. approval which includes any of City/state: Tualatin, OR Zip: 97062 the following: Phone: 503-612-2935 Email: preregcoord@pgn.com • Subdivisions or Partitions Contact name: SDPM James Chrisman Phone: 503-736-5749 • Street widening • Mainline installation for Sanitary ) ( Contractor: PGE See Above sewer, Storm sewer, Tigard water and/or Tigard Water Service Area CCB#: Expiration: Address: SUBMIT COMPLETED APPLICATION TO; City/state: Zip: City of Tigard Planning/Engineering Phone: Email: 13125 SW Hall Blvd. Contact name: Phone: Tigard,OR 97223 Applications for"minor work in light-of-way" Engineer: N/A only may be emailed to: rowpennits a,tigard-or.gov Address: FOR ONLY City/state: Zip: f 1- Phone: Email: Case No.: t`1�0 13 -002 Contact name: Application submittal fee: $ 42-' Additional fees: $ Estimated value of work is required(if over$5,000):$ 13,613.01 Application accepted: (witlun the public right-of-way) By: A Date: Application reviewed: Is work related to a LAND-USE DECISION? ❑ Yes IO No If so,please specify (MLP,SDR,SUB, etc.) case#: By: & UL�Date: Applicant notified: I Is work related to a BUILDING PERMIT? ❑ Yes EKY No By: S� Date: If so,please specify(BUILDING PERMIT)case#: i:\ENG\Permitapplications\pfE_application Rev.12/16/2016 t _ ....._ ,,,,.. .,.. ... .. ....................� s„�.. .m....,,.x..n..»,iS.«&xi .wr,.,.... .x... .._,. .».......,. ,.,,,...,,. ._...,.......»,..�.»';?»,,l3' aY City of Tigard 13125 SW Hall Blvd. Tigard,Oregon 97223 wwwtigard-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 Tigard,when the owner and the applicant are different people,the applicant must be the purchaser of record or a lessee in possessiou 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 ro.ert . • 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 peri-nit 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. 12 01 Applicant/Authorized Agent's signature Print 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 • wwwtigard-or.gov 503-718-2421 Page 2 of 4 l E C E `fix 4� b, DEC 2 S 2017 CITY OF Y,rl- r) PLAN NING/Et• G1*,A;EERIN(;� Page 84 2011 Edition 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 both directions of traffic on low volume roads (less than 400 ADT)with good sight distance as discussed below. 1. Use truck-mounted flashing warning lights on work and protection vehicles. See Section 4.3—Lights and Lighted Signs for exceptions. 2. For added visibility, a truck-mounted arrow board or PCMS in caution mode may be used. 3. Flaggers at each approach are required if any of the following 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. d. Traffic volumes are greater than 400 ADT. 4. The length between the Flagger Ahead signs shall not exceed one mile. Use Diagram 340— Lane Closure with Pilot Car if exceeding one mile. 5. Cones should be used to outline the work space when curves or other roadway alignments prevent clear direction for the motorists to pass the work space safely. 6. Cones along the work space are recommended when posted speeds are 45 mph or greater, when working under heavy traffic or when travel lanes are narrower than 11 feet. 7. Extended queue signing (see Diagram 5-4) should be used when traffic queues extend beyond the initial advance warning sign. 8. 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 the side road(s). 9. Sign set-up and flagger placement shown may be used for intermittent full road closures of 20 minutes or less. 10. The"ONE LANE ROAD AHEAD" (W20-4) sign is optional and should be considered on high volume or high speed roads, or when extended queues are expected. Chapter 5 September 2016 ----- -------------- ry Cn 1 a C I CD �^ I Sinle Flager Operation I ' d J,, , o vai t. uWi o N o I gg ( M for Low Volumes I (Optional) 0 0- CD w I (ADT<400) m smP59>I �} O N v an W ``' I I BE ..: a o 0 o L� 0 0 0 a a ^ FsAccER PREPARED ONE LANE CL A;.s b s A c s: TO STROAD OP a AHEAD o U, o w W O O O O m m — — — r — — — • ROAD AH WORK � n K +i K K I AHEAD o a ca a � I c\ �1 aSAW I o M m � " G o � N� M I � I]RR wfSw I N I IQ AF�AD roptknen I [—A B B I------------------------ Tt :+ 1 1 mile I -n` f max. —1 tt1 C B B A Buffer Protection Vehicle wl TMA(both Optional} WORK See Chapter 4 AHEAD; BE (Q ONE LANE RO P s%o� Two Flagger Operation -U AH TO wCD UI (Optional) O 0 m F t+ J. ..�.►. M Z .J G) OVERHEAD LEGEND • .. "` M INSTALL FACILITIES C1 '. ________ INSTALL 2-#2 ACRS OH PRIMARY& 1-#2 ACSR LOW NEUTRAL I__........__...._.... .:.,R - -- INSTALL 1-40 AL-OX OH SECONDARY 4551 .e iiTK: i a • ^d10 INSTALL CUTOUT PL�SSi: zDo-03 • .......... SIZE FUSING AS NOTED INSTALL B-PHASE AVIAN COVER - RLMOVi 36170 200�1 12MAOV O i - f ...... A50 60001 % -. .......... _......__.....__........ POLES 0 3 S 1 54 POLE CLASS(l,2,3,4,Hl,H2,S) .........IT­J ...... ..... POLE HEIGHT(FEET) ::ar:• 020m03 O FRAMING TRANSMISSION 8 DISTRIBUTION(SEE CODES BELOW) ........... ............. D37 FRAME DISTRIBUTION-LC10729,MU 0037 AVIAN (JPH LOFT SGL IT,TANG,PIM ryry yy //^^ FRAME DISTRIBUTION SLACK 2,MU POLY)(2PH BFT IT Oel DE,SLACK SPAN,POLh �Z C1i--35D 3z • ANCHORS o W x W 8'LEAD 5 O. 'B`7 1,375 LBS) - ANCHOR CODE At A3 A5 A7 A8 In _ _ GUYING x = i u s1988 ................. -..... ................ .......- -.............. O O O O u0 0 -._..__2.142 CO F25T 0 G76 (PRI-1,375 LBS) f A50 ' uACK sPAN 9p -- -- -- --- �jBio INSTALL A7 PL-59 7200V PL-55 " 1 GUY GI G4 G7 GI i GI 22 SOKVA A 12 IOKVA 8 g 12()240V T GUYS c2 Gs GS GT1 n 23 3 GUYS G7 G6 G9 GI 1 G2 24 s ` 412 n:m EXISTING METER SERVICE £ 3 PHASE 12M40V i OPEN DELTA CONNECTED LOAD b: 44.BKW PHASE LOAD VT v5 6.3M 3-PHASE LOAD .......TIP ......._.... ....._ --_.-._.-.. REMOVE AERIAL CROSSING 35-5 _.... _...... 880e ............. CONSTRUCTION NOTES: OH 40 • I. SEE THE PGE ELECTRIC SERVICE REQUIREMENTS(ESR)BOOK FOR THE FULL SEE Of REQUIREMENTS.THE ESR BOOK CAN BE FOUND AT hnpr/�.-w+.pardandRenerol.com • "" "- I Z. CUSTOMER IS RESPONSIBLE FOR ORTNNING ALL BUILDING AND ELECTRICAL PERMITS FOR .-....-.._.................._.._- THE APPROPRIATE MUNICIPALITY.CUSTOMER IS ALSO RESPONSIBLE FOR ORATINING ALL 1 EASEMENTS AND TREE-TRIMMING PERMITS,AS REQUIRED. 3. ALL TREE TRIMMING IS REWIRED EO BE COMPLETED PRIOR TO PGE INSTALLING SERVICE. 4. CONTACT PGE SERVICE COORDINATOR IN ORDER TO RECENT AN APPROVED METER SPOT AND CONFIRM THAT THE SERVICE WILL MEET ALL APPLICABLE CODE CLEARANCE REONREMENTS OVER GOUND.STREETS,PARKING LOTS,ROOFS,DECKS AND BALCONIES, ACROSS OR BESIDE OTHER OVERHEAD UNUrY WIRES.ANO ADJACENT TO WINDOWS. ,.... •... `_.-__ ....-....... ............ ..._...........__. ................ ............. 5. AFTER PASSING THE APPROPRIATE MUNICIPAL ELECTRICAL INSPECTION, -- CUSTOMER TO RfOUESI AN INSPECTION 8Y PGE BY CONTACTING A SERVICE COORDINATOR AT 800-542-.8818 OR 503 323-6700 IN THE PORTLAND AREA PGE WILL NOT ENERGIZE IF THE SERVICE UNTIL ALL INSPECTIONS HAVE BEEN PERFORMED. PGE CONSTRUCTION DRAWING AS-BUILT VERIFICATION & NESC VIOLATIONS CORRECTED IM-55 IM-59 errs This do-mem accu,alely represents FIELD Construction, INSTALL: INSTALL: SAFBTY Foreman: Date: FIPJM General Foreman: Date: 45-3 (Signature only required for field construction changes.) 50-3 SDPMIENG REVIEW: JASBUILT BY DESIGNER: '1/} CONTACT SERVICE COORDINATOR DAM. 12/2a17 SCALE:NTS ACC—r 1070001 AWO:1000004545 oe NO M2409413 107 D37 FOR TRENCH AND CONDUIT INSPECTION PRIOR LINE WI IO AACKFR1 PGE LL NOT INSTALL WIRE nTLF LINE uNrx TRENCH a nox AACKnI_ED. PGE—John Stevenson SERVICE COORDINATOR CIRCUO SIZE 503-323-6700 OR 800-542-8818(SALEM) TIGARD-13361 17x22 WEST 107 BUCK ATTENTION CALL 811 BEFORE YOU DIG PG� O7CA I30 S 8'L OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED - n' II730 SW 95TH AVE,71GARD,OR 97223 Al 1,375# BY THE OREGON UTILITY NOTIFICATION CENTER. DESCRIPTION THOSE RULES ARE SET FORTH IN OAR 952-001-0010 ` 2 Pole Set to fix VDflkr Issues and Aerial Crossing.Open Delta OH Service B-PHASE AVIAN COVER G16 PRI 1,375# THROUGH 952 001 0090 YOU MAY OBTAIN COPIES OF COUNTY FCT/oms) WORK WITH SHEET THE RULES BY CALLING THE OREGON UTIUTY eEAVERroN WASHINGTON C11350 T of I NOTIFICATION CENTER ADMINISTRATION @ (S03-232-1987) LINE CREW CENTER DESIGN BY PHONE(503J DRAWN BY B-PHASE AVIAN COVER TO REQUEST UTILITY LOCATES CALL THE OREGON Know whats below. LAMES CHRISMAN 736-5749 CESAR DEL ROSARIO UTILITY NOTIFICATION CENTER,811 AT LEAST Call before you dl �RTa+ T BUSINESS DAYS PRIOR TO EXCAVATION. y 9• O PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED