PFI2018-00073 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT
COMMUNITY DEVELOPMENT Permit#: PF12018-00073
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 04/02/2018
Parcel: SEG807
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: PGE
Project Description: SEG807, associated with 11863 SW Greenburg Rd. PGE- Replace UG PRI Cable-335Ft& Remove
shoo-fly. PGE Job M2442435
Owner: FEES
Description Date Amount
PFI Permit Fee 04/02/2018 $300.00
PHONE:
Contractor:
PHONE:
FAX:
Applicant:
PHILL MERRIMAN
10800 SW AVERY STREET
TUALATIN, OR 97062
PHONE: 503-963-6943
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: GCAh
Issued By:
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for PF12018-00073
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.
Contact 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
MAR 2 6 2018
City of'Tigard CITY OF�iUARC7
PLANNING/EN INEERING
41 PUBLIC WORKS —ENGINEERING
Public FacilityImprovement (PFI) Permit
TYPEOF WORK
DESCRIPTION OF WORK(in the right-of-way)
E(
TYPE 1—Franchise Utility NX/ork
E
Check one: Utilities ❑ Sidewallc/drive,.vay approach ❑Street improvements performed by NWN, PGE
Detailed description: PGE - REPLACE UG PRI CABLE and/or utility agency.
-335FT& REMOVE SHOO-FLY [ITYPE 2—Sidewalk/Driveway/Sewer
PGE Job M2442435 Work performed for the purpose of:
• Sidewalk installation or repair.
•
Property address/location(s): 11863 SW GREENBURG RD Driveway approach installation
n and/or repair
,,t 0-T TIGARD, OR 97223 • Sanitary sewer lateral installation
and/or main line tap
Portland General Electric Submitted b Am Swean
TYPE 3—Full scale Development
Applicant: [ Y y Yl Work performed with Land use
Address: 10800 SW Avery Street approval which includes any of
City/state: Tualatin, OR Zip: 97062 the following:
Phone: 603-612-2935 Email: preregcoord@pgn.com • Subdivisions or Partitions
Phil Merriman 503-963-6943 Street widening
Contact name: Phone:
• Mainline installation for Sanitary
TBA-Will notify Cit after Contractor Bid Walk sewer, Storm sewer, Tigard water
Y Y a
Contractor:
and/or Tigard Water Service Area
CCB#: Expiration:
Address: SUBMIT COMPLETED APPLICATION TO:
City/state: Zip: City of Tigard
Pla n n i ngl'Engi n e e r ng
Phone: Email: 13125 SW Hall Blvd.
Contact name: Phone: Tigard,OR 97223
Applications for"ming work in right-of-way"
only may be emailed to:
Engineer: rQ3=ermits@tigaard-or.gov
Address:
FOR STAFF USE ONLY
City/state: Zip: p
Phone: Email: Case No.:
Contact name: Application submittal fee(.007%of
Engineer's Estimate) $ iav 00
Estimatedvalue of workis required(if over$$5,000):4$ 13,800.32 Additional fees: $
(within the public right-of-way) Application accepted:
By: SC Date: �wa-��
Is work related to a LAND-USE DECISION? ❑ Yes C No
Application reviewed:
If so,please specify (IVILP,SDR,SUB,etc.) case #:
By: i ate:
Is work related to a BUILDING PERMIT? ❑ Yes Cv3'No Applicant notified: I
If so,please specify(BUILDING PEI I.MIT)case#: By: Date: Z
1:\ENG\PermitApplitat fons\pfi—application Rev.10/16/7.017
i
1
3tr�wu
�v wntw_ 91'W'4L.., Ok t+(.rhe
f
City ofTigard 13125 Shy!Hall Blvd. Tigard,Oregon 97223 • www.tigard-ongov • 503-7,18-2421 • Page 1 of4
C0444-r*r--v Pitt to— �& wqtaL i�e&xj r, 4v tklw -5-o 5 �,46 Itoi
APPLICANTS
NOTE: Person specified as"Applicant"shall be designated"Perinittee"and shall provide funancial assurance for work,if
required by the city pursuant to TTMC 15.041.140.
* With the exception of a utility operating;pursuant to a valid franchise with the City of'Fig,,ard,when die owner and the applicant are different
people,the applicant must be the purchaser of record or a lessee in possession with written authorisation 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 APPLICANTS) SHALL CERTIFY THAT:
• The above request does not violate any recorded deed restrictions that may be attached to or unposed upon the subject
property.
• If the application is granted,the applicant will exercise the rights granted ui 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 revolted 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 tlne
requirements for approving or denying the application.
/ iA A
..L
Applic y
t/Authorized Agent's signature Print name ate
SIGNATURES of each owner of the subject property, if required.
Owner's signature Print name Date
Owner's signati.ire Print name Date
Owner's signature Print name Date
..:..r.-x.. w.,,:::. .a,w,;:..ac.,.a ,:,W''_"'_s^""�C ..,.. :,,""`°.:`°a:^,`^`.,, ,;.:a"��„. �:.\�....?Fi^'.<,,.;.\.: ....'''.�`..'�,T"`.`°:-"r .._,..,<`'"S`A;. ^y.�..'.""i..;.. ,.,.r .... ... ... ...... ... :'�:-F,^^_t^�-"?.:...•--"'.^--.*+,n� ....—e^^-..__.1
PUBLIC FACILITY IMPROVEMENT PERMIT
CityofTigard • 13125 SSV Hall Blvd. • Tigard,Oregon 97223 • www6gard-or.gov 503-718-2421 Page 2of4
Page 108 2011 Edition
5.5 Multi-Lane Roads
Right Lane Closure, Multi-Lane Non-Freeway Diag. 500
Diagram 500 covers work which closes the right lane of a multi-lane non-
freeway road.
If closing more than one lane on a multi-lane road, provide a minimum
tangent distance of 2L between the end of the first lane closure taper and the
beginning of the second lane closure taper.
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. When the posted speed is 40 mph or less, the RIGHT LANE CLOSED
AHEAD signs may be omitted.
4. Placement of signs in a non traversable median or other median that is
not a two-way left turn lane is required for lane closures any time there
is room for a truck to be parked on the left, out of the travel lane.
When there is no room for a truck to be parked on the left an additional
RIGHT LANE CLOSED AHEAD sign should be placed on the right side
and placement of signs in the median is optional.
5. If flagging is needed for work vehicle ingress/egress, use Flagger
Layout Detail (see Inset).
Sign Spacing and Buffer Lengths (feet)
Posted S acing Between Signs Buffer
Speed A B C Space
20 50
25 100 100 100 75
30 100
35 40 350 350 350 125
150
45 180
50 500 500 500 210
55 250
Chapter 5 December 2011
2011 Edition Page 109
Right Lane Closure, Multi-Lane Non-Freeway Diag. 500
1 1 t 1
• Protection vehlde
• w/TMA(both Optional)
' See Chapter 4
•
_T
f ,
I
• I
I I
Buffer •
I t I I Buffer
I A I
I B I •
I
6 BE •
I • PREPARED •
I � L TO STOP I �
—1—� —�--- — —� • (OptfonaQ
FlagLayout •• L/3gDetail �-
* itA
Iti
See Note 4 RICHTuwE
* CLOSED
1 1 1 t I AHEAD
ROAD
* WORK
AHEAD
December 2011 Chapter 5
11790 11842 LEGEND
11830 REMOVE/ABANDON FACILITIES_INSTALL FACILITIES
45 N INSTALL ADDITIONAL FACILITIES MODIFY FACILITIES
25-4 n 1 WORK LOCATIONS
1991 11555 N
A 7� -------I SURVEY GRID BOUNDARY
11795 A 15 50042
11850 C 50 39384 CONDUCTORS
PD-10 INSTALL AO#2 AL EPR JKT-D PRIMARY
50 66155 11930 11950 •PROVIDED d INSTALLED BY PGE
ABC 112 972 1-2-CONDUIT
PD-86 'PROVIDED d INSTALLED BY PGE APPROVED CONTRACTOR
11860 a q _ _ _
REMOVE SHOO-FLY
11825 ABANDON PRIMARY CABLE
VT-88 'GROUND ABANDONED CABLE PER LC22035-7
07STING SECONDARY CONDUIT
WL 3 PD-6940:
11870 Install: WL 1 PD-9: EQUIPMENT
ELBOW KIT-JKTD CABLE-#2AL 9 Remove: FUSE 25T
Remove: ELBOW KIT-JKTD CABLE-#2AL
ELBOW KIT-JKTD CABLE-#2AL 46 11960 REMOVE TEMP POLF
10 4 1991 25'-4 ♦ 60' POLES
6WL 2 VT-76
NOTE:LINE CREW TO TAG TRANSFORMER
TRANSFORMER TRANSFERRED FROM 60 TOAs �N00#• VT 106 ROW I�Stall: -POLE CLASS(1,2.3,4,H1,H2,S)
cj� <G p5' ELBOW KIT-JKTD CABLE-#2AL
8863 3 POLE HEIGHT
1190 , 8 30'-5
30'-4 1990
1990 PD-9 0 LANDSCAPkGAhIV
s ♦ ,�P B 50 39742 C 8865
` t e POST-LANTHINK
C1 7-350 ,K VT-76 �Fy o 191110 WL2 VT-76: SAFETY
♦♦ �2 9� �G,Q 8875 WL3 PD-6940:
r C TEMP POLE:ASF I RS T
WHERE TEM
1 i
i
11930 i ` VT-110
♦ 107 L4TION FROM THIS DESIGN MUST
� 35'-Unknown
1 I, �1 P ♦
2011 P� Zl
�+ BE APPROVED BY THE PGE PROJECT MANAGER
♦ 'L
8935 ABC 75 33241; Pio vT-111
-0940 PD-102
11970 ATTENTION: CALL 8II BEFORE YOU DIG
A 1fi7 31571 PD108• OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED ,
BY THE OREGON UTILITY NOTIFICATION CENTER,
35'-Unknown THOSE RULES ARE SET FORTH IN OAR 952-001-0010
11867 2011 THROUGH 9S2-001-0090 YOU MAY OBTAIN COPIES OF
3 _ THE RULES BY CALLING THE OREGON UTILITY
• NOTIFICATION CENTER ADMINISTRATION @(502.231-1987)
` Kr—what's below
T
V-113 ,1 qQ5 TO REQUEST UTILITY LOCATES CALL THE OREGO'
TIGARDEN COURT APARTMENTS REMOVE SHOO-FLY '4225 T UTILITY NOTIFICATION CENTER,811 AT LEAST Call befomyoudig.
ON-SITE MANAGER: b(3)TEMP POLES B 25 94657 VT-104 N 2 BUSINESS DAYS PRIOR TO EXCAVATION
RUTH 503-620-1551 8945 3-142 65T
Gym POE CONSTRUCTION DRAWING
ASSET MANAGER: 5062
AS-BUILT VERIFICATION&NESC RECTED
TOM 360-694-6000 GyP 45'-4 4
11950 t' 2010
WL 4 PL-5062: A 15 39556 PO VT-112 Foreman: Date:
Install: 12035 109 General Foreman. Date:
(3)FUSE LINK 25 AMP(REPLACE FUSES HOT) B 15 39555 35'-Unknown (Signature orgy required for field constr chon changes)
------ C 15 39557 2011
Remove: �. SDPMiENG REVIEW.' JASBUILTBYDESIGNER'
(3)FUSE LINK 65 AMP -- '---4" ""$ �' '"- 75 75--- ..� L JOB No
CO +5'4 Ht DFIR 1/16/2018 1 in=60 ft 1070001 0000014628 M2442435
NOTE:25T FUSE HAS BEEN REPLACED WITH A 65T �(�'� 1985
FOR THE SHOO-FLY. 0 TITLE
-REPLACE UG PRI CABLE-335FT 8 REMOVE SHOO-FLY
65T WILL NEED TO BE REPLACED WITH A 25T �G 3-142 ` CIRCUIT SrzE
ONCE THE SHOO-FLY IS REMOVED. 5 PPC TIGARD-13336 11 x 17
8975 C2 1-02A Np gC19`'ppG /ME LOCATION
p i10 11863 SW GREENBURG RD,TIGARD,OR,97223
H6 DFIR NES�RoyK� N ` DESCRIPTION
FROM VT-76 TO PD-6940 SHEET
8985 S: S
F995 eROGt;9y�GN`PC PGIFIGN WASHINGTON COUNTYSC113T.5D WORKwrTH 1 OF 1
0 30 60 120 Feet P BEAVER DESIGN BY PHONE DRAWN BY
I Io025 I I I I 1 I A 50 726 S UNecnrwcrerrR PHIL MERRIMAN 971-804-3579 HEIDI BOOMER
B 50 �VERTQIV—
I21J SW 153RD) ®PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED
w r;
U a;
c�
y a m
r �
W
Vi
SW PIAFFLESI
Li
U m> Q N
z o
rn
f a
to �c
0
SW LFW1S LN SIN� Lu
Q
w = J
[�
A
ST C Q w co !� c
THINK T,�
Q Q N PLz�
SAFETY � WORK ��
`" " DOVE' V' i AREA
FIRSTJ DOUR C Sw SWr Zy vp,�
MFRc�C ST atiP� Szl GAR
PL
`sc o K sry
et, C3
P,�sr = R �
0 330 660 1,320 Feet
L_j 0, PGE N
WR CHECKLIST YES COMMENT
HOLEDIGGER REMOVE 3 TEMP POLES/SHOO FLY
BOOM
BACKHOE
PGE TRENCH
CONTRACT BORE X 335FT
VAC TRUCK X
LOCATES
STAKI NG
FLAGGING
TREE TRIM
LANDSCAPE X POST
EASEMENT X
PERMITS X TI GARD
TRAFFIC PLAN OTTC
CUTSHEET
UG CIR. VER.
TRANS SHUTDOWN
CUST SHUTDOWN 34 ACCOUNTS
DOOR HANGER
CONTACT
COMPANY
PHONE: CELL:
DATE: TIME-
PGE
TME-PGE CONSTRUCTION DRAWING &V M2442435 DESCRIPTION INSTALL FROM VT-76 TO PD-6940
LOCATION 11863 SW GREENBURG RD, TIGARD, OR,
97223
PGE TITLE PGE - REPLACE UG PRI CABLE - 335FT& REMOVE SHOO-FLY
CREATED BY HEIDI BOOMER DATE 01/16/2018