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PFI2018-00096 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12018-00096 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 05/03/2018 Parcel: SEG1151 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Frontier PFI Project Description: Access MH7 located on SW Hunziker Owner: FEES Description Date Amount PHONE: Contractor: PHONE: FAX: Applicant: JIM STAATS 4155 SW CEDAR HILLS BLVD BEAVERTON, OR 97005 PHONE: 503-758-3119 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 Signature: (, J P Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12018-00096 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. 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 City of Tigard APR 2 4 2018 PUBLIC WORKS —ENGINEERING CITY OF TIGARD PLANNING/ENGINEERING Public FaciImprovement (PFI) PermittY WIN TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) N(TYPE 1—Franchise Utility Work Check one: Utilities ❑ Sidewalk/driveway approach ❑Street improvements performed by NWN, PGE Detailed description: Access MH7/54 located on SW Hunziker and/or utility agency. St near 8100 SW Hunziker St ❑ 'TYPE 2—Sidewalk/Driveway/Sewer Work performed for the purpose of: For TCP ODOT Diagram 320 • Sidewalk installation or repair. • Driveway approach installation Property address/location(s): Splice in MH7/54 for service/to and/or repair Ryerson Inc 7930 SW Hunziker St C +��! • Sanitary sewer lateral installation and/or main line tap Applicant: Frontier Communications ❑ TYPE 3—Full scale Development Work performed with Land use Address: 4155 SW Cedar Hills Blvd approval which includes any of City/state: RPayPrtnn QR Zip: 97005 the following: Phone: 503-644-7153 Email: Subdivisions or Partitions Contact name: Jim Staats Phone: .503-758-3119 • Street widening • Mainline installation for Sanitary Contractor: sewer, Storm sewer, Tigard water _ and/or Tigard Water Service Area CCB#: Expiration: Address: SUBMIT COMPLETED APPLICATION TO: City/state: Zip: City of Tigard Phone: Email: Planning/Engineering 13125 SW Hall Blvd. Contact name: Phone: Tigard,OR 97223 Applications for"minor work in right-of-way" Engineer: Julia Smith only may be emailed to: _ Address: 4155 SW Cedar Hills Blvd rowPermitstigard-or.gov City/state: Beaverton, OR Zip: 97005 Phone: 503-644-7153 Email: julia.smith@ftr.com Case No.: ?FiP� t6 _000cl Contact name: Julia Smith Application submittal fee: $ `' Additional fees: $ Estimated value of work is required(if over$5,000):$ Application accepted:Al6 �'j/zq / (within the public right-of-way) By: Date: F ! r Is work related to a LAND-USE DECISION? El Yes IQ No y. �N/j,,,t�, ltApplication reviewed:Date: r / d S Z I� B If so,please specify (MLP, SDR,SUB,etc.) case#: Applicant notified: Af Is work related to a BUILDING PERMIT? ❑ Yes N(No By: �(_ Date: If so,please specify(BUILDING PERMIT)case#: I:\ENG\PermitApplications\pfl_application 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"Tigard,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. 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 imposed upon the subject ro e • 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. r Julia Smith 4/23/08 Ap cant/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 • www.tigard-or.gov 503-718-2421 • Page 2 of 4 DEVELOPMENT ENGINEERING FEES FOR STAFF USE ONLY Public Facility Improvement(PFI)Permit: DETAILED SUBMITTAL APPLICATION FEE REQUIREMENTS Part 1: Required submittal fee$300.00 FRANCHISE UTILITY AND SIDEWALK/ PERMIT FEE DRIVEWAY AND UTILITY Part 2: All non-water system improvements CONNECTIONS,ETC. Engineer's estimate X 5%(less$300.00 submittal fee) (work in the right of way) Engineer's estimate X 2%Plan Review Sketch (including information below) WATER SYSTEM FEE ❑ Dimensions Part 3: All public water system improvements ❑ Street Name Engineer's estimate X 12% ❑ Site Address PFI Permit Fee Exemptions: FULL SCALE DEVELOPMENT There will be no permit fee charged,or assurance required (Subdivisions/Partitions and Street Improvements) for the following types of work: • Sidewalk repair(less than 20 lineal feet) • Relocate or replace mailbox Design Plans • Ditch cleaning that does not involve regrading. (6 sets,24x36 or 22x34) • Weep hole repair ❑ Cover—Site,Vicinity,Abbreviation,Legend • Curb repair or replacement(less than 20 lineal feet) ❑ General Notes(City,Water,Sewer,etc.) • Lawn sprinkler system installation or repair ❑ Street(Plan,Profile) • Street tree pruning or planting ❑ Water,Storm and Sanitary(Plan Profile) • Planter strip landscape maintenance ❑ Water Quality Facilities • Test wells ❑ Grading ❑ Landscaping/Tree Plan ❑ Composite Utility Plan(Electrical,Phone,Gas, Note: A cash assurance may be required per Storm,Sanitary,Water,Signage,Street Lights,etc) TMC 15.04.140.(customer deposit) ❑ Details ❑ Traffic Sight Distance ❑ Signing and Striping ❑ Street Light Plan and Photometric ❑ Engineers seal/signature ❑ Sheet label(project land use name,revision and plan log block,dates and sheet numbers.) Additional Submittals (per Land Use conditions) ❑ Traffic Report ❑ Storm water Drainage Calculations ❑ Geotechnical Report ❑ Preliminary Access Report(Sight Distance) ❑ Proposed Plat ❑ Pathway Design(if applicable) ❑ Water Department Approval to'ffi•ts..'_��14.1[•.tlmw43 i.`%$WCaa�" .. _. :w:s'.��Y.:SK�'�=c.:'}:st%ii'A`3,t.. .,...�:t��"...�c e.�._a,Se�..'ix.�.�u-`z�=�"YL,�!adL'r31f+5A9biFx5 „°_ vffiAi"3.i-.'_�_a..m..'8 -.s���' s�. PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 3 of 4 SAMPLE SKETCH: Edge of Pavement I I Ditch Streetlight •�•—.—.—•�•�•—.—r • RairLDrdn s ' T�MVMF S' cl''SeWer'rrie'� I , Existing House I aI I Existing it I >1 Driveway a C 1R � �+ h a i LZo to to' I w L � ;� I 1 0. Existing Shop C" C � Povwerpole I 95' I --—-—-—-Irroper -Lni e----------- � I . I I i Fire Hydrant(FH) � I � I . Scale: 'I"=30' I I � I . MINIMUM SKETCH REQUIREMENTS (Put"N/A"if Not Applicable): North arrow Property lines & dimension Slope of property Street &street name(s) Existing building, structures Utility&street light poles Proposed work Existing curb or edge Trees Existing S/W or of pavement Existing utility locations D/W apron (sewer,water,storm) PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 4 of 4 51351 -5223976-44 W®630531 1 . IN NIH 7154 PUSH ASR #300397 FC20331052®653 TO H 1009 2. PLACE RED JUNIPER FROM 1 O FES F TO H 100 1 033,653 9,5 7930 SW HUNZIKER ST f a r Knee Builldiii9 " Materials co Po-rformance ConIrac inn t mad pp ad ' r FRONTIER CONTACT INFORMATION ,�y ENGINEERING MANAGER:JOE VANDECOEVERING--503-626-3270 t ® NETWORK ENGINEER:JULIA SMITH-503-644-7153 i CONSTRUCTION SUPERVISOR-DAVE CARNLEY-971-940-9000 CONSTRUCTION COORDINATOR:RON SITTON-503-871-8065 FACILITIES TECHNICIAN:MICHELE CRISMAN-503-643-0180 l.h ��� � ' OPCEN SCHEDULER:RYAN ROBERTS-503-643-3713 � -n-he' r �,. "► _ flo 930 southiwesl rxrA„r ccations Muniker Street TGRD-10M FES 7930 SW HUNZIKER ST PROJECT C.O.AREA:TIGARD NUMBER:5223976-44 EXCH.CODE:51351 DRAWN DATE: ENGft: JULIA SMITH NTY:WASHINGTON 4/24118 PHONE: 503-644-7153 FILE: W0630531 SCALE:1=1 00 TAX DISTRICT: DWG 1 OF 4 TWNSHP: RNG: SEC: `\\\� `\ \\ 8185 SW HUNZIKER ST \ GRD MH7/54 8100 SW HUNZIKER ST `\ IN MI-17/54 PUSH FC2038,652-658 \�\ FROM 864F TO 24F GOING TO \ HUB 1009 '\ 7930 SW HUNZIKER ST TGRDORXA 69970 / anti er TGRDORXA H1009,49-51+ /� cations XD,4-6 TGRD-10M FES 7930 SW HUNZIKER ST PROJECT C.O.AREA.TIGARD NUMBER 5223976-44 lEXCH.CODE 51351 / DRAWN DATE: ENGR: JULIA SMITH JCNTY:WASHINGTON 4/24/18 PHONE: 503-844-7153 FILE: W0630531 _SCALE 1=100 TAXDISTRICT: JDWG 2 OF 4 TWNSHP I RING: SEC , i AT H1009 PLACE I ED , QI JUMPER FROM FC2038 658 l X1 TO H100951 FOR 10M FES 1 ORDER TGRDORXA H1009 -- II � �f 1 II II ICommuniratinnr flo-n-her IPROJECT C.O.AREA: NUMBER. EXCH.CODE: DRAWN DATE. ENGR: NTY: PHONE. FILE: PSCALE: TAX DISTRICT: DWG OF TWNSHP: RING. SEC: 24SM FC2038 PUSH FC2038,652-658 FROM C3:1-1500 649-651, 864F INTO 24F TO H1009 UGSS15-2fr-- XD 4-24 —=— (\ 24SM C12:1-800+C2:301-400 FC2038 20ODD+C12:1101-1800 UGSS18-2 649-658, XD,11-24 COIL 864SM 864SM T78:1-6+6DD+13 1 + FC2038 FC2038 6DD+25+28 1-600, 1-696, AE28-22DD XD 601-864 XD 697-864 T14:1-28 UGAE28-22D T1022:1-48 YGD48-S T102:1-100+X1-X O W cn J `� Ln 0 O O Ot,/,-AE106-22DDS\ AE106-22DD a, O n U � \ Ln 0 T101:1-100+X1-X6 Ln 0 f- -7 0 C3:1501-1800+C12:1801-210 UGAE6-24 Z= \ — C16:1-1800+60ODD C16:1-1800+600[)D UGMKF24-26 UGMKF24-2 L8 MH7 MH54 34+78 5106TA 546-0121784 UG2S1 B ftonfier HUNZIKER W/0O RAILROAD REV 1-8-97 BKY cations TGRD-10M FES 7930 SW HUNZIKER ST MH 54 PROJECT C.O AREA:TIGARD NUMBER:55223976-44 EXCIi.CODE:51351 IDRAWN DATE: ENGR. JULIA SMITH NTY:WASHINGTON 4/24/18 PHONE: 503-844-7153 FILE: W0630531 SCALE:1=100 TAX DISTRICT: DWG 4 OF 4 TWNSHP. RNG: SEC: