PFI2018-00198 ` PUBLIC FACILITIES IMPROVEMENT PERMIT
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COMMUNITY DEVELOPMENT Permit#: PF12018-00198
p 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 08/06/2018
Parcel: SEG2469
Jurisdiction: Tigard
Site address:
Subdivision: Lot:
Project: PGE
Project Description: SEG 2469.Adjacent to 16135 SW 74th Ave. Install new anchor. PGE Job M2410223
Owner: FEES
Description Date Amount
PFI Permit Fee 07/31/2018 $300.00
PHONE:
Contractor:
PORTLAND GENERAL ELECTRIC CO
121 SW SALMON ST C/O LEGAL DEPT
PORTLAND, OR 97204
PHONE: 503-464-8852
FAX:
Applicant:
JORDAN WELLS
10800 SW AVERY STREET
TUALATIN, OR 97062
PHONE: 503-646-7777
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 t N
Signature: �...� r�'� 1(' �r%� •�-�,
I '
Issued By:
Special Conditions(See Attached)
Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY
Conditions for PF12018-00198
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 Names 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
RECEWED
City of°Tigard JUL 2 5 2018
PUBLIC WORKS —ENGINEERING
CITY OF TIGARD
Public Facility Improvement (PFIP)A EERIN"G
TYPE OF WORK
DESCRIPTION OF WORK(in the right-of-way)
TYPE 1—Franchise Utility Work
Check one: 9 Utilities ❑ Sidewalk/driveway approach ❑ Streetimprovements performed by NWN, PGE
Detailed description: Install new anchor and/or utility agency.
❑ TYPE 2—Sidewalk/Driveway/Sewer
PGE Job M2410223 Work performed for the purpose of:
• Sidewalk installation or repair.
• Driveway approach installation
16135 SW 74th Ave
Property address/location(s): and/or repair
Tigard, OR 97224 • Sanitary sewer lateral installation
and/or main line tap
Applicant: PGE [Submitted by Shanea Hardcastle] 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: 503-646-7777 Email: Preregcoord@pgn.com • Subdivisions or Partitions
Contact name: Jordan Wells Phone: 603-718-6311 • Street widening
• Mainline installation for Sanitary
Contractor: Portland General Electric sewer, Storm sewer, Tigard water
103663 and/or Tigard Water Service Area
CCB#: Expiration:
Address: SUBMIT COMPLETED APPLICATION TO:
City/state: Zip: City of Tigard
Phone: 503-464-7777 Email: Planning/Engineering
13125 SW Hall Blvd.
Contact name: Phone: Tigard,OR 97223
Applications for"minor work in right-of-way"
N/A only may be emailed to:
Engineer: royM - g ermits ti and-or.g ov
Address:
FOR STAFF USE ONLY
City/state: Zip: ffQ
Phone: Email: Case No.: 1�b"00
Contact name: Application submittal fee (.007%of
Engineer's.Estimate) $
Estimated value of work is required(if over$5,000):$ N/A Additional fees: $
(within the public right-of-way) Application accepted:
By: Dater
Is work related to a LAND-USE DECISION? ❑ Yes No
If so, please specify (MLP,SDR,SUB, etc.) case #: Application reviewed:
.Date:
Is work related to a BUILDING PERMIT? ❑ Yes V No Apphcarltnotified:
If so,please specify(BUILDING PERMIT)case#: By Date: 3t
I:\ENG\PermitApplications\pfi_application Rev.10/16/2017
City ofTigard 13125 SW Hall Blvd. Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 Page 1 of4
APPLICANT'S
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 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 er .
• 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.
Vonh D Nguyen 'I"'ln PEnedbyVinhD
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PE
Date:2018.07.2511:31:20
-07'00'
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 ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 • Page 2 of4
DEVELOPMENT ENGINEERING FEES FOR
Public Facility Improvement(PFI)Permit:
DETAILED5V
REQUIREMENTS
APPLICA'T'ION FEE
Part 1: Required submittal fee$300.00 (nninimum) FRANCHISE UTILI'T'Y AND SIDEWALK/
DRIVEWAY AND UTILI'T'Y
PERMIT FEE CONNECTIONS,ETC.
Part 2: All non-water system improvements (work in the right of way)
Engineer's estimate X 5% (less$300.00 minimum
submittal fee) Sketch
Engineer's estimate X 2%Plan Review (including information below)
❑ Dimensions
WATER SYS'T'EM FEE ❑ Street Name
Part 3: All public water system improvements 0 Site Address -
Engineer's estimate X 12%
FILL SCALE'DEVELOPMENT
PFI Permit Fee Exemptions: (Siibdivisions/Partitions and Street Improvements)
There will be no permit fee charged,or assurance required
for the following types of work: Design Plans
• Sidewalk repair(less than 20 lineal feet)
(6 sets..24x36 or 22x34)
• Relocate or replace mailbox r Cover—Site,Vicinity;Abbreviation,Legend
• Ditch cleaning that does not involve regrading. ❑ "General Notes(City,"Water;Sewer;etc
• Weep hole repair El Street(Plan,Profile)
• Curb repair or replacement(less than 20 lineal feet) ❑. Water,Storm and'Sanitary(PlanTrofile) " .
• Lawn sprinkler system installation or repair 0 Water Quality Facilities
• Street tree pruning or planting 0 Grading
• Planter strip landscape maintenance ❑`Landscaping/Tree"Plan
,
• Test wells ElCorriposite.Utility Plan(Electrical;Phone,:Gas,
Storm;Sanitary,Water,Signage;Street Lights;:etc)
❑ Details
Note: A cash/bond assurance maybe El Traffic.Sght_Distance.
required per TMC 15.04.140. ❑ Signing and Striping
(customer deposit) ❑ 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)
E] Proposed Plat
❑ Pathway Design(if applicable)
❑ Water Department Approval
❑ Engineers Construction Estimate
PUBLIC FACILITY IMPROVEMENT PERMIT
City ofT'igard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tlgard-or.gov 503-718-2421 Page 3 of
SAMPLE SKETCH:
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Edge.of P avement
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MINIMUM SKETCH REQUIREMENTS Tut"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 ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 . www.tlgard-or.gov • 503-718-2421 • Page 4 of4
WL 1 PL-2913:PGE OWNED OVERHEAD LEGEND
2912 Install: .� REMOVE/ABANDON FACILITIES INSTALL FACILITIES
45-3 Al-L16'-1,614# INSTALL ADDITIONAL FACILITIES/MODIFY FACILITIES
1996.,B 50 37875G16-PRI-1,035# 1 WORKLOCAT70NS
C`15 49212 G16-NEU 580#
Remove: POLES
16135 Al r-POLE CLASS(1,2,3,4,H1,H2,S)
7632 ` (2)G16
HT-CL
gec' 46 \
4`' s POLE HEIGHT
''oyq aye
Q ANCHORS p GUYING = _
X X Z O x 0 2 Cl C7
2913 1 .�� w w o G_ 6 to
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50'-4 5� x x os.LBS. = c = r
1996 (LEAD) g rn n c n
OG�,y 18' A_ (LBS) 5 rl c � 1 GUY GI G4 G7 GIC G1 31
9� 35,E ry G2 G5 G8 Gil G1
�O C 7 997.' Anchor CGUYS ode AlA7 A3 AS A7 AS
�DURHAM-IBRIDGEPORT 6 AL-T 146'k 3 GUYS G3 G6 G9 G1 G1 GZt G2
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1996 hpPG QLot
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las' C,� Pe���� REE TRIMMING NOTE
T1 CLEAR AROUND GUY
16255
csq<. 2918 �.
60'-2
1996
0 20 40 80 Feet
I I I 1 1 1 1 1 tU
THINK PGE CONSTRUCTION DRAWING
SAFETY
AS-BUILT VERIFICATION&NESC VIOLATIONS CORRECTED
TM1is tlocumanl acr.irtalely rapesnnh FIE LDCnn t,r di
F I R S T Foreman: Date:
General Foreman: Date:
Signature only required for field construction changes.)
SDPNI/ENG REVIEW. ASBUILT BYDESIGNER:
ANY DEVL417ON FROM THIS DESIGN MUST 7ATE SCALE. ACCOUNT.' A J08 NO.
1/15/2018 1 in=40 ft 1070001 1000001400 M2410223
BE APPROVED BY THE PGE PROJECT MANAGER I TITLE
2016 OH FITNES-INSTALL NEW ANCHOR
CALL 811 BEFORE YOUDIG CIRCUIT SIZE
ATTENTION: DURHAM-BRIDGEPORT 11 x 17
OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED .' pV LOCATION
sd
BY THE OREGON UTILITY NOTIFICATION CENTER. x 16135 SW 74TH AVE,TIGARD,97224
THOSE RULES ARE SET FORTH IN OAR 952-001-0010 ,'- m a DESCRIPTION
THROUGH 952-001-0090 YOU MAY OBTAIN COPIES OF 2016 OH FITNES-INSTALL NEW ANCHOR SHEET
THE RULES BY CALLING THE OREGON UTILITY % COUNTY SECTIONS WORK WITH
NOTIFICATION CENTER ADMINISTRATION @(502-232-1987) WASHINGTON C2113B,C2113A 1 OF 1
TO REQUEST UTILITY LOCATES CALL THE OREGON KnGWwharsbelOVlt• WILsoRVRLE DESIGN BY PHONE DRAWN BY
UTILITY NOTIFICATION CENTER,811 AT LEAST 0811 k10M VW dig. LfNHCREW CENMR JOSEPH TURK 503.718.6342 Joseph Grimes
IN 2 BUSINESS DAYS PRIOR TO EXCAVATION 4180 SW 90ECKMAN RD
0 PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED
www.invarion.com
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Diagram
430 shows work in the travel lane(s) next to a continuous two-way
left turn lane with one direction of traffic diverted into the continuous two-way
left turn lane.
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 PCIVIS in caution
mode may be used.
3. When two or more travel lanes are reduced to a single lane before the
diversion, each lane shall be closed separately. Layout traffic control
according to OD®T Standard Drawing TM 852 for 5-lane sections.
4.A shifting taper (LI2) may be added in the diverted traffic direction
across the continuous two-way left turn lane (as shown). This option is
recommended when the speed is 45 mph or greater.
Sign spacing and Buffer Lengths (feet)
�
ate" . etia� MM
?pp�nfY#`h� �1 o+t„ 1. � Iy� Ell r%Ft R ATA:y
20 50
25 100 100 100 75 Supplement Table
30 100
35 350 350 350 125 Updated:February 12,
40 150 2016
45 180 By,OD OT Traffic-Raodway
50 500 500 500 210 Section
55 250
Signs Spacing and Buffer Lengths (feet) Supplement
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60 285
65 700 700 700 325
70 365
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Protection Vehicle
wIT'MA(both Optional)
See Chapter 4
0
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