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PFI2018-00230 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12018-00230 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 09/05/2018 Parcel: SEG968 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: PGE Project Description: Relocate PGE facilities for ODOT street improvements. PGE Job M2434394. Owner: FEES Description Date Amount PFI Permit Fee 09/05/2018 $300.00 PHONE: Contractor: PHONE: FAX: Applicant: AMY SWEANY 10800 SW AVERY ST TUALATIN, OR 97062 PHONE: 503-612-2935 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 FA Signature: Issued By: J Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12018-00230 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 mECEIVED City ofTigard SEP 0 4 2018 -ta PUBLIC WORKS —ENGINEERING Pubhc Fact Improvement (Pta flNG TYPE OF WORK DESCRIPTION OF WORK(gra the right-®f--way) N(TYPE 1—Franchise Utility Work Check one: q Utilities ❑ Sidewalk/driveway approach ❑ Street improvements performed by NWN, PGE Detailed description: RELOCATE PGE FACILITIES FOR and/or utility agency. STREET IMPROVEMENTS-ODOT K18838 ❑ TYPE 2—Sidewalk/Driveway/Sewer PGE Job M2434394 Work performed for the purpose of: • Sidewalk installation or repair. • Driveway approach installation SW Commercial Street Property address/location(s): and/or repair Tigard, OR 97219 _Q • Sanitary sewer lateral installation and/or main line tap PGE Submitted b Swean EJ TYPE 3—Full scale Development Applicant: Y Amy y� Work performed with Land use Address: 10800 SW Avery Street 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: Henry English Phone: 503-672-5489 • Street widening • Mainline installation for Sanitary Contractor: TBD - Permit Needed for Bid Walk 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 right-of-way" Engineer: N/A only may be emailed to: g rownermfltsktigard-or.gov Address: F'011 STAFF USE ONLY City/state: Zip: Phone: Email: Case No. Contact name: Application submittal fee(.007%of Engineer's Estimate) $ 54,305.98 Estimated value of work is required(if over$5,000):$ Additional fees: (within the public right-of-way) Application accepted: By: Date: Is work related to a LAND-USE DECISION. ❑ Yes Rf No Application reviewed: If so,please specify (MLP, SDR, SUB, etc.) case #: B : Date: y Is work related to a BUILDING PERMIT? ❑ Yes M'No Applicant notified: If so,please specify(BUILDING PERMIT)case#: By: Date: 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 APPLICANTS NO'T'E: 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 12rol2em. • 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. � -� (�7WU4-a.4� STEVE HURSH 8/22/2018 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 STAFF USE ONLY Public Facility Improvement(PFI)Permit: DETAILED SUBMITTAL • • EMENTS APPLICATION FEE Part 1: Required submittal fee$300.00 (minimum) VRANCHISE UTILTTY AND SIDEWALK/ DRIVEWAY AND U'T`ILITY 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 SYSTEM FEE ❑. Street Name Part 3: All public water system improvements El Site Address Engineer's estimate X 12% FULL.SCALE DEVELOPMENT.- PFI EVELOPMENT -PFI Permit Fee Exemptions: (Subdivisions/Partitions and Streetlrriprovements) 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) (G sets;24x36.or 22k34) • Relocate or replace mailbox ❑ Cover'-,Site,Vicinity;'Abbreviation,Legend' . • Ditch cleaning that does not involve regrading. ❑ General Notes(City,Water;Sewer;etc.) • Weep hole repair ❑ Street(Plan,'Profile) • Curb repair or replacement(less than 20 lineal feet) ❑. Water,Storm-and Sanitary(Plan-Profile) • Lawn sprinkler system installation or repair ❑ :Water Quality Facilities • Street tree pruning or planting Grading' • Planter strip landscape maintenance ❑ Landscaping/Tree Plan • Test wells El Composite Utility Plan(Electrical,Phone,Gas; Storm,Sanitary;Water,Signage,Street Eights;efc) .❑ Details Note: A cash/bond assurance maybe 0 Traffic Sight Distance required per TMC15.04.140. ElSigning.and Striping (customer deposit) ❑ Street LightPlan and Photometric El 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) �. Pro-posed.Plat ❑ Pathway Design(if applicable) El Water Department Approval ' Engineers Construction Estimate. PUBLIC FACILITY IMPROVEMENT PERMIT City of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 Page 3 of4 SAMPLE SKETCH: Edge.of P avement I - Ditch u. StreetlightRain I ■ ■�■�■�. r�. �e. t Al 8 1 ® J-Exist'ing�H.ouse Ii I Existing >' Drivewa.y. 3� I a:0 o' a l O ' I. E"Ilk xi�sti nygedS li o pj. '� I� - s5'4 ■ Powerpole I I a e.®-®.76'p;t�Line---®---®-®- I . I Fire Hydrant(FH) 1 . Scale- 'I"=30' Ie a I � I . I MINIMUM SKETCH REQUIREMENT'S(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 ofTigard • 13125 SW Hall Blvd. ° Tigard,Oregon 97223 ° www.tlgard-or.gov . 503-718-2421 • Page 4 of4 PORTLAND GENERAL ELECTRIC SW Commercial St & SW Main St Tigard 4 PGE Contact: Kelly Despars NOT TO SCALE 503-672-5551 kelly.despars@pgn.com Job #M2434394 SW Main St �N'QRIS�e iA oaa Signs:48"x 48° reflective w flags SW Commercial St Cones: 28" reflective �. nn Spacing: 20' •;fie 9a SW Commercial St WGPR.0'asF.. 04,2 HR '`��� �{�• 40— PARKING �� kltlM3015 PD8732 Night work requested.Two flaggers to set up. One flagger per crew to act as spotter.All traffic control will be removed at end of work. RR R RR RR Field adjustments will be made as needed for safety. RR RR ODOT and MUTCD standards will be applied. SIDEWALK CLOSED SW Tigard St SIDEWALK CLOSED MANIFEST SW Main St/ Q; 5 Road Work Ahead 1 Sidewalk Closed 1 Sidewalk Closed/Ped Prepared by: Lord and Associates, Inc. arrow left 503-777-4902 1 Sidewalk Closed/Ped Debbie McCann, TCS arrow right 20 Cones 2018 August 31, flaggers@aol.com 2 Flagger/Spotters 9210' C.- TRANSFER EXISTINGR �, VJ• gZ1p COMMERCIAL LEGEND �llq, OH SERVICE TREE7RIMT7ING vrED43 i 9210 NEW PGE FACILITIES TO BE INSTALLED /Q C 15 14109 TREE R IMM NOTE:MUST PGE CONTRACTOR TO CALL PGE SERVICE DESK. (UNLESS OTHERWISE SPECIFIED) SECONDARY \ @ 503-323-6700,TO SCHEDULE CREW STAND BY C 25 12'ST UNDER WHILE PLUMBING INTO VAULT SA43 9210 ®eEoorFr E.TKm s©=IT.woos r I vs 2 STORM DRAIN I • ela w Es Asa n 235NEED PRF 8 API 742 25•• ASPHALT CUCON T 6 REPAIR' 14325 7 ••• 9305', 9210 '- AL, .•Osm ,TD 679 4e9ti wa 45'-3 ® ogle PIe-1860 PGS 679G2-.G 40'-4 om 7ro•-I 48 2 � �'Fn.�`, O 83 75 N � 1958 PL 03017 �nsrul wNenoe: 7 DFIR POLES INSTALL: O •__-�. 0 5017 ,� U,1e5R ® 1221 M«)roIF ctAu RI ,HL Hx,s) Da UNE VT 6643 PN22?8.100/ E HEIGHT F2A 50 37034FRAMING rAANEMasrow s asnlearww/see copeseT3 a,/ooR C 10 2 038 GIb NEUT loP w.OrE.wE,«,L tQp�vJ • • (/D'a�� I" �' '6a».e,o„o.,N«ti, Gib NEUT 5./87• INSTALL' ' 1P25 KVA OH 120/ 7.2 NT1C8 SCO+ 166090 ESS l�PGy� • - _ REMOVE:V345 O19550 tt' 1 OF 95'1•G 1p - 72245 ANCHORS p;: A 16 66883 REMOVE PL 67s 16 DFIR ! I Q� PG 1�G A t L ss)) `PT � P�`PGPG � u N As AT M FRONTIER roLEG A 10 60224 _ PGE TO PULL A OWN \� J teooe TRANSFER STREET UGHr '1p�pS� G,`,G PRKON BRUSHOUT GUYING ]21 NEED TREE TRIMMINGA 15 490,,93110 4; ❑��PU UDER COMM(s!, 8 16490193997_ TOPPED TO COMM(S). C•1$490117 4450 \ 7NsrALL 7]JD 12217 6O'-2;' INSTALL'POLE CONDUIT UNIT 331 EIA• SECONDARY 1970....^_. WITH 12'BRACKETS,-u2 Go F 25 T JUNCTION BOX •� 2526790 a LIGHTNING ARRESTER 110 ,•`\ a 4'NORTH OF EXISTING • a� C 5028651 ^\ 2 DFIR G5? /42 10 T R 9a REI4oVE •.. GJ a• �,yP� } 142 10'T EXISTING Ino 0 _ •9e 9 rO ,•`,• app' CONDUIT Lam/;\ 413.19 tiPG,yt�P Ag2yo,•'• ,rte C p� c2•, \ �',�, ,1223 CONSTRUCTION NOTES: CMDEV maC,, p 10 Q- G C t GJ C'iq :.FPcc`�om."s�Q` laru�u`sE I""`Neu"uowP'�coNwE°.TPOEwv,"w�id5twu,... �QO�, 332 105 �.1/T-95 'I' $ �O !, o _ Rv.t:E000Row.rtDnMN.v2v,w ��gG,�S 1 DFl I\ 6P�O �P�� P �' s w CaFwu To rRTN4EowTTHroe,cREs/Vee—RATTOPOTC—T E. O!1'� P�'C� 0G y ', s oxo rtwml uu s s u n'ro oETeRM PD 8732 ; o ti TnmE a .9 PGE CONTRACTOR TO CALL PGE SERVICE DESKPOP—S aov axRr:uss eE.os R-f EteT WHILE PLUMBING INTO PA.D 8732 �. �. sMt°uEP. 38 CREW STANDBY VT-103 `•/\• ��• oPEcleo 1enarrt�CUnrusxrs.au!'rc w�E I,enn OranµP�rE��Errtl , `. _ 9 ..Hawks rnvwFcnow Ic �wuih • • 1221D0 "`I`OW MMRSE€ `I `Ki EP' s .Xa L.I POST-CON REPAIR H2 DFIR PRF{ON CONCRETE CUT, voPe �rmm u rN 1661 65 ✓ t 9250 m. 12345 83�,• '�� o Rs.R�s•eE• rFEµS E ® B.UNK • Z -.�\ 90._1...: , C5025163 T. Fa E"F�.RF3�,�5'cn"ta:Bo.6i r' EOW oTPB�N�E'��.,orvoeTAn 9295TR",,.TFOR�R.x 2007 RTN.sT ARE ExraBEo STEEL P Bu+eRRnsZ.RE=La,+tED..a,NO o.'fco..rsF:Mo:a°EH,Eeae'T"rIETFvw'""`iieL�.3`o"A"k'N"w`c;ours�E1`...M°wlcTm iN ow SKETc cO�MgMILTBNeJ�P*DNN�KIA--I ri P<.[Ano�pws`TRIS. NCa REoumEMEHrs Bgnoo _ 12U rsiD EiV pDl1.MY B��NZn&M%NAD�fpW'.L CoeT it THIN ,'`y�4.--TMT SAFETY AS-BUILT VERIFICATION 8 NESC VIOLATIONS CORRECTED RIGHT-OF-WAY PERMIT NOTICE: eu•I IRI 7 Tn•ia'""•"'"a'^"'•y..P,...^n FlEIO CourrMReri. foreman: Duro: PERMIT FROM TIE LOCAL JURI501LTON IS REQ/ O BEFORE ANY General Foreman: Dah; —KNTNE.RIGHT#-WAYMAYSEPERFOPMED.IX+JYaOE AOVEO OqM 'c piure irwL/pF RMd mnfMrtlian CM+TPACTORSMDCOwrtUCTORSW-HAVEMAOEOTHERSPECMI - NO e' AGREEMEwTS wInr PGE wRL BE UIQVFO:O wORK UaDER PGE9 PCRMIT. '•'10-Y TSDPMENG REVIEW: ASBUILT BY DESIGNER: CO—TICOMUST IE�OW JUAISNC'—AS HOURS T— BEFORE 'Un CONTACT!MCI' aAr+�enrxols su,E;� =70)0007 `O IDp000.Yb Maey/39A BEFtwE wORN i5 TO BE�N A COw TME PERM MUST BE Ow SITE ns J • ®�� YOY' - wu ..P"'�1 O� Sa1]aMTap � HHIFGRY Of iTGARD Tru 5£INKE�OOeg M O W a.Le"y ` TCARD-13336 2x,3/ CUL an BEFORE YOU DIG eoo-e�ete /PG I WM U. n.....o a.. �uw REouen rau ro raaow eue ADorEc •'�I•Y?. ` SW CCWMFRCw ST,itGAtO.OR 9T]F THE areoN SET NOTRIUTeDw¢NIu. THOSF RUlfS AE SFI FWrN IN O.ae esa-0owou ��:" eFLOG7E PGE FACRITIES FOR STREET IMIROVEMENnF00pT RRBJB THeoaaH sv-oosmw.rou.Mr osuw,mFes aF - '' .oM INE IwIEs er Wawa nE orLcoN ICI%IIY , wwsNlNcroN catoaA ,DwASTo.Trow w pas-xl�tvrn m..e 77= pe ANY DEVIATION FROM THIS DESIGN MUSTJI'1.REouEST orlon.tourEz cAu nn oacow Keee, eyR�, ENGLRH ala-Suvw.RAYAww BE APPROVED BY PGE PROJECT MANAGER IITNTV wOnnUTIOw C—1 ee AT IPASI .aw[55 WYS PRIOR ro FiUVAROw. C-11 BelwR/w Ae. OPORIUMNp GEMRAL REC'IR'C ro.-ALL RT.lfrs esMnn