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PFI2018-00278 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT a COMMUNITY DEVELOPMENT Permit#: PF12018-00278 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 10/16/2018 Parcel: SEG2009 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: PGE Project Description: SEG 2009/14960 SW 92nd Ave. Replace poles PL 8014& PL 80150. PGE Job M2602031 Owner: FEES Description Date Amount PFI Permit Fee 10/16/2018 $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: RODRIGO SOLIS 10800 SW AVERY STREET TUALATIN, OR 97062 PHONE: 503-464-7777 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 Signature: Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12018-00278 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. Mike White 503-804-0658 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 ofTigard OCT 15 2018 N PUBLIC WORKS —ENGINEERING ``ITY()r Ti�-ARD Public Fadhty Improvement (PFI) P&i ffERING TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) TYPE 1—Franchise Utility Work Check one: V Utilities ❑ Sidewalk/driveway approach ❑Street improvements performed by NWN, PGE Detailed description: Replace poles PL 8014 & PL80150 and/or utility agency. ❑ TYPE 2—Sidewalk/Driveway/Sewer Work performed for the purpose of: PGE Job M2602031 of- - Sidewalk installation or repair. lqqyo • Driveway approach installation Property address/location(s): �' SW 92nd Ave and/or repair NEAA 21 Tigard, OR 97224 • Sanitary sewer lateral installation and/or main line tap Portland General Electric ❑ TYPE 3—Full scale Development Applicant: Work performed with Land use Address: 10800 SW Avery St approval which includes any of City/state: Tualatin, OR Zip: 97062 the following: Phone: 503-464-7777 Email: preregcoord@pgn.com • Subdivisions or Partitions Contact name: Rodrigo Solis Phone: 503-672-5417 • Street widening • Mainline installation for Sanitary Contractor: Portland General Electric sewer, Storm sewer, Tigard water and/or Tigard Water Service Area CCB#: 103663 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" Engineer: N/A only may be emailed to: romMermitsa.tiga�r,gov Address: City/state: Zip: kmt�ftlnmmmmmiQ Phone: Email: Case No.: P020 l 6-W Z� Contact name: Application submittal fee(.007%of Engineers Estimate) $ Estimated value of work is required(if over$5,000):$ Additional fees: $ (within the public right-of-way) Application accepted: Is work related to a LAND-USE DECISION? ❑ Yes No By: AL, Dater GJ S If so,please specify (MLP,SDR,SUB,etc.) case #: Application reviewed: By: 1 Date: a Is work related to a BUILDING PERMIT? ❑ Yes iZ No Applicant notified: If so,please specify(BUILDING PERMIT)case#: By: tM6 Date: -0 1:\ENG\PertnitApplications\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 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 anv 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. Kevin D Muck 10/10/18 Appiicant/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: DET 1 SUBMITTAL APPLICATION FEE REQtTIREMENTS Part 1: Required submittal fee$300.00 (minimum) FRANCHISE UTILITY AND SIDEWALK/ DRIVEWAY AND UTILITY 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 ❑ Site Address Engineer's estimate X 12% FULL SCALE DEVELOPMENT PFI Permit Fee Exemptions: (Subdivisions/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 ❑ 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 ❑ Composite Utility Plan(Electrical,Phone,Gas, Storm,Sanitary,Water,Signage,Street Lights,etc) ❑ Details Note. A cash/bond assurance maybe ❑ Traffic Sight Distance required per TMC 15.04.140. ❑ Signing and Striping (customer deposit) ❑ Street Light Plan and Photometric ❑ Engineers seal/signature ❑ Sheet label(pro)ect 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 ❑ Engineer's Construction Estimate PUBLIC FACILITY IMPROVEMENT PERMIT City ofTigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 Page 3 of4 SAMPLE SKETCH: Edge of Pavement I I Ditch -00- Streetlight I •!■i■!■!■!■!■!■!r i■ • Rain►Drain ' Tl7ronoscf~5'el ;1_ri'ne" I I ,� Existing House Existing I >i Driveway 01 C i � I � �• I I 1 0 11 I I 1 ■ a� I 1 0I � Existing Shap � Powerpole I a I . . Q . o Property � I . I I Fire Hydrant(FH) I I Scale: -1"=30' I � � � � I ' I 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 ofTigard - 13125 SW Hall Blvd. - Tigard,Oregon 97223 - www.tigard-or.gov - 503-718-2421 - Page 4 of4 PL a 80140 OPTION A LIGHTING LEGEND f� INSTALL 39W LED TOWN&COUNTRY ON 20' rao1;50 14815 y FIBERGLASS 2-DC DB BLACK DOLE,FUSE AT INSTALL 39W LED TOWN&COUNTRY ON 20'LIGHT !►1'6 SOURCE,CONNECT IS)240V ON 20'BLACKFG 2-PC DB POLE,FUSEATSOURCE r' r I i 1 A(1 y/ � CONVECT 210 VOLTS -4 6 1S fill _ 14930- 14M 4931 '44 45 � Y INSTALL 29W LED LEOTEK LIGHT ON 20•LIGHT 7 ON 20'BLACK FG 2-PC(18 POLE N77H J'MA,FUSE A T - SOURCE CONNECT 2/0 VOLTS Will ,{t "'� '�MA.taLIE fn7s 8 /fes §oleo 1' ,• ,` �r.' i -..._15610 �f r' •�#!6 ' 15005 150Gi 5 6 PL#80150 I50 INSTALL 30AMP FUSES IN SECONDARY PEDESTALS OR SECONDARY VAULTS(WHICHEVER 15 ST LT POINT OF ATTACHMENT)FOR EACH --1 4 15015 STREET LIGHT PER T&D CO^ISTRUCTION 5TANDARD LC-11550 � i5065 —= - ( � 4 ei, INSTALL 29W LED LEOTEK ON 20'FIBERGLASSATTENTIONCALL 811 BEFORE YOU DIG : , 2W-4 5 OREGON LAW REQUIRES YOU TO FOLLOW RULES ADOPTED -PC DB BLACK POLE W/8"MAST ARM,FUSE A'? BY THE OREGON UTILITY NOTIFICATION CENTER. , THOSE RULES ARE SET FORTH IN OAR 952-001-0010 SOURCE,CONNECT P 240V THROUGH 952-001-0090.YOU MAY OBTAIN COPIES OF SW DAVM_' P THE RULES BY CALLING THE OREGON UTILITY I NOTIFICATION CENTER ADMINISTRATION @ (503-232-1987) a�ww rO REQUEST UTILITY LOC; tS CALL THE OREGON Know what's below. UTILITY NOTIFICATION CENTER,811 AT LEAST Call before oudl 2PtECFF18ERYaL..4SS(c;C1MP�O,S/TEIPOLE 2 BUSINESS DAYS PRIOR TO EXCAVATION. Y 9• s.,...�. A&a_ 1 Lei` _ <++■r PGE CONSTRUCTION DRAWING SDPMENG REVIEW: ASBUILT BY DESIGNER: AS-BUILT VERIFICATION & NESC VIOLATIONS CORRECTED w.wwr This document accurately represents FIELD construction. Foreman: Date: GF: Dote: ✓� DATE: 9/25718 SCALE: WA ACCOUNT: 18100 AWO: 1000004600 108 NO.102602031 TITLE City of Tigard EOL Pole#80140, 80150 /` CIRCUIT SIZE �-'•'� f// DURHAM-BATTLER 1 tX17 .�.._....�r PGE Louno" 14991 SW 92nd Ave THINKreplaceLaminatedwoo pole wi black, Globe es 1 BOTTOM PIECE POLE INSTALLATION ` DESCRIPTION T&C LED&1-29w LeoTek Cobra on an 8"Tenon arm.30amp fuse,connect @ 24 SAFETY �,+K,�„r,,,,,,w,,,,,,,�,,,r COUNTY EC710N(5) WORK WfTH SHEET BEAVERTON WASHINGTON C2111A ,....r...».......,.......” I of 1 FIRST! ,�,:. r.r.w..vr LINE CREW CENTER DESIGN BY PHONE(503) DRAWN BY 4itl '~'•!"""'O"^'"' 2213 SW 153RD DR RICO SO/'S672-5477 Rica Solis BEAVERTON,OR 97006 Q PORTLAND GENERAL ELECTRIC CO.-ALL RIGHTS RESERVED 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 December 2011 U -- C/) N -0 0 3Cn n n CSingle Flagger Operation ,�,,,,,� ' Cr 1 for Low Volumes (Optional) o' a ry cn w (n1 (ADT<400) ro I o o 0 o D E L cn BE F AGGFR I PREPARED ONANE CL ROAD 3 e 3 e 3 c 3 I TO STOP r AHEAD o W W 4-- ',a F I 0 0 0 — — — r• — — — I • ROAD • ® •• I WORK M fD K c K e K e K A I--I \ I AHEAD O O O 0 f55 1 I O N Ivd TIM Oolh opa.q N w 8N Ql.pin 4 I ,o I RaD I 0000cNi,oU'o �� I rowan I TtA B B i------------------------i I_ 1 mile _ -n f max. — • • • �• • • — — — cc cc • • • Fin •'• S, cc B I A Buffer Protection Vehicle ROAD • w/TMA(both Optional) WORK See Chapter 4 AHEAD BE cc ONE LANE � E o TO STOPREPAREDP Two Flagger Operation w CD CDN 00 �, (Optional) p L,