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PFI2018-00315 CITY OF TIGARD PUBLIC FACILITIES IMPROVEMENT PERMIT COMMUNITY DEVELOPMENT Permit#: PF12018-00315 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Date Issued: 11/26/2018 Parcel: SEG2086 Jurisdiction: Tigard Site address: Subdivision: Lot: Project: Frontier Project Description: SEG2086, across from 15195 SW 98th Ave in ROW planter strip. Place new pole and anchor to extend strand 78'across street from pole FTR#36275 to new pole to anchor pole lead going north on SW 98th Ave. Owner: FEES Description Date Amount PFI Permit Fee 11/26/2018 $300.00 PHONE: Contractor: PHONE: FAX: Applicant: ROSALIE SIMS 4155 SW CEDAR HILLS BOULEVARD BEAVERTON, OR 97005 PHONE: 503-319-7787 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: See application Issued By: Special Conditions(See Attached) Note:THIS PERMIT DOES NOT COVER WORK ON PRIVATE PROPERTY Conditions for PF12018-00315 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 NOV 2 0 2018 PUBLIC WORKS — ENGINEERING C E\Ji "!'EERING Public Facihty Improvement (PFI) Permit TYPE OF WORK DESCRIPTION OF WORK(in the right-of-way) ® TYPE 1—Franchise Utility Work Check one: ® Utilities ❑ Sidewalk/driveway approach ❑Streetimprovements performed by NWN, PGE Detailed description. Place new pole and anchor to extend and/or utility agency. strand 78'ft across street from pole FTR #36275 to new pole ❑ TYPE 2—Sidewalk/Driveway/Sewer Work performed for the purpose of: to anchor pole lead going north on SW 98th Ave • Sidewalk installation or repair. Property address/locations): � �2� b • Driveway approach installation and/or repair Across from 15195 SW 98th Ave, Tigard in R/W in planter strip. - Sanitary sewer lateral installation and/or main line tap Frontier Communications ❑ TYPE 3—Full scale Development Applicant: Work performed with Land use Address: 4155 SW Cedar Hills Blvd approval which includes any of City/state: _Beaverton, OR Zip: 97005 the following: Phone: 503-319-778 Email:_rosalie.h.sims@ftr.com - Subdivisions or Partitions Contact name: Rosalie Sims Phone: 503-319-7787 - Street widening - Mainline installation for Sanitary Contractor: North Sky Communications sewer, Storm sewer, Tigard water CCB#: 208747 Expiration: 3/01/2020 and/or Tigard Water Service Area Address: 11818 SE Mill Plain Blvd. Suite 410 SUBMIT COMPLETED APPLICATION TO: City/State: _Vancouver, WA Zip: 98684 City of Tigard Phone: 503-647-9991 Email: dcoriaO-northskvcomm.com Planning/Engineering - 13125 SW Hall Blvd. Contact name: _Diane Coria Phone: 503-647-9991 Tigard,OR 97223 Applications for"minor work in right-of-way" Engineer:_N/A only may be emailed to: rowpermits(&tigard-or.gov Address: City/state: Zip: (� in - i r Phone: Email: Case No.: ` FI L01�--0 U3+S Contact name: Application submittal fee: $ Additional fees: $,, Estimated value of work is required(if over$5,000):$ $2500.00 Application accepted: (within the public right-of-way) By: SC Date: Is work related to a LAND-USE DECISION? ElYes X1 No Application reviewed: Sy: Date: If so, please specify (MLP, SDR,SUB,etc.) case#: Applicant notified: Is work related to a BUILDING PERMIT? ❑ Yes 1`i i No By: SL Date: I �� If so,please specify(BUILDING PERMIT)case#: L\ENG\PermitApplications\pfi_applkation 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 owners 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 propeiu- • 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. signed E SIMS ON;cn=ROSALIE SIMS,o=FRDNTI ERR SALIE SIMSCOMMUNCATIONS, ou,email=rh$iMS@ftr.COm,r—US Date:2018.11.1917:40:56-08'00' _Rosalie Sims 11/19/18 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 of Tigard 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov 503-718-2421 Page 2 of 4 DEVELOPMENT ENGINEERING FEES Public Facility Improvement(PFI)Permit: DETAILED 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. (G 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 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 Ditch Streetlight .—.—.—.—.—.—.—.—r—. — • Racin DT&tn ' T—'�roj�os' cf�5erovleiTne" I I - I N� I Existing House r� I Existing I >I D rivewa y 01 al I �i I OL C 1 R ' � �• �I Q1 o� .� al > . Existing Shop Powerpole I I •------- ------ -—- I property L ni e. — Fire Hydrant(FH) I I � � Scale: -1-=30' I � � I � � I I � 1 . 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 0 www.tigard-or.gov - 503-718-2421 - Page 4 of 4 I AERIAL 862' SS 26 24 i 0 07.2006 AERIAL BBGTD DK13,126-150+ FDT A STRN 4 PORT 4 XD,26 TGRDORXA H3013,123-126 -A AERIAL o 07.200 07.2006 AERIAL O) FDT A STRN 6 PORT 6 I FDT A STRN 6 PORT 6 Q 000 TGRDORXA H3013,127-132 , TGRDORXA H3013,117-122 , O � 9765 SW Sattler St, Tigard, OR 97224, USA oG w + Sb fo r _, �S`3 `IV 601 07.2006 I—I `� YJD 0 AERIAL 0 i pO�C���00 TGRDORXA H3013,1-288 O� 36273 C2111C1148U) I 36275 C2111C1290 A B FRONTIER FRONTIER 500892 C2111C872 PORTLAND GENERAL ELECTRIC 36274 966'AERIAL dRONTIER AERIA SW SATTLER ST SW SATTLER ST) AKF 400 26 50007.2 06 — — BBGTD DKB,1401-1675+ FTTP PIGTAIL 50OFT 4 I - XD,276-300+ TGRDORXA H3013,251-253+ ` 358 07.2006------ �Y_� BBGTD DK6,1701-1800 XDA I YJD BURIED 486, BURIED 1305202 TGRDORXA H3013,133-240+ AKF 100 26 E 25 24 AERIAL 0 I I FRONTIER XD,109-144 BBGTD DKB,601-617+ BBGTD DK6,151-175 6e 2s I I I 35C4 BBGTD D CONSTRUCTION NOTE BBGTD KB,622-634+ e'&To -�--`- PLACE NEW OHG POLE 35C4 xD,635+ 'r0 TO 3�2 IWBBGTD DKB,636-647+ ea '63sx°�e 8 I> GRDORXA 2468P1 WITH ANCHOR AND DN GUY cT 62 xD,48-50+ AERIAL Xp23 O�e6 66` x f I� 12'FT . I BBGTD DKB,651-673+ 6 ,?. _ I SEE SHEET 2 FOR POLE XD,74-75+ O 1812 07.2006 664,x { I~ I l DETAIL. BBGTD DKB,676-684+ YJD 0 I m ; SEE SHEET 3 FOR VICINITY BBGTD TGRDORXA H3013,1-132+ !! I I BBGTD DKB,686-698+ XD,133-144 i j MAP. XD,99-100 AERIAL I I PERMIT REQUIRED. � ,I�m © 1000 07.2006 I FTTP PIGTAIL 1000FT4 SW OAKS LN. TGRDORXA H3013,243-246 --------------- lT GRD NESC PLACE OHG POLE SW 981 H AVE AND SW SATTLER AERIAL I I PROJECT C.O.AREA TGRD © 500 07.2006 NUMBER: EXCH.CODE: WORK WITH PT3085549 DRAWN DATE: ENGR NTY: FTTP PIGTAIL 500FT 4� I � ROSALIESI WASHINGTON TGRDORXA H3013,247-250 PHONE: FILE: I SCALE: __ TAX DISTRICT: DWG I Pt OF TWNSHP:9,q RNG jw SEC:llrA ROW EIP E/P R CONSTRUCTION NOTE PLACE X OVER CLAMP ON STRAND GOING WEST AND EAST, PLACE NEW STRAND TO NEW 35C4 POLE ON SW 98TH AVE. PLACE NEW 50' ANCHOR WITH 12'FT DOWN GUY IN PLANTER 15105 SW 98TH STRIP AVE 0 E 30' 10' 9765 SW SATTLER ST -- - ROW ROW- <-20'--> SW 98TH AVE 13 7 112' 10 NO SIDEWALK/GRASS E/P ��STORN�� - E/P DRAIN FTR 36275 S C21 11C121 40' 45C3'89 25' 34' SW SATTLER AVE 60' E/P T -- E/P 7 I1/2 2 1/2' BARKDUST AREA ROW W 18' STORM 5'SIDEWALK 13' DRAIN FIRE HYDRANT O 11 ROW I 15195 SW 98TH 16 10' FENCE BEHIND SIDEWALK AVE X10' 40, I 2 1/2' 5' I CONSTRUCTION NOTE GAS I PLACE NEW 35C4 POLE LINES FOR OVERHEAD GUY I 60' POLE IN PLANTER ❑ STRIP. PLACE NEW 51351-5229002 W 12' I ANCHOR WITH 12'FT E/P � y I DN GUY. 5460-TGRD ROW E/P ROW WP2 OF 3A N VICINITY MAP Elementary School V n c. Sw Rad. a� Sw Re,unns' Bonaventure of Tigard: Retirement,Assisted., c SW 841h PI a n J n Sw Sallie(St SW Sattler St SW Saltier St SW Sattler St SW Sattler St SV, WORK LOCATION v � ACROSS FROM a SWCorrlandLn i > < Sw m E $ N n 15195 SW 98TH SW oaks In < a 3 ry �� o rn a 3 ae 0' SW Lakerrdr Cj � lakes w SW DAlflower S! 0 I Ite Church of SW ftp-Ln Jesus Christ of Latter.. 8 °� -+ SwAsnrwa� R Sw Asbfu d SI 5 Ln t � r Google SW c,e�,�91. ypon,erl�e,dU, z Map data£2018 Goouie Unrted States Temu Send fee bw-* 2X ft , 51351-5229002 5460-TGRD 2S1 W11 CA WP3 OF 3 A 4.620 Lane Closure at Intersection with Flagging i�rMl Diagram 620 #&mop Lane Closure at Intersection with Flagging Diagram No. 620 covers work within an intersection when normal traffic: control must be interrupted. Work vehicles may or may not be in the work ROAD WOR W� space. A+EAD >C LAw 1 1 1 During flagging, traffic signals shall be turned off. Contact the road Opllonar may, — gn jurisdiction for approval and assistance (see Section 1.516). B s g��a acting(ft) Buffer (mph) A 1 B C [ft) wr ASO 2. For multi-lane facilities, traffic approaching the intersection shall be 105TCP D, ,00 ,00 ,00 pD reduced to a single lane on each approval and approach. See Chapter less B 3s ao iso iso iso zso 1.515 and 1.516 for information on flagging through intersections. � — as-ss soo soo soD iso A �oarinnat 3. There should be one flagger for each approach. One flagger may control two adjacent approaches if sight distance, low volumes on side roads, ft Tt , and flagger position allows for safe operation and clear direction to 100ft.Max. IREP'ARED motorists. For low traffic volume intersections (fewer than 400 entering �� tO57(X' vehicles per day), one flagger may be used- A B B C 4. The ONE LANE ROAD AHEAD sign is optional and should be considered on high volume or high speed roads, or when extended Buffer queues may be expected. � ♦.. � -- --► - -- — 100 ft Max C B B A ROAD , WORK v�Cl i, 100 ft.Max AH[AD � ONE LANF �1 - 1 IOPhonnn JA - In B aE vro qT n nr B (Onhonali ONE LAJ4L "" C 1 1 `�' Al) ROAD WORK Diagram No. 620 AHEAD 92 93