HomeMy WebLinkAboutMaster Franchise Permit Applicationrentonwa.gov/permitservices | developmentengineering@rentonwa.gov | 425-430-7240 3/8/2023 | Page 1 of 1
CITY OF RENTON Ι PERMIT SERVICES
MASTER USE | FRANCHISE UTILITY
PERMIT APPLICATION
“I certify that I am the applicant’s owner or authorized agent and do hereby agree to abide to the terms and conditions
set forth under this permit and shall comply with the City of Renton’s Trench Restoration and Street Overlay
Requirements.”
SIGNATURE:_______________________________________________________ DATE: _________________________
A CITY INSPECTOR SHALL BE NOTIFIED 24 HOURS PRIOR TO COMMENCEMENT OF ALL WORK BY CALLING THE
INSPECTION LINE AT 425-430-7203. Jobs are required to be called in for job start, re-inspection, and project final.
For City Use Only
CITY PERMIT MFP#: WORK ORDER #:
DATE OF APPLICATION: FRANCHISE AGENCY:
MAILING ADDRESS:
CONTACT NAME: PHONE:
EMAIL: JOB #:
JOB SITE ADDRESS: PROJECT NAME:
DESCRIPTION OF WORK:
CHECK ALL THAT APPLY:
New Construction
Open Trench
Bore # of feet:________
Repair/Relocate
Underground
Other:_______________
Overhead
Sidewalk
Street
Gas
Electric
CONTRACTOR NAME: PHONE:
CITY OF RENTON BUSINESS LICENSE #: STATE CONTRACTORS LICENSE #:
Approved as submitted
On-site pre-con required
Approved with comments or redlines
Traffic control plan attached
Camera inspection of utilities required
Issue Date:__________________________________________
Permit expires 6 months from issue date
Development Engineering /Utility Inspector Date