Loading...
HomeMy WebLinkAboutA_Franchise_Permit_Application_MFP17001586_v1PLEASE RETURN APPROVED ROW AND TCP PERMITS TO: AMY LEDVINA: CAV of , D Q� 4610 TACOMA AVE, SUMNER, WA. 98390 E: amyledvina@sefnco.com P: 253-299-8588 DEPARTMENT OF COMMUNITY AND ECONOMIC DVELOPMENT DEVELOPMENT SERVICES DIVISION MASTER USE/FRANCHISE UTILITY PERMIT APPLICATION Phone: (425) 430-7266 Fax: (425) 430-7231 franchise@rentonwa.gov TO THE APPLICANT: Submit 3 copies of plans with application. Permit cost is $360.50. Inspection fee for trenching more than 60 lineal feet or installation of 6 or more poles will be billed at $60.00 per hour. For City Use Only CITY PERMIT NO: MFP WORK ORDER NO.: 87029 Date of Application: 6-20-2016 Franchise Agency: COMCAST OF WASHINGTON Mailing Address for Permit: 410 VALLEY AVE NW, PUYALLUP, WA. Zip: 98059 Contact Name: Jerry Steele Job Number: 195912 Job Site Address: 18613 124th Ave SE Phone: 253-288-7532 e-mail: Jerry_Steele2@cable.comcast.com Project Name: KC I -NET Ceder River Description of work: Overlashing a 48ct fiber on existing Comcast system. See plans for details. lease check all that apply: ❑ New Construction ❑ Repair/Relocate ❑ Underground © Overhead ❑ Sidewalk ❑ Street ❑ Open trench ❑ Bore ® # of feet: 5589' ❑ Gas ❑ Electric ❑ Other: Estimated Job completion date: TBD Contractor name: Sefnco Communications Phone: 253-244-1611 City of Renton Business License Number: BL.029666 State Contractors License Number: SEFNCI*994P9 "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 permitpnd;hall comply with the City of Renton's Trench Restoration and Street Overlay Requirements. " Signature 1W it, Date 6-20-2016 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. Plan Review/Development Services Date Utility Inspector Date Public Works Permit Supervisor Date 2/13 ❑ Approved as Submitted ❑ On -Site Pre -Con Required ❑ Approved with Comments or Redlines Q Traffic Control Plan Attached ❑ Camera Inspection of Utilities Required Issue Date: Permit expires 6 months from issue date Print Form Reset Form CITY OF RENTON c+ry°f TRAFFIC CONTROL PLAN D `�` �, PROJECT NAME: )T-195912 PERMIT# CONSTRUCTION COMPANY: Sefnco Communications PHONE#: CONTACT NAME: Mark Lee ADDRESS: 4610 Tacoma Ave Sumner Wa E-MAIL ADDRESS: mlee@sefnco.com PROJECT LOCATION: 18613 124th ave SE WORK TIME: 9AM - 3PM WORK DATE: TBD - PENDING OTHER PERMITS Permit Holder agrees to all the following: PHONE#: CELL#: FAX#: N/E/S/W OF: APPROVED BY: APPROVAL DATE: 253-244-1611 253-244-1611 • Comply with all traffic regulations of the City of Renton and the State of Washington. • Prepare a traffic control plan and obtain City approval of that plan. That plan shall be implemented for all street and lane closures, and the plan shall be performed in compliance with the Manual on Uniform Traffic Control Devices. • Notify emergency services (253-852-2121) twenty-four (24) hours before any street or lane closures. • Any lane or street closures not in conformance with the approved traffic control plan and/or without notification of emergency services may result in receiving a citation for violation of R.C.W. 47.36.200 through 47.36.220, 9A.36.050 Reckless Endangerment, and other applicable State and City codes. • Indemnify and hold harmless the City of Renton from any and all claims, actions, and judgments, including all costs of defense and attorney's fees incurred in defending against same, arising from and related to implementation of the approved traffic control plans including claims arising from towing of private vehicles and the acts of the Permit Holder's agents and employees. • The City of Renton shall be entitled, in its reasonable discretion, to settle claims prior to suit or judgment, and in such event shall indemnify and hold harmless the City for any such claims paid, including the City's reasonable attorney's fees and litigation costs incurred resulting from such claim. • In the event any claim or suit is brought against City within the scope of this Agreement, Permit Holder will pay for legal counsel chosen by the City to defend against same. • Flagger and sign placement are subject to revision by the City Inspector on site, if needed to address traffic or pedestrian safety or travel. • By my signature herein, I acknowledge all the above requirements. PRINT NAME: Roxy. Ltr_ DATE:zo_A9 SIGNATURE: IL T r OFFICE COPY T_ CONTRACTOR DEV. SERVICE, INSPECTION K. KITTRICK/ DEV. SERVICE, PLAN REVIEW A. FIENNINGER/1. ILLIAN POLICE CLARK WILCOX FIRE DAVID PARGARS/STA.N13 NOTES: • Work Zone Traffic Control shall be in accordance with the Manual on Uniform Traffic Control Devices (MUTCD) and shown by sketch or reference to WSDOT. • The plan must be submitted to the City's PW/Transportation Division for review and/or approval at least three working days prior to work. • Approved Temporary Traffic Control Plan must be at the work site during work hours. • Contractor or entity must call Renton School District (425-204-4455) or any public/private agency to be affected by a temporary lane or road closure. • Complete assistance and accommodation shall be provided to all kinds of pedestrian traffic when sidewalk or walkway is impeded. • Total road closure lasting more than 24 hours is subject to the approval by the City Council. • Any vehicle, equipment, barricade, or portable tow -away sign used within the work area must display a company logo or any legally acceptable sign showing the company name, address, and telephone number at a conspicuous place on the vehicle or equipment. In the case of Temporary No Parking Zones, all the following apply in addition to previous: • Contractor must complete form to show limits of Temporary No Parking Zone identifying barricade locations for vacate parking or curb lane usage. • Contractor must post notice of dates and time of Temporary No Parking Zone with at least two signs per block 72 hours in advance of effective date and time. • The cover sheet of this Traffic Control Plan form must be attached to each Temporary No Parking Sign on the project site. • Temporary traffic control devices must be removed immediately when work is done or no construction activities are going on. If deemed abandoned, City crews will remove and store them at the City's maintenance shop (3555 NE 2nd Street). SKETCH -- NORTH --