HomeMy WebLinkAboutA_Application_170602_V1DEPARTMENT OF COMMUNITY CITY OF
AND ECONOMIC DEVELOPMENT Renton ''D
Planning Division 1 1055 South Grady Way, 6th Floor I Renton, WA 98057 1425-430-7200
Email: franchisepermits@rentonwa.gov Website: rentonwa.gov
FRANCHISE PERMIT APPLICATION
Published: 3/30/2017
TO THE APPLICANT: Submit an electronic copy of the plans with the Franchise Permit Application and the
Traffic Control Application to franchisepermits@rentonwa.gov. 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.
Franchise Agency: Puget Sound Energy- Gas
Franchise Job Number: 106324481
Contact Name: Aurelie Johannson
Job Site Address:
Phone: (425) 466-4771
Email: Aurelie.Johannson@pse.com
206 Wells Ave N Project Name:
Description of work: One at a time occupying N and S bound lanes of Wells Ave N to install new long
side 1-1/8" PE gas service to 206 Wells Ave N. 2 (3x5) cuts anticipated
)lease check all that apply:
❑ New Construction ❑ Repair/Relocate ❑ Underground ❑ Overhead ❑ Sidewalk ❑ Street
❑ Open Trench ❑ Bore # of feet:
Contractor Name: PSE/Infrasource
Phone: (425) 466-4771
State Contractors License #: INFRASL871 C2 City of Renton Business License #: BL.036742
"I certify that I am the owner or applicant's authorized agent and do hereby agree to abide to the terms and conditions set forth
under this per it and shall c ply with the ity of Renton's Trench Restoration and Street Overlay Requirements."
SignatureA Oajm�vn Date LC 12-1 % Q l 1
INSPECTIONS SHALL BE RE U STED 24 HOURS P R TO OMMENCEMENT OF ALL WORK BY CALLING THE
INSPECTION LINEAT 425-430-7203 OR BY GOING TO MYBUILDINGPERMIT. COM
Jobs are required to be called in for job start, re -inspection and project final. Re -inspection fees are billed at $75/hour.
All Pre -Construction meetinas shall be scheduled at a maximum of 14 days prior to the job start date.
Plan Review/Development Engineering Date
Site Construction Inspector
Development Engineering Manager
Date
Date
Approved as submitted
Pre -Construction Meeting required
Approved with comments or redlines
Camera inspection of utilities required
Page 1 I Published: 3/30/2017
Print For Reset Form
CITY OF RENTON p `I'''°r C*i
..TRAFFIC CONTROL PLAN)
PROJECT NAME: 106324481
CONSTRUCTION COMPANY: PSE/Infrasource
CONTACT NAME. Aurelie Johannson
ADDRESS: 1660 Park Lane Burlington 98233
E-MAIL ADDRESS: Aurelie.Johannson@pse.com
PROJECT LOCATION:206 Wells Ave N
WORKTIME:
WORK DATE:
Permit Holder agrees to all the following:
PERMIT#
PHONE#: (425) 466-4771
PHONE#:
CELL#:
FAX#:
N/E/S/W OF: N 2nd St
APPROVED BY:
APPROVAL DATE:
• 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 NAMEVI r� li t� I✓KOOMV f) DATE:Uc JZJJ 1
SIGNATURE:
OFFICE COPY T -
CONTRACTOR
DEV. SERVICE, INSPECTION
P. MILLER
DEV. SERVICE, PLAN REVIEW
B. BANNWARTH
POLICE
CHARLES KARLEWICZ
FIRE
FIRE MARSHALL FS 413
NOTES:
• Worl( 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 (425-2044455) 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 2°d Street).
SKETCH
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