HomeMy WebLinkAboutA_Elliott Farms Grading Permit Application_20210426_v1H:\CED\Data\Forms-Templates\Self-Help Handouts\Building\Grading License Permit Application.pdf Updated 4/25/18
4. CONTRACTOR INFORMATION
DOING THE WORK AS THE BUILDING/HOME OWNER. If yes, please fill out the Owner Affidavit and include it with this
form. Tenants cannot do the work without written permission from the owner.
HIRING A LICENSED CONTRACTOR WILL BE DOING THE WORK. Fill out the portion below (Required):
NAME: ________________________________________________________ PHONE: ___________________________________
STATE OF WASHINGTON CONTACTOR’S LICENSE: _________________________________________________________________
CITY OF RENTON BUSINESS LICENSE: ___________________________________________________________________________
Development Services Division
1055 S. Grady Way
Renton, WA 98057
(425) 430-7200
www.rentonwa.gov
GRADING PERMIT
APPLICATION
This application must be filled out completely in order to be submitted for review. We will not accept incomplete applications. This application is
good for one (1) year from the submittal date. A one –time extension of one (1) year can be requested at a cost of half the plan review fee. Once
issued, the permit is good for one (1) year from the issue date. A one –time extension of one (1) year can be requested at a cost of half the permit
fee. Please follow our Electronic File Standards if plan review is required. This application must be a .pdf and included in your submittal.
FOR OFFICE USE ONLY:
PERMIT NUMBER: _______________________ PROJECT NUMBER: _________________ LAND USE NUMBER: _______________
ASSOCIATED BUILDING PERMIT NUMBER (REQUIRED):_____________________________________________________________
This number is required if your work is associated with work being done under a Building Permit. The Building Permit could
belong to someone else, but we still need the number to keep all associated permits tied together. You may need to contact the
Building Permit owner.
Description of work: ________________________________________________________________________________________
1. LOCATION AND VALUATION INFORMATION
JOB ADDRESS: ________________________________________ PARCEL NO.: ________________________ LOT #: ___________
VALUE OF WORK: (Fair market value for time + materials) $____________________ BOEING JOB # (If applicable): ____________
2. OWNER INFORMATION
PROPERTY OWNER NAME: ______________________________________________ PHONE: _____________________________
ADDRESS: _____________________________________________ CITY: _____________ STATE: _________ ZIP: ______________
3. CONTACT INFORMATION
CONTACT NAME: ______________________________________________________ PHONE: _____________________________
EMAIL: _________________________________________________________ FAX: _____________________________________
Tier Grade /Fill Qty. Cleared/Disturbed Area New/Replaced Hard Surface Review/Intake Fee Issuance/Inspection Fee
1* < 50 cy < 7,000 sf <2000sf $155.00 $148.00
2* 50 cy - 499 cy 7,000 sf - < 3/4 acre 2,000sf – 4999 sf $466.00 $444.00
3* 500 cy - 4,999 cy 3/4 ac - < 1 ac 5,000sf - <1ac $621.00 $887.00
4* 5,000 cy - 49,999 cy 1 ac - < 2.5 ac 1ac -<2.5 ac $932.00 $1,183.00
5* 50,000 cy - 99,999 cy 2.5 ac - < 5 ac 2.5ac -<5ac $1,242.00 $2,366.00
6* 50,000 cy - 99,999 cy 2.5 ac - < 5 ac 5 ac and Larger $1,553.00 $3,550.00
*+ 5% Technology Fee Assessment
GRADING PERMIT INFORMATION
5. GENERAL INFORMATION
Number of total cubic yards to be excavated: ____________________________________________________________
Number of total cubic yards to be filled: ________________________________________________________________
Note: Excavation and/or fill in excess of 500 cubic yards require Environmental Review with the Planning Department.
Please contact Development Services at 425-430-7200 for an application and information on requirements and procedures.
Brief Description of proposed activity: _________________________________________________________________
Will fill be brought on site? _______________________________________________________________________
Where does the fill originate from? ________________________________________________________________
Is this located near the shoreline of Lake Washington or associated wetlands? _____________________________
Is the project site located within an identified 100 -year flood plain? ______________________________________
Please specify if there are any regulated trees (RMC 4‐11‐20) to be removed? ______________________________
I certify that the information on this application furnished by me is true and correct and that the applicable requirements of the City of Renton
will be met. I understand that this application is valid for one year from the application date. If a permit is not issued during this time period,
the application will become void. This application does not constitute a permit to work. Work is not to commence until the building permit is
posted on premises where work is to be performed. Certification is hereby rendered that no work is to be done except as described, and that
all work shall conform to applicable codes. Work in public rights-of-way and/or utility easements are not authorized under this application.
Any work done without the benefit of having a building permit issued is subject double the permit fee. Fees to be paid at permit intake.
APPLICANT SIGNATURE: ______________________________________________________ DATE: ________________________
APPLICANT NAME PRINTED: _________________________________________________________________________________
SUBMITTAL REQUIREMENTS:
A site plan showing proposed graded location, topography and erosion control measures.
Plans drawn by a licensed civil engineer.
Fill Source Statement is required for projects located within an Aquifer Protection Area. If the project will involve importing fill
in excess of 50 cubic yards, please provide five (5) copies of a source statement certified by a professional engineer. A source
statement will be required for each source location from which imported fill is obtained.