HomeMy WebLinkAboutMFP18001170DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
Franchise Permit: MFP18001170
IVR Number: 18001170
Permit Informa!on
Permit Name:Century Link Permits
Address/Loca!on:03/02/2018Applica!on Date:3343903482Parcel Number:1726 NE 16TH ST
Permit Type :03/15/2018Issue Date:Franchise
Permit Work Class:03/15/2019Expira!on Date :Minor U&lity
Job Number:18030592Franchise Type :Telephone
Descrip!on:Permit is for work already completed.
Place 35' of BSW from pole to customer, including a 20' Driveway bore, to provide telephone
service. Restoration per City of Renton standards.
Contacts
Name Address PhoneTypeBilling
C/O QWEST CORP 1801 CALIFORNIA ST #4600
Denver, CO 80202
Applicant
Kim Parker
QWest Corpora&on
931 14th St, Suite 1000A
Denver, CO 80202
B: (303) 992-0752Contact
Heather Binkly
Dycom Industries dba North Sky Communica&ons LLC
11770 Us Hwy 1, SUITE 101
Palm Beach Gardens, FL 33408
B: (360) 254-6920
O: (360) 450-3287
Contractor
Business License Number: BL.036846Construc!on Contractor : NORTHSC857Q4
CITY OF RENTON ROW 1055 S Grady Way
Renton, WA 98057-3232
Owner
A?n : Dana Smith
QWest /Century Link - Billing
5018 85th Ave E, Bldg F9
Puyallup, WA 98371
Specialized
Billing
X
General Condi!ons & Signature
Permission is hereby given for the work described on this permit according to the conditions hereon and according to the
approved plans and specifications pertaining thereto, subject to compliance with the Ordinance of the City of Renton.
This permit and plans must be posted at the job site at all times.
I hereby certify that no work is to be done except as described above and in approved plans, and that work is to conform to
Renton Trench Restoration and Street Overlay Requirements.
Call (425) 430-7203 or go to: www.MyBuildingPermit.com one working day in advance to schedule an inspections and for ANY
work in the Right of Way.
Call 8 1 1 to locate underground utilities at least two full business days prior to any excavation.
In accordance with RCW 19.122.033(4) the permit holder is required to contact (Williams Northwest Pipeline at 425.868.1010)
(Olympic Pipeline at 206.510.0575)(Puget Sound Energy at 425.457.5816) to request a consultation with the transmission
pipeline company prior to performing any construction or excavation activities. This requirement to consult with the
transmission pipeline company is in addition to the requirement to Call before You Dig as required in RCW 19.122.
(Date)(Signature)
Page 1 of 1THIS PERMIT AND PLANS MUST BE POSTED AT THE JOB SITE AT ALL TIMES
DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
Page 1 | Published: 3/30/2017
Planning Division | 1055 South Grady Way, 6th Floor | Renton, WA 98057 | 425-430-7200
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:
Franchise Job Number: Phone:
Contact Name: Email:
Job Site Address: Project Name:
Description of Work:
Please check all that apply:
☐ New Construction ☐ Repair/Relocate ☐ Underground ☐ Overhead ☐ Sidewalk ☐ Street
☐ Open Trench ☐ Bore # of feet:
Contractor Name: Phone:
State Contractors License #: City of Renton Business License #:
“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 permit and shall comply with the City of Renton’s Trench Restoration and Street Overlay Requirements. ”
Signature Date
INSPECTIONS SHALL BE REQUESTED 24 HOURS PRIOR TO COMMENCEMENT OF ALL WORK BY CALLING THE
INSPECTION LINE AT 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 meetings shall be scheduled at a maximum of 14 days prior to the job start date.
Plan Review/Development Engineering Date Approved as submitted
Pre-Construction Meeting required
Site Construction Inspector Date Approved with comments or redlines
Camera inspection of utilities required
Development Engineering Manager Date
Qwest Corp. dba Centurylink QC
18030592
Dana Smith
(253) 597-5136
dana.smith2@centurylink.com
1726 NE 16th St 18030592
Place approx 35' of BSW from pole to customer, including a 20' driveway bore,
to provide telephone service.
15'
Northsky Communications (253) 883-1779
NORTHSC857Q4 BL.036846
3/1/18
PLEASE SUBMIT INVOICE TO:
Qwest Corp dba Centurylink
Attn: Dana Smith
5018 85th Ave E Bldg F9
Puyallup, WA 98371
MFP118001170
Restoration Per City of Renton Standards
Scott Warlick 3/8/2018
Justin Johnson 3-14-2018
MFP118001170
Qwest Job #
This request for permit is for the placement of underground telephone service wire to our
customer at the following address:
Legend: Trench in ROW (total footage):
_______ ROW Push or Bore 2” PVC or BIP under roadway (total footage):
_ _ _ _ _ Bore Path Push or Bore 2” PVC or BIP under driveway(s) (total footage):
_ _ _ _ _ Trench Path Trench dimensions: ‘L x 1’W x 3’D
_______ Water Proximity of trench/bore to Utilities: Trench Disturbance:
_______ Sewer Horizontal clearance ≥ 5’
_______ Stormwater Vertical clearance ≥ 2’
Yd3
Road: Grind/Overlay: Section:
Sidewalk: No Cut: Township: N
Planter Strip: Arterial: Range: E
Curb/Gutter:
*All crossings and ROW work at 36 inches.
*All pits and trenching require select fill.
N
18030592
1726 NE 16th St
10'
N/A
5'
10
3
Soft
N/A
5'
4'
N/A
No
No
No
5
23
5
MFP118001170