HomeMy WebLinkAboutA_Franchise_Permit_170510_v1_17049421DEPARTMENT OF COMMUNITY CITY OF
AND ECONOMIC DEVELOPMENT
Planning Division 1 1055 South Grady Way, 6th Floor I Renton, WA 98057 1425-430-7200
Email: franchise_permits@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.Rov. 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: Qwest Corp. dba Centurylink QC
Franchise Job Number: 17049421
Contact Name: Dana Smith
Job site Address: 659 Ferndale PI NE
Phone: (253) 597-5136
Email: dana.smith2@centurylink.com
Project Name: 17049421
Description of work: Place approx. 85' of BSW in ROW from pedestal to customer, including a 15' driveway
push, to provide telephone service
Please check all that apply:
❑ New Construction ® Repair/Relocate ® Underground ❑ Overhead ❑ Sidewalk ❑ Street
❑ Open Trench ® Bore # of feet: 15
Contractor Name: NOrthsky Communications
Phone: (253) 330-5464
State Contractors License #: NORTHSC857Q4 City of Renton Business License #: BL.036846
"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 and shall comply with he City of Renton's Trench Restoration and Street Overlay Requires. "
Signature �r�C Date �0 j
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.
Hu Pre -construction meetings span ve scneauiea at a maximum or 14 days prior to the job start date.
Page 1 1 Published: 3/30/2017