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HomeMy WebLinkAboutA_Renton_Franchise_Application_N.196316_170710DEPARTMENT 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: Franchise Agency: Mailing Address for Permit: Zip: Contact Name: Phone: Job Number: e-mail: 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: __________  Gas  Electric  Other: ______________________ Estimated Job completion date: Contractor name: Phone: City of Renton Business License Number: State Contractors License Number: “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 permit and shall comply with the City of Renton’s Trench Restoration and Street Overlay Requirements. ” Signature Date 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.  Approved as Submitted Plan Review/Development Services Date  On-Site Pre-Con Required  Approved with Comments or Redlines  Traffic Control Plan Attached Utility Inspector Date  Camera Inspection of Utilities Required Issue Date: Public Works Permit Supervisor Date Permit expires 6 months from issue date 2/13