HomeMy WebLinkAboutA_Franchise_Permit_Application_N.252054_170609_v1_DEPARTMENT OF COMMUNITY CITY of
AND ECONOMIC DEVELOPMENT lemon
Planning Division l 1055 South Grady Way, 6'h Floor l 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: Qwest Corp d/b/a Centurylink MFP17003544
Franchise Job Number: N.252054
Contact Name: Michael Fuget
Job Site Address:
Description of Work:
Phone: 253-854-4074
Email: Michael.Fuget@Centurylink.com
1201 Monster Ave SW, Renton, WA 98057 Project Name:
Access MH125, HH1500, HH1400, HH1201, & PED. Place aerial fiber along 5 poles
from P.A0561404 to P.A0561421. No disturbance of surface.
Please check all that apply:
0 New Construction ❑ Repair/Relocate 0 Underground 0 Overhead ❑ Sidewalk 0 Street
❑ Open Trench ❑ Bore # of feet:
Contractor Name: North Sky Communications
Phone: 360-254-6920
State Contractors License #: NORTHSC857Q4 City of Renton Business License #: BL.028638
"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. "
Digitally signed by Mich,,l F,g,t
Signature Michael Fuget DN c. -M h,dF,g, o_Dent ry i k.o..em. _MicbaeLF,getOCen Ii,k m.c-us Date 6/09/2017
Date'. 2017.06.0910'. 27:18 0)'00'
INSPECTIONS SHALL BE REQUESTED 24 HOURS PRIOR TO COMMENCEMENT 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 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
Page 1 Published: 3/30/2017