HomeMy WebLinkAboutA_Franchise_Permit_Application_N.268417_170717_v1DEPARTMENT OF COMMUNITYIIIIIIIIIIII"CITY OF
AND ECONOMIC DEVELOPMENT Renton(D
Planning Division 1 1055 South Grady Way, 6t" Floor I 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 MFP17003643
Franchise Job Number: N.268417
Contact Name: Charlene Greene
Job Site Address:
Description of Work
Phone: 253-854-4074
Email: Charlene.Greene@Centurylink.com
3701 East Valley Rd Project Name:
CenturyLink to access MH349 and HH348 to place and splice fiber. No disturbance of surface.
Tease check all that apply:
0 New Construction ❑ Repair/Relocate 0 Underground ❑ 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."
Signature Charlene Greene oazo„o;»as=,°°dry°°°°�m°ro.m°°�°°°�°�w�mm. Date 7/17/2017
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.
_Huffiy Powers
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
Pagel I Published: 3/30/2017