HomeMy WebLinkAboutA_Application_170620_V1DEPARTMENT OF COMMUNITY CITY OF
Renton t���
AND ECONOMIC DEVELOPMENT �� �_
Planning Division 1 1055 South Grady Way, 6th 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: Puget Sound Energy- Gas
Franchise Job Number: 109104814 Phone: (425) 466-4771
Contact Name: Aurelie Johannson Email: Aurelie.Johannson@pse.com
Job Site Address: 11242 SE 186th St Project Name:
Description of work: One at a time occupying E and W bound lanes of SE 186th St to replace
existing long side gas service to 11242 SE 186th St. Cuts anticipated.
lease check all that apply:
New Construction ❑ Repair/Relocate ❑ Underground ❑ Overhead ❑ Sidewalk ❑ Street
Open Trench ❑ Bore # of feet:
Contractor Name: PSE/Infrasource Phone: (425) 466-4771
State Contractors License #: INFRASL871 C2 City of Renton Business License #: BL.036742
"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 UAdJf�Ohnzoacuy) Date
INSPEC IONS SHALL BE LIESTED 24 HOU S PRIOR TO COMMENCEMENT OF ALL WORK BY CALLING THE
INSPECTION LINE AT 425-430-7203 OR BY GOING TO MYBLIILDINGPERMIT.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 ve scneaulea at a maXlmum of 14 days prior to the JOn start date.
Plan Review/Development Engineering Date ❑ Approved as submitted
R Pre -Construction Meeting required
Site Construction Inspector Date ❑ Approved with comments or redlines
❑ Camera inspection of utilities required
Development Engineering Manager Date
Page 1 I Published: 3/30/2017
Print Form Reset Form
CITY OF RENTON
TRAFFIC CONTROL PLAN
PROJECT NAME: 109104814
CONSTRUCTION COMPANY: PSE/Infrasource
CONTACT NAME: Aurelie Johannson
ADDRESS: 1660 Park Lane Burlington 98233
E-MAIL ADDRESS: Aurelie.Johannson@pse.com
PROJECT LOCATION:11242 SE 186th St
WORK TIME:
WORK DATE:
Permit Holder agrees to all the following:
PERMIT#
PHONE#:
PHONE#:
CELL#:
FAX#:
(425) 466-4771
11 If
if if
N/E/S/W OF: 114th Ave SE
APPROVED BY:
APPROVAL DATE:
• Comply with all traffic regulations of the City of Renton and the State of Washington.
• Prepare a traffic control plan and obtain City approval of that plan. That plan shall be implemented for
all street and lane closures, and the plan shall be performed in compliance with the Manual on
Uniform Traffic Control Devices.
• Notify emergency services (253-852-2121) twenty-four (24) hours before any street or lane closures.
• Any lane or street closures not in conformance with the approved traffic control plan and/or without
notification of emergency services may result in receiving a citation for violation of R.C.W. 47.36.200
through 47.36.220, 9A.36.050 Reckless Endangerment, and other applicable State and City codes.
• Indemnify and hold harmless the City of Renton from any and all claims, actions, and judgments,
including all costs of defense and attorney's fees incurred in defending against same, arising from and
related to implementation of the approved traffic control plans including claims arising from towing of
private vehicles and the acts of the Permit Holder's agents and employees.
• The City of Renton shall be entitled, in its reasonable discretion, to settle claims prior to suit or
judgment, and in such event shall indemnify and hold harmless the City for any such claims paid,
including the City's reasonable attorney's fees and litigation costs incurred resulting from such claim.
• In the event any claim or suit is brought against City within the scope of this Agreement, Permit Holder
will pay for legal counsel chosen by the City to defend against same.
• Flagger and sign placement are subject to revision by the City Inspector on site, if needed to address
traffic or pedestrian safety or travel.
• By my signature herein, I acknowledge all the above requirements.
PRINTNAME:`U�YI�%y✓I�YL DATEtVIEDI1-1
SIGNATURE: rl I V
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OFFICE COPY T -
CONTRACTOR
DEV. SERVICE, INSPECTION
P. MILLER
DEV. SERVICE, PLAN REVIEW
B. BANNWARTH
POLICE
CHARLES KARLEWICZ
FIRE
FIRE MARSHALL FS #13
NOTES:
• Worl< Zone Traffic Control shall be in accordance with the Manual on Uniform Traffic Control Devices (MUTCD)
and shown by sketch or reference to WSDOT.
The plan must be submitted to the City's PW/Transportation Division for review and/or approval at least three
working days prior to work.
Approved Temporary Traffic Control Plan must be at the work site during work hours.
Contractor or entity must call Renton School District (425-204-4455) or any public/private agency to be affected
by a temporary lane or road closure.
- Complete assistance and accommodation shall be provided to all kinds of pedestrian traffic when sidewalk or
walkway is impeded.
- Total road closure lasting more than 24 hours is subject to the approval by the City Council.
Any vehicle, equipment, barricade, or portable tow -away sign used within the work area must display a
company logo or any legally acceptable sign showing the company name, address, and telephone number at a
conspicuous place on the vehicle or equipment.
In the case of Temporary No Parking Zones, all the following apply in addition to previous:
• Contractor must complete form to show limits of Temporary No Parking Zone identifying barricade locations for
vacate parking or curb lane usage.
• Contractor must post notice of dates and time of Temporary No Parking Zone with at least two signs per block
72 hours in advance of effective date and time.
• The cover sheet of this Traffic Control Plan form must be attached to each Temporary No Parking Sign on the
project site.
- Temporary
traffic control devices must be removed immediately when work is done or no construction activities
are going on. If deemed abandoned, City crews will remove and store them at the City's maintenance shop
(3555 NE 2"d Street).
SKETCH
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