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HomeMy WebLinkAboutA_Application_170519_V1DEPARTMENT OF COMMUNITY CITY OF AND ECONOMIC DEVELOPMENT Renton 7� 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: 108597532 Phone Contact Name: Aurelie Johannson (425) 466-4771 Email: Aurelie.Johannson@pse.com Job Site Address: 13606 156th Ave SE Project Name: Description of work: Occupying S bound lane of 156th Ave SE to cut and cap gas service to 13606 156th Ave SE at the main. 1 (3x5) hard surface cut anticipated. please 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 mply with the City of Renton's Trench Restoration and Street Overlay Requirements. " SignatureDate 20 i INSPECT ONS SHALL BE EQ ESTED 24 HOU RI R TO COMMENCEMENT OF ALL WORK BY CALLING THE INSPECTIO EAT 425-430-72 OkAYGOING 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 snail De scneaulea at a maXlmum of 14 clays prior to the fop start crate. Plan Review/Development Engineering Date Site Construction Inspector Date Development Engineering Manager Date ❑ Approved as submitted Pre -Construction Meeting required Approved with comments or redlines Camera inspection of utilities required Page 1 1 Published: 3/30/2017 Print For Reset Form CITY OF RENTON TRAFFIC CONTROL PLAN PROJECT NAME: 108597532 CONSTRUCTION COMPANY: PSE/Infrasource CONTACT NAME: Aurelie Johannson ADDRESS: 1660 Park Lane Burlington 98233 E-MAIL ADDRESS: Aurelie.Johannson@pse.com PROJECT LOCATION:13606 156th Ave SE NY] zrirl► lei WORK DATE: TBD upon permit approval Permit Holder agrees to all the following: PERMIT# PHONE#: PHONE#: CELL#: FAX#: (425) 466-4771 N/E/S/W OF: SE 2nd PI 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. PRINT NAMEA"' KC/11 J 070 rl0 0P_rL.ATE: q I 1 11 1 -7 I•11�TTIU11-am OFFICE COPY T - CONTRACTOR DEV. SERVICE, INSPECTION P. MILLER DEV. SERVICE, PLAN REVIEW B. BANNWARTH POLICE CHARLES KARLEWICZ FIRE FIRE MARSHALL FS H13 NOTES: • Work 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 (425-2044455) 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 -- NORTH --