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HomeMy WebLinkAboutMaster Franchise Permit Applicationrentonwa.gov/permitservices | developmentengineering@rentonwa.gov | 425-430-7240 3/8/2023 | Page 1 of 1 CITY OF RENTON Ι PERMIT SERVICES MASTER USE | FRANCHISE UTILITY PERMIT APPLICATION “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: _________________________ A 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. For City Use Only CITY PERMIT MFP#: WORK ORDER #: DATE OF APPLICATION: FRANCHISE AGENCY: MAILING ADDRESS: CONTACT NAME: PHONE: EMAIL: JOB #: JOB SITE ADDRESS: PROJECT NAME: DESCRIPTION OF WORK: CHECK ALL THAT APPLY: New Construction Open Trench Bore # of feet:________ Repair/Relocate Underground Other:_______________ Overhead Sidewalk Street Gas Electric CONTRACTOR NAME: PHONE: CITY OF RENTON BUSINESS LICENSE #: STATE CONTRACTORS LICENSE #: Approved as submitted On-site pre-con required Approved with comments or redlines Traffic control plan attached Camera inspection of utilities required Issue Date:__________________________________________ Permit expires 6 months from issue date Development Engineering /Utility Inspector Date