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  <br />H:\CED\Data\Forms-Templates\Self-Help Handouts\Building\Small Cell Application.pdf                                  Updated 4/25/18  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br />  <br /> <br />Development Services Division <br />1055 S. Grady Way <br />Renton, WA 98057 <br />(425) 430-7200 <br />www.rentonwa.gov <br />SMALL CELL <br />WIRELESS APPLICATION <br />This application must be filled out completely in order to be submitted for review.   We will not accept incomplete applications.  This application is good for one (1)  <br />year from the submittal date.  A one–time extension of one (1) year can be requested at a cost of half the plan review fee.  Once issued, the permit is good for one  <br />(1) year from issue date.  A one–time extension of one (1) year can be requested at a cost of half the permit fee.  Please follow our Electronic File Standards if your  <br />permit requires plan review.  This application must be a .pdf and included in your submittal.  <br />FOR OFFICE USE ONLY: <br />PERMIT NUMBER:  _______________________ PROJECT NUMBER:  _________________ LAND USE NUMBER:   <br />1. LOCATION AND JOB DESCRIPTION <br />ADDRESS:  __________________________________________ TENANT NAME:  ____________________ Parcel #:  _____________ <br />DESCRIPTION OF WORK:  _____________________________________________________________________________________  <br />FRANCHISE AGREEMENT NUMBER: (REQUIRED):  ___________________________________________________________________________________ <br />NUMBER OF UNITS:  ______________________________   1-5 unit max.  <br />FEE:  $500 Non-refundable Application Fee.  Additional fees may be added based on review time.  Additional 5% Technology Fee  <br />added to all permits.  <br />2. OWNER INFORMATION <br />PROPERTY OWNER NAME:  ____________________________________________________ PHONE:  __________________________________ <br />ADDRESS:  ___________________________________________________________ CITY:  ____________ STATE:  _______ ZIP:  ______________  <br />3. CONTACT INFORMATION <br />CONTACT NAME:  ______________________________________________________ PHONE:  ______________________________ <br />EMAIL:  _______________________________________________________________ FAX:  ________________________________ <br />4. CONTRACTOR INFORMATION -List the Washington State Contractor’s License Number for the following: (Required) <br />ELECTRICAL CONTRACTOR NAME:  _______________________________________________ PHONE:  _______________________ <br />STATE OF WASHINGTON CONTACTOR’S LICENSE:  __________________________________________________________________ <br />CITY OF RENTON BUSINESS LICENSE:  ____________________________________________________________________________ <br />If applicable, list the construction contractor information below.  <br />BUILDING CONTRACTOR NAME:  ________________________________________________ PHONE:  _______________________  <br />STATE OF WASHINGTON CONTACTOR’S LICENSE:  __________________________________________________________________ <br />CITY OF RENTON BUSINESS LICENSE:  ___________________________________________________________________________