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Grading Permit ApplicationH:\CED\Data\Forms-Templates\Self-Help Handouts\Building\Grading License Permit Application.pdf Updated 4/25/18 4. CONTRACTOR INFORMATION DOING THE WORK AS THE BUILDING/HOME OWNER. If yes, please fill out the Owner Affidavit and include it with this form. Tenants cannot do the work without written permission from the owner. HIRING A LICENSED CONTRACTOR WILL BE DOING THE WORK. Fill out the portion below (Required): NAME: ________________________________________________________ PHONE: ___________________________________ STATE OF WASHINGTON CONTACTOR’S LICENSE: _________________________________________________________________ CITY OF RENTON BUSINESS LICENSE: ___________________________________________________________________________ Development Services Division 1055 S. Grady Way Renton, WA 98057 (425) 430-7200 www.rentonwa.gov GRADING PERMIT APPLICATION 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) 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 (1) year from the 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 plan review is required. This application must be a .pdf and included in your submittal. FOR OFFICE USE ONLY: PERMIT NUMBER: _______________________ PROJECT NUMBER: _________________ LAND USE NUMBER: _______________ ASSOCIATED BUILDING PERMIT NUMBER (REQUIRED):_____________________________________________________________ This number is required if your work is associated with work being done under a Building Permit. The Building Permit could belong to someone else, but we still need the number to keep all associated permits tied together. You may need to contact the Building Permit owner. Description of work: ________________________________________________________________________________________ 1. LOCATION AND VALUATION INFORMATION JOB ADDRESS: ________________________________________ PARCEL NO.: ________________________ LOT #: ___________ VALUE OF WORK: (Fair market value for time + materials) $____________________ BOEING JOB # (If applicable): ____________ 2. OWNER INFORMATION PROPERTY OWNER NAME: ______________________________________________ PHONE: _____________________________ ADDRESS: _____________________________________________ CITY: _____________ STATE: _________ ZIP: ______________ 3. CONTACT INFORMATION CONTACT NAME: ______________________________________________________ PHONE: _____________________________ EMAIL: _________________________________________________________ FAX: _____________________________________ Tier Grade /Fill Qty. Cleared/Disturbed Area New/Replaced Hard Surface Review/Intake Fee Issuance/Inspection Fee 1* < 50 cy < 7,000 sf <2000sf $155.00 $148.00 2* 50 cy - 499 cy 7,000 sf - < 3/4 acre 2,000sf – 4999 sf $466.00 $444.00 3* 500 cy - 4,999 cy 3/4 ac - < 1 ac 5,000sf - <1ac $621.00 $887.00 4* 5,000 cy - 49,999 cy 1 ac - < 2.5 ac 1ac -<2.5 ac $932.00 $1,183.00 5* 50,000 cy - 99,999 cy 2.5 ac - < 5 ac 2.5ac -<5ac $1,242.00 $2,366.00 6* 50,000 cy - 99,999 cy 2.5 ac - < 5 ac 5 ac and Larger $1,553.00 $3,550.00 *+ 5% Technology Fee Assessment GRADING PERMIT INFORMATION 5. GENERAL INFORMATION Number of total cubic yards to be excavated: ____________________________________________________________ Number of total cubic yards to be filled: ________________________________________________________________ Note: Excavation and/or fill in excess of 500 cubic yards require Environmental Review with the Planning Department. Please contact Development Services at 425-430-7200 for an application and information on requirements and procedures. Brief Description of proposed activity: _________________________________________________________________  Will fill be brought on site? _______________________________________________________________________  Where does the fill originate from? ________________________________________________________________  Is this located near the shoreline of Lake Washington or associated wetlands? _____________________________  Is the project site located within an identified 100 -year flood plain? ______________________________________  Please specify if there are any regulated trees (RMC 4‐11‐20) to be removed? ______________________________ I certify that the information on this application furnished by me is true and correct and that the applicable requirements of the City of Renton will be met. I understand that this application is valid for one year from the application date. If a permit is not issued during this time period, the application will become void. This application does not constitute a permit to work. Work is not to commence until the building permit is posted on premises where work is to be performed. Certification is hereby rendered that no work is to be done except as described, and that all work shall conform to applicable codes. Work in public rights-of-way and/or utility easements are not authorized under this application. Any work done without the benefit of having a building permit issued is subject double the permit fee. Fees to be paid at permit intake. APPLICANT SIGNATURE: ______________________________________________________ DATE: ________________________ APPLICANT NAME PRINTED: _________________________________________________________________________________ SUBMITTAL REQUIREMENTS:  A site plan showing proposed graded location, topography and erosion control measures.  Plans drawn by a licensed civil engineer.  Fill Source Statement is required for projects located within an Aquifer Protection Area. If the project will involve importing fill in excess of 50 cubic yards, please provide five (5) copies of a source statement certified by a professional engineer. A source statement will be required for each source location from which imported fill is obtained.