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Franchise Permit ApplicationDEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT Page 1 of 1 | Published: 1/2/2019 Planning Division | 1055 South Grady Way, 6th Floor | Renton, WA 98057 | 425-430-7200 Email: franchisepermits@rentonwa.gov Website: rentonwa.gov FRANCHISE PERMIT APPLICATION Published: 1/2/2019 TO THE APPLICANT: Submit an electronic copy of the plans with the Franchise Permit Application and the Site Specific Traffic Control Application to franchisepermits@rentonwa.gov. Permit cost is $630.00. 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: Franchise Job Number: Phone: Contact Name: Email: Job Site Address: Project Name: Description of Work: Please check all that apply: ☐ New Construction ☐ Repair/Relocate ☐ Underground ☐ Overhead ☐ Sidewalk ☐ Street ☐ Open Trench ☐ Bore # of feet: Contractor Name: Phone: State Contractors License #: City of Renton Business License #: “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 Date INSPECTIONS SHALL BE REQUESTED 24 HOURS PRIOR TO COMMENCEMENT OF ALL WORK BY CALLING THE INSPECTION LINE AT 425-430-7203 OR BY GOING TO MYBUILDINGPERMIT.COM Jobs are required to be called in for job start, re-inspection and project final. Re-inspection fees are billed at $125/hour. All Pre-Construction meetings shall be scheduled at a maximum of 14 days prior to the job start date. Plan Review/Development Engineering Date Approved as submitted Pre-Construction Meeting required Site Construction Inspector Date Approved with comments or redlines Camera inspection of utilities required Development Engineering Manager Date