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HomeMy WebLinkAbout00070381FOR OFFICE Y CASE NO.: DATE SUBhUM SUBMITTAL CBECRED BY: 3 r PUBLIC IMPROVEMENT PERMIT (PIP) APPLICATION MINIMUM SUBMITTAL REQUIREMENTS Attach 4 copies of a facility layout plan, which may include the following: Location, identification, and dimensions of ROW and pavement edge/curb) Location of all proposed improvements Location of all public utilities (existing) - dimensioned from right-of--way or back of curb, material, size If applicable, the facility layout plan must include the following (these may be drawn on separate sheets): A signage plan - include dimensions of sign (s), location from back of curb, materials, elevation drawing Drainage and/or erosion control plan Proposed waterway alterations with supporting drainage report Landscape plan showing the location and type of plantings (existing and proposed, both common names and scientific) The cost estimate for relocating any public facilities associated with the work An electrical plan Irrigation/Plumbing plan (must be sealed) A Structural plan showing details with anchoring, attachment, and material description (must be sealed) Private utilities plan- dimensioned from right-of-way or back of curb, material, size Attach one copy of the following: Indemnity agreements from abutting fee owners APPLICANT/PROJECT MANAGER'S INFORMATION (Party responsible for completion of all work associated with the project): Name / Mailing Address (f.S ca -C 'ge,4 City State Zip Code -IV 7- 0 E-Mail Address a a c&~ Phone Numbe c7 ---Y-31- 77`J Fax Number 6571P-) x,131- 79: ~ PARTY RESPONSIBLE FOR MAINTENANCE: (if party is a group, please provide information for contact person) Name/Group AA -.qa 5 7`.f e -i- 4ate &->41x~f C L`..~e,~ ~•~+t-• ~~ic i.7~, Mailing Address ~Ej6ts 116-cz u -e-- City State Zip Code ;?'z.' V- E-Mail Address Phone Number gam ( . Fax Number 6; IZ.P 5 3/ - 93-T IDENTIFY THE TYPE OF WORK TO BE PERFORMED: Electrical irrigation system Demolition Master Electrician Master Irrigator &4,,64)w, ,r W,i -b,) e_ Structural Contractor PIP APPLICATION 1 of 2 PIPAPP.DOC 3/25/99 Wood fence Masonry fence -Sign(s) Facade Awning Cafe -Canopy Benches Bike racks ✓ Landscaping Waterway Alterations Other (please describe) *Structural Contractor *Structural Contractor *Sign Contractor. Structural Contractor Structural Contractor *Structural Contractor *Structural Contractor *Landscape Architect/Company Design Engineer Identify party to perform this work: *the starred items may not require that structural contractors, sign contractors, or landscapers perform the work - contact applicable City Departments for determination IDENTIFY THE FOLLOWING: The total valuation of the work: S lv ~1er74 The total square footage of the site: The total linear feet of water lines crossing under paved road: Estimated cost of future relocation of improvements: $ I hereby verify that the information contained in this application is true and complete, to the best of my knowledge. I understand that the City has the authority to inspect the work to be conducted within the public right-of-way at any time. I also understand that this permit may be revoked at any time at the discretion of the City Officials. A)Ipmls s' re Date applied Conditions of Approval: Authorization of City Engineer Date approved PIP APPLICATION 2 of 2 PIPAPP.DOC 3/25/99 FOB OFFICE US- CASE NO.: - DATE SUBMMED• SUBMITTAL CBECIM BY: PUBLIC IMPROVEMENT PERMIT (PIP) APPLICATION MINIMUM SUBMITTAL REQUIREMENTS Attach 4 copies of a facility layout plan, which may include the following: Location, identification, and dimensions of ROW and pavement edgelcurb) Location of all proposed improvements Location of all public utilities (existing) - dimensioned from right-of-way or back of curb, material, size If applicable, the facility layout plan must include the following (these may be drawn on separate sheets): A signage plan - include dimensions of sign (s), location from back of curb, materials, elevation drawing Drainage and/or erosion control plan Proposed waterway alterations with supporting drainage report Landscape plan showing the location and type of plantings (existing and proposed, both common names and scientific) The cost estimate for relocating any public facilities associated with the work An electrical plan Irrigation/Plumbing plan (must be sealed) A Structural plan showing details with anchoring, attachment, and material description (must be sealed) Private utilities plan- dimensioned from right-of--way or back of curb, material, size Attach one copy of the following: Indemnity agreements from abutting fee owners APPLICANT/PROJECT MANAGER'S INFORMATION (Party responsible for completion of all work associated with the project): Name A ->(.a a. . a-:) Mailing Address /oz.lol/ Res ~~c-rC+~ c• V City _ -7f"-4) State Zip Code '1g7~ E-Mail Address eAoe-Ae- (2 a o/ ~ Phone Numbe %7`7 7 Fax Number 6 57.0 3,3/ - 7-s PARTY RESPONSIBLE FOR MAINTENANCE: (if party is a group, please provide information for contact person) Name/Group A74,La! 5 ~ 7,fe-sZ y(aye_ - .c .J~,~ G~ rocs 74, Mailing Address % i-ZAtr 2'f `L -e- City &/%e. 7S~r~'c~✓ State ~ Zip Code zz.0 ~y E-Mail Address Phone Number ) 619.57-,-14/64 Fax Number 531- 735,- IDENTIFY TIE TYPE OF WORK TO BE PERFORMED: Electrical i4rngation system Demolition PIP APPLICATION PIPAPP.DOC 3/25/99 Master Electrician Master Irrigator Z(,t _ a? -YV,s. e- Structural Contractor 1 of 2 } Wood fence Masonry fence -Sign(s) Facade Awning Cafe -dopy Benches Bike racks ✓ Landscaping Waterway Alterations -Other (please describe) *Structural Contractor *Structural Contractor *Sign Contractor Structural Contractor Structural Contractor *Structural Contractor *Structural Contractor *Landscape Architect/Company Design Engineer Identify party to perform this work: *the starred items may not require that structural contractors, sign contractors, or landscapers perform the work - contact applicable City Departments for determination IDENTIFY THE FOLLOWING: The total valuation of the work: S (,coo The total square footage of the site: / © q o s'~ j-A The total linear feet of water lines crossing under paved road: Estimated cost of future relocation of improvements: $ I hereby verify that the information contained in this application is true and complete, to the best of my knowledge. I understand that the City has the authority to inspect the work to be conducted within the public right-0f--way at any time. I also understand that this permit may be revoked at any time at the discretion of the City Officials. ~ /Sra?QDO i0can's s' re Date applied Conditions of Approval: Authorization of City Engineer PIP APPLICATION PIPAPP.DOC 3/25/99 Date approved 2 of 2