Devonshire 1-CN 930408HOLD HARMLESS AGREEMENT
our OF LOT
(~D~S), COPPE~, '~'~ (~ O~ER) ~DERST~
AC~O~EDGE ~T T~ FENCE ~ICH IS LO~TED ON ~IR PROPER~
ENCROAC~S 0~0 T~ CI~ OF COPPE~ ' S D~I~GE ~;
~D
~, T~ O~ ~E~T~D ~ AC~O~EDGE ~T IN ~E
~PAIRS OR I~RO~E~S ~ ~QUI~D TO BE ~E T0 ~ CI~ OF
COPPE~'S D~I~GE ~EE~ ~ICH WO~D ~QUI~ ~MOV~ OF
FENCE IN O~ER TO EFFECT SUCH I~RO~ENTS; ~D
~, ~ O~ERS ~COGNIZE ~ AC~O~EDGE T~T SUCH FENCE
W~ INSTALLED DESPITE ~O~EDGE OF T~ CI~'S D~GE ~EE~;
O~RS ~BY AGUE TO ~MO~ SUC~ FENCE AT ~IR O~ COST
~ON ~Q~ST BY T~ CI~ OF COPPE~, ~D IF O~RS FAIL TO ~MO~
~ FENCE ~ON ~Q~ST BY T~ CI~, ~N CI~ WI~ ~MO~ SUCE
FENCE ~D O~RS ~BY INDE~IFY ~D HOLD T~ CI~ ~ESS FROM
~ C~I~ OF D~GE TO ~ FENCE ~ICE ~ISE FROM T~ CITY'S
~MOV~ OF SUCH FENCE ~I~ ~PAIRING, INSPECTING, I~ROVING OR IN
~ WAY SEEKING ACCESS TO ~ D~I~GE ~EE~. ~DITIO~IJ'Y,
O~RS AGUE TO ~I~SE ~ CI~ FOR ~O~LE COSTS INC~D
~MOVING ~ FENCE.
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BUILDING PERMIT APPLICATION
Print or Type in a Clear, Legible Manner
Job Address:
Contractor: ~_
~Hption of Work to ~ ~ne
Class of Work:
Subdivision:
Phase or Section Number:
Address: Phone #:
90 bw-/t~7,,CcppeL/ ~501c(- /0~7
[~ew ~adatio.
'~ $ 0~,~ Phone #: ~ ~?~'- lic ~,~
[] Alteration [] Repair [] Demolition
Area of Building in Square Feet
First Floor
Second Floor
Garage. Value of Work
to be Performed
NOTICE
This permit becomes null and void if work or construction authorized is not commenced
within 180 days, or construction on work i~ suspended or'abandoned for a period of 180
days at any time a~er work is commenced.
I hereby certify that I have read and examined this application and know the same to be true
and correct. All provisions of laws and ordinances governing this type of work will be
complied with whether specified herein or not. The granting of a permit does not presume to
give authority to violate or cancel the provisions of any other federal, state or local law
regulating construction or the performance of construction.
Signature of Contractor or Authorized Agent Print NameJ
GRAY AREA FOR OFFICE USE ONLY
imber: ~
Occupancy Classification;
Electrical Contractor Plumbing Contractor
Mechanical Contractor