12090c&,,, 4 4aQu;Mrw
ENCROACHMENT PERMIT
PUBLIC WORKS CONSTRUCTION
See below for Finance Revenue Codes
(= (Z) [71=) ilkv
For the construction of public or private curbs, driveways; pavements, sidewalks, parking lots, sewers, water mains and other like public
works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS.
±� Subdivision Improvement Permit - Class III
Minor Improvement Permit -Class IV
DATE: 12/19/2012
LOCATION OF CONSTRUCTION: IID; Fred Waring Drive and Dune Palms Road
PURPOSE OF CONSTRUCTION: Reconfigure Overhead CKT N922 & N911
DESCRIPTION OF CONSTRUCTION: Remove Existing Jumpers Top to Bottom Circuit and Install New Overhead Switch Disconnect
DIMENSION OF INSTALLATION OR REMOVAL:
APPROXIMATE TIME WHEN WORK WILL BEGIN: 12/26/2012 TIME OF COMPLETION: 1/14/2012
ESTIMATED CONSTRUCTION COST: • $8,977 (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing
permanent resurfacing and/or replacing improvements) , 1 MTrp tCoT4 oibQ ern .
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COMMENTS City of La Quinta will Invoice the Permittee for Time & Material Expenses To Be Determined on Material Ledger
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, defend avid save the City,, its authorized agents, officers, representatives and.employees, harmless from and against any
and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or
property happening or occuring as a proximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started at (760) 777-
7097. To submit an inspection request, .leave a message on the Inspection Request Hotline at (760) 777-7097 prior to 1:30 P.M. at
least twenty-four (24) hours prior to the anticipated inspection.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City
of La Quinta and to pay for any additional replacement necessary as the result of this work.
IID - Javier Soliz / Esteban Ramos 81-600 Avenue 58, La Quinta, CA 92253 (760) 801-9762 / 427-7336
Name of Applicant Business Address Telephone No
IID Forces
Name of Contractor and Job Foreman Business Address Telephone No.
N/A N/A
Contractor's License Number City Business License No
Self -Insured Self -Insured
Applicant's Insurance Company Policy Number
FEES Subdivision Improvement Permit - Class I
Minor Improvement Permit- Class I
Finance Revenue Code
Inspection Fee EE=1
$0.00
Permit Fee EE=1
$0.00
As -Built Deposit E-A
$0.00
Cash Deposit -Surety Bond, E_B
$0.00
if required
TOTAL
$0.00
Public Improvements: 3% of estimated construction costs
Private Improvements: 3% of estimated construction costs
PERMIT NUMBER: 12090 COMPLETE
DATE ISSUED: -7- g / -z-
EXPIRATIO ATE: Z4 /3
BY: v
WORK INSPECTED BY*: let.- VmmmiaA
PERMIT COMPLETION DATE*: JAW
' If the work is covered by a Subdivision Improvement Agreement, Subdivider
shall request final acceptance of improvements from the City Council.