2843proper validation
form constitutes an
ncroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
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 I II '
DATE: 10/2�/98 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION PGA West Tract 28522
(Street address or Description of Location) ;
PURPOSE OF CONSTRUCTION Install subdivigiiS
t Sketch (attach construction plans if appropriate)
imorovements: .:..,� ....M
DESCRIPTION OF CONSTRUCTION Curb & Gutter. St4orm
Drain•. '€ind` Street Comntxuct;
SF.E ATTACHED CONDITIONS,.
DIMENSION OF INSTALLATION OR REMOVAL See auorovod
' olans. SEE APPROVED PAS
' SIZE OF EXCAVATION, IF NEEDED See a»oroved •mania.
APPROXIMATE TIME WHEN WORK WILL BEGIN 11/2/93
APPROXIMATE TIME OF COMPLETION Unknown,*
ESTIMATED CONSTRUCTION COST $ 154, 828,.00
,(Including removal of all obstruction,'materials, and debris, backfilling, con
paction and, placing permanent resurfacing and/or. replacing improvements)
In consideration of- the granting of this permit, the applicant hereby agrees to: r,
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and againwany_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 occurring 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.
Comply with all 'applicable City Ordinances, the terms'and conditions. of the, permit and all applicable rules and .regulations'ofrthe City of
La Quinta and to pay for any additional replacement necessary as the, result of this work.. -
Signature of Applicant or Agent
Bristol Construction Inc., 73-929 Lnrre'a. Palm Desert. ' CA 92260•' 760/346-4061
Name of Applicant (please print) Business Address Telephone No.
James 0.. Hue Cohotictioni M. Box13810'*-Palm 'Desart, 'CA 92255 .760/568-6600 .
Name of Contractor and Job Foreman Business Address 'Telephone -No.
316895 2727
Contractor's License No. City Business License No.`'
Saf e o Ios4,Co. GL-AA1300898
Applicant's Insurance Company i Policy Number.
FEES:, Subdivision 'Improvement Permit —.Class.11l
Public improvements: 3/0 of estimated construction costs.
Pri,bafe•improvements 3%of estimated construction costs
Minor,,lmprovement Permit — Class'IV- See attached schedule
Inspection'Fee $ 4644.84
Permit Fee r, 100.00`
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 4744.84
Receipt No.
Received by Date
Recorded by
' .• OCT 3 0 ��
PERMIT VALIDATION
PERMIT NO. 2843
DATE APPROVED. 10/29/96
EXPIRATION DATE-10/29/99
DATE ISSUED 10/29/98
By
Administrative Authority
Telephone: (619).777-7075
CONSTRUCTION DEFICIENCY FORM.
This trm documents deficient construction and the requirements to bring deficient items of construction into
conformance with the requirements of the City of La Quinta. Copies of this form will be, delivered to the
project owner, developer, subdivider, or designee. Failure to correct construction deficiencies will prevent -City
acceptance of the work, release of any or all improvement securities, and may require the City to assume
responsibility for completion of all required improvements as authorized by the improvement agreement
governing the work.
The contractor and the developer/owner assume all responsibility and costs associated with the removal and
replacement of improvements not meeting the requirements of the City of La Quinta.
Development Name: ' '` f"'?' D.I.N.(Tract No.):
Contractor: (s+�Ff Ac 1'rt/`°%�.;�J:. %fr,y� Foreman:t�c':1>>!,_ ,t.;
� Permit No.:
GRADING
DON -SITE STREET IMPROVEMENTS
El OFF -SITE STREET IMPROVEMENTS
DEFICIENT WORK
STORM DRAINAGE IMPROVEMENTS
GENERAL SITE IMPROVEMENTS
OTHER
_DESCRIPTION
4
,:� K,' =!r �.C.-�'T.f'�G�,lS° :�:i I✓-'�'�'' �, % .F.�'i�" .'ti C..' % ���:r%:�' j �.+'�l i:� l'�. �t`�--''4 ; c�:`rf sfl1�`.C"!Y' #� {.��,,r�: 1
All constructiorlactivity shall cease until deficiencies as noted hereinabove are corrected as directed by the
City of La Quinta. Contractor and developer/owner acknowledge that all work completed after receipt of this
construction deficiency form is considered "at risk" and subject to removal upon demand by the Public Works
Department if found to be unacceptable. Construction deficiencies will not be considered_ corrected until Page
2 of this form is attached hereto and has received the Inspector's approval and the Public Works Department's
certification.
Contractor:
Contractor's Signature
Public Works Inspector:
ZZ
Public Works Inspector
lkhy
Date
Date
Title(i.e. Superintendent, foreman, etc.)
CONSTRUCTION DEFICIENCY FORM C:\WP\FORMS\F044.WP 12/98 . REV-0 Page 1 of 2
WHITE COPY - OWNER YELLOW COPY - CONTRACTOR PINK COPY - INSPECTOR GOLD COPY - PERMIT FILE