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4072 (2)NOTE: • — - With proper validation this form constitutes an encroachment 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 III DATE: 1/27/04 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 81805 Ave Juarez and Cille Sinaloa (Street address or Description of Location) PURPOSE OF CONSTRUCTION Paving Only Repair Sketch (attach construction lans if a p ppropriate) DESCRIPTION OF CONSTRUCTION 3'X3"n LINX- Calle Sinaloa Ill' W�aat of c4nter\1 DIMENSION Ok INSTALLATION OIL' REMOV 1 i side R� 112�9' SIZE OF EXCAVATION, IF NEEDEIJ I I APPROXIMATE TIk1E WHEN WOR144WILL,BEGIN 2--29-04 1 i APPROXIMATE TIME OF COMPLETION I ESTIMATED CONSTR UCTION COST $ - (Including removal ofVll obstruction) materials, and debris, backfillin j, com- paction and placing permanent resurlacig and/or replacing ilmprove$nents) In consideration of thigranting of this permit, the applicant hereby agrees to: Indemnify, de?end a d save the C �y, its authorized agents, officers, reRresentatives ani penalties, liabilitiesr loss resulting from claims or court action and a ising out of ai happening or occurs g as a proximate result of any work undertaken der the perm Notify the Administrative Authority at lest twenty-four (24) hours in fdvance of the Comply with all applicable City (IrdinanA, the terms and conditions ofj the permit ar La Quinta and to pay fqr any additional repl,ac,, ement sec sary as the result of this w employees, harmless from afid against any and all accident, loss or dams to persons or property granted pursuant to t fs application. ime when work wil a started. all applicable rules and regulations of the City of Signature of Applidant or Agent Southern Califronia Gas; PO Box 3003; Redlands, CA 92373; 909--335-7963 Name of Applicant (please print) Business Address Telephone No. A.M. Ortena►s 10125 Channel Rd; Lakeside, CA; 619-390-1988 Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. 04114 City Business License No. Gag: Comvanv Self Insured Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I I I Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by 100.00 $ 100.00 Date A 4072 PERMIT VALIDATION PERMIT NO. A079 DATE APPROVED 1-28-04 EXPIRATION DATE 2--28--04 DATE ISSUED 4� 2A By �`,�,r Administrative Authority Recorded by Telephone: (760) 777-7075 v.� NOTE: FINANCE With proper validation Revenue Code — this form constitutes an CITY OF LA QUINTA encroachment permit 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 III DATE: 1/27/04 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 81805 Ave. Juarez and'Calle Sinaloa (Street address or Description of Location) PURPOSE OF CONSTRUCTION Paving Only: Repair Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 3 `::3' in 3"m u. South side F, Calle Sinaloa 121' W st of c nter ine of ve Juar DIMENSION 0 INSTALLATION O fREMOV L SIZE OF EXCAV AT ION, IF NEEDE APPROXIMATE TI E WHEN WOR WILL EGIN 2-29— 4 APPROXIMATE TI OF COMPLE ION ' r ESTIMATED CONST UCTION COS $ (Including removal of II obstruction ma rials, and debris, b kfillin paction and placing p rmanent resu aci g and/or replacing i prove In consideration of th granting of his ermit, the applica hereb Indemnify,. defend• d save the Ci y, it authorized agents, o ficers, re penalties, liabilities r loss resulti g fro claims or court ac ion and a happening or occurri g as a proxi ate r suit of any work u dertaken Notify the Administr ive Author. y at le st twenty-four (2 hours in Comply with all appli ble City rdinance the terms and conditions o La Quinta and to pay r any a ditional re cement nec ssary as the , com- ents) agree resenta ising c der tl dvana the F r suit c > to: tives and employees, harmless from d against any and all ut of an accident, loss or from/hid to persons or property ie permi granted pursuant to t s application. of the :ime when work wil a started. ermit an all applicable r s and regulations of the City of IF this wo k. Signature of App ' nt or Agent Southern Califronia Gas; PO Box 3003: Redlands, CA 92373; 909-335-7963 Name of Applicant (please print) Business Address Telephone No. A.M. Ortega; 10125 Channel Rd; Lakeside, CA; 619-390-1988 Name of Contractor and Job Foreman Business Address Telephone No. 496111 Contractor's License No. 04114 City Business License No. Gas Company Self Insured Applicant's Insurance Company Policy Number FEES: Subdivision Improvement.Permit — Class 111 Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor. Improvement Permit — Class IV: See attached schedule Inspection Fee $ Permit Fee 100.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 100.00 Receipt No. Received by Date Ng 4072 PERMIT VALIDATION PERMIT NO. 41717? DATE APPROVED 1-28-04 EXPIRATION DATE 2-28-04 DA IS ED — Z7O By Administrative Authority Recorded by II Telephone: (760) 777-7075 _ ; OTE - _- 4 t r / h� With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT).�� For the construction • of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers l water mains and other like public works improvements .in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit — Class III DATE: 1/27/04 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 81805 Ave Juarez and Calle Sinaloa 1 (Street address or Description of Location) PURPOSE OF CONSTRUCTION Pav1.nt- Onlv Repair Sketch (attach construction plans if appropriate) �" + DESCRIPTION OF CONSTRUCTION13y1.3Yin 3"m e. South side �(1�R '� )�Z'�9 Calle Sinaloa 121~" W st of c4nter\l.ine of �A.ve Juar DIMENSION O�FkINSTALLATION OR REMOVAL L ) SIZE OF EXCAVATION, IF NEEDE APPROXIMATE TIME WHEN WORK(WILL`I3EGIN �— APPROXIMATE TIME OF COMPLE ESTIMATED CONSTRUCTION COE (Including removal ofUl obstructior paction and placing permanent-resu In' consideration of the granting of Indemnify, defend. and save the C penalties, liabilities .M loss resulti happening or occurring as a proxi Notify the Administra Comply with all appli La Quinta and to pay ble City pr any i ;ION f1. matl aclnl This P Iy, its g fro late r( yatli •a1.1 rn itional rials, and debris, bab kfillind, com- / and/or replacing improvements) )rmit, the applicant hereby1 agrees to: authorized agents, officers, representatives and employees, harmless from �nd against any and all / i claims or court action and. arising out of an accident, loss or damage to persons or property sult of any work urr�ldertaken u�,nder the permi , granted pursuant to th�fs application. t twenty-four 12%4') hours in �dvance of the time when work will be started. es,�the terms and of, the permit ani all applicable rules and regulations of the City of replacement nece//ssary as the result of this work. Signature of Appl:ieant or Agent Southern Oalifronia Gas; PO Box 3003; Redlands, CA 92373; 909-335-7963 Name of Applicant (please print) Business Address Telephone No. A.M. Orteea; 10125 Channel Rd; Lakeside, CA; 619-390-1988 Name of Contractor and Job Foreman Business Address Telephone No. /AA61111 Contractor's License No. 04114 City Business License No. Gas Cotnnany Self Insured Applicant's Insurance Company Policy. Number FEES: Subdivision Improvement Permit —Class III Public improvements: 3% of'estimated construction costs Private improvements: 3% of estimated construction costs Minor, Improvement Permit — Class IV: See attached schedule Inspection Fee Permit Fee ' 100.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 100.00 Receipt No Received by Date 4072 PERMIT VALIDATION PERMIT NO. An77 DATE APPROVED 1-28-04 y -EXPIRATION DATE 2--28-04 DATE ISSUED` J-2Z_j4A Administrative Authority Recorded by Telephone: (760) 777-7075 NOTE: With proper validation this form constitutes an encroachment 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 `, t ' K,' DATE: - Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION -' = (Street address or Description of Location) PURPOSE OF CONSTRUCTION �� "�°"' �� �'' �" Sketch (attach construction plans if appropriate) DESCRIPTION OF, CONSTRUCTION ' \r DIMENSION OF INSTALLATION OR' REMOVAL SIZE OF EXCAVATION, IF NEEDED i rye APPROXIMATE TIME WHEN WORK'WILL BEGIN APPROXIMATE T14E OF COMPLETION � ESTIMATED CONSTRUCTION COST $ (Including removal of `,'all obstruction;", materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) In consideration of the, granting of this permit, the applicant hereby agrees to: Indemnify, defend, and 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 occurri%g as a proximate result of any work undertaken d,nder the permit, granted pursuant to this application. Notify the Administrative Authority at leest twenty-four (24) hours in advance of *the time when work wi kbe started. 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. f� Signature of Applicant or Agent Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class II I Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor, Improvement Permit — Class IV: See attached schedule Inspection Fee $ Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. $ : o Received by Date PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE - `"�' A-0 DATE ISSUED By Administrative Authority Recorded by Telephone: (760) 777-7075 NOTE: With proper validation this form constitutes an encroachment 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 DATE 1/27/0+4 Subdivision Improvement Permit — Class I I I Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 81005 Ave Juarox and C4110 ULnal.oa (Street address or Description of Location) PURPOSE OF CONSTRUCTION Pa'vinn Only Aopoir Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION ".3 2g' fsogii3 tsac:r Cairo �f.ivaloc tii ugo-r or coneorNixnc of Ave . DIMENSION OF INSTALLATION OR REMOVAL t 1t f i i SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN" APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ (Including removal oflall obstruction' materials, and debris, backfiIIing, com- paction and placing permanent resurfacing and/or replacing improvements) { In consideration of the t granting of this permit, the applicant hereby agrees to: Indemnify, defend• and 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 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. ' f Comply with all applicable City Ordinance's, the terms and conditions of the permit and all applicable rulend regulations of the City of La Quinta and to pay for any additional replacement necessary as the result of this work. Signature of Applicant or Agent Southara ColiProniaa Gnn# PO Box 3003; tludlcn4c, CA 92373; 909-335-7963 Name of Applicant (please print) Business Address Telephone No. A.rL Ortoro; 10125 Chn-anol 11d; Lahuclido. CA; 619--SOO-1980 Name of Contractor and Job Foreman Business Address Telephone No. 486311 Contractor's License No. Goo Co:nVcnp Solt Insured 04114 City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class Ill Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor, Improvement Permit — Class IV: See attached schedule Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ 100.00 $ IGO.00 Receipt No. Received by Date fi t 072 PERMIT VALIDATION PERMIT NO. 6072 1.20-04 DATE APPROVED �--2C-04 EXPIRATION DATE DATE ISSUED ` By Administrative Authority Recorded by 11Telephone: (760) 777-7075 Routing Path m 0 I L�J I FE-1 i•1 " city'"'f -a uin anCheckFf2eview(White) o Q ta` Final.Review (Green) Y k ,PublicWos nf 6y `PLAN APPROVAL / REVISION REVIEW Plan Re eived By iv: Protect Name: % 9w5 DIN: "� of Description: Pla��}},,Check Round t��// 1 2 3 /4t 5 6 7 8 9 10 City's Consultant Approval Date: DIRECTOR Tim Jonasson, Public Works Director Needed By: [ ] Approved [ ] Rejected Signed On: Comments: ENGINEERING Steve Speer, Assistant City Engineer Needed By: [ ] Approved [ ] Rejected Signed On: Comments: DEVELOP114ENT Paul Goble, e n er Needed By: [ ] Approved [)(Rejected Signed On: ,D Comments: DEVELOPMENT Brian Ching, Associate Engineer Needed. By: [ J Approved [ ] Rejected Signed On: Comments: DE LOPMENT Tkqy Co i, Assistant Engineer I Needed By: [LyApproved [ ] Rejected I Signed On: Comments: MA T & OPERATION James Lind se , Maintenance Mana er Needed By: Approved [ ] Rejected Signed On: Comments: BUILDING & SAFETY Greg Butler, Building Mana er Needed By: [ ].Approved [ ] Rejected Signed On: Comments: COMM DEVELOPMENT Oscar Ord, Interim Director Needed By: [ ] Approved [ ] Rejected Signed On: Comments: PCLOADMFSI\PUBWRKSIPWDEPTD=TORMSXFO05.dx - I PLAN CHECK NUMBER: