4583NOTE:
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
January I2 Subdivision Improvement Permit — Class I I I
DATE: ► 2006 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Wendy's Next to Goodyear,, SDP „280&829., 79-275 Hwy 111
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Precise Grad
DESCRIPTION OF CONSTRUCTION
ee
DIMENSION OF INSTALLATION OR REMOVAL S
PSN
Sketch (attach consfruction plans if appropriate)
SIZE OF EXCAVATION, IF NEEDED i \\
APPROXIMATE TIME WHEN WORK WILL BEGIN f After ke—con
and schedule has been provided \ I \
APPROXIMATE TIME OF COMPLETION March, 17, 2006
ESTIMATED CONSTRUCTION COST $ 85.415.10 \
(Including removal of all obstruction, E aterials, and debris, backfilling, cA-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrl,to,
Indemnify, defend• and (save the City, its authorized agents,`officers, representatives,,and/e,ployees, harmless from and against any and all
penalties, liabilities or loss resulting rom claims or court ac ion and arising out of adent, loss or damage to persons or property
happening or occurringyas a proximate result of any work undertaken u7der the permed pursuant to this application.
Notify the Administrative Authority at\least twenty-four (24) hours in advance of th%hen work will be started.
Comply with all applicable City Ordinances, the terms and condi;ions o)f the permit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional r4eplacement necessary as the result of this work.
Wendv'a International
Name of Applicant (please print)
Name of Contractor and Job Foreman r
708936
Contractor's License No.
Westchester Fire�Inurance
Applicant's Insurance Company
5,r0ranlze,
nature of Applicant or Agent
CA 92066
ness Address
Business Address
FEES: Subdivision Improvement Permit Class I II
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor. Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 2,560.00
Permit Fee 100.00
Penalty As —Built 'Dep (1.000.00) "
Cash Deposit -Surety Bond
if required
TOTAL: $ 3,660.00
Receipt No.
Received by Date
Nick Ricb-
(214) 649-9256
Telephone No.
Telephone No.
City Business License No.
GLW — 786115
PERMIT NO
Policy Number
So') 4583
PERMIT VALIDATION
4583
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Recorded by 11 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: january 12, 2006
LOCATION OF CONSTRUCTION Wendy t s
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Precise Grad
DESCRIPTION OF CONSTRUCTION See PSN
DIMENSION OF INSTALLATION OR REMOVAL S
SIZE OF EXCAVATION, IF NEEDED
PSN
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
ez,r 9 SDZ,2095-4Z , 79-275 Pwv 111
APPROXIMATE TIME WHEN WORK WILL BFQGIN After Ce—cou
afad schedule has been • rovi c1
APPROXIMATE TIME OF COMPLETI N `Klarci. 17 2006
ESTIMATED CONSTRUCTION COST k 85 415. 0
(Including removal of all obstruction, aterials, and de ris, backfilling,
paction and placing permanent resurf cing and/or repla\condi
provers
In consideration of the granting of t is permit, the aphereby
Indemnify, defend• and ave the City its authorized ageers, rep
penalties, liabilities or oss resulting rom claims or couand al
happening or occurring s a proximat result of any wotaken u
Notify the Administrati Authority at least twenty-fouurs in
Comply with all applicab a City Ordinan es, the terms ai ions oILa Quinta and to pay fo any additional placement na the 0
international
Name of Applicant (please print)
Name of Contractor and Job Foreman
708936
Contractor's License No.
YVestchcster Fire In -
Applicant's Insurance Company
FEES: Subdivision Improvement Permit — Liss III
Sketch (attach constkuction plans if appropriate)
i n ; Pre— oa
:+ng Sche uie
to:
�entativ and a ployees, harmless from and against any and all
ing out any accident, loss or damage to persons or property
Jer the permi granted pursuant to this application.
Ivance of th time when work will be started.
the permit and all applicable rules and regulations of the City of
;ult of this work.
of Applicant or Agent
ness Address
Business Address
Public improvements: 3% of estimated struct n costs
Private improvements: 3% of estimated con lon costs
Minor. Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 2,560.00
Permit Fee 100.00
Pemity As —Built Dep (3 , 000 - 00 )
Cash Deposit -Surety Bond
if required
TOTAL: $ 3.660,00
Receipt No.
Received by
Recorded by
Date
Nick Rice
(214) 649--9256
Telephone No.
Telephone No.
City Business License No.
GLTAT — 786115
Policy Number
N® 4583
PERMIT VALIDATION
PERMIT NO. 4583
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
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: January 12, 2006
LOCATION OF CONSTRUCTION Wendy's Next to
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Precise Grad
DESCRIPTION OF CONSTRUCTION See PSN 05207
DIMENSION OF INSTALLATION OR REMOVAL SeqtPSN 05207
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN /After ke—con
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
)P._ 9055 - _. 79-275 Hwv 111
Sketch (attach construction plans if appropriate)
Pre -ton
Schellule
APPROXIMATE TIME OF COMPLETION Marcb\'17 r 2006 /
ESTIMATED CONSTRUCTION COST � 85.415.`�0 I
(Including removal of all obstruction, materials, and de-r s, back filling, com
paction and placing permanent resurfJcing and/or replanimprovements)
In consideration of the granting of this permit, the applicant hereby a�gre s�to,
Indemnify, defend and N� ve the City�its authorized agents officers, representatives9and employees, harmless from and against any and all
penalties, liabilities or Voss resulting from claims or court action and arising out of any accident, loss or damage to persons or property
happening or occurring has a proximate result of any work unde`ertaken under the permi granted pursuant to this application.
Notify the AdministrativeAuthority at least twenty-four 1241 ht urs in advance of t time when work will be started.
Comply with all applicable City Ordinances, the terms and cond�ions 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 �,esult of this work.
S-gnature of Applicant or Agent Nick Ric@—
wp.ndvI s Tntp.rnatioral. 910 B. Palilmira Ave. Orange, CA 92066 (214) 649-9,
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.
Westchester Fire Ins ance Comp nv GLW — 786115
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 $ 2,560.00
Permit Fee 100.00
Penalty, As -Built Deg (1 � 000 - 0n )
Cash Deposit -Surety Bond
if required
TOTAL: $ 3.660.00
Receipt No.
Received by Date
Recorded by
'2 4583
PERMIT VALIDATION
PERMIT NO. 4583
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Telephone: (760) 777-7075
Administrative Authority
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: Januury 1�s 2{)(#6 Subdivision Improvement Permit— Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Wandy's Next to Goodyear, SAP-,2406-14,9 79-275 Hwy 111
(Street address or Description of Location) f
PURPOSE OF CONSTRUCTION Prtaciya Grading jf
DESCRIPTION OF CONSTRUCTION See P$D 05207
Sketch (attach const'r�uction plans if appropriate)
ndin.B Pr
DIMENSION OF INSTALLATION OR REMOVAL Sea PS14 05207 Pa din,B Sc
�l
SIZE OF EXCAVATION, IF NEEDED 1 \
t �
APPROXIMATE TIME WHEN WORK WILL BEGIN After fie -con
and nchodult has bean provided
APPROXIMATE TIME OF COMPLETION March 17, 2006 J
ESTIMATED CONSTRUCTION COST $ 859415.10 ,1 �
(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` o:
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 ti
happening or occurringxas a proximate; result of any work undertaken under the permlgranted pursuant to this application.
1
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 of the City of
La Quinta and to pay foriany additional replacement necessary as the result of this work.
Signature of Applicant or Agent
ticudy" a International '� 910 E. Pnbauru Ave. ) Oravne, CA 92066
Name of Applicant (please print) ``� Business Address
Korriasay Cvnatruct:ion \
Name of Contractor and Job Foreman "
708936
Contractor's License No*'-,,,
Wsotchestsar Firs lr iburance
Applicant's Insurance Company
063 Oceanside Blvd Ocan
Business Address
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 $ 2*560.00
Permit Fee 100.00
Penarfy- As -Built Dep (1,000.00)
Cash Deposit -Surety Bond
if required
TOTAL: $ 3,660.00
Receipt No.
Received by
Date
Nick Bic0-
(214) 649-9256
Telephone No.
760) 639--04
Telephone No.
City Business License No.
GLW w 786115
Policy Number
' 4583
a ..
PERMIT VALIDATION
PERMIT NO. 4583
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Recorded by
Telephone: (760) 777-7075
NOTE:
INit�`I'i 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 II I
DATE: 2006 JAnuazy 12, Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Wandy f o Noxt to Goody*ar, 8Dp_.Z0Q6-A7,9, 79-275 Hwy III
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Preci.aa Grading Sketch (attach construction plans if appropriate)
Y
DESCRIPTION OF CONSTRUCTION Nod Yb14y!iikU/
t
k9nding Pre- on
DIMENSION OF INSTALLATION OR REMOVAL bee PUR 1 2ul Pe%di.ng, Sche >uia
SIZE OF EXCAVATION, IF NEEDED
f
APPROXIMATE TIME WHEN WORK WILL BEGIN Atter pro -colt
and aChodul,a hay lbaaau providod
APPROXIMATE TIME OF COMPLETION tfurclu `r+ lvv } /
ESTIMATED CONSTRUCTION COST $ ti��af5'
(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 y
happening or occurring as a proximate result of any work undertaken under the permitgranted pursuant to this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.
t
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.
Signature of Applicant or Agent Nick Rico—
Weady'>a International. 910 F.. Falnuris Aya* ; 0rau86, CA 92066 (214) 649-9256
Name of Applicant (please print) _ Business Address Telephone No.
Korria say Conatrvetion 4063 Occancido Blvd Oacannaidc, CA (760) 639-0498
Name of Contractor and Job Foreman Business Address Telephone -No.
708936
Contractor's License No.
Weatchastor Fi.rao Inleuran,co Corm ny
City Business License No.
Girl - 766115
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 $ 2,560.00
Permit Fee 140.00
Penalty AO -Built DeP (11000.00)
Cash Deposit -Surety Bond
if required
TOTAL: $ 3,660 .00
Receipt No.
Received by Date
Recorded by
4583
PERMIT VALIDATION
4583
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075