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CIP2018-0001ta Qa ig ra See below for Finance Revenue Codes - GEM ofhDESERT - - CI P PUBLIC WORKS CONSTRUCTION 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: 9/10/2020 LOCATION OF CONSTRUCTION (Street address or Description): 78495 Calle Tampico PURPOSE OF CONSTRUCTION: CITY HALL INTERIOR RESTROOM REMODEL DESCRIPTION OF CONSTRUCTION: C1P2017-03 CITY HALL MISC. INTERIOR ADA IMPR. DIMENSION OF INSTALLATION OR REMOVAL: APPROXIMATE TIME WHEN WORK WILL BEGIN:2/22/2018 TIME OF COMPLETION: 4/4/2018 ESTIMATED CONSTRUCTION COST: $177,760.00 (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing permanent resurfacing and/or replacing improvements) NTS: CIP PROJECT NO. 2017-03 CITY HALL MISCELLANEOUS INTERIOR ADA IMPROVEMENT PROJECT CDBG PROJECT NO. 4.LQ.29-17 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 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 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 4) 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. Signature of Applicant or Agent Name of Applicant (please print) Business Address NEW CONSTRUCTION SOLUTIONS INC P 0 BOX 1436 LA QUINTA, CA 92247 Name of Contractor and Job Foreman Business Address 813954 Contractor's License No. City Business License No. Telephone No. (760)861-1725 Telephone No. Applicant's, Insurance Company Policy Number Finance Revenue Code TOTAL: $0.00 PERMIT NO: C1P2018-0001 DATE ISSUED: 2/21/2018 EXPIRATION DATE:8/20/2018 BY: WORK INSPECTED BY*: PERMIT COMPLETION DATE*: If the work is covered by a Subdivision Improvement Agreement, Subdivider shall request final acceptance of improvements from the City Council.