CIP2018-0003vi
See below for Finance Revenue Codes
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CIP
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: 7/23/2018
LOCATION OF CONSTRUTlON(Street address or Description): MILES B1W ADAMS AND LOS MANOS
PURPOSE OF CONSTRUCTION: LANDSCAPE RENOVATION
DESCRIPTION OF CONSTRUCTION: C1P2016-03CLA QUINTA LANDSCAPE RENOVATION IMPROV -QUINTERRA
DIMENSION OF INSTALLATION OR REMOVAL: PER APPROVED PLANS
APPROXIMATE TIME WHEN WORK WILL BEGIN: 7/30/2018 TIME OF COMPLETION: 12/6/2018
ESTIMATED CONSTRUCTION COST: 5558.863.00 (Including removal of all obstruction, materials, and debris, backfilling, compaction and
placing permanent resurfacing and/or replacing improvements)
COMMENTS: SEE PROJECT CONTRACT AND SPECIFICATIONS FOR CIP 2016-03C FOR PERMIT CONDITIONS
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 (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 he City of and to
pay for any additional replacement necessary as the result of this work.
SignqWe of plicant or Agent
CONSERVE LANDCARE INC - ESTELA
CANDELARIO 72265 MANUFACTURING RD THOUSAND PALMS, CA 92276 (760)507-6554
Name of Applicant (please print) Business Address Telephone No.
CONSERVE LANDCARE INC 72265 MANUFACTURING RD THOUSAND PALMS, CA 92276 (760)343-1433-
Name of Contractor and Job Foreman Business Address Telephone No.
958748 108534
Contractor's License No. City Business License No.
WESCO INSURANCE COMPANY WPP1242999 03
Applicant's Insurance Company Policy Number
Finance Revenue Code
TOTAL: $0.00
PERMIT NO: CIP2018-0003
DATE lSSUED:ijI %.'
EXPIRATION DATE:IJVII It
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.
Date:
Purpose of Construction (i.e.: Rough Grading, Offsite Street,
scription of Construction (1 e See Plan Set No 012) [DthoIutun f exUjIa'e .,VPr1 1n,.W.A';
Dimension of Installation or Removal: [fetto
L
Approximate Construction Start Date: t7i3OI.i8T c••:•.
Approximate Construction Completion Date '12/6/IS'
. 1
Estimated Construction Cost $[083
Estimated Construction Cost shall include the removal of all obstructions, materials, and debris, back-filling, compaction and
placing permanent resurfacing and or replacing improvements
Contact Name EeJ!!9 77 _JPhone Number :17#0
Name of Applicant/Owner - 71111 V ,7
Applicant Address [765 Mnufaunngq jisand Paln)s CA2_2l ,. .1 J
Applicant Telephone Number: 7650765 :' ': .: ..
Applicant E-mail Address:
Name of Contractor: öflser)ie:Lafldçare.-..
Contractor Address: tCi: Pafrii,'CA 2i '7
Contractor Telephone Number [760-343-1433
Contractor State License Number: 1958748.'. •
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Contractor City Business License Number:
Contractor E-mail Address:econs&andcarecom 1_-
110- A COPY OF THE CURRENT INSURANCE CERTIFICATE MUST BE PROVIDED 4
Applicant or Contractor General Liability Insurance Company: -
ñco 3'
pplicant or Contractor General Liability Insurance Policy Number:
i_fl
Office Use Only: - . - Office Use Only:
Inspection Fee: -, Assigned PeEmit NumbcrC (?2.0 I-000 3
Permit Fee: - Approval Date:
Dust Control
Deposit: -
Credit
Amount:
TOTAL FEE DUE:
I Unve/UflecklIsts - Forms & Applicatlo
Expiration
Date:________________________________________
Issue
Date:
Administrative Authority:
3tion for 1'errnit postea -25-U . -