CIP2020-0001ta 09 ig rav
See below for Finance Revenue Code
-GEM ofthcDESERr-
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: 9/10/2020
LOCATION OF CONSTRUCTION(5treet address or Description): COVE AND CALLE TECATE
PURPOSE OF CONSTRUCTION:
DESCRIPTION OF CONSTRUCTION: 2018-012019-13 COVE PUBLIC RESTROOM AND TECATE PARKING
DIMENSION OF INSTALLATION OR REMOVAL:
APPROXIMATE TIME WHEN WORK WILL BEGIN: 1/13/2020 TIME OF COMPLETION: 4/7/2020
ESTIMATED CONSTRUCTION COST: (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing
permanent resurfacing and/or replacing improvements)
COMMENTS:
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
THREE PEAKS CORP
Name of Applicant (please print)
THREE PEAKS CORP
Name of Contractor and Job Foreman
941528
P 0 BOX 101 CALIMESA, CA 92320 (909)795-1690
Business Address Telephone No.
P 0 BOX 101 CALIMESA, CA 92320 (909)795-1690
Business Address Telephone No.
Contractor's License No.
JAMES RIVER INSURANCE COMPANY
Applicant's Insurance Company
Finance Revenue Code
TOTAL: $0.00
City Business License No.
000659951
Policy Number
PERMIT NO: C1P2020-0001
DATE ISSUED: 1/7/2020
EXPIRATION DATE: 7/5/2020
BY: CARLEYESCARREGA
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.