DRVA2015-0001.4Z4 U4a1 See below for Finance Revenue Codes
ENCROACHMENT PERMIT
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: 2 /17/2015
LOCATION OF CONSTRUCTION(Street address or Description): 77-400 CALLE CHILLON
PURPOSE OF CONSTRUCTION: DRIVEWAY APPROACH
DESCRIPTION OF CONSTRUCTION: DRIVEWAY APPROACH
DIMENSION OF INSTALLATION OR REMOVAL:
APPROXIMATE TIME WHEN WORK WILL BEGIN: 2/16/2015 TIMEOF COMPLETION: 2 /18/2015
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
(24) hours prior to the anticipated inspection. S
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable of the City of and
to pay for any additional replacement necessary as the result of this work.
of Applicant or Agent
CALl BUILT CONSTRUCTION 52945 AVENIDA VELASCO LA QUINTA CA 92253 )-8474
Name of Applicant (please print) Business Address ne No.
CALl BUILT CONSTRUCTION 52945 AVENIDA VELASCO LA QUINR CA 92253 (760)250-8474
Name of Contractor and Job Foreman Business Address S Telephone No.
923574
Contractor's License No. City Business License No.
INT'L INS. CO. OF HANNOVER RWCC48100764
Applicant's Insurance Company Policy Number
Finance Revenue Code
PERMIT INSPECTION
.DRIVEWAY RESIDENTIAL $145.00
TOTAL: $145.00
PERMIT NO: DRVA2015-0001
DATE ISSUED:2/L7/ WtC
EXPIRATION DATE:2/17/2016
BY:TOMMI SANCHEZ
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
CityCouncil.
DRIVEWAY APPROACH PERMIT APPLICATION
Finance Revenue Code PD
Applicant Information:
Applicant/Owner (please Drint name here): [ALI BUILT CONSTRUCTION, INC S
Applicant Address:
F5665-5 1IWASI-BNGToN ST, STE C114 IlLAQUINTA IICA 1192253 71
Number Street City State Zip Code
Address or Parcel No. of work location, if different from applicant's address above:
F77-400 1ICALLE CHILLON 7ILA QUINTA 1ICA 1192253
Number Street City State Zip Code
Date: 1/ Ell /[2015j Applicant's Phone No: (ö 1) 1902-4308 I
Applicant's Signature:
Approximate Start Date: 102 1116 Il2015lApproximate Completion Date: Ic...J120 112015]
Contractor Information:
Address:
150855 IFWASHINGTON ST, STE C114 lILA QUINTA IlCA 192253
Number Street City State Zip Code
Phone Number: (1760 ) 1250-8474 bontractors License Number:1923574 .1
City Business License Number: I10544 0
General Liability Insurance Company: INTL INS. CO. OF HANNOVER Policy No.
Request for Inspection - Please call (760) 777-7097 before 1:30pm to request an inspection at least 24
hours prior to your requested inspection date. Public Works Counter (760) 777-7075.
Please Note: Inspections are normally performed Monday through Friday between 8am and 4pm
Permit No. Expiration Date
Permit Issued by: Date Issued lTiflil i
Signature of Administrative Authority
Work Inspected by: Permit Completion Date: IlIJl J
Inspector's Signature
Note: Driveway approach must be constructed per City of La Quinta Standard #221