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DRVA2015-0011DRIVEWAY APPROACH PERMIT APPLICATION. Finance Revenue Code PD Applicant Information: . . . Applicant/Owner (please print name here): I AnnIint Aidmss . Number Street City .State - Zip Code Number Street .. . . City Date: Appcant's Phpne No (:1) ca Signature:V • ;i\ ki Approximate Start Date: ./PIApproximate Completion Date: State Zip Code Contractor Information: Address:.. . . . . 1VENID14ERER' 1iii , 'I Number -. Street / . . City State Zip Code Phone Number: 7O2 62O9' Contractors License City Business License Number: General Liability Insurance Company: AM TRUST INTERNATIONAL Policy No.71 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) 7777075. Please Note: Inspections are normally performed Monday through Friday between 8am and 4pm Inspection Fee $20 + Permit Fee $10 = $30 Total Fee Permit No Expiration Date Permit Issued by: Date Issued 1i[°N of Administrative Work Inspected by: Permit Completion Date: iF*.J Inspectors Signature I : : . •.. :i... ..... '.... Note: Driveway anoroach must be constructed ner City of La Quinta Standard #221 PUBLIC WORKS DEPARTMENT APPLICATION FOR PERMIT PPVo, - Do,' Date: Tract No: Project Name: ç ô Vicinity: Purpose of Construction (i.e.: Rough Grading, Offsite Street; etc.)/,tJ v 44 Description of Construction (i.e.: See Plan Set No. 01234) a -i VL Dimension of Installation or Removal: / ( / 6' Approximate Construction Start Date: Approximate Construction Completion Date: P3 Estimated Construction Cost: $ cô 0 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: . /jail ,/ MA Name of ApplicantlOwner: Applicant Address: S 1 6 ç ti Applicant Telephone Number: C Applicant E-mail Address: 4. i Phone Number: 70 Z Name of Contractor: Contractor Address: c3ç1A-vtAoVA jz it -..erô TIIcLô c Contractor Telephone Number: 11C76 a) 702—,_2-C' Contractor State License Number: .. .I Contractor City Business License Number: Contractor E-mail Address: 10- A COPY OF THE CURRENT INSURANCE CERTIF'JCATE MUST BE PROVIDED 4 Applicant or Contractor General Liability Insurance Company: Applicant or Contractor General Liability Insurance Policy Number: 46 /iciOPi/?'Ol Office Use Only: Inspection Fee: Permit Fee: As-Built Dust Control Deposit: Credit Amount: Office Use Only: Assigned Permit Number: Approval Date: Expiration Date: Issue Date: Administrative Authority: TOTAL FEE DUE: - 1-orms & Applications/Application fo IN THE CITY OF LA QUINTA, COUNTY OF RIVERSIDE. STATE OF CALIFORNIA SITE PLAN FOR LOT 21 OF BLOCK 151 OF UNIT NO.16 OF SANTA CARMELITA AT VALE LA QUINTA, PER MB 18/99 APN: 773-294-003 LOCATES WITHIN THE S 1/2 01 THE NE 1/4 OF SECTION 12, T6S, TEE. SASH ABDREVIATIQN$ LEGEND H TATTOTIT __ THE $4 P$TTVIAT INTl RIOT STIR APN IF LEGAL DEDCR(PTIO 1 . 11 11 11 "1 IINII T.\ 101001$ / 00LOO.L.LO 00.5 -I' LL, IDI : I) L'IT11 L. —11 TA T5SV2ET 000R$TPPKT$$T . FF-1002.27 E* TO IN 59 -__________________ F I PAD= 1DO1 A o ROSA 111$ K - TVA ION CT 21BCK11I OH /TA ARM 52560 AVENIDA)€ERA Fw THrOAT F TYf /CALASD1 TEj/ NTRI'KHR1 * DATUM POINT: THIS DATUM POINT AT TOP OF CURB AT THE CENTERLINE OF LOT I IS THE 501AM POINT WHERE THE MEASUREMENT UP THE FINISH FLOOR WAS TOKEN. BEING I V WIN ABOVE THIS ELEVATION :NOTE ALL BLOCK WALL, RETAINING WALL, STEM WALL. FENCES ARE PER SLPAAAUE PLAN, UNDER SEPARATE PERMIT (TYPICAL) NORTH ('Y")SWALE SECTION (TYPICAL) $01 TA 10000 DRIVEWAY APPROACH REQUIRES A SEPARATE PERMIT & INSPECTION FROM CITY OF LA QUINTA PUBLIC WORKS DEPARTMENT DIG A L_'R T UTL7SioSRrNo.ç1' TE6WI..RORT A TAN W.N001C AO*RKCTKR &PTRK.N1 noun_rn / 'WT0TH PRTPOATO MOOR TNT AlERT NUPIRORNARE OF PP000RO 00 0$ FOft4OTOR ENGINEERING L OT OTT 01 14 001.40 O*JRTT VT —1- RIOTS $4 T.$LCTRN:A rILE NA SOSAT J_RIITFTV 10 000 SITE OR PLAN C*TW00H AUI.ROKNTT FT / 52560 A0NIDAHERRERA. LMDIJINTA, CA 92253 U No ~OFA NT N•NNA Ill iONOIOLT-IT$0 000 IIN0I TOT-IT*) 'Fr!'' !0V'0ATT LOMOOT' AROl$RllN ISOMETRIC VIEW NOT TO SCALE I LOT LINE — — - 2 MIN. FROM LOT LINE A a 5TRANSITION WEAKENED PLANE JOINTS 4. - A 40 I 4 iA SIDEWALK 6 VERTICAL r VERTICAL CURB CURB PLAN VIEW SIDEWALK S RIGHT-OF-WAY . 2% VARIES I DETAIL NOTES: ALL CONCRETE SHALL USE TYPE V CEMENT AND PER CITY STANDARD 200. 20 FEET OF FULL-HEIGHT CURB REQUIRED BETWEEN DRIVEWAYS WITHIN ANY ONE PROPERTY FRONTAGE. USE S MIL PLASTIC SHEETING WHEN ABUTTING SOIL HAS A HIGH SULFATE CONTENT. CONSTRUCT THE PROFILE GRADE OF THE PRIVATE ON-SITE DRIVEWAY SO THAT IT PROVIDES SMOOTH VEHICLE ACCESS OVER THE DRIVE APPROACH. S. WEDGE CURB DRIVEWAYS SHALL BE USED ONLY WHEN POSTED SPEED IS IS 25 MPH OR LESS. WEDGE CURB DRIVEWAYS SHALL BE APPROVED BY THE CITY ENGINEER. CHANGE IN GRADES SHALL NOT EXCEED 8%, UNLESS THE LENGTH IS LESS THAN 2 FEET THEN GRADE SHALL NOT EXCEED 15%. T— ~i-CURB L1' 6"ThICK .=1I CONCRETE WED SEE STD. 211 SECTION A - A REVISIONS _________ DEPARTMENT OF PUBUC WORKS No. I DATE I ENGINEERING DIVISION t jAN-1 APPROVED BY: . 440THY R. JNAON. P.C. Di Publlc Woiks'OocW1C1y Englocr R,CENo. 45843 Exp. 12/31/12 Ta* 4 cu- DRIVEWAY WITH SIDEWALK ADJACENT TO WEDGE CURB STANDARD :PLAN No. 221 SHEET 30F3 ACbRDJ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD(YYYY) I 08/04/2015 PRODUCER 760-341-3477 C Asc&nd Insurance Agency 36917. Cook Street, Ste 101 . Palm Desert, CA 92211 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Dantor Martinez Construction 81057 Avenida Romero Indio, CA 92201 INSURERA AmTrust International Underwriters INSURER B: California Automobile Insurance Comp INSURER C: James River Ins. Co. INSURERD: Markel Insurance Co. INSURERE COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR Wt. TYPEOFINSURANCF POUCYNUMBER POLICY EFFECTIVE DATEIMMIDDIYY POLICY EXPIRATION DATE (MM LIMITS_____________ / GENERAL UABILTY EACH OCCURRENCE $ 1,000,000 A / COMMERCIAL GENERALUABLITY DAMAGE TO RENTED PREMISES (Fa occsirencel $100,000 ___ I CLAIMS MADE OCCUR MED EXP (Any one person) $ 5,000 Deductible $2500 ] - B105008113-01 05/05/2015 05/05/2016 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'I. AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 PRO- TIT POLICY fl flLOC / AUTOMOBILEUABILfTY - ANYAUTO COMBINED SINGLE LIMIT (Eaacddent) $ 1000000 BODILY INJURY $ B AU. OWNED AUTOS / SCHEDULED AUTOS BA040000020291 01/27/2015 01/27/2016 BODILY INJURY (Peracddon*) $ HIRED AUTOS - NON-OWN DA PROPERTY DAMAGE (Peracadenl) $ - GARAGEUAEIUTY AUTO ONLY -EAACCIDENT $ OTHER THAN EAACC $ ANYALITO $ - AUTO ONLY: AGG - EXCESSIUMBRELLAUABILFTY EACH OCCURRENCE $ 1000000 C 71 OCCUR CLAIMS MADE AGGREGATE $ 1000000 $ JR0048331-0 01/20/2015 01/20/16 ____________________ S DEDUCTIBLE • ____________ S - RETENTION $ - WORKERS COMPENSATION AND I WCSTATU- I 10TH. I TORY LIMITS I I ER D EMPLOYERS' LIABILITY ANY PROPRIETORPARTNEREXECUT1VE OFFICERIMEMBER EXCLUDED? MWC019705-15 05/05/2015 05/05/2016 E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - CA EMPLOYEE $1000000 - Ifyas, descilbe under SPECIAL PROVISIONS below E.L DISEASE - POI CYUMIT S 1000000 OTHER DESCRIPTION OF OPERATIONS! LOCATIONS IVEH1CLES I EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS Certificate Holder is named as an additional insured. '10 Day Notice of Cancellation for non-payment' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 78-495 Calle Tampico DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN La Quinta, CA 92253 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) . . . ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer nghts to the. certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor .does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25