DRVA2016-0005See below for Finance Revenue Codes
oj' 1.4z
OF
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: 4/25/2016
LOCATION OF CONSTRUCTION(Street address or Description):
PURPOSE OF CONSTRUCTION:
DESCRIPTION OF CONSTRUCTION: DRIVE WAY APPROACH / PEPE BUILDS LLC
DIMENSION OF INSTALLATION OR REMOVAL:
APPROXIMATE TIME WHEN WORK WILL BEGIN: TIME OF COMPLETION:
ESTIMATED CONSTRUCTION COST: (Including removal of all obstruction, materials,
permanent resurfacing and/or replacing improvements)
COMMENTS:
In consideration of the granting of this permit, the applicant hereby agrees to:
QTYQFLA and
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 rulçs pd regulations of he City of and
to pay for any additional replacement necessary as the result of this work. / \A , A I
Applicant or Agent
HUITRON CONSTRUCTION 50427 RIGO COURT COACHELLA, CA 92236 (760)457-9960
Name of Applicant (please print) Business Address Telephone No.
HUITRON CONSTRUCTION 50427 RIGO COURT COACHELLA, CA 92236 (760)457-9960
Name of Contractor and Job Foreman Business Address Telephone No.
926190
Contractor's License No.
AMTRUST INTERNATIONAL UWS
Applicant's Insurance Company
Finance Revenue Code
PERMIT INSPECTION
DRIVEWAY RESIDENTIAL $145.00
TOTAL: $145.00
lic-106213
City Business License No.
DSI 1256669500 S
Policy Number
PERMIT NO: DRVA2016-0005
DATE ISSUED: 4/25/2016
EXPIRATION DATE: 4/25/2017 -
BY: RAMSES SEVILLA
WORK INSPECTED BY:
PERMIT COMPLETION DATES:
*If the work is covered by a Subdivision Improvement Agreement,
Subdivider shall requestfinal acceptance of improvements from the
City Council.
OF DRIVEWAY APPROACH PERMIT APPLICATION
rinance Kevenue uoae ru
Applicant Information:
Applicant/Owner (please pL name here):
Applicant Address: '5 0 %*0XV-464" y
-7
Number Street . City State Zip Code
Address-or Parcel No. of work location, if different from. applicant's address above:
Number Street City State Zip Code
Date: _/_/ Ap i
S Applicant's Signature
Approximate Start Datei Completion Date: iiJk
Contractor Information:
[
Number Stree.tj City . State Zip Code
Phone Number: (74b0) 457g0 Contractors License Number: 2_ r1 0
City Business License Number:
General Liability Insurance Policy No.1)SI 1Z.5 CWV' 00
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
I Permit Fee $145 = $145 Total Fee I
Permit No. Expiration Date //
Permit Issued by: -' Date Issued / /
Signature of Administrative Authority
Work Inspected by: Permit. Completion pate: Ii
Inspector's Signature
Comments:
Note: Driveway approach must be constructed per City of La Quinta Standard #221
.,..-.
T ih t .4 4uii
ENCROACHMENT PERMIT
PUBLIC WORKS CONSTRUCTION a2ENT
nue Codes
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: 6/14/2016
LOCATION OF CONSTRUCTION(Street address or Description): 54220 AVENIDA VALLEJO
PURPOSE OF CONSTRUCTION: DRIVEWAY APPROACH FOR RESIDENTAIL PROPERTY
DESCRIPTION OF CONSTRUCTION: LOPEZ RESIDENCE/ DRIVEWAY APPROACH
DIMENSION OF INSTALLATION OR REMOVAL:
MATE TIME WHEN WORK WILL BEGIN: 6/5/2016 TIME OF COMPLETION: 6/22/2016
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 pubnt to this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when wo wi be started at (760) 777-7097. To
submit an inspection request, leave a message on the Inspection Request Hotline at (760) 777-7097 nor o 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 rul s d regulations of the City of and
to pay for any additional replacement necessary as the result of this work.
SigAlere of Applicant or Agent
JESUS LOPEZ 54220 AVENIDA VALLEJO LA QUINTA, CA 92253 \ (760)275-0437
Name of Applicant (please print) Business Address Telephone No.
OWNER/BUILDER
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Applicant's Insurance Company
Finance Revenue Code
IPERMIT INSPECTION
DRIVEWAY RESIDENTIAL
TOTAL:
Policy Number
PERMIT NO: DRVA2016-0006
DATE ISSUED: 6/14/2016
EXPIRATION DATE: 12/11/2016 (a
BY: MARY FASANO
WORK INSPECTED BY*:
PERMIT COMPLETION DATES:
51f the work is covered by a Subdivision Improvement Agreement,
Subdivider shall request final acceptance of improvements from the
City Council.
cvtz.
r" DRIVEWAY APPROACH PERMIT APPLICATION
Finance Revenue Code PD
Applicant Information:
Applicant/Owner (please pjJt name here):
Applicant Address: 2C2.2_ NJ
Number Street City ' State Zip Code
Address or Parcel No. of work lo if different from applicant's address above:
Number Street City State Zip. Code
Date: UP Applicançs P o4 No: (1O) z15- 49
Applicant's Signature:
Approximate Start Date: Approximate Completion Dàte:OJjZZIj_
Contractor Information:
Address: -
Number Street City State Zip Code
- -S-
Phone Number:
City Business License Number:
General Liability Insurance Compa
Contractors License Number:
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 Fee $145 = $145 Total Fee
Permit No. Expiration Date II
Permit Issued by: Date Issued / I
Signature of Administrative Authority
Work Inspected by: Permit Completion Date: //
Inspector's Signature
Comments:
Note: Driveway approach must be constructed per City of La Quinta Standard #221