Loading...
DRVA2016-0006A f F ance ue 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: 6114/2016 LOCATION OF CONSTRUCTION(Street address or Description): $4220 AVENIDAVALLEJO PURPOSE OF CONSTRUCTION: DRIVEWAY APPROACH FOR RESIDENTAIL PROPERTY DESCRIPTION OF CONSTRUCTION: LOPEZ RESIDENCE/ DRIVEWAY APPROACH DIMENSION OF INSTALLATION OR REMOVAL:.. 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, backfllling, compaction and placing permanent resurfacing and/6r replacing improvements) 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 pu(bnt.to this application. Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when woi submit an inspection request, leave a message on the Inspection Request Hotline at (760) 777-7097 (24) hours prior to the anticipated inspection. Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rL to pay for any additional replacement necessary as the result of this work. be started at (760) 777-7097. To o1:30 P.M. at least twenty-four regulations of the City of and 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 P. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number -- - Finance Revenue Code PERMIT INSPECTION DRIVEWAY RESIDENTIAL $145.00 TOTAL. $145.00 PERMIT NO: DRVA20I6-0006 DATE ISSUED: EXPIRATION DATi. E:12/1112016__c_à1i1-i hi BY: MARY FSANO 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. DRIVEWAY APPROACH PERMIT APPLICATIO N Revenue Coda PD Applicant Information: t Applicant/Owner (p/ease pfjj_t name here): L?çE2_ Applicant Address; 222O Number Street City State Zip Code Address or Parcel No. of work IocatJo'\, if different from applicant's address above: Number Street 'City State Zip Code Date: Jpj/UD Applicin ion ,No:: 131D 1 29'5_O49 Applicant's Signature: Approximate Start Date: Approximate Completion Date:OQjjj. Contractor Information: Address: ©) c (bo\LO-t - W Number Street City State Zip Code Phonr "u mber: C) - Contractors License Number: City Business Business License Number: GeneralLiabilityInsuranceCompany: 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. P/ease Note: Inspections are normally performed Monday through Friday between 8am and 4pm PermitFee$145 =$145TotalFee Permit No. Expiration Date _l_/, 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 0