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DRVA2017-0024-GEM cfthOESERT--- DRIVEWAY APPROACH PUBLIC WORKS CONSTRUCTION ' belo1War Finance Rev Codes _ 1 Cfl'YOFLAQUIii COMMUNI1YDEVELOPMENTDEPARThIENT 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: 10/25/2017 LOCATION OF CONSTRUCTION(Street address or Description): 54211 AVENIDA OBREGON PURPOSE OF CONSTRUCTION: DRIVEWAY APPROACH DESCRIPTION OF CONSTRUCTION: HESSE RESIDENCE /_DRIVEWAY APPROACH DIMENSION OF INSTALLATION OR REMOVAL: MATE TIME WHEN WORK WILL BEGIN: 10/25/2017 TIME OF COMPLETION: 11/1/2017 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 tle 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. Complywith all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of and to pay for any additional replacement necessary as the result of this work. Signature of Applicant or Agent MARTHA HESSE 54211 AVENIDA OBREGON LA QUINTA, CA 92253 (760)485-5466 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 PERMIT INSPECTION 0 DRIVEWAY RESIDENTIAL $156.00 TECHNOLOGY ENHANCEMENT FEE $5.00 TOTAL: $0.00 Policy Number PERMIT NO: DR AO17-OO24 DATE ISSUED: , b i7,7 EXPIRATION DATE!?4( BY4J! 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. L LOT LINE 2' MIN. FROM 4 - LOT LINE — I - - - - WEAKENED PLANE JOINTS @ 5 FT. INTERVALS RIGHT-OF-WAY 6' SIDEWALK Q J. * MAYBE REDUCED TO 30 FT. MIN. WITH APPROVAL OF CITY ENGINEER ** COMMERCIAL: UP TO 8% RESIDENTIAL: UP TO 9% RESIDENTIAL 12' MIN. - 30' MAX. COMMERCIAL 35' MIN. -40' MAX. tI AM 111C IAl RIGHT-OF-WAY STREET GRADE 2' I-"--' STREET GRADE ---i VARIES 100 PREFERRED PREFERRED 15°! I - 2 MAX. 1 Lip miff co: SECTION A - A SECTION B - B 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 6 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. COMMERCIAL: UP TO 8% RESIDENTIAL: UP TO 9% CHANGE IN GRADES SHALL NOT ISOMETRIC VIEW EXCEED 8%, UNLESS THE LENGTH IS LESS THAN 2 FEET THEN GRADE SHALL NOT TO SCALE NOT EXCEED 15%. STANDARD REVISIONSDEPARTMENT OF PUBLIC WORKS PLAN No. - No. DATE ENGINEERING DIVISION 221 JAN-li APPROVED BY: DRIVEWAY -1 "Na. HEET t/ADJACENT TO CURBIRI - (/ Ex. 12/31/12 LOT LINE — WEAKENED PLANE JOINTS 2' MIN, FROM LOT LINE 5' SIDEWALK 4 APRON WHEN STREET GRADE EXCEEDS 4% L.UIV1IVIttV.,IfrL iO IVIII'J. - '(Li IVL/'kA. PLAN VIEW ' SIDEWALK RIGHT-OF-WAY 1"LIP MAX. 4~4 6 TH'~ ICK CONCRETE SECTION A - A DETAIL NOTES: * MAYBE REDUCED TO 30 FT. MIN. WITH APPROVAL OF CITY ENGINEER ** COMMERCIAL : UP 108% RESIDENTIAL: UP TO 9% 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 6 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. CHANGE IN GRADES SHALL NOT EXCEED 8%, UNLESS THE LENGTH IS LESS THAN 2 FEET THEN GRADE SHALL NOT EXCEED 15%. ISOMETRIC VIEW NOT TO SCALE **COMMERCIAL UP TO 8% RESIDENTIAL UP TO 15% DEPARTMENT OF PUBLIC WORKS ENGINEERING DIVISION 444 4 tJhJ STANDARD PLAN No. 221 "NDATE JAN11 APPROVED /1 DRIVEWAY WITH SIDEWALK r TO R I W A DJACE NT —IL- SHEET 20F3 R.JNA. PuUc W5r)s fred /C8y&inem RCE.NO 45843 Exp. 12/31/2 - A WEAKENED PLANE JOINTS . INTERVALS RIGHT-OF-WAY LOT LINE 14 2MIN.FROM : LOT LINE 4 > 4 S S • 4 SIDEWALK 5 TRANSrI]ON - - 5 TRANSITION 6 VERTICAL rL I I 6 VERTICAL FL CURB CURB A i I WEDGE CURB T SIDEWALK RIGHT-OF-WAY VARIES I 6.1 THICK CONCRETE ALL CONCRETE SHALL USE TYPE V WEDGE CURB CEMENT AND PER CITY STANDARD 200. SEE STD. 211 SECTION A —A 20 FEET OF FULL-HEIGHT CURB REQUIRED BETWEEN DRIVEWAYS WITHIN ANY ONE PROPERTY FRONTAGE. USE 6 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. Ø.. 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 ISOMETRIC VIEW LESS THAN 2 FEET THEN GRADE SHALL NOT TO SCALE NOT EXCEED 15%. REVISIONS DEPARTMENT OF PUBLIC WORKS PLAN No. a # STANDARD ENGINEERING DIVISIONNo. DATE ,4j4/ UJ. uV RIP# JAN-11 APPROVED BY:DRIVEWAY WITH 221 SIDEWALK ADJACENT SHEET OTHY R. J NAbbN. P.E. DATE Pubhc WOI*S too /Cly Eng000't T' WEDGE CURB 3 OF 3 RC,E No. 45843 Exp. 12/31/12 SEE STD. 211 RESIDENTIAL 12 MIN. - 30 MAX DETAIL NOTES: -CEMefie DESERT ----- DRIVEWAY APPROACH PERMIT APPLICATION Applicant Information: Applicant/Owner (please psjnt name here): Applicant Address: S /C--)1/ c2L 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: /ëio527 Applicant's Phon No: 'c)) ¶/e7S Applicant's Signature- Approximate StartStart Date:/e) /''//7Approximate Completion Date/./.O.../27 Contractor Information: Address: £5&J,EJeEX_ £d 6 67L- Number Street City State Zip Code Phone Number: ( S Contractors License Number: City Business License Number: General Liability Insurance 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. The Hub Counter (760) 777-7125. Please Note: Inspections are normally performed Monday through Friday between 8am and 4pm Permit Fee $156 + $5 Technology Enhancement Fee = $161 Total Fee Permit No.fl'ZV1920/7 '(XLpiratio Date /0 12C12015 Permit Issued by: 7')"24,t- 7Ii2 0 Date Issued iLigiiiL2.. Signature of'Administrative Authority Work Inspected by: Permit Completion Date: _I_J Inspector's Signature Comments: Note: Driveway approach must be constructed per City of La Quinta Standard #221 ;j GM qdw D1!SEI4T -. PROPERTY OWNER'S PACKAGE Disclosures & Forms for Owner-BuiLders Applying for Driveway Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner:• .. An application for a driveway permit for work within the public right-of-way has . been' submitted in your name listing ourself as the builder of the driveway improvements specified at 5 4/7 df.' i--. &. We are providing you with an Owner-Builder Acknowledgment -and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a. driveway permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval' of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. 1 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 012A understand driveway permits-are not required to be signed by property owners unless they are responsible for the construction and are not hiring a Licensed Contractor to assume this responsibility. EIZJ.3. I understand as an "Owner-Builder" I am the responsible party of record on the permit.I understand that I may protect myself from potential financialrisk by hiring'a licensed Contractor and having the. permit flied in his or her, name instead of my own. E14. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 95. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my, construction is at least five hundred dollars ($500), including labor and materials, I may be considered on "employer" under state and federal law. . . "06. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 11.i.7. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. Ii 8. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Deportment of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. I am aware of and consent to an Owner-Builder driveway permit applied for in my name, and understand that I amthe party legally and financially responsible for proposed construction activify at the following address: 10. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. EJii. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be .in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a driveway permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. S Signature of property owner Date: 78495 calle Tampico La Quinta, CA 92253 -- 760.777.7000 Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder. S AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary-to obtain an Owner-Builder Permit for my project. . S Scope of Construction Project (or Description of Work): /T#t il/ J(P1O14(u/ Project Location or Address: .. Name of Authorized Agent: •Z Tel No. ZL57 Address of Authorized Agent.: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. S --:7 Property Owner's Signature &__- Dote: __________ 78-495 Cafle Tampico La Quinta, CA 92253 . 760.777.7000