DRVA2017-0026ta Qu&& -
See below for Finance Revenue Cod(
—GEM fdieDESERT— -
DRIVEWAY APPROACH
PUBLIC WORKS CONSTRUCTION
For the construction of public or private curbs, driveways, pavements, sidewalks, parking Iots,•sewers, water mains and other like public wor
improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS.
DATE: 11/9/2017
LOCATION OF CONSTRUCTION(Street address or Description): 52230 AVENIDA MADERO
PURPOSE OF CONSTRUCTION: DRIVEWAY APPROACH
DESCRIPTION OF CONSTRUCTION: PEPE BUILDS / COVE / DRIVEWAY APPROACH
DiMENSION OF INSTALLATION OR REMOVAL:
MATE TIME WHEN WORK WILL BEGIN: 11/9/2017 TIME OF COMPLETION: 11/23/2017
ESTIMATED CONSTRUCTION COST: (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing
permanent resurfacingand/or 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 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 rules and regulations of ity of and
to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
CORONEL ENTERPRISES INC 42760 MADIO STREET INDlO, CA 92201 (760)775-1234
Name of Applicant (please print) Business Address Telephone No.
J - Z CONCRETE CONSTRUCTION INC 42760 MADIO STREET INDlO, CA 92201
Name of Contractor and Job Foreman Business Address
813261 LIC-0003629
Contractor's License No. City Business License No.
ASSOCIATED INDUSTRIES INS. . AE51022833
Applicant's Insurance Company Policy Number
(760)775-5550
Telephone No.
Finance Revenue Code
PERMIT INSPECTION
DRIVEWAY RESIDENTIAL $156.00
TECHNOLOGY ENHANCEMENT FEE $5.00
TOTAL: $161.00
PERMIT NO: DRVA2017-0026
DATE ISSUED: /f,4i7
ExPlR4çN DATE:
BY:
WORK INSPECTED BY*:
PERMIT COMPLETION DATE*:
*lf the work is covered by a Subdivision Improvement Agreement,
Subdivider shall request final acceptance of improvements from the
City Council.
Vr
DRIVEWAY APPROACH PERMIT APPLICATION
Finance Revenue Code PD
Applicant Information:
caIOwner (please print name here):
Applicant Address: -\7Q J S\.1 T.,.0 1 CA j() \
Number Street City State Zip Code
Address or Parcel No. of location, if d nt from applicant's address above:
'!
Number Street City State Zip Code
Date: _\j.j_ijj Applicant's Phone : (7O) S7 - 33 7
C,—L) Applicant's Signature: ___
Approximate Start Date: \I/ It /jJApproximate Completion Date:
Contractor Information:
Address: 7(0 M-c $ CA
Number Street City State Zip Code
Phone Number: (7D) 77__\.'f Contractors License Number:
City Business License Number:
General Liability Insurance Company: 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 $445— $-1-45.TotaI Fee
Permit No. Expiration Date II
Permit Issued by: Date Issued II
Signature of Administrative Authority
Work Inspected by: Permit Completion Date: II
Inspector's Signature
Comments:
Note: Driveway approach must be constructed per City of La Quinta Standard #221
V .
4 u14
--GEM .fdDEsrRr -•
DRIVEWAY APPROACH
PUBLIC WORKS CONSTRUCTION
See below for Finance Revenue Coth
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public wor
improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS.
TE: 11/9/2017
LOCATION OF CONSTRUCTION(Street address or Description): 52230 AVENIDA MADERO
PURPOSE OF CONSTRUCTION: DRIVEWAY APPROACH
DESCRIPTION OFCONSTRUCTION: PEPE BUILDS/ COVE / DRIVEWAY APPROACH
DJMENSION OF INSTALLATION 0.11 REMOVAL:
-
ROXIMATE TIME WHEN WORK WILL BEGIN: 11/9/2017 TIME OF COMPLETION: 11/23/2017
ESTIMATED CONSTRUCTION COST:
_(Including removal of all oIstruction, materials, and debris, backfilling, compaction and placing
permanent resurfacing and/or replacing Improvements)
COMMENTS:
Inconsideration 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.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of Ityof and
to pay for any additional replacement necessary as the result of this work.
- -.
Signature of Applicant or Agent
CORONEL ENTERPRISES INC 42760 MADIO STREET INDlO, CA 92201 (760)775-1234
Name of Applicant (please print) Business Address Telephone No.
.1- Z CONCRETE CONSTRUCTION INC 42760 MADIO STREET INDIa, CA 92201 (760)775-5550
Name of Contractor and Job Foreman Business Address Telephone No.
813261 IJC-0003629
Contractor's License No. City Business License No.
ASSOCIATED INDUSTRIES INS. AES1022833
Applicant's Insurance Company - Policy Number
Finance Revenue Code
PERMIT INSPECTION
DRIVEWAY RESIDENTIAL $156.00
TECHNOLOGY ENHANCEMENT FEE $5.00
TOTAL: $161.00
,1lT NO: DRVA2017-0026
ISSUED:
QN DATE: 4zf8
BY:
YORK INSPECTED Br:
ERMIT COMPLETION DATE':
f the work is covered by a Subdivision Improvement Agreement,
ibdivider shall request final acceptance of improvements from the
ty Council.
-
DRIVEWAY APPROACH PERMIT APPLICATION
runance iievenue code PU
App!icant Information:
Owner (please pjt name here):
Applicant Address: T7 J_\ r'' Number Street City State Zip Code
Address or Parcel No. of work location, if different from applicant's address above:
S3
Number Street City
Date: j.'1/JJ Applicant's Phone p: (7O) 7 33 7
Applicant's Signature: .2
Approximate Start Date: /_JJApproximate Completion Date:
State Zip Code
Contractor Information:
Address 4Th,O L CJ.
Number Street City State Zip Code
Phone Number: (7D). 77c__\'q Contractors License Number: (.\
City Business License Number:
General Liability-insurance Com0an:0 .' Policy No. c
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 $446- -$445J.oal4flo -
Permit No. Expiration Date
Permit Issued by: Date Issued
Signature of Administrative Authority
Work Inspected by: Permit Completion Date:
Inspector's Signature
Comments:
NOtO Driveway approach must be constructed per City of La Quinta Standard #221