DRVA2017-0027•.
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See below for Finance Revenue Cod
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DRIVEWAY APPROACH
PUBLIC WORKS CONSTRUCTION
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.
DATE: 11/13/2017
LOCATION OF CONSTRUCTION(Street address or Description): 54010 AVENIDA DIAZ
PURPOSE OF CONSTRUCTION: DRIVEWAY APPROACH
DESCRIPTION OF CONSTRUCTION: HART/ DRIVEWAY APPROACH
DIMENSION OF INSTALLATION OR REMOVAL:
APPROXIMATE TIME WHEN WORK WILL BEGIN: 11/13/2017 TIME OF COMPLETION: 11/17/2017
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 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 personsor 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 the City of and
to pay for any additional replacement necessary as the result of this work.
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L-,gnature OT ippcant or
CAU BUILT CONSTRUCTION 52945 AVENIDA VEI.ASCO LA QUINTA, CA 92253 (760)250-8474
Name of Applicant (please print) Business Address Telephone No.
CALl BUILT CONSTRUCTION 52945 AVENIDA VELASCO. LA QUINTA, CA 92253 (760)250-8474
Name of Contractor and Job Foreman Business Address • Telephone No.
923574 105440
Contractor's License No. City Business License No.
AMERICAN CONTRACTORS INDEMNITY COMPANY SC5005996
Applicant's Insurance Company Policy Number
Finance Revenue Code
PERMIT INSPECTION
DRIVEWAY RESIDENTIAL
TECHNOLOGY ENHANCEMENT FEE
TOTAL:
PERMIT NO: DRVA2017-0027
DATE ISSUED:l/// 2/I
EXPIRATION DATE:
BY:
WORK INSPECTED BY*:
*If the work is covered by a Subdivision Improvement Agreement,
Subdivider shall requestfinal acceptance of improvements from the
City Council.
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GEM oftise DESERT
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DRIVEWAY APPROACH PERMIT APPLICATION
Applicant Information:
Applicant/Owner (please pjk,_t name here): 7C
Applicant Address: 52130 4/i. (IlL
Number Street City State Zip Code
I Address or P2rcet No, of work location, if different from address above:
Number •Street City State
Date: Lijji Applicant's Phone No: (176 ) 4 Z —/2.1
Applicant's Signature: 5T1izii, i,
Approximate Start Date: L/_I.JiJ1 Approximate Completion Date: JL.'jlijI.
Z2-t3
Code
Contractor Information: CAL/ ?6wLr
Address: U
Number City. Zip Code
Phone Number: 402 — Contractors License Number: t92351/
City Business License Number: JL6'f4'O
.
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. The Hub Counter (760) 777-7125:
Please Note: Inspections are normally performed Monday through Friday between 8am and 4pm
Permit Fee $ 156-i- $5 Technology Enhancement Fee = $161 Total Fee
Permit No. /32 (14 2uti Expirati 2atOI I '/JjL
Permit Issued Date Issued LLJJ.3._Li2
00
Work Inspected by: Permit Completion Date: _/_.J
Inspector's Signature -
Comments:
Note: Driveway apDroach must be constructed per City of La Quinta
See below for Finance Revenue Cod(
-- GEM q. nisr -•
DRIVEWAY APPROACH
PUBLIC WORKS CONSTRUCTION
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.
DATE: 11/13/2017
LOCATION OF CONSTRUCTiON(Street address or Description): 54010 AVENIDA DIAZ
PURPOSE OF CONSTRUCTION: DRIVEWAY APPROACH
DESCRIPTION OF CONSTRUCTION: HART/ DRIVEWAY APPROACH
DIMENSION bF INSTALI.ATION OR REMOVAL:
APPROXIMATE TIME WHEN WORK WILL BEGIN: 11/13/2017 TIME OF COMPLETION: 11/1712017
ESTIMATED CONSTRUCTION COST: - (Including removal of all obstruction, materials, and debris, backfilllng, compaction and placing
permanent resurfacing and/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 conditidns 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 App ant or Agent
CALl BUILT CONSTRUCTION 52945 AVENIDA VELASCO LA QUINTA, CA 92253 (760)250-8474
Name of Applicant (please print) Business Address Telephone No.
CALl BUILT CONSTRUCTION 52945 AVENIDA VELASCO LA QUINTA, CA 92253 (760)250-8474
Name of Contractor and Job Foreman Business Address Telephone No.
923574 105440
Contractor's License No. City Business License No.
AMERICAN CONTRACTORS INDEMNITY COMPANY 5C5005996
Applicant's Insurance Company Policy Number
Finance Revenue Code
PERMIT INSPECTION
DRIVEWAY RESIDENTIAL $156.00
TECHNOLOGY ENHANCEMENT FEE $5.00
TOTAL: $0.00
PERMIT NO: DRVA2017-0027 -
DATE lSS1UED1Ia41/7
EXPIRATION DATE: L1ZL//
BY:
WORK INSPECTED BY':.____
PERMIT COMPLETION DATES:_.
'If the work is covered by a Subdivision Improvement Agreement,
Subdivider shall request final acceptance of improvements from the
City Council.
•
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-- GEM .fzlw DESF.W) --
DRIVEWAY APPROACH PERMIT APPLICATION
I Applicant Information: 1 110
I Applicant/Owner (please RdiLt name here): if zd & r/ --
Applicant Address: 61
Number City State Zip Code
or P2!cel.Ng, of work location, if different from a address above: A.
Number street City State Zip Code
Date: /jjjjj Applicant's Phone No: (125) 422 —i2..1
Applicant's Signature: ; )12L, jr, ',d1J4
Approximate Start Date: LL ....//J7. Approximate Completion Date: JLii1J..tL
Contractor Information: CAl-, 4147 cqNsre'4r/o11
Address: ' 5,6//4L 4Jti,,kAA, g22
Number Stre*dt City State Zip Code
Phone Number: tO) .o2._432'Contractors License Number: '923
City Business License Number: dzip 6'i",'O
General Liability Insurance ComDanv:
Request for Inspection - Please call (760) 777-7097 before 2:0pm 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. OEC/42,4l€7 Expirpii a'/ I_JIIJi?..
Permit Issued by: Date Issued L_/j./_j2
# SIgnatr6 dffrsq6tive Authority
Work Inspected by: Permit Completion Date:
Inspector's Signature
Comments:
Note: Driveway approach must be constructed per City of La Quinta Standard #221