DRVA2018-0013See below for Finance Revenue Codes
-GEM qtheDESERT-----
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 works'
improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS.
DATE: 8/9/2018
LOCATION OF CONSTRUCTION(Street address or Description): AUTO CENTER WAY S CUL-DE-SAC
PURPOSE OF CONSTRUCTION: DRIVEWAY APPROACH FOR TEMPORARY AUTOMOBILE STORAGE LOT
DESCRIPTION OF CONSTRUCTION: DRIVEWAY APPROACH FOR TORRE NISSAN TEMP AUTOMOBILE STORAGE
DIMENSION OF INSTALLATION OR REMOVAL:
APPROXIMATE TIME WHEN WORK WILL BEGIN: 8/13/2018 TIME OF COMPLETION: 8/31/2018
ESTIMATED CONSTRUCTION COST: (Including removal of all obstruction, materials, and debris, backfilling, 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 advancèof 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 rule and re lati s of the C of and to
pay for any additional replacement necessary as theresult of this work. j1 [••_111_;5k
- Signature of Applicant or Agent
LIPPERT CONSTRUCTION INC - DAVE
LIPPERT
Name of Applicant (please print)
LIPPERT CONSTRUCTION INC
Name of Contractor and Job Foreman
843418
Contractor's License No.
P 0 BOX 5477 LA QUINTA, CA 92248 (760)863-5700
Business Address Telephone No.
P 0 BOX 5477 LA QUINTA, CA 92248 (760)863-5700
Business Address Telephone No.
LIC-102366
City Business License No.
IRONSHORE SPECiALTY INSURANCE CO • S • AGS6013406
Applicant's Insurance Company • • Policy Number
Finance Revenue Code
PERMIT INSPECTION
DRIVEWAY COMMERCIAL $156.00
TECHNOLOGY ENHANCEMENT FEE • • $5.00
TOTAL: $0.00
PERMIT NO: DRVA2018-0013
DATE ISSUED: .A-j ti.4 '9 2oi
1
'
EXRA ION DATE: A4&icJ—
BY-
WORK IN44CTED BY*:
IPERMIT COMPLETION DATE*:
*If the work is covered by a Subdivision Improvement Agreement,
Subdivider shall request final acceptance of improvements from the
City Council. • -
S
- CCM eft4e DESERT -.
DRIVEWAY APPROACH PERMIT APPLICATION
Applicant Information:
Applicant/Owner (please print namehere):
Applicant Address:P- crr1 L -L C'i-
Number Street City State Zip Code
Address or Parcel No.
Number -Stret
Liffernpfrom c tica} address above:
V, IN V-4 TV'_________
(ity State Zip Code
Dote: _/_/ Applicant's Phone No:
Applicant's Signature:
Approximate Start Date: II Approximate Completion bate: __i..........J
;j,g-
Number Street . City. State Zip Code
Phone Number: Ago 7o2 Contractors License Number: 4 11
City Business License Number: 10
General Liability Insurance Company: 1"OPt.SO ie l't5Uø.0tcL *&5ool3q,o )'olicy 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 Barn and 4pm
Permit Fee $156 + $5 Technology Enhancement Fee = $161 Total Fee
Permit No. Expiration Date
Permit Issued by: Date Issued
Signature of Administrative Authority
Work Inspected by: Permit Completion Date: __/_I__
Inspector's Signature
Comments:
Note: Driveway approach must be constructed per City of La Quinta Standard #221
Contractor Information:
Address: ... 15,41-7 .
Permit application submittal requirements:
1. Application completely filled out with the following items attached
a. Ensure there's a City Business License # on application
2. Current Certificate of Liability. Insurance
City of La Quinta as additional insured with endorsement if work is being done in the
public right of way
3. Traffic Control Plan if there are lanes on public streets being closed
a: Traffic Control plan must be stamped by a Civil or Traffic Engineer or;
b. Applicable traffic control plan from 2012 WATCH Manual or 2012 California MUTCD.
4. Bonds or cash deposits may be required for grading, off-site improvements, and/or dust control
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