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DRVA2019-0021ta Qal4tt See below for Finance Revenue Code - GEM of:kDESERT - - DRIVEWAY APPROACH \EJ L Il PUBLIC WORKS CONSTRUCTION OCT 152019 For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, seweririater rO QUAlike Upublic work improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS. DESI GN & DEVELOPMENT DEPARTMENT DATE: 10/15/2019 LOCATION OF CONSTRUCTION (Street address or Description): 52425 AVENIDA VELASCO PURPOSE OF CONSTRUCTION: DRIVEWAY APPROACH FOR NEW CONSTRUCTION. DESCRIPTION OF CONSTRUCTION: STEMMER /_DRIVEWAY APPROACH DIMENSION OF INSTALLATION OR REMOVAL: APPROXIMATE TIME WHEN WORK WILL BEGIN: 10/20/2019 TIME OF COMPLETION: 10/25/2019 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 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 rule a d regul t o s of the City of La Quinta and to pay for any additional replacement necessary as the result of this work. Agna of Applican or Agent JOE STEMMER 52075 AVENIDA NAVARRO LA QUINTA, CA 92253 (760)880-3585 Name of Applicant (please print) Business Address Telephone No. OWNER BUILDER - JOE STEMMER 52075 AVENIDA NAVARRO LA QUINTA, CA 92253 (760)880-3585 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 DRIVEWAY RESIDENTIAL $175.00 TECHNOLOGY ENHANCEMENT FEE $5.00 TOTAL: $0.00 Policy Number PERMIT NO: DVi20190021 DATE ISSUED:ID is- 7-01 EXPI RATION DATE:/ JZ/o2.O 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. 10o stuo w 2 GEM of the DESERT - DRIVEWAY APPROACH PERMIT APPLICATION Applicant Information: - Applicant/Owner (please print name here): Applicant Address: Number Street City State *Zip Code Address or Parcel No. of work ion, jf different from applicant's address above: Number Street City State Zip Code Date: )o iij APliant's Phone No: (htl 3 Sè5 Applicant's Signature: Approximate Start Date: Approximate Completion Date: LiLi'( Contractor Information: Addess:g2ç L ic ?/ o zz ) Number Street J City State Zip Code Phone Number: ('Jb) 'S'%) SS Contractors License Number: LOS City Business License Number: L4?1 L3 General Liability Insurance Company: 1 Policy No. (see back for required insurance documents) 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 No*L40002 Expi tion Date 4 /p AD Permit Issued by: 4I- Date Issued (O/15/I1 Signat4 inistrative 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 REV: 8/19/2019 / 'r' • RE: Driveway I Encroachment Permits - Compliance with Insurance Requirements Per Engineering Bulletin #97-04 please provide proof of the insurance items and endorsement certificates below: C3 General Liability - $1M per occurrence I $2M general aggregate O General Liability - Additional Insured Endorsement (for ongoing and completed operations) 0 General Liability - Primary I Non-contributory Endorsement 0 Automobile Liability - $1M combined single limit 0 Workers' Compensation - Statutory Limits / Employer's Liability $1M per accident or disease 0 Workers' Compensation - Waiver of Subrogation Endorsement 4 tucrev - c;EI nfthr L)ESLR1 - 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 build?r,of the driveway improvements specified at Jg- )j-' 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. It. 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. L1 2. I 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. DL. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect from potential financial risk by hiring a licensed Contractor and having the per ml flied his or her name instead of my own. 7 64. I understand Contractors are required by raw to be licensed and bonded in California and to list their license numbers on permits and contracts. 5. 1 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 an "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. 1b. 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. 111 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 Department 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. 89. I am aware of and consent to an Owner-Builder driveway permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at tle fo,lowing 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. IJ ii. 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 41 river's license, form notarization, or other verification acceptable to the agency is requird to be prese te hen the permit is issued to verify the property owner's signature. Signature of property owner: Date: 78-495 Calle Tampico La Quinta, CA 92253 760.777.7000 LOT LINE A --I 2' MIN. FROM 4• - LOT LINE I I WEAKENED PLANE JOINTS @ 5 FT. INTERVALS I I $1 4' I I, 6 SIDEWALK I- RIGHT-OF-WAY 4.7 Q * MAYBE REDUCED TO 30 FT. MIN. WITH APPROVAL OF CITY ENGINEER COMMERCIAL: UP TO 8% RESIDENTIAL: UP TO 9% FL A - RESIDENTIAL 12 MIN. - 30 MAX. COMMERCIAL 35 MIN. - 40 MAX.* DI AM 111 CIAl RIGHT-OF-WAY STREET GRADE VARIES I--- iOO PREFERRED STREET GRADE PREFERRED ,2% MAX. - — 1 . LIPI - 6' THICK CONC. SECTION A - A SECTION B - B DETAIL NOTES: oy ALL CONCRETE SHALL USE TYPE V CEMENT AND PER CITY STANDARD 200. . 20 FEET OF FULL-HEIGHT CURB REQUIRED i BETWEEN DRIVEWAYS WITHIN ANY ONE PROPERTY FRONTAGE. USE 6 MIL PLASTIC SHEETING WHEN . ABUTTING SOIL HAS A HIGH SULFATE CONTENT. CONSTRUCT THE PROFILE GRADE OF THE PRIVATE ON-SITE DRIVEWAY SO THAT IT PROVIDES SMOOTH VEHICLE ** ACCESS OVER THE DRIVE APPROACH. . COMMERCIAL : UP TO 8% RESIDENTIAL: UP TO 9% CHANGE IN GRADES SHALL NOT EXCEED 8%, UNLESS THE LENGTH IS ISOMETRIC VIEW LESS THAN 2 FEET THEN GRADE SHALL NOT TO SCALE NOT EXCEED 15%. REVISIONS DEPARTMENT OF PUBLIC WORKS PLAN No. N ENGINEERING DIVISION lay4 .4va1ii$i STANDARD JAN-il APPROVED BY: DRIVEWAY 221 -1 EJSS YE,, Q'TE WITH SIDEWALK SHEET - Pucwor4'L ADJACENT TO CURB 10F3 R.CE No 458 121311 f2 A WEAKENED PLANE JOINTS I LOT I @ 5 FT. INTERVALS - RIGHT-OF-WAY 2' MIN. FROM J LOT LINE 5' SIDEWALK 4 APRON WHEN / L STREET GRADE EXCEEDS 4°/a II- A ill' 3' RESIDENTIAL 12' MIN. -30' MAX. 3' - MIN. COMMERCIAL 35' MIN. - 40' MAX .* MIN. ri A Li 1I1IA1 5, SIDEWALK RIGHT-OF-WAY P; Q100 1 LIP 6THICK CONCRETE SECTION A - A * MAYBE REDUCED TO 30 FT. MIN. WITH APPROVAL OF CITY ENGINEER ** COMMERCIAL UP TO 8% RESIDENTIAL: UP TO 90/0 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 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 REVISIONS Q STANDARD ENGINEERING DIVISION PLAN No. No. DATE JAN -1i APPROVED BY: DRIVEWAY 2__21 JRJN1J WITH SIDEWALK AN,P.E, AT SHEET Pubhc rec/Cty Eogeer ADJACENT TO R I W 2 OF 3 RCE No 4543 Exo 12/31/12 ISOMETRIC VIEW NOT TO SCALE LOT LINE 2' MIN. FROM LOT LINE • 4. a 4 4 5' TRANSITION 6" VERTICAL CURB rL _____ WEAKENED PLANE JOINTS I @5 FT. INTERVALS RIGHT-OF-WAY 7,71 W. •p . • . a a . • a • • a 4 a 40 a I ., . 4 • a. • •• a • •• a a • SIDEWALK a ad a ________ a f-'-. • • a 6" VERTICAL rt CURB I WEDGE CURB A SEE STD. 211 - RESIDENTIAL 12' MIN. - 30 MAX. — I Al tII%AI I — SIDEWALK RIGHT-OF-WAY 0100 —.-1 2% 1VARIES I MAX.I I —I 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. 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 LESS THAN 2 FEET THEN GRADE SHALL NOT EXCEED 15%. —I II— II —I I ' - a &THICK CONCRETE WEDGE CU SEE STD. 211 SECTION A — A REVISIONS DEPARTMENT OF PUBLIC WORKS Imft &t (, PLAN No. STANDARD — — ENGINEERING DIVISION 44" jii APPROVED BY: DRIVEWAY WITH 221 — -tl;tt; ~L."m •J • i/J'i SIDEWALK ADJACENT -OtOTHY It ATE SHEET -- 'c ACE. No. 45843 Exp. 12/31/12 TO WEDGE CURB 30F3