CIP2017-0008owkra
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CIP
PUBLIC WORKS CONSTRUCTION
See below for Finance Revenue Codes
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: 1/20/2022
LOCATION OF CONSTRUCTION (Street address or Description): CITY OF LA QUINTA (CITY-WIDE)
PURPOSE OF CONSTRUCTION: STRIPING, SIGNS, MARKINGS, AND MARKER INSTALLATION THROUGHOUT THE CITY OF LA QUINTA
DESCRIPTION OF CONSTRUCTION: 2012-07F PMP PHASE 3 CITY-WIDE STRIPING
DIMENSION OF INSTALLATION OR REMOVAL:
APPROXIMATE TIME WHEN WORK WILL BEGIN: 11/26/2017 TIME OF COMPLETION: 1/10/2018
ESTIMATED CONSTRUCTION COST: (Including removal of all obstruction, materials, and debris, backfilling, compaction and placing
permanent resurfacing and/or replacing improvements)
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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 the City of La
Quinta and to pay for any additional replacement necessary as the result of this work.
CAL STRIPE INC
Name of Applicant (please print)
CAL STRIPE INC
2040 EAST STEEL ROAD COLTON, CA 92324
Business Address
2040 EAST STEEL ROAD COLTON, CA 92324
Name of Contractor and Job Foreman Business Address
685387
Contractor's License No.
Applicant's Insurance Company
Finance Revenue Code
TOTAL: $0.00
LIC -0108530
City Business License No.
Policy Number
PERMIT NO: CIP2017-0008
DATE ISSUED: 11/21/2017
EXPIRATION DATE:11/21/2018
BY: UBALDO AYON
WORK INSPECTED BY*:
PERMIT COMPLETION DATE*:
Signature of Applicant or Agent
(909)884-7170
Telephone No.
(909)884-7170
Telephone No.
*If the work is covered by a Subdivision Improvement Agreement,
Subdivider shall request final acceptance of improvements from the
City Council.
Date: I/ -
Tract No:
Vicinity:
PUBLIC WORKS DEPARTMENT
APPLICATION FOR PERMIT
Project Name: ?M?
z est'7
Purpose of Construction (i.e.: Rough Grading, Offsite Street,
Description of Construction (i.e.: See Plan Set No. 01234) jZc— _4 c S 'p�--
Dimension of Installation or Removal:
Approximate Construction Start Date: - i l -Zb —.Zdl
Approximate Construction Completion Date:
o
Estimated Construction Cost: $ �Sa, noo s—
Estimated Construction Cost shall include the removal of all obstructions, materials, and debris, back -filling, compaction and
placing permanent resurfacing and or replacing improvements
Contact Name: d A wt L,; Phone Number: 40g :ao a�
Name of Applicant/Owner: _2 ts �n
Applicant Address: 70 Q E• S�eQ� C z
Applicant Telephone Number:
Applicant E-mail Address: A L : pmg�wg C,�IS,Fir,< • ear
Name of Contractor: E Zr��
Contractor Address: .0414 -I- -SQL. led .
Contractor Telephone Number: _999—
Contractor State License Number: Cn g
Contractor City Business License Number:
Contractor E-mail Address: 44p0A (A Coq./
)o -,A COPY Or THE CURRENT INSURANCE CERTIrICATC MUST BE PROVIDED �
Applicant or Contractor General -Liability Insurance Company:
Applicant or Contractor General Liability Insurance Policy Number:
_Off ice Use On_ ly:
Inspection Pee:
Permit Pee:
As -Built
Deppsil:
Dust Control
Deposit:
Credit
Amount'
TOTAL FEE— DUE:
rlve/UlIeCKIIStS —
Application
Office Use Only:
Assigned Permit Number:
Approval Date:
Expiration
Date:
Issue
Date:
Administrative Aulhorily: