HomeMy WebLinkAboutN2017-0086�R�qr City of Newport Beach III111111111111111111111111 ill 1111111111 1111111�
oS d 100 Civic Center Drive, Newport Beach, CA 92660 N 2 0 1 7 0 0 8 6
F Permit Counter Phone (949)644-3311
v Online Inspection Request- www.newportbeachca.gov/Online
na��wvY£s Services
Job Address : 2334 ARALIA ST NB
Description : INSTALL SEWER CLEAN OUT EXISTING SEWER LATERAL PER STD-406-L
Parcel #
4400-222-3 -
Legal Desc :
N TR 4705 LOT 122
Owner:
GODWIN ANNALYN A
Phone:
0
Address :
2334 ARALIA ST
Applicant: GODWIN ANNALYN A
Phone: [
Address
Special Cond.: Preconstruction meeting required with
Public Works inspector.
Permit Processing Fee:
$241.00
Sewer Connection:
$0.00
Agreement Fee :
$0.00
4TT Box Cover:
$64.00
Traffic control Plan Check :
$0.00
Total Water Meters :
$0.00
Inspection Fee :
$330.00
Water Meter Connection :
$0.00
Refundable Deposit:
$0.00
Total Water Meter Box:
$0.00
Street Tree Fee :
$0.00
Adjustment :
$0.00
Processed By:
Utilities Approval
Traffic Approval :
General Services Approval
Date
Date
Date
Date
Permit No: N2017-0086
Project No: 1096-2016
Inspection Requests Phone (949)644-3255
Thomas:Guide: 889E4 8CANNED
Contractor : WEILER DON R REVIEWED
Phone: 714-842-5800
Address : 17451 GRASS CIRCLE
HUNTINGTON BEACH CA
Contractor State Lic: 586459
License Expire : 01 31, 2016
Business License: BT30051169
Business Expire : 02 28, 2017
Workers' Compensation Insurance - -
Carrier: EXEMPT
Policy No:
W. C. Expire:
Total Fee
Paid :
Balance
Receipt No
g o--(� Zsa
$635.00
$635.00
$0.00
Other Department : Date: _/_/
Permit Denied Date: _/ /_
Issued Permit: Date : 2-/22/ t—t
�a
e
WORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
COMPLETE THE BELOW INFORMATION
PROJECTADDRESS: _S^ r _ i
DETAILED DESCRIPTION OF PROPOSED WORK:
I
l
�G l �'ib - sot ito
APPLICANT:
Phone:
Email Address: A44 S/
Mailing Address: r 3S�
LLW-CCAL
City/State/Zip: Y
- _L]
OWNER: Phone:
Email Address:
Mailing Address: City/State/Zip:
ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE COMPLETE
CONTRACTOR: .
I
f Office
Phone:
Company (if different):
Jobsite Phone:
Other Phone:
Email Address:
51
Mailing Address: q
i 1
City/State/Zip:
06
State License Number & Class:
Expires:/ ——
City Business License Number:
�3'�?UO:-�11F;`1 Expires: Z28 I$
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: `` f!_ k Policy No: Expires:
Municipal Oerations: 949-644-3055
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
FOR OFFICE USE ONLY
Special Conditions of Permit: PPF'-CbN
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS '
Utilities:
Municipal Op5rations
Traffic: Firer
Other:
r' Technician:
Permit Specialist
Date:
�---
Permit No.
N2017- DUSIp
[Iuserslpbwlsham roach/masterslepwotsheet.xls
pC # �0C1(o rwl(,o
Public Works Department 949.644-3311
100 Civic Center Drive, Newport Beach, CA 92660
FEE WORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
All Fees Are Non -Refundable Unless Otherwise Stated
PROJECT ADDRESS: PERMIT N2017-
L3�� CL'rLGl�tCl S}f"tit NUMBER: (J('
APPLICANT:
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
Inspection Fee:
t. .
$241.00 l
Public Works Field Inspection
$165.00 v'
$275.00
Utilities Field Inspection
$121.00
General Services Inspection
$165.00
$817.00
Water Quality/Artificial Turf Inspection
$108.00
$192.00
Refundable Deposit:
TBDB
$502.00
Improvements
TBD
Street/AlleylWalk Closure: $65.00= Newspaper Rack Inspection $108.00
Traffic Control Plan Check
8-1/2" x 11" $65.00= Sewer Connection Fee $250.00�
24" x 36" $143.00 4TT Box & Cover $64.00 1
Additional
------------------------- -----i
( THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division
I REVENUE DIVISION PRIOR TO PAYMENT OF FEES Approval:
(Water Meter:
13/4" Meter $50.25
11" Meter $121 50
11 1/2" Meter $285.00
11 1/2" Turbine Meter $700.00
12" Meter $425.00
12" Turbine Meter $845 00
13" Meter $3,310.00
4" Meter $4,730.00
Installation Charge $528.000
Water Meter Boxes:
For Parkway & Sidewalk Area (Box + Cover = Cost)
1" Meter: 13.00 + 37.00 $50.00[:::�
2: Meter: 27.00 + 61.25 $88.25
For Traffic & Alley Areas (Box + Cover = Cost)
1" Meter 13 00 + 38.00 $51.00
2" Meter. 27.00 + 162.00 $189.00
Certificate of Compliance Fee (+100 of hrly over 3 hrs)
$288.00
5200-5029
Development Services Fee (Plan check hourly)
$155.00
5200-5015
Final Tract Map Checking Fee
$2,488.00
5200-5026
Final Parcel Map Checking Fee - Moderate
$2,488.00
5200-5027
Lot Line Adjustment Fee
$1,079.00
5200-5028
Park Dedication Fee Zone _
TBD
405-470_
Street Easement/Vacation Fee (+1o0%ofhrlyover 4hrs)
$1,022.00
5200-5031
Street Tree Fee ($700 Planting Fee)
TBD
030-2284
Engineering Tech:
Total Amount Due:
For Finance use only
,C
Permit Specialist
Receipt No.
f /userslpbwlshared/encroach/masters/ep front and back masters/
Rev. 1/5/2017
epfeesheet xis -revised 10/21/2016
ALL UNDERGROUND WORK SHALL BE PERFORMED BY A LICENSEDCONTRACTOR
Contact"Underground Service Alert" At Least 48•Hours In Advance of Any Excavation at 1-800-227-2600 or 811 t
TERMS AND CONDITIONS OF ENCROACHMENT PERMIT
WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code)
Encroachment Permits may be taken out by the owner of benefited property or a licensed contractor. A licensed
I certify that I have a Certificate of consent to self -insure, Certificate of Worker's
contractor must provide a "Letter of Authorization" to allow another party to pull a permit. An approved copy of the
Compensation Insurance, or a Certified Copy thereof.
permit and construction plan shall be kept at the job site at all times. Work, which has been done prior to issuance of
a permit, is subject to rejection/fine. City reserves the right to void penult if work does not commence within 30 days
Date: Signature:
after date of issuance.
The Permittee agrees to defend, indemnify and hold the City, its authorized agent, officers, representatives and
CERTIFICATE OF EXEMPTION (Section 3800 Labor Code)
employees harmless from any responsibility, liability, suit or action of any description arising out of any accident, loss
I certify that in the performance of the work under this permit, I shall not employ
or damage to persons or property occurring as a result of work undertaken under this permit.
any person so as to become subject to California Worker's Compensation Laws. If,
All work shall be done in accordance with the approved plans, Standard Special Provisions and Standard Drawings
after signing this certificate I become subject to the Worker's Com nsation
of the City of Newport Beach, and in compliance with all applicable State laws and City ordinances.
provisions of the State Labor Code, I must comply wt the provision f Section
Permittee guarantees all work performed under this permit to be free of hidden and latent defects. Any failures shall
37700 or this permit shall be deemed revoked.
be corrected within two weeks after notification to the satisfaction of the Public Works Director.
-
A valid State licensed contractor must perform all construction within the public right-of-way, unless waived by the
Date: _ a Signatur
Public Works Director. A valid State Contractor License Class A can perform any work in the public right-of-way. For
construction or connection to water lines a valid State Contractor License Class C-34 is required, For construction or
CONTRACTOR LICENSE EXEMPTION
connection to sewer lines a valid State Contractor License Class C-42 is required.
All trenching and/or resurfacing shall conform to City Standard 105-L for parkway/roadway and City Standard 140-L,
As the Owner of the benefiting property, I certify I am personally performing all
in the alley, where a minimum half -alley width resurfacing shall be provided, unless otherwise directed by the Public
work in the Public Right -of -Way,
Works Dept. Contractors shall obtain permits to perform excavation or trench work from the California Division of
Date: Signature:
Industrial Safety prior to commencing underground construction as required by State law. Walls and faces of all
excavations over 5 feet in depth shall be protected by a shoring system, sloping of the ground, or other equivalent
means. Trenches less than 5 feet in depth shall be guarded when hazardous ground movement may be expected.
HOLD HARMLESS STATEMENT
The Public Works Department Inspectors must inspect all work in the Public right-of-way. Forms and subgrede must
I understand that I am locating minor encroachments within the City Right -of -
be inspected and approved before concrete is ordered/poured. Sewer, pipelines, and subgrade construction must be
WaylEasement. As property owner it is my responsibility to maintain the
inspected and approved before backfilling, or applicant may be required to excavate site. Separate inspections by
encroachments. I will be responsible for replacing the improvements if the City
the Municipal Operations Department may be required depending on scope of work performed.
removes them for maintenance of utilities or other public need. I shall indemnify
All trench restoration must be inspected by the Public Works Department. No utility installation(s) shall be allowed
and hold the City harmless for any liability associated with the minor
over or within 5 feet of any City utilities, unless approved by the Public Works Department. Locate and pothole
encroachments.
existing City -owned utilities (le: water, sewer, or street lighting conduits) to verify locations. Maintain a one -foot
clearance over or under existing City -owned utilities. Sewer cleanouts require VCP or PVC SDR35 be used with a
Date: Signature:
4TT box over the riser.
Property lighted barricades must be provided and maintained around all trenches, excavations and obstructions. All
"Manual
Inapeetlons should be requested by -Dolling Ile W rks Inspect!"signs,
flags, lights and other warning and safety devices shall conform to the requirements of the current of
Warning Signs, Sights and Other Devices for the Use in Performance of Work Upon Highways", issued bMhe.
Rpquest Line at: 949.644-3256, INITIALS:
California Department of Transportation. If needed, barricades can be obtained from the City at a charge of $10.00
�
per barricade per day, with a minimum charge of $36.00. It is the responsibility of the applicant to place barricades to
16. All above ground facilities shall comply with the Municipal Code, including but not limited
protect the general public. Access to fire hydrants must be maintained at all limes.
to Chapter 13.20.
0. Work within or near beach sensitive areas will not be allowed during, City holidays, spring break, Memorial Day
Water
16 Homeowner, contractors, and subcontractors may each be liable for violations of Water
a
weekend, summer between June 15 and September 15, and during the holiday season from December 19 to
Quality Laws, Best Management Practices will enforced. It is against the law
January 1, unless approved by the Public Works Department.
1. Any work that extends into trato
ffic or parking lanes and impedes the normal Sow of traffic requires the applicant to
discharge construction debris into the gutter and storm drain. Felony violations of Water
acquire a Temporary Street Closure Permit from the Public Works Department. Access for fire, police and
Quality Laws are punishable by fines up to $25,000 and/or up to three years in State
prison plus the full cost to clean up an illegal discharge or spill.
emergency vehicles must be maintained at all times. Traffic Control must be per Work Area Traffic Control
17. If a refundable deposit was paid, applicant must submit a Soils Compaction CerOflcate or
Handbook (WATCH). No nighttime traffic lane closures, unless prior approval has been granted. Any lentils) closure
Evidence of a Slurried Backfill and request a final inspection from the Public Works
on a major
street will only be allowed between 9:00 a.m. and 3:00 p.m. (Monday thru Friday), unless approved by
Department. Monies may be held for six months after final inspection before a refund will
the Public
Works Department. Any work affecting the State Highway's traffic or within the State Highway right-of-way
be processed.
will require a Caltrans Permit. All vehicles shall be lawfully parked.
2. This permit does not authorize the closure of sidewalks, streets, or alleys for construction access, storage of
18. No trees in the public right-of-way shall be planted, removed, trimmed, or relocated
materials, or parking of construction vehicles unless detailed on an attached Temporary Street Closure,
without approval from the Municipal Operations Department, Parks and Street Trees
Division,
3. Applicant must notify USA at 1.800.227-2600 2 days before starting any underground constructlon. Applicant
19. All work in the public right-of-way must meet the approval of the Public Works Department
must notify all affected residents 24 hours in advance of restricted access and any inconveniences. All USA marks
or corrections will be required (i.e. removals, exposing connections, etc,), Additional
shall be removed prior to Final Public Works Inspection.
inspection fees may be required.
inspection
4. Refuse or unused materials shall be removed within 24 hours after completion of the work. If not removed, the City
Permit is for standard materials in the public right-of-way only, unless previously approved
may remove and bill the applicant. Coordinate alley closures with City's refuse pick-up days by calling 949-644-3066
by Public Works and an Encroachment Agreement has been processed,
for the collection schedule so service is not interrupted. To place a dumpster or materials in the public right-of-way, a
21 Permit is valid for "description" of work noted on front only. Additional work performed
Temporary Street Closure Permit must be obtained from the Public Works Department
may require issuance of a separate permit and/or additional fees.
le were relatsd,to thhvencroachri ant parritkcahUflbwparformad until the Public Work*. Department has Issued fin
ondalons of this, permit and hahho agrees to abide by them. Pernik IS void If work Is notcommencedwithin 30er
'ormh Ma are nonrefundable, Pleasenots: Preparation of Encroachment Agreement fee Is non-refundable'.
heck A L,icense - License Detail Page 1 of
Contractor's License Detail for License # 586459
)ISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this
nformation, you should be aware of the following limitations.
CSLB complaint disclosure is restricted by law (B&P 7124.6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below. Click on the
link or button to obtain complaint and/or legal action information.
Per B&P 7071.17 , only construction related civil judgments reported to the CSLB are disclosed.
Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration.
Due to workload, there may be relevant information that has not yet been entered onto the Board's license database.
Business Information
DON R WEILER
7071 WARNER AVENUE F-135
HUNTINGTON BEACH, CA 92647
Business Phone Number:(714) 612-7915
This license is current and active.
All information below should be reviewed.
GENERAL ENGINEERING CONTRACTOR
Entity Sale Ownership
Issue Date 01/23/1990
Expire Date 01/31/2018
License Status
Classifications
Bonding Information
Contractor's Bond
This license filed a Contractor's Bond with HUDSON INSURANCE COMPANY.
Bond Number: 30018660
Bond Amount: $15,000
Effective Date: 12/17/2016
Contractor's Bond History
Workers' Compensation
This license is exempt from having workers compensation insurance; they certified that they have no employees at this time.
Effective Date: 01/22/2016
Expire Date: None
Workers' Compensation History
Miscellaneous Information
07/01/2008 - SOLE TO CORP REASSIGN 13A-1H REJECT
Other
Personnel listed on this license (current or disassociated) are listed on other licenses.
tps://www2.cslb.ca.gov/OnlineServices/CheckLicenseII/LicenseDetail.aspx?LicNwn-586459 02/22/201
heck,A License - License Detail
Page 2 of
tps://www2.eslb.ca.gov/OnlineServices/CheekLicenseII/LicenseDetail.aspx?LieNum=586A59 02/22/2.01
\ \950 SF TO BE REMODELED
9
THE EXISTING (2,400 so FT
T
NE STORY SINGLE FAMIL)
BUILDING
TO PL
PROPOSED
OVERHANG TO P.L.
;F 011'
2/2312017 City of Newport Beach Page 3 of 10
4:30:37PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 02/24/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 2334 ARALIA ST
A/PID Information:
Activity : N2017-0086
SubType:
Status: APPROVED
OWNER: GODWIN ANNALYN A Phone: o
Description : INSTALL SEWER CLEAN OUT EXISTING SEWER LATERAL PER STD-406-L
Requested Inspection(s)
Item: 10200 PRE JOB - PW
Requested Time: 2/24/2017 12:00:OOAM Requestor: NBIVR
7146127915
Entered By: NBIVR
Comments: AM
Assigned to:
op Eok /o - /a '30 .rf--
Inspector: V Is Date: -ZZ 7'7 Time: /o: o7n6MJPM
Comments: 11/lE T- bD X/ G>> /'/eyl e r-> A d-/2
i� � ,�o A M - po/(l w r G � —_ � F '� ✓ v✓I Grp rZ i�, _ i� - �
F:\Users\PBMShared\ENCROACH\MASTERS\FORMS\I nsoeclorSheel doc
REPT131 Run Id: 4018
3l8/2017 City of Newport Beach
4:30:41PM INSP150 - Daily Inspection Request Report
Requested Inspection Date :
03/09/2017
Inspection Type :
ENCROACH
Inspection Area:
PW
Site Address :
2334 ARALIA ST
A/P/D Information:
Activity :
N2017-0086
SubType:
Status :
APPROVED
Page 3 of 14
OWNER: GODWIN ANNALYN A Phone: 0
Description : INSTALL SEWER CLEAN OUT EXISTING SEWER LATERAL PER STD-406-L
Requested Inspection(s)
Item: 10030 CLEAN -OUT ,/ mArr c wt1}N
Requested Time: 3/9/2017 12:00:OOAM
Entered By: NBIVR
Comments: AM -o 'I
Assigned to :
Inspector: J j
Comments:
Requestor: NBIVR
7146127915
Date: 3 1-7 Time: /D' 36 M� M
A�P=nO> 1 /nallL E 5;/O257- r.,� r ,si
43='/, 1� TcJ Gil/ST#�� /5���2
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet doc
REPT131 Run Id: 4018
3/13/2017 City of Newport Beach
6:34:57AM INSP150 - Daily Inspection Request Report
Page 2 of 11
Activity :
SubType :
Status
OWNER
Requested Inspection Date :
03/13/2017
Inspection Type:
ENCROACH
Inspection Area :
PW
Site Address :
2334 ARALIA ST
A/P/D Information:
N2017-0086
APPROVED
GODWIN ANNALYN A
Phone: 0
Description : INSTALL SEWER CLEAN OUT EXISTING SEWER LATERAL PER STD-406-L
Requested Inspection(s)
Item: 10010 BACKFILL / COMPACTION- PW
Requested Time: 3/13/2017 12:00:OOAM Requestor: NBIVR
Entered By: NBIVR 7146127915
Comments: AM
Assigned to :
Inspector: Date: / l -7 Time: _)0 Z5AM PM
Comments: 0 777 �//(%,�F Z-
5ca -,�4 r-T
F:\Users\PB\MShared\ENCROACH\MASTERS\FORMS\Ins ectorSheet doc
REPT131 Run 1d: 4018