HomeMy WebLinkAboutN2017-0081q�Q�t•„�r City of Newport Beach IINIII111111111111111111111111111111111111111111111 II
o� 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3311
Online Inspection Request - www.newportbeachca.gov / Online
na«x *ems Services
Job Address: 4361 BIRCH ST NB Thomas:Guide:
Description : INSTALL SEWER CLEAN OUT PER STD 406-L.
Parcel # :
-
Legal Desc :
Owner:
TRACT NO NO 5169 LOTS 7 8 9 AND 10
BIRCH 4361
C0� �►rF`,�
r..JIV,
Phone:
Address :
333 CITY BLVD WEST #1115
ORANGE CA 92868
Applicant: COASTAL PACIFIC CONST INC
Phone: 949-770-1555 [
Address : 23121 LA CADENA STE C
LAGUNA HILLS CA 92653
Special Cond.: PRE -CONSTRUCTION MEETING REQUIRED
Permit No: N2017-0081
Project No: 1162-2016
Inspection Requests Phone (949)644-3255
859F6
REVIEWED
Contractor: COASTAL PACIFIC CONST INC
Phone: 949-770-1555
Address : 23121 LA CADENA STE C
LAGUNA HILLS CA 92653
Contractor State Lie: 478584
License Expire : 08 31, 2017
Business License:
BT98042401
Business Expire :
08 31, Ike201il
Workers' Compensation Insurance - -
Carrier :
IN CO OF THE WEST
Policy No:
WSD5031414
W. C. Expire:
10 01, 99W 7017
Permit Processing Fee :
$241.00
Sewer Connection :
$0.00
Total Fee $635.00
Agreement Fee:
$0.00
4TT Box Cover:
$64.00
Paid : $635.00
Traffic control Plan Check:
$0.00
Total Water Meters:
$0.00
Balance : $0.00
Inspection Fee :
$330.00
Water Meter Connection :
$0.00
Receipt No
Refundable Deposit:
$0.00
Total Water Meter Box:
$0.00
Street Tree Fee :
$0.00
Adjustment:
$0.00
Processed By:
Date :
_/ / Other Department :
Date :
/
_/
Utifities Approval :
Date:
_/_/_ Permit Denied
—Date:
Traffic Approval:
Date :
_/_/_ Issued Permit:
Date
General Services Approval :
Date:
_/_/
WORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
COMPLETE THE BELOW INFORMATION
PROJECT ADDRESS: ( Bmcq S
DETAILED DESCRIPTION OF PROPOSED WORK:
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APPLICANT: CbA)-3 ,AC (Frc �pivST� Ci/��
Phon Gl�f� 7%U- l 5S
Email Address:
Mailing Address: 2 8 c-D r--C f"F1 /v
City/State/Zip:
OWNER: L-/\/T' rP2i F- L l NG
Phone:
Email Address:
Mailing Address: City/State/Zip:
ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE COMPLETE
CONTRACTOR:
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Office Phon u - I ,S
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Company (if different):
Jobsite Phon �/ 29 - ifs
Other Phone:
Email Address:
Mailing Address: Z�
C 1 t tate/(Z( i /pC
State LicenseSN mbef & Class:
�7 l5 Ex ires:0 / YoR
City Business License Number:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
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Company. / wo2L - policy No:wS'DSo Q Expires: j0 01
Municipal Oerations: 949-644-3066
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
FOR OFFICE USE ONLY
Special Conditions of Permit:
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ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS '
Utilities: Traffic: Fire: u
Municipal Operations Other:
Engineering Technician: Permit Spa ' ist Date: Permit No.
1 ._ 1142017-
-SS
Vuserelpew/snamelencroaC imastef /epwoMsheet.xls V�I
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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
NUMBER: N2017-
APPLICANT:
Permit Processing Fee:
Public Works Only $241.00
Other Department $275.00
Agreement Fee:
Preparation of Report/Agreennent $817.00�
Document Recordation Fee $192.00
Monitoring Wells $502.00
►- i
Street/Alley/Walk Closure: $65.00=
Traffic Control Plan Check
Inspection Fee: t
Public Works Field Inspection $165.
Utilities Field Inspection $121.0
General Services Inspection $165.00
Water Quality/Artificial Turf Inspection $108.00
Refundable Deposit: TBD
Improvements TBD
Newspaper Rack Inspection $108.00
8-1/2" x 11" $65.00= Sewer Connection Fee $250.0�
24" x 36" $143.00 4TT Box & Cover $64.0
Additional
----------- ------ -----i
I THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division
I REVENUE DIVISION PRIOR TO PAYMENT OF FEES Tooroval:
[Water Meter:
13/4" Meter $50.25
11" Meter $121.50
111/2"Meter $285.00
11 1/2" Turbine Meter $700.00
12' Meter $425.00
12" Turbine Meter $845.00
13" Meter $3,310.00
14" Meter $4,730 00
6" Meter $71190.00
Installation Charge $528.00F_�l
Water Meter Boxes.
For Parkway & Sidewalk Area (Box + Cover = Cost)
1"Meter: 13.00+37.00 $50.00B
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
.. . MlAr-r-I
1 AMIMI IS FPCR
Certificate of Compliance Fee (+100% of hrly over 3 hrs) $288.00
Development Services Fee (Plan check hourly) $155.00
Final Tract Map Checking Fee $2,488.00
Final Parcel Map Checking Fee - Moderate $2,488.00
Lot Line Adjustment Fee $1,079.00
Park Dedication Fee Zone _ TBD
Street Easement/VacationFee (+100%ofhnyover4hrs) $1,022.00
Street Tree Fee ($700 Planting Fee) T8Dl
5200-5029
5200-5015
5200-5026
5200-5027
5200-5028
405-470_
5200-5031
030-2284
Engineering Tech: To al Amount Due: For Finance Use only
Permit S list Receipt No.
f fuserslpbwlsharedlencmach/masters/ep front and back masters/
Rev. 1/5/2017 epfeesheet xis -revised 1012112016
ALL UNDERGROUND WORK SHALL BE PERFORMED BY A LICENSED CONTRACTOR
Contact "Underground Service Alert" At Lent 48•Houn In Advance of Any Excavation at 1-800.227-2800 or 811
TERMS AND CONDITIONS OF ENCROACHMENT PERMIT
WORKER'S COMPENSATION INSURANCE (Section 3800 Labor CO e)
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 elf-insu , ertifi t� �f�Worker's
contractor must provide a "Letter of Authorization" to allow another party to pull a permit. An approved copy of the
ompensation Insurance, or a Certified Cop t e f.
permit and construction plan shall be kept at the job site at all times. Work, which has been done prior to issuance o
n )
�ate: 7
a permit, is subject to rejection/fine. City reserves the right to void permit if work does not commence within 30 days
DSignature:
after date of issuance.
k
The Pennines agrees to defend, indemnity 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, Iany
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 Compensation
of the City of Newport Beach, and in compliance with all applicable State laws and City ordinances.
e guarantees all work performed under this permit to be tree of hidden and latent defects. Any failures shall
provisions of the State Labor Code, I must comply with the provisions of Section
re
bco
be corrected within two weeks after notification to the satisfaction of the Public Works Director.
3700 or this permit shall be deemed revoked.
. A valid State licensed contractor must perform all construction within the public right-of-way, unless waived by the
Date: 2 Signature:
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
connection to sewer lines a valid State Contractor License Class C-42 is required.
CONTRACTOR LICENSE EXEMPTION
. 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 hag -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 subgrade 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
Way/Easement. 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 (ie: 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.
Properly lighted barricades must be provided and maintained around all trenches, excavations and obstructions. All
"Manual
Inspections should he requested by calling the Public Works Inspection
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 by the
Request Line at: 949.644-3256. INITIALS: r _
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 $35.00. It is the responsibility of the applicant to place barricades o
Al 15. 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 times.
13.20.
ive areas will not be allowed during, City holidays, spring break, Memorial Day
0. Work within or near beach sensitive
16. Homeowner, contractors, and subcontractors may each be liable for violations of Water
weekend, summer between June 15 and September 15, and during the holiday season from December 19 to
Quality Laws. Best Management Practices will be enforced. It is against the law to
January 1, unless approved by the Public Works Department.
1. Any work that extends into traffic or parking lanes and impedes the normal flow 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 Certificate or
Handbook (WATCH). No nighttime traffic lane closures, unless prior approval has been granted. Any lane(s) closure
Evidence of a Slurried Backfll 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 Slate Highway's traffic or within the State Highway right-of-way
be processed.
will require a Caltrans Permh. 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
3. Applicant must notify USA at 9.800-227.2600 2 days before starting any underground construction. Applicant
Division.
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.
4. Refuse or unused materials shall be removed within 24 hours after completion of the work. If not removed, the City
20. 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.
AgrnoteementocesseAdditional
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 on front only. 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 work related to thleanaroechmaM Permit ahel[IlwP4 RN i d until the Public Works. Department hu Issued this psmll
ondklona of this permit and hMaha agrees to abide by them. ,Permit Is void If work U not commenced yq a' after
Permit Mee are nonrefundable. Plans note: Preparation of. Encroachment Agreement fee Is non_refundabl Date:
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CONSTRUCTION NOTES:
STORM DRAIN:
O INSTALL RECTANGULAR CAST IRON CURB DRAIN
PER CITY OF NEWPORT PUBLIC WORKS STD-184-L.
SEE DETAIL 5 ON SHEET C7.1.
�2 RECTANGULAR CURB OPENING PER DEATIL 9 ON
SHEET C7.0
�3 PROVIDE 4"X12" OPENING IN WALL.
�4 PLANTER AREA TO BE USED FOR BIORETENTION
(5 INSTALL BOTTOMLESS TRENCH DRAIN PER DETAIL 4
ON SHEET C7.1.
INSTALL 24"X24" OVERFLOW CATCH BASIN PER
DETAIL 6 ON SHEET C7.0.
SEWER:
21 INSTALL CLEANOUT ON THE EXISTING SEWER
LATERAL PER CITY OF NEWPORT BEACH PUBLIC
WORKS STD-406-L, PER DETAIL 2 ON SHEET
C7.1. VERIFY IN FILED THE LATERAL LOCATIONS.
SHEET NOTES:
1. PROVIDE TEMPORARY SHORING AS
NEEDED PER RECOMMENDATIONS
WITHIN THE SOILS REPORT AT
THE PROPERTY LINE WHEN
EXCAVATION EXCEEDS 3 FEET
DEEP.
2. FOR GENERAL NOTES, LEGENDS
AND ABBREVIATIONS, SEE SHEETS
C1.0.
I
ji
SEWER CO 55 FT
FROM SW P/L.
3/9/2017 City of Newport Beach Page 2 of 11
4:30:48PM INSP150 - Daily Inspection Request Report
Requested Inspection Date : 03/10/2017
Inspection Type : ENCROACH
Inspection Area: PW
Site Address: 4361 BIRCH ST
A/P/D Information:
Activity :
N2017-0081
SubType:
NEW
Status :
APPROVED
OWNER:
BIRCH 4361
Phone:
APPLICANT:
COASTAL PACIFIC CONST INC
Phone : 949-770-1555
g mason@coastal
pacificcons
Description :
INSTALL SEWER CLEAN OUT PER STD 406-L.
Requested Inspection(s)
Item:
10250 FINAL - PW
Requested Time:
3/10/2017 12:00:OOAM Requestor:
NBIVR
7142772820
Entered By:
NBIVR
;M I`.j0N
Comments:
AM `,J
/
G�2 Pie 15 E'
Assigned to: \ \'
Inspector: 'A Date: J IC)/ 11
Time: 7 a'D AM PM
Comments: '
F:\Users\PB W\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131 Run Id: 4018