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oitylVof Newic Center Dport Beach ortacn, CA 92660 11111111111111111111111111111111111111111111111111111I
Permit Counter Phone (949)644-3311
Online Inspection Request- wvw.newportbeachca.gov/Online
Services
Permit No: N2017-0046
Project No 1240 2015
S r p `j'
Inspection Requests Phone (949)644-3255
Job Address:
606 POINSETTIA AVE INS
Thomas:Guide:
919F3
Description :
REPLACE SCE CONDUIT
Parcel # :
4592-310-4 -
Legal Desc :
CORONA DEL MAR BLK 643 LOT 8
Owner:
JOHNSON DAVID G
Contractor:
COAST WATER & POWER
Phone:
415-641-4765
Phone:
949-548-0106
Address :
3897 24TH ST
Address :
P 0 BOX 3341
SAN FRANCISCO CA 94114
NEWPORT BEACH CA 92659
Contractor State
Lie: 738400
Applicant:
COAST WATER & POWER
License Expire :
07 31, 2017
Phone:
949-548-0106 [
Address:
P 0 BOX 3341
NEWPORT BEACH CA 92659
Business License:
BT96014951
Business Expire
: 12 31, 2017
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation
Insurance --
Carrier :
STATE COMP INS FUND
Policy No:
9087110
W. C. Expire:
10 01, 2017
Permit Processing Fee :
$241.00
Sewer Connection :
$0.00
Total Fee : $636.00
Agreement Fee:
$0.00
4TT Box Cover:
$0.00
Paid: $0.00
Traffic control Plan Check :
$65.00
Total Water Meters:
$0.00
Balance : $636.00
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 : _/_/_
Utilities Approval :
Date :
_/_/_
Permit Denied : Date
Traffic Approval :
Date :
Issued Permit : C ' Date
_/_/_
General Services Approval :
Date:
_!_/
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PROJECT ADDRESS:
DETAILED DESCRIPTION OF PROPOSED WORK:
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Email Address: a-� kf— cL. mkt k
Mailing Addre%22S City/State/Zip;
OWNER: lPhone:
Email Address:
Mailing Address: 1
0 Lo Q�LC!Wstatafzip:
CONTRACTOR:
I-Vi r 'I d& gr 6 lOffice phone:
Company (if different). obslle Phone:
CDCLS± -y. Other Phone:
Email Address: n:�i kt�t mt �L f- k bir�die 0, e-0 A, -
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Ctty/SlatelZip;
State License Number & Class: Expires:
— -1301400 .6bil.
City Business Livens b Number:
S-T%R0ICq-qSj
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Companx: &�u &a LL Enhos: /0
WA44400: ........
........... .......................... •
...........
.... ... ....
2601 NAN
Special Conditions of Permit:
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Utilities: Traffic: Fire:
Municipal operations Other.,
Engineering T niclan: ParmitAppciallst 1pannit No.
b—(,) C1 IN200
Vc n do r AA111-
Cj o Public Works Department 9494443311
100 CIVIO CO"bef Drive, Newport Beath, CA 92660
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PROJECT ADDRESS;
PERMIT
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N2017 -
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NUMBER: V.
IIAPPLICANT:
Panhit Prhf`raR:scinn Fm• f�f Mananfinn Cm• nl..
Public Works Only $241.00 Public Works Field Inspection $165.
Other Department $275-00 Utilities Field Inspection $121-
General Services Inspection $165-00
Agreement Fee: Water QualityArtificial Turf Inspection $108-00
Preparation of ReporliAgreement $817-00
Document Recordation Fee $192.00 Refundable Deposit: T60P
Monitoring Wells $502.00 Improvements TBD
Street/Alley/Wolk Closure; $65.00 Newspaper Rack inspection $108.00
Traffic Control Plan Check
8-112" x 11" $65-00 Sewer Connection Fee $250.00�
24" x 3W $143.00 4TT Box & Cover $64.00
Additional
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•:• •:•:•:•:•:•'•'• -'- • ::h1�Natign;CFia�:::::::::: $��-ti.:•:•:• •:1
314":Meer:•:•:•:•:•:':•::::•:-:::: �50,:z •: •:•:•('Nafs�tfilletsr,&fixes:::::-:•:•:•:•:•:•:•:•:•:•::-:-:-:•:f
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VIN".Mertar:-:•.-:-:•:-:•:-:-:•:•.:-:.:$2$�.tj0-.-.-.- 1"avleTer..•.13A0-•y 7A0-:-:-:•:-:•:•.:$59A -1
iim)�strteteri :'-_ ':'•:700.0 :2iMeter:-:a?.vo..st,z5::-::_::-:::::•ss.2
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pier:•: -:•:•:•:•.•.•:$4,730-t18 •--.-.'e- ----2i.A0':ra620(9.•:- :-:-:g9$$- ..........
Certificate of Compliance Fee (+10o%of my ovar s 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/Vacation Fee(+100% of hriy over 4 hrs)�$1,022.00
Street Tres Fee ($700 Planting Fee) TBD
52005029
6200-5015
62005026
52005027
5200-50,20
405-470�
5200-5031
030-2284
Engineer- 9Tech:
Total ountDue;
---------. -
For FlnanceuseOnly
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Perri t,Spflciallst
Receipt No.
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Rev. 10/21aaia
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NSTAL.ATION
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WORKSPACE
SURFACE -MOUNTED OR SEMI-FLUSFI
METER INSTAUATION
SEE ESR 8.25
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FINAL DESIGN
APPROVED FOR CONSTRUCTION
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POWEEMA AVE
A OEL J0, CA 02625
City o€ Newport Beach
Newport Reach police Dispatch
Phone: 949-644-3717 Public Works Department
APPLICATION FOR TEMPORPhone: 949-644-3311 Fax: ARY 5TREET! $ILK CLOSURE OR DUMPSTER pl �44 3318
gGEMEN
Criy of NawpaT Beach Aiunlcipat Code 72.62.p>D Permif far Temporary Streef Closura
Name: MIKE KILBRIDE PLICANT INFORMATION'
Company Name: COAST WATER & POWER Ci of Newport Beach Business license No.
Address: P.O. BOX 3341
City/zip; MEWPORT BEACH, CA92659-8341 Phone: Day 949-289-IO�Qi8 Night BT96014951
Exact Location of Encroachment: t .� G V &
1{1
Iu� sheet address orapproximate number of feet fc --
Reason inter 1 %coon)
Reason for Encroachment: UTILITY IMPROVEMENTS - Generally one day between dates below.
NOTE; No work on holiday(s) or, weekends.
Date Closure to Begin:
Dat® Closure to End:
(Anaximum 74 flays) � '
I Time of Closure: 7:00 AM to 5:00 pM
J
9 1 V'h1F'P< « Avg
ee reverse side of this permit for regulationscoverrng use of this permit. "` I
ADDITIONAL CON DITIpNS pF AP1 1, 1 AL FOR THIS PERMIT ARE AS FOLLOWS:
1) Close only the portion of alleyistreet adjacent to where work will be dgne_
2j Provide access to erne,rgency vehicles if needed. 3) Notify adjacent residents 48-hrs prior to closure
4) Post road closed barricades on either side of work area. 51 Plate and backfill e;
or street Burin non -construction. 6) Place delineators around construction area.
e) hereby certify the in(urmation provided is true and correct, and agree to comply with the terms ar
on the front and back of this permit. Pormitee guarantees to indemnify and hold the City of Newport
gains[ any claims, { bbili . orj�JtJeMZnQ damages arising out of perm/iten'ts activiti@os/.
W1 V•�1'_V bate: X 1441 d
Approved b 4 i
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�W W rxn�P Pn0 5[IlingP'C tnMLOBjl�inyylYpTCarory lll[lntl fPB.51CBn�¢n1 �e:NwPN� FUOyiBmF $if¢0� C�BN.B Pp04[dI�M K
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Encroachment P^ No
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