HomeMy WebLinkAboutN2017-0016City of Newport Beach 1pIIIII IIIIIIIIIIIIIIIIIIIIIiIIIIIIIIIIIIIIIIIII II Permit No: N2017-0016
100 Civic Center Drive, Newport Beach, CA 92660 N 2 0 1 7 0 0 1 6
k tip. Permit Counter Phone (949)644-3311 Project No : 2539-2015
Online Inspection Request-www.newportbeachca.gov/Online SCANNED
Services Inspection Requests Phone (949)644-3255
Job Address : 1715 PORT ABBEY PL NB Thomas:Guide: 889G5
Description: Remove and replace existing driveway approach (W=25') per City Standard #162-L and install curb drain per City Standard #184-L.
Parcel #:
4581-112-0 -
Legal Desc :
N TR 6621 LOT 30
Owner:
FEELEYJOHNE
Contractor: LANDCRAFTERS INC
Phone:
0
Phone: 949-249-1086
Address :
1715 PORT ABBEY PL
Address : 29512 ANA MARIA LANE
NEWPORT BEACH, CA
LAGUNA NIGUEL CA 92677
Contractor State Lic: 754071
Applicant:
PAUL ELLISON
License Expire : 09 30, 2018
Phone:
949-683-9861 [
Address :
24642 VIA RAZA
LAKE FOREST, CA 92630
Business License : BT30039467
Business Expire: 05 31, 2017
Special Cond.:
Pre -job inspection required
Workers' Compensation Insurance - -
Carrier: EMPLOYEE SERVICE GROUP
Policy No: WC589703104
W. C. Expire: 12 01, 2017
Permit Processing Fee :
$241.00
Sewer Connection :
$0.00
Total Fee $736.00
Agreement Fee:
$0.00
4TT Box Cover:
$0.00
Paid : $736.00
Traffic control Plan Check :
$0.00
Total Water Meters :
$0.00
Balance : $0.00
Inspection Fee :
$495.00
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 : Date:
General Services Approval :
Date:
_/_/
City of Newport Beach *N2017-0016*
� 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3311
Online Inspection Request - www.newportbeachca.gov / Online
Services
Permit No: N2017-0016
Project No: 2539-2015
Inspection Requests Phone (949)644.3255
Job Address : 1715 PORT ABBEY PL NB Thomas:Guide: 889G5
Description : Remove and replace existing driveway approach (W=25') per City Standard #162-L and install curb drain per City Standard #184-L.
Parcel # : 4581-112-0 -
Legal Desc : N TR 6621 LOT 30
Owner: FEELEY JOHN E
Phone : 0
Address : 1715 PORT ABBEY PL
NEWPORT BEACH, CA
Applicant: PAUL ELLISON
Phone: 949-683-9861 [
Address: 24642 VIA RAZA
LAKE FOREST, CA 92630
Special Cond. : Pre -job inspection required
,SC,At4ED1
Contractor: LANDCRAFTERS INC
Phone: 949-249-1086
t
Address: 29512 ANA MARIA LANE
a M1 `�
LAGUNA NIGUEL CA 92677
i, ,;>SyTacb
@�
Contractor State Lic: 754071
License Expire : 09 30, 2018
Business License: BT30039467
Business Expire: 05 31, 2017
Workers' Compensation Insurance - -
Carrier : EMPLOYEE SERVICE GROUP
Policy No: WC589703104
W. C. Expire: 12 01, 2017
Permit Processing Fee :
$241.00
Sewer Connection :
$0.00
Agreement Fee:
$0.00
4TT Box Cover:
$0.00
Traffic control Plan Check :
$0.00
Total Water Meters:
$0.00
Inspection Fee :
$495.00
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
Total Fee $736.00
Paid : $736.00
Balance : $0.00
Receipt No:
Other Department: Date : _/_(
Permit Denied Date : _/_/_
Issued Permit: Date: /_/
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
Compensati n 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 issuanr"gjo
;k ,, /
�SDate: f /ZJ
a permit, is subject to rejection/fine. City reserves the right to void permit if work does not commence within 30 days
Signature:
after date of issuance.
The Pennittee 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 Compensation
of the City of Newport Beach, and in compliance with all applicable State laws and City ordinances.
provisions of the State Labor Code, 1 must comply with the provisions of Section
Permittee guarantees all work performed under this permit to be free of hidden and latent defects. Any failures shall
3700 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: 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
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 140-1-1
As the Owner of the benefiting property, I certify 1 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 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. 1 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 (is: 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
Inspecticne shotlidbe-repliebfect•b}t�calll'ng the:%bl!'�Wett'Itaiirispecti4n
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
Repdest Lh7e8t.149 44*32551 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 $35.00. It is the responsibility of the applicant to place barricades to
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.
to Chapter 13,20.
I. Work within or near beach sensitive areas will not be allowed during, City holidays, spring break, Memorial Day
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.
I. 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 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 construction. 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.
f. 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.
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.
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreennent
Document Recordation Fee
Monitoring Wells
Street/AlleylWalk Closure:
Traffic Control Plan Check
8-1/2" x 11"
24" x 36"
Additional
THE FOLLOWING II
MMICKn rr m111
Q
$241.00
$275.00
$817.00
$192.00
$502.00
$65.00=
$65.
$143.
Inspection Fee: Qt .
Public Works Field Inspection $165.00
Utilities Field Inspection $121.00
General Services Inspection $165.00
Water Quality/Artificial Turf Inspection $108.00
Refundable Deposit:
Improvements
Newspaper Rack Inspection
Sewer Connection Fee
4TT Box & Cover
$.00 $64"
64.00
Wis on -- 1
I
(City.
Qt I
(Water Meter: '
Installation Charge $528.00'1
13/4" Meter
$50.25
Water Meter Boxes: I
11" Meter
$121.50
For Parkway & Sidewalk Area (Box + Cover = Cost)
11 1 /2" Meter
$285.00
1"Meter. 13.00 + 37.00 $50.00� I
11 1/2" Turbine Meter
$700.00
2:Meter: 27.00+61,25 $88.25
12" Meter
$425.00
12" Turbine Meter
13"Meter
$845,00
For Traffic & Alley Areas (Box + Cover = Cost)
$3,310.00
1"Meter: 13.00+38.00 $51.00
� 4" Meter
$4,730.00 '.
2" Meter: 27.00 + 162.00 $189.00
r6" Meter
$7.190.00
i
Certificate of Compliance Fee (+100%of hrlyover 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 (+100%ofhrlyover4hrs) $1,022.00 5200-5031
Street Tree Fee ($700 Planting Fee) TBDI 030-2284
Engineering Tech:
Total Amount Due:
For Finance use only
-'
Permit Specialist
Receipt No.
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f./users/pbw/shared/encroachtmesters/ep front and back masters/
Rev. 1/5/2017
epfeesheat.xls-revised 10/21/2018
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APPLICANT: l�e'V jPhone:
Email Address:
Mailing Address. FCity/StatelZip:
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11OWNER: -Jo t'W 66el'ePhone: 759. SS'yz
Email Address:
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Mailing Address:
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CONTRACTOR:wCY
lOffice Phone:
Company (if different):
lJobsite Phone:
1Other Phone:
Email Address:
Mailing Address:
7 10?- AML 04fll 1,1
City/State/,Zip:
('6fIvAe- flifV'ej
State License Number & Class:
151o'7) 0 Expires: vu//A
City Busine" License Number:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: Policy No: Expires: '-z-///17
jimunicipai operations: 949-644-3056
lUtilities: 949.644-3011
11 l.k-- OAO aAA-Ingq
Special Conditions of Permit:
Utilities: Traff ic: 0 Fire:
Municipal Operations Other:
Engineering Technician: Permit Specialist Date: Permit No.
N2017.
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100 Civic Center Drive, Newport Beach, CA 92660
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