HomeMy WebLinkAboutN2017-0284City of Newport Beach 111111111111111111111111111111111111111111111111I 11
100 Civic Center Drive, Newport Beach, CA 92660 N 2 0 1 7 0 2 8 4
Permit Counter Phone (949)644-3311
sa + Online Inspection Request-www.newportbeachca.gov/Online
Services
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Permit No: N2017-0284
Project No:1244-2016 SCANNED
Inspection Requests Phone (949)644-3255
E-VicW�n
Job Address : 2443 VISTA NOBLEZA NB Thomas:Guide: 889D3 t
Description: INSTALL SEWER CLEAN OUT PER STD 406-L.
Parcel # :
4402-713-6 -
Legal Desc :
N TR 7052 LOT 35
Owner:
MCKENNA INVESTMENTS II LLC
Contractor: DRILL SUB INC
Phone:
949-300-0845
Phone: 888-782-9110
Address:
516 EMERALD BAY
Address : 4805 5TH STREET STE 210
LAGUNA BEACH CA 92651
RAINBOW, CA
Contractor State Lic: 937432
Applicant:
MCKENNA INVESTMENTS II LLC
License Expire : 09 30, 2018
Phone:
[
Address:
Business License: BT30047532
Business Expire : 10 31, 2017
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation Insurance - -
Carrier: STATE COMP FUND
Policy No: 9040882
W. C. Expire: 12 01, 2017
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 : _/_/
Utilities Approval :
Date: _/_/
Permit Denied
Date:
Traffic Approval :
Date : _/_/_
Issued Permit
—Date: b/ at n
General Services Approval : Date : _/_/
I
WORKSHEET FOR ENCROAGFIMENT PERMIT
CITY OF NEWPOR'I BEACH
PUBLIC WORKS DEP/\RTMENT
PROJECT ADDRESS:. • C4 Li 3 V c S12g 1A
DF�T�ILED DESCRIPTION OF PROPOSE�D WORK:
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APPLICANT: j,n Phone:
Email Address:
Mailing Address:
CitylStatelZip:
OWNER: G cJ , ti n Phone: dqy a 7— `
Email Address:
Mjlp Address: S C ty StatelZip: +
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ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE COMPLETE
CONTRACTOR: f-a\ S'-� t) ' C_
Office Phone: t 0
Company (if different):
ljobsite Phone: \
Other Phone:
Email Address:
lin Addr�gs:�
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Clt !StatelZip:
7r 2 877
State License Number & Class:
'-7 413 Z , Expires: / V 4
Cigy Business License Number*
l> L 3 o C, _C2 F6i Expires: (Z I
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: 1<_We_ Policy No:'TO V tl e) 7 Expires: Z Z
REF,.UNfOARk:E:DEPOS:IT:)NFORMATIQN:(ffAFiRflcdbie ......::: ..-...........:::': is>.;:>......
7'3». is : : ..........`t` i? ::i_i3:i; :: ?i : .................
Rtifiidd C'a:`able . cc .......................... :':2:: _:.:j:i ! >3>: i3:i :?::::: i :: i i : ii
Refuiiil'To:
FOR OFFICE USE ONLY
Special Conditions of Permit:
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ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities: Traffic: Fire:
General Services: Other:
Engineering Technician:
Public Works Specialist:
Date:
PerAmi�� o.
fJ m1pb%v/shumd/ancmaQ masleWep%vo sheeUls
J
N
.. Public Works Department 949-644-334'i
Permit Processing Fee:
Inspection Fee:
Public Works Only
$241.00
Public Works Field Inspection
$165.00
Other Department
$275.00
Utilities Field Inspection
$121.00
General Services Inspection
$165.00
Agreement Fee:
Water Quality/Artificial Turf Inspection
$108.00
Preparation of Report/Agreement
$817.00
Document Recordation Fee
$192.00
Refundable Deposit:
TBDP
Monitoring Wells
$502.00
Improvements
TBD
Street/Alley/Walk Closure:
$65.000
Newspaper Rack Inspection
$108.00
Traffic Control Plan Check
8-1/2" x 11"
$65.00=
Sewer Connection Fee
$250.00Vn
24" x 36"
$143.00
4TT Box & Cover
$64.00
Additional
_ _ _ _
THE FOLLgW1NG ITEMS REQUIRE APPROVAL FROM THE Revenue Division '1
r REVENUE DIVISION
PRIOR TO PAYMENT OF FEoneoval.
ES A
1
1
sty,
c1 1
IWater'Metor:
Installation Charge $528.00
13/4" Meter
$50.25
Water Meter Boxes: ` 1
11" Meter
$121.50
For Parkway & Sidewalk Area (Box + Cover es Cost)' 1
11 1/2" Meter
$285.00
1" Meter: 13.00+ 37.00 $50.00
11 112"
Turbine Meter
$700.00
2: Meter: 27.00 + 61.25 $88.25
12" Meter
$426.00
12" Turbine Meter
13"
$845,00
For Traffic & Alley Areas (Sox + Cover z Cost)
Meter
$3,310.00
1" Meter. 13.00 + 38.00 $51.00
�4" Meter
$4,730.00
2" Meter: 27.00 + 162,00 $189.001
t
r6" Meter
$7.190.00
r
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 (+100%ofhrlyover 4hrs)
$1,022.00
5200-5031
Street Tree Fee ($700 Planting Fee)
TBDI
030-2284
Engineering Tech:
Total Amount Due:
For Finance use only
Permit Sp fat_ ist
Receipt No.
\)
Elusers/pbw/shared/encroach/masters/ep front and back masters/
Rev. 1/5/2017
epfeesheetxls-revised 10/21/2016
TERMS AND CONDITIONS OF ENCROACHMENT PERMIT
1. Encroachment Permits may be taken out by the owner of benefited property or a licensed contractor. A licensed
contractor must provide a Letter of Authorization' to allow another party to pull a permit. An approved copy of the
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 permit if work does not commence within 30 days
after date of issuance.
2. The Permittee agrees to defend, indemnify and hold the City, its authorized agent, officers, representatives and
employees harmless from any responsibility, liability, suit or action of any description arising out of any accident, loss
or damage to persons or property occurring as a result of work undertaken under this permit.
3. All work shall be done in accordance with the approved plans, Standard Special Provisions and Standard Drawings
of the City of Newport Beach, and in compliance with all applicable State laws and City ordinances.
4. Permittee guarantees all work performed under this permit to be free of hidden and latent defects. Any failures shall
be corrected within two weeks after notification to the satisfaction of the Public Works Director.
5. A valid State licensed contractor must perform all construction within the public right-of-way, unless waived by the
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.
6. All trenching and/or resurfacing shall conform to City Standard 105-L for parkway/roadway and City Standard 140-L,
in the alley, where a minimum half -alley width resurfacing shall be provided, unless otherwise directed by the Public
Works Dept. Contractors shall obtain permits to perform excavation or trench work from the California Division of
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.
7. The Public Works Department Inspectors must inspect all work in the Public right-of-way. Forms and subgrade must
be inspected and approved before concrete is ordered/poured. Sewer, pipelines, and subgrade construction must be
inspected and approved before backfilling, or applicant may be required to excavate site. Separate Utilities
Department or General Services Department inspections may be required depending on scope of work performed.
8. All trench restoration must be inspected by the Public Works Department. No utility installation(s) shall be allowed
over or within 5 feet of any City utilities, unless approved by the Public Works Department. Locate and pothole
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
4TT box over the riser.
9. Properly lighted barricades must be provided and maintained around all trenches, excavations and obstructions. All
signs, flags, lights and other warning and safety devices shall conform to the requirements of the current "Manual of
Warning Signs, Sights and Other Devices for the Use in Performance of Work Upon Highways', issued by the
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
protect the general public. Access to fire hydrants must be maintained at all times.
10. Work within or near beach sensitive areas will not be allowed during, City holidays, spring break, Memorial Day
weekend, summer between June 15 and September 15, and during the holiday season from December 19 to
January 1, unless approved by the Public Works Department.
11. Any work that extends into traffic or parking lanes and impedes the normal flow of traffic requires the applicant to
acquire a Temporary Street Closure Permit fromthePublic Works Department. Access for fire, police and
emergency vehicles must be maintained at all times. Traffic Control must be per Work Area Traffic Control
Handbook (WATCH). No nighttime traffic lane closures, unless prior approval has been granted. Any lane(s) closure
on a major street will only be allowed between 9:00 a.m. and 3:00 p.m. (Monday thru Friday), unless approved by
the Public Works Department. Any work affecting the State Highway's traffic or within the State Highway right-of-way
will require a Caltrans Permit. All vehicles shall be lawfully parked.
12. This permit does not authorize the Closure of sidewalks, streets, or alleys for construction access, storage of
materials, or parking of construction vehicles unless detailed on an attached Temporary Street Closure.
13. Applicant must notify USA at 1-800-227-2600 2 days before starting any underground construction. Applicant
must notify all affected residents 24 hours in advance of restricted access and any inconveniences.
14, Refuse or unused materials shall be removed within 24 hours after completion of the work. If not removed, the City
may remove and bill the applicant. Coordinate alley closures with City's refuse pick-up days by calling 949-644-3066
for the collection schedule so service is not interrupted. To place a dumpster or materials in the public right-of-way, a
Temporary Street Closure Permit must be obtained from the Public Works Department.
WORKER'S COMPENSATION
ify that I have a Certificate of
sensation Insurance, or a Ce 1
SE73//r-7 i
(Section 3800 Labor Code)
self -insure, Certificate of Worker's
CERTIFICATE OF EXEMPTIO11 (Section 3800 Labor C' a
I certify that in the performance of the wror, under this permit, I shall not employ
any person so as to become subject to Cah"%rnia Worker's Compensation Laws. If,
after signing this certificate I become subject to the Worker's Compensation
provisions of the State Labor Code, I must comply with the provisions of Section
3700 or this permit shall be deemed revoked.
Date:
Signature:
CONTRACTOR LICENSE EXEMPTION
As the Owner of the benefiting property, I certify I am personally performing all
work in the Public Right -of -Way.
Date:
Signature:
HOLD HARMLESS STATEMENT
I understand that I am locating minor encroachments within the City Right-of-
Way/Easement. As property owner it is my responsibility to maintain the
encroachments. I will be responsible for replacing the improvements if the City
removes them for maintenance of utilities or other public need. I shall indemnify
and hold the City harmless for any liability associated with the minor
encroachments.
Date:
Signature:
r notice for Encroachment Permit Inspection is required by calling
Works at 949-644-3311. %
15. Any above ground utility facilitiegog"'utter
require documented approval from the adjacent
affected property owners).
16. Homeowner, contractors, and sucotrs may each be liable for violations of Water
Quality Laws, Best Managemetices will be enforced. It is against the law to
discharge construction debris into and storm drain. Felony violations of Water
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.
17, If a refundable deposit was paid, applicant must submit a Soils Compaction
Certificate or Evidence of a Slurried Backfill and request a final inspection from the
Public Works Department. Monies may be held for six months after final inspection
before a refund will be processed.
18. No trees in the public right-of-way shall be planted, removed, trimmed, or relocated
without approval from the General Services Department.
19. All work in the public right-of-way must meet the approval of the Public Works
Department or corrections will be required (i.e. removals, exposing connections,
etc.). Additional inspection fees may be required.
20. Permit is for standard materials in the public right-of-way only, unless previously
approved by Public Works and an Encroachment Agreement has been processed.
21. Permit is valid for "description' of work noted on front only. Additional work
performed may require issuance of a separate permit and/or additional fees.
1EGE D
`�T TREE
POWER POLE
=SE;),FER CLEANOUT
[I - A TER METER 13OX
CENTERLINE
CITY OF NEWPORT BEACH
ENCROACHMENT PERMIT
Permit No.20t? - M'
APPLICAN'�
OWNER
AE5CRIPTION OF WORK
" 1*5/3112017
City of Newport Beach
Page 6 of 19
4:30:16PM
INSP150 - Daily Inspection Request Report
Requested Inspection Date: 06/01/2017'
Inspection Type : ENCROACH
Inspection Area : PW`
Site Address : 2443 VISTA NOBLEZA
Activity :
N2017-0284
SubType:
NEW
Status :
APPROVED
OWNER:
MCKENNA'INVESTMENTS II LLC
Phone : 949-300-0845
Description :
INSTALL SEWER CLEAN OUT PER STD`406-L
l Z p�
Ite
10200 PRE JOB - PW
Requested Time:
6/1/2017 Requestor:
WEBUS
7146558537 r S
Entered By:
WEBUSER
Comments:
ANY -
Assigned Assi ned to:
_
zzzzzzzzzzz•
Inspector:
Y Date: 1 1-7
Time: -tO A M
Comments:
C'1:5L zM�/L Wv er-1
�
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131'
Run Id: 4018
•-ice t ��
e;
6/6/2017 City of Newport Beach Page 12 of 14
,6:34 13AM INSP160 - Daily inspection Request Report
Requested Inspection Date : 06/05/2017
Inspection Type.- ENCROACH
Inspection Area: PW
Site Address : 2443 VISTA NOBLEZA
Activity : N2017-0284
SubType: NEW
Status : APPROVED
OWNER: MCKENNA INVESTMENTS II LLC Phone 949-300-0845
Description : INSTALL SEWER CLEAN OUT PER STD 406-L
Item: 10250 FINAL - PW
Requested Time: 6/5/2017 12:00:OOAM Requestor: WEBUSER`
7146558537
Entered By: WEBUSER
Comments: ANY
Assigned to: zzzzzzzzzzz*
Inspector: v Dater i%% Time: `2 J1) AM
Comments. lt::141;yo�t 7g
COMPLETED-
F:\Users\PB\MShared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
6/1/2017
City of Newport Beach Page 4 of 11
4:30:25PM
INSP150 - Daily Inspection Request Report
Requested Inspection Date : 06/02/2017
Inspection Type: ENCROACH -
Inspection Area: PW
Site Address : 2443 VISTA NOBLEZA'
Activity :
N2017-0284
SubType :
NEW
Status :
APPROVED
OWNER:
MCKENNA INVESTMENTS II LLC Phone : 949-300-0845
Description :
INSTALL SEWER CLEAN OUT PER STD 406-L,
Item:
10030 CLEAN -OUT
Requested Time:
6/2/2017 1200:OOAM Requestor: WEBUSER
Entered By:
7146558537
WEBUSER
Comments:
AM
Assigned to:
zzzzzzzzzz'
Inspector:
Date: Z (7 Time: �2 •` � AM OM
Comments: (PAAYWk ,1_0K_ CQGV C-61-6-0 SC -I)
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I vW t-5 l 04P6rx `/A PC& p+&
p r
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F:\Users\PBMShared\ENCROACH\MASTERS\FORMSkinspectorSheet.doc
REPT131.
Run Id: 4018