HomeMy WebLinkAboutN2017-0558City of Newport Beach
100 Civic Center Drive, Newport Beach, CA 92660
N Permit Counter Phone (949)644-3311
4fi... Online Inspection Request - www.newportbeachca.gov / Online
Services
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Job Address : 2961 CLIFF DR NB
Description : Core 2 private drains into existing drainage ditch wall along Avon Street.
Parcel#: 0491-030-1 -
Legal Desc : FIRST ADD TO NEWPORT HEIGHTS LOT BLK Z PARK
Owner: HALLERDAVID
Phone: 0
Address : 2961 CLIFF DR
NEWPORT BEACH, CA
Applicant:
TEAM ULTIMO
Phone:
949-689-5293 [
Address:
1529 MAXWELL WAY
COSTA MESA, CA 92627
Special Cond.: Pre -job inspection required
Permit Processing Fee :
$241.00
Sewer Connection:
$0.00
Agreement Fee:
$0.00
4717 Box Cover:
$0.00
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: N2017-0558
Project No :
Inspection Requests Phone (949)6443255 '
Thomas:Guide: 888H6
LDDAWNED
Contractor : TEAM ULTIMO REAL ESTATE
Phone: 949-689-5293
Address: 1529 MAXWELL WAY
COSTA MESA CA 92627
Contractor State Lic: 964742
License Expire : 08 31, 2019
Business License:
BT30036733
Business Expire :
08 31, 2018
Workers' Compensation Insurance - -
Carrier :
STATE COMP
Policy No:
9051279
W. C. Expire:
04 01, 2018
Total Fee
Paid :
Balance:
Receipt No:
Other Department :
$571.00
$571.00
$0.00
v{ - B2'S�
Permit Denied Date : / /
Issued Permit : Date: it /3 / t`Z
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TERMS AND CONDITIONS OF ENCROACHMENT PERMIT
WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code)
1. 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 permit if work does not commence within 30 days
Date: Signature:
after date of issuance.
CERTIFICATE OF EXEMPTION (Section 3800 Labor Code)
2. The Permittee agrees to defend, indemnify and hold the City, its authorized agent, officers, representatives and
employees harmless from any responsibility, Iiabifty, suit or action of any description arising out of any accident, loss
I certify that in the performance of the work under this permit, 1 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,
3. 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 Stale laws and City ordinances.
provisions of the State Labor Code, I must comply with the provisions of Section
4. 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.
5. 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.
6. 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
7. 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 Utilities
encroachments. I will be responsible for replacing the improvements if the City
Department or General Services Department inspections may be required depending on scope of work performed.
removes them for maintenance of utilities or other public need. I shall indemnify
8. 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.
Y4-hour notice for Encroachment Permit Inspection is required by calling
9. Properly lighted barricades must be provided and maintained around all trenches, excavations and obstructions. All
"Manual
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
Public Works at 949-644-3311. -
California Department of Transportation. If needed,barricades can be obtained from the City at a charge of $10.00
15. Any above ground utility facilities will require documented approval from the adjacent
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.
affected property owners).
10, Work within or near beach sensitive areas will not be allowed during, City holidays, spring break, Memorial Day
16. Homeowner, contractors, and subcontracotrs 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.
11. 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 Stale
prison plus the full cast 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
Handbook (WATCH). No nighttime traffic lane closures, unless prior approval has been granted. Any lane(s) closure
Certificate or Evidence of a Slurried Backfill and request a final inspection from the
on a major street will only be allowed between 9:00 a.m. and 3:00 p.m. (Monday thou Friday), unless approved by
the Public Works Department. Any work affecting the State Highway's traffic or within the State Highway right-of-way
Public Works Department. Monies may be held for six months after final inspection
will require a Caltrans Permit. All vehicles shall be lawfully parked.
before a refund will be processed.
12. 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 General Services Department,
13, 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
must notify all affected residents 24 hours in advance of restricted access and any inconveniences.
Department or corrections will be required (i.e. removals, exposing connections,
14. Refuse or unused materials shall be removed within 24 hours after completion of the work. If not removed, the City
etc.). Additional inspection fees may be required.
may remove and bill the applicant. Coordinate alley closures with City's refuse pick-up days.by calling 949-644-3066
20. Permit is for standard materials in the public right-of-way only, unless previously
for the collection schedule so service is not interrupted. To place a dumpster or materials in the public right-of-way, a
approved by Public Works and an Encroachment Agreement has been processed.
Temporary Street Closure Permit must be obtained from the Public Works Department.
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.
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Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
Street/AlleylWalk Closure:
Traffic Control Plan Check
8-1/2" x 11"
24" x 36"
Additional
Q Inspection Fee:
$241.00 1 I Public Works Field Inspection
$275.00 Utilities Field Inspection
General Services Inspection
Water Quality/Artificial Turf Inspection
$817.00P
$192.00 Refundable Deposit:
$502.00 Improvements
$65.000 Newspaper Rack Inspection
Sewer Connection Fee
4TT Box & Cover
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/Vacation Fee (+100%ofhrlyover 4 hrs) $1,022.00
Street Tree Fee ($700 Planting Fee) TBD
Q .
$165.00 2
$121.00
$165.00
$108.00
TBD BTBD
$108.00
$.00 $6464.00
5200-5029
5200-5015
5200-5026
5200-5027
5200-5028
405-470
5200-5031
030-2284
Engineering Tech:
Total Amount Due:
For Finance use only
Rod;
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Permit Specialist
Receipt No.
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i�Rev. 1/5/2017
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epfsesheet.As-revised 10/2112016
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COMPLETE THE BELOW INFORMATION'
PROJECT ADDRESS: I G L 1
DETAILED DESCRIPTION OF PROPOSED WORK:
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APPLICANT: E�Ay.-1 U Ut1mu
Phone:
Email Address: (b\\ V- q05 1--e M U L O. Cg Yn
Mailing Address: U
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City/S ate/Zip:
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OWNER: Acku I I.e ( Phone: ( — 9 3 —7 3 9
Email Address:
Mailing Address: G ( Cl l � ��� City/State/Fi
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CONTRACTOR: �� Q L+1'44 b
Office Phone: `[ qq— 6 3I 1 It
Company (if different):
Jobsite Phone:
Other Phone: of Ltq-689- 29`
Email Address: a5 &064
Mailing Address:
City/State/Zip:
State License Number & Class: p�jCity
C[ P4 7 `f - Expire : [
Business License Number:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: Polic No: Expires:
Municipal Operations; 949-644-3055
Utillues: 9404444011
Urban Forestry: 949-6444083
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Special Conditions of Permit: 1're—'o1> %n ch'sn r uincd ,
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Utilities: Traffic: Fire: 0
Municipal Operations Other:
Engineering Technician:
ROCI;
Permit Specialist
1
Date:
1 n -3- fly
Permit No.
N2017-05;�V
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Public Works Department 949-644-3311
100 Civic Center Drive, Newport Beach, CA 92660
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