HomeMy WebLinkAboutN2017-0306City 00CiivicCNewenter port Beach rive, NewportBach, CA 92660 II IIIIIIIII II IIIII IIIIIII�III IIII�III IIII� II
Permit Counter Phone (949)644-3311
as - Online Inspection Request- www.newportbeachca.gov/Online
Services
Job Address : 177 RIVERSIDE AVE NB Thomas:Guide:
Description: REPLACE SEWER LATERAL AND BUILD CLEAN OUT PER STD 406-L.
Parcel#:
0491-103-0 -
Legal Desc :
TR 919 LOT F POR OF LOT
Owner:
MARINERS CENTER M2, LLC
Phone:
Address :
2220 UNIVERSITY DR
NEWPORT BEACH CA 92660
Applicant:
COAST WATER & POWER
Phone:
949-548-0106 949-289-0078[
Address :
P 0 BOX 3341
NEWPORT BEACH CA 92659
Special Cond.: PRE -CONSTRUCTION MEETING REQUIIRED
Permit No: N2017-0306
Project No: 0702
Inspection Requests Phone (949)644-3255
888H6
%ID Contractor: COAST WATER & POWER
Phone: 949-548-0106 949-289-0078
,40Address : P O BOX 3341
NEWPORT BEACH CA 92659
Contractor State Lic: 738400
License Expire: 07 31, 2017
JI
Permit Processing Fee:
$241.00
Sewer Connection
Agreement Fee:
$0.00
4TT Box Cover:
Traffic control Plan Check :
$65.00
Total Water Meters
Inspection Fee :
$1,980.00
Water Meter Connection
Refundable Deposit:
$0.00
Total Water Meter Box:
Street Tree Fee :
$0.00
Adjustment :
Processed By:
Utilities Approval
Traffic Approval :
General Services Approval
Date:
Date
Date : _/ /
Date
Business License: BT96014951
Business Expire: 12 31, 2017
Workers' Compensation Insurance --
Carrier : STATE COMP INS FUND
Policy No: 9087110
W. C. Expire: 10 01, 2017
$250.00 Total Fee : $2,600.00
$64.00 Paid: $2,600.00
$0.00 Balance: $0.00
$0.00 Receipt No:
$0.00
$0.00
Other Department : Date
Permit Denied Date
Issued Permit : t Date :/�/ (%`7
INBOUND NOTIFICATION : FAX RECEIVED SUCCESSFULLY
TIME. RECEIVED
REMOTE CSID DURATION
PAGES
STATUS
]urge 6, 2017 3:38:52
Pm PDT 226
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PROJECT ADDRESS:-
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DETAILED DESCRIPTION OF PROPOSED WORK:
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Emall Address:
Mailing Address! Clty4sts.femp.-
CONTRACTOR:
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Officephow:
Company (if different):
Jobsite Phone.- (?t4q, Z"' 12077
Other Phone:
Email Address; nalk C- ge IM4, k i ib x �
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Mailing Address: ?0
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Citylatalelzip:
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Wilts 1.108MO Number & Class:
:2MI400 EXPITe:151-11
City Business 1.1cenab Number:
W!hl? 41 �i 41 S 1. Efires: 12L31,1 *7
KERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
orn an 91L F"r, CL PoIlqtNo: ROT2/10 •j4p Egirerz/0447
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Special Conditiom; of Permit.
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Utilities: Traffic:
Municipal Operations Other:
Fire:
Engineering Technician: j
Specialist Permit Specla
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1Permit No.
N201V,0 �)C
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Public Works Department 949-644-3311
100 Civic OenW Drive, Newport Beach, CA 92660
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CITY OF NEWPORT BEACH DRESS
ENCROACHMENT PERMIT � AP€�u€UCAW �3��$��
Permit No. 2017 ---- �
0WNNER
DESCRIP'itON OF WORK (p ��
Newport Beach Police Dispatch City of Newport Beach
Phone: 949-644-3717 ^L _ - _- Public Works Department
Name: MIKE KILBRIDE APPLICANT INFORMATION
LCO
any Name: COAST WATER & POWER E:BT96014961
ss: P.O. BOX 3341 "�°rt �� 6yaNexa
op NEWPORTBEACH, CA 92659-8341 Phone: Day 949-289-0078 Night
Exact Location of Encroachment:
(Use street address or approxl6 to beroffeet Rcm near2stiMa geglan)
Oeason for Encroachment: UTILITY IMPROVEMENTS - Generally one day between dates beiow_
NOTE: No work on holiday(a) or weekends.
Date Cinsure to Begin.
&Iaximum 14 Days) Date Closure to End:
]IAGRAna t
Time of Cim,m: 7:00 AM to 5:00 PM
nrn�..,.. ..� �..__ _
iae
Ho
FOR
v �'un.eef nereoy Certify the Info -- _— _. .�••••.,••- • . vllut I PUNS Al
conditions on rms p: i provided is true and correct, and 1 agree to comply wdh the terms and
the (rant and back of this permit, Permitee guarantees to indemnIN and hottl the City of Newport B
ha s gains any claims, tiabil , or -udgme s fry amages arising out of permitee's activities.
x L
Date: CO. 10 1-7
------------
Approved by:
c:wommana,ge spore rown. - Date:
� NCYI Sb�A,ge\iemppyyn�gme1 Flq¢oNegIdESWJyV68G$empalteBl Clomy g001iCa110q WleudaM omnn vinnn..o
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0R4
Ho
FOR
v �'un.eef nereoy Certify the Info -- _— _. .�••••.,••- • . vllut I PUNS Al
conditions on rms p: i provided is true and correct, and 1 agree to comply wdh the terms and
the (rant and back of this permit, Permitee guarantees to indemnIN and hottl the City of Newport B
ha s gains any claims, tiabil , or -udgme s fry amages arising out of permitee's activities.
x L
Date: CO. 10 1-7
------------
Approved by:
c:wommana,ge spore rown. - Date:
� NCYI Sb�A,ge\iemppyyn�gme1 Flq¢oNegIdESWJyV68G$empalteBl Clomy g001iCa110q WleudaM omnn vinnn..o
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Newport Beach Police Dispatch
Phnnn• CAD eA..—
City of Newport Beach
Public Works Department
Ph0ne:949-9ee_aa.4
MIKE KILBRIDE nrruaANT INFORMATION
Iny Name: COAST WATER &, POWER city or ntewp� e¢
s: P.O. BOX 3341
r: NEWPORT BEACH, CA 92659-8341 Phone: Day 949-289-0078 Night BT9
Location of Encroachment: lwL ,ar.
eas o for Encroachment. UTILITY IMPROVEMENTS - Genefaily one day between dates below.
NQTE: Na work on holida (s) or weekends.
Date efosure to Begin: s�
`I bate Closure to Eno -
Time of Closure:
MID TRWIA,
4951
- - - •— - •-� + �¢� : r 11 -=KI It r ARE AS FOLLOWS:
ion per 2006 W.A•T_C.1-1. Manual, Pa es 47�ig,
to emergency vehicles if needed. 3) Notify adjacent residents 4$ f11$ prior to closure.
rtrty
.ri "ons o% th eey nt and the roof this on.pravided is true and correct, and I agree to cornpiy with the t nos and AM T an moot v¢rmlt rv�
conditions on the £rent and back of this permk. P9Ynlltee guarantees to indemnify and hold the Ciry of Newport Beach
ha s gains ny claims, Habit , or-udgme _It, 2 Q f ^r
1 fqr amages arising Out Of permitee's activities. 1•
X 1. Data: , (Q - 1-7
Approved by: _sdl' L.�✓
_ Date:
C:i[lpcy'¢gm9 ME sMlA�galpyman{q¢g�8^�`¢¢m¢¢rarymlc¢81 RI¢81Comam.lE5wJaCRBGyT¢m p3lfNl Gl¢LmB dpplipll¢n-ItlICrNFN.agngp,xlzi8�e,11