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HomeMy WebLinkAboutN2017-0478� wry City Beach ���uI��������u Il Permit No: N2O17-04 i 8 Dport ivo CenterCA92660 . F �^. Permit Counter Phone (949)644-3311 Project No '. s4 Online Inspection Request-www.newportbeachca.gov/Online Services Inspection Requests Phone (949)644-3255 - Job Address: 3822 CAMPUS DR NB Thomas:Guide: 859E7 Description : Install new 6-inch fire service and double detector check per City Standards. Concrete restoration per City Standards. SCANNED Parcel#: 4271-510-7 - Legal Desc : N TR 3201 LOT 9 Owner: Phone: MAHONEY & GRAU LLC 0� prep Contractor: Phone: COAST WATER &POWER 949-548-0106 949- Address : 3822 CAMPUS DR #111 Address : P O BOX 3341f EW; NEWPORT BEACH, CA NEWPORT BEACH CA 9922 Contractor State Lic: 738400 Applicant: COAST WATER AND POWER License Expire : 07 31, 2019 Phone: 949-289-0078 [ Address : PO BOX 3341 NEWPORT BEACH, CA 92659 Business License: BT96014951 Business Expire: 12 31, 2017 Special Cond.: Pre -job inspection required. Workers' Compensation Insurance - - Traffic control per WATCH 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 : $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 r Street Tree Fee : $0.00 Adjustment: $0.00 I / ^� j 20 I� Processed By: Date: _/_/ Other Department : Date Utilities Approval : Date : _/_/_ Permit Denied Date Traffic Approval : Date : /_/_ Issued Permit: Date: General Services Approval : Date : _/_/_ �jl�� J3 I Ti ce PLEASE COMPLETE THE FOLLOWING INFORMATION PROJECT ADDRESS: 3822 CAMPUS DESCRIPTION OF WORK: INSTALL 6" FIRELINE w,d double dvlcckor Check Par G-1 Sa-ci3 APPLICANT: MIKE KILBRIDE Phone: 949-289-0078 Mailing Address:. PO BOX 3341 City/State/Zip: NEWPORT BEACH, CA 92659 3822 CAMPUS DRIVE LLC Phone: PR: 5 Address: 3822 CAMPUS DR City/state/Zip: NEWPORT BEACH 92660 CONTRACTOR: MIKE KILBRIDE Office Phone: 949-548-0106 Company (if different): COAST WATER AND POWER Jobsite Phone: 949-289-0078 Other Phone: FAX: 949-548-1616 Mailing Address: PO BOX 3341 City/State/Zip: NEWPORT BEACH, CA 92659 State License Number & Class: 738400 A, B, C-10 City Business License Number: BT9601491 EXP: 12-31 2017 WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code) Compan : STATE FUND Polic No: 9087110-14-2 Expires: 10/1/2017 REFUNDABLE DEPOSIT INFORMATION (If Applicable Made Payable To: MIKE KILBRIDE Vendor No: 9833 Mailing Address: PO BOX 3341, NEWPORT BEACH, CA 92659 !9L NUM-. .. N M3 i -ass.-; Mir Special Conditions of Permit: r?re^iob tna c4'ox iced Utilities: General Services: Traffic: 0 Other: Engineering Technician: mod, Public Works Specialist: Date: q—t8—n Permit No. N2017- 04+`1'g Permit Processing Fee: Q Inspection Fee: Q Public Works Only $241.00 p I 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 ReporUAgreement $817.00 Document Recordation Fee $192.00 Refundable Deposit: TBDB Monitoring Wells $502.00P Improvements TBD StreetlAlley/Walk Closure: $65.000 Newspaper Rack Inspection $108.00 0 Traffic Control Plan Check 8-1/2" x 11" $65.00= Sewer Connection Fee $250.00 24" x 36" $143.00 4TT Box & Cover $64.00" Additional � THE FOLLOWING ITEMS REQUIRE APPROHALFROM THE Revenue Division I REVENUE DIVISION PRIOR TO PAYMENT OF FEES Approval: - a Qty. I (Water Meter: Installation Charge $528.00 � 13/4" Meter $50.25 Water Meter Boxes: !' J 11" Meter, $121.50 For Parkway & Sidewalk Area (Box + Cover = Cast) 'I 11 1/2" Meter $285.00 1" Meter: 13.00 +37.00 $50.00� 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 $3,310.00 For Traffic & Alley Areas (Box + Cover = Cost) 1" Meter: 13,00 + 38.00 $51,00 14" Meter $4,730.00 2" Meter: 27.00 + 162.00 $189.00P 1 16" Meter $7,190.00 Certificate of Compliance Fee (+100 i of hrly over3 hm) $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) TBD 030-2284 Engineering Tech: Total Amount Due: For Finance Use only god; IAL 13110. -a- Permit Specialist Receipt No. t/users/pbw/shamd/encroacNmesterslep front and back masters/ Rev. 1/5/2017 epfeasheet.Aa-remsetl 10/2112016 TERMS AND CONDITIONS OF ENCROACHMENT PERMIT 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. 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. 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. Penmittee 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. 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. 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. 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, All trench restoration must be inspected by the Public Works Department. No utility installations) 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 (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 4TT box over the riser. 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. 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. 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 from the Public 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. 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. 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. 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 daysby calling 949-644-3066 for the collection schedule so service is not interrupted. To place a dumpster ormaterials in the public right-of-way, a Temporary Street Closure Permit must be obtained from the Public Works Department. WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code) , I certify that I have a Certificate of conserit to self -insure, Certificate of Worker's ate: ,(cation' Insurance, or a Certified Cody i reof ate: 1u SE P'1 Signature: � �1^` CERTIFICATE OF EXEMPTION (Section 3800 Labor Code) 1 certify that in the performance of the work under this permit, I shall not employ any person so as to become subject to California 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: 24-hour notice for Encroachment Permit Inspection is required by calling blic Works at 949-644-3311. 15. Any above ground utility facilities will require documented approval from the adjacent affected property owner(s). 16. Homeowner, contractors, and subcontracotrs may each be liable for violations of Water Quality Laws. Best Management Practices will be enforced. It is against the law to discharge construction debris into the gutter and storm drain. Fetony 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 maybe 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. City of Newport Beach Public Works 100 Civic Center Drive Newport Beach, CA. 92660 949-644-3311 =NOTSTOO JOB NAME JOB # JOB ADDRESS :30:'!-Z M , OWNER/ CONTRACTOR INSPECTOR JULI© 1�r' �w �t - CL.i AdJ O kA'l— F Mm Recipient Signature P'L-(j . L- 10/28/2Q17 City of Newport Beach Page 8,of 16 6:34:24AM INSP160 - DailyInspection Request Report Requested Inspection Date : 10/23/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 3822 CAMPUS DR Activity : N2017-0478 - SubType: Status : APPROVED OWNER: MAHONEY & GRAU U-C /// Phone: 0 APPLICANT: COAST WATER AND POWER / Phone :' 949-289-0078 Description : Install new 6-inch fire service and double detector check per City Standards. Concrete restoration per City Standards. Item: 10216 ROUGH UTIL 5 Requested Time: 10/23/2017 12:00:OOAM Requestor: WEBUSER 9495480106 Entered By: WEBUSER Comments: AM 97S Assigned to: zzzzzzzzzzz` G4 GL Inspector: Date: 7-3l Time: AM PM Comments: S'7 A 2Ti� �f�2 G Li7/�'OU I. NS•r-e�adv . Logged l G T7 Refile vvJ o -.5"60 F:\Users\PBMS hared\ENCROACH\MASTERS\FORMS\I nsoectorS heet.doc Tura u. -sc EX. CURB & GUTTER EX. WATER METER BOX 1 (ss) ' (ss) MPUS Df EX. 8" MCP WATER MAIN - (ss) (is) (W) Qv} --------------- ® 3 4 R 2 EX. LIGHT EX. DRAINAGI P.O.C. FOR SPRINKLER 6 CONTRACTOR 3822 CAMPUS DRI / VE EX. SEWER MANHOLE U. FIRE HYDRAN�T� f 14' EX. DRIVEWAY �\ -(ss) / (Ss) (ss) (ss} 3 4 INLET EX. IJGHT 7 — / VE bo M EX. SEWER MANHOLE 25' I EX. FlRE HYDRANT1 I V I j 14' EX. DRIVEWAY �\ -(ss (ss} (ss) (ss) (Nye—w} (w) w) INLET EX LIGHT 7 ' nr PFVfSIONS APP'D - No. 39478 " Exp. t2-3t-17 �lF OF F r. -`Eon j c aG R.C.E. NO. 39478 DATE 9/it/17 DESIGNED GC DRAYYN U GC �c 10' 0' 10' GRAPHIC SCAT. 3822 c FIRE SEF MVNMRT I CITY OF NEWPOF PUBLIC WORKS DE