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HomeMy WebLinkAboutN2017-0416City of Newport Beach IIIIII�IIIIIIII�IIIIIIIIIIIIIIIIIIIIIII Permit No: N2017-0416, , . 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3311 Project No : �+�og - pY s;��, - a 4r Online Inspection Request- www.newportbeachca.gov/Online o7�s/1�IMId+ Services - o7isC►NN . Inspection Requests Phone (949)644-3255 = Job Address : 127 JADE AVE NB Thomas:Guide: 919D1 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Avenue adjacent to address. Pavement restoration per City Standards. Parcel # : 0501-832-2 - Legal Desc : BALBOA ISLAND SEC 5 BLK 3 LOT 16 Owner: LONG JOHN K Phone: 0 Address: 127 JADE AVE NEWPORT BEACH, CA Applicant: AT&T CALIFORNIA Phone: 714-618-9132 [ Address : 3939 E CORONADO ST, 2ND FLOOR ANAHEIM, CA 92807 Special Cond.: Pre -job inspection required Traffic control per WATCH Contractor : H C I INC Phone: 951-520-4200 Address: P 0 BOX 638 NORCO CA 7 Contractor StateLic: 378587 License Expire : 09 30, 2019 Business License: BT97021542 Business Expire : 06 30, 2018 Workers' Compensation Insurance - - Carrier : STARR INDEMNITY & LIABILITY CO Policy No: 1000001397 W. C. Expire: 06 15, 2017 Permit Processing Fee : $241.00 Sewer Connection: $0.00 Total Fee $1,066.00 Agreement Fee: $0.00 4TT Box Cover: $0.00 Paid: $1,066.00 Traffic control Plan Check : $0.00 Total Water Meters : $0.00 Balance: $0.00 Inspection Fee : $825.00 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 : f it Date: _/_/ Other Department : Date: _/_/ Utilities Approval : Date: _1 / Permit Denied Date : _/_/ Traffic Approval : Date: _/_/ ^ Issued Permit : 1.b — — Date :/b /Ig / 174— General Services Approval : Date: _/_/ 2. 3. 4. 5. X 8 9 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. 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. 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-34is 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 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 SOR35 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 Califomia 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 or materials in the public right-of-way, a Temporary Street Closure Permit must be obtained from the Public Works Department. WORKER'S COMPENSATION INSURANCE (Secticy1800 Labor Code) I certify that I have a Certificate of consent to self-lnsqte,Certlficate of Worker's- C9mpen/s�atio1n Insurance, or a Card led Copy thereof. Date. Ib ^l7 (f /tsinnafi,rn- CERTIFICATE OF EXEMPTION (Section 3800 Labor Code) I 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 1 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 Public Works at 949-644-3311. 15. Any above ground utility facilities will require documented approval from the adjacent affected property owners): 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. 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 Backfll 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 o ont only. Additional work performed may require issuance of a separate pe it an /or additional fees. Client#: 1799803 305HCIINC CORD,a CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 6/12/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOWJHIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER BB&T Insurance Services of Orange County 2400 Katella Avenue Ste 1100 CONTACT NAME: Allie Mosier PHONE 714 941-2900 F 877-297-1116 Ezt : A/C, No E-MAILo, ADDRESS: amosier@bbandt.com Anaheim, CA 92806 INSURER(S) AFFORDING COVERAGE NAIL# INSURER A: Executive Risk Indemnity Inc 35181 INSURED HCI, Inc. INSURER B: Federal Insurance Company 20281 PO Box 5389 INSURER C: Norco, CA 92860 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTRR TYPEOFINSURANCE NSRADDL SUBF MD POLICY NUMBER MMIOI %YEYYY MMIDOYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-XIOCCUR BI/PD Ded:25,000 54309444 D6111512017 06/15/201E EACH OCCURRENCE s2,000,000 PREMISES aoccurrence $100000 X MED EXP(My one person) $SOOO PERSONAL B ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECTPRO- LOC OTHER: GENERAL AGGREGATE $4,000,000 PRODUCTS-COMP/OPAGG $4,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED AUTOS 54309443 6/15/2017 06/151201E COMBINED SINGLE LIMIT Esaccident $2,000,000 X BODILY INJURY (Per parson) $ X BODILY INJURY (Per accident)$ PROPERTY DAMAGE P..... itlent $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 54309445 6/15/2017 06/151201E X PER OTH- T TER E.L. EACH ACCIDENT $1 00O 000 E.L. DISEASE - EA EMPLOYEE $1 000000 E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) Re: Permits City of Newport Beach 3300 Newport Blvd. Newport Beach, CA 92663-3884 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) 1 of 1 #S182791761M18278032 The ACORD name and logo are registered marks of ACORD ACMOS 12? bode Avenve NT + Permit Processing Fee: Q Public Works Only $241.00 Other Department $275.00 Agreement Fee: Preparation of ReportlAgreement $817.00� Document Recordation Fee $192.00 Monitoring Wells $502.00 Street/Alley/Walk Closure: $65.000 Traffic Control Plan Check 8-1/2" x 11" $65.00 24" x 36" $143.00 _ Additional THE FOLLOWING IITEMS REQUIRE APPRC REVENUE DIVISION PRIOR TO, PAYME 1 Qty. (Water Meter: 13/4 Meter $50.25 I1"Meter $121.50 11 1/2" Meter $285.00 11 1/2" Turbine Meter $700.00 12" Meter 12" $425.00 Turbine Meter 13" Meter 14" $84&00 $3,310.00 Meter $4,730.00 16" Meter $7.190.00 N2017- 0+11 to Inspection Fee: Q . Public Works Field Inspection $165.00 gj Utilities Field Inspection $121.00 General Services Inspection $165.00 Water Quality/Artificial Turf Inspection $108.00 Refundable Deposit: TBD Improvements TBD Newspaper Rack Inspection $108.00 0 Sewer Connection Fee $250.00 4TT Box & Cover $64.00 (Approval: - Qt . rge $528.00 Kes: 1" Meter: 13.00 + 37.00 $50.00 2: Meter: 27.00 + 61.25 $88.25 For Traffic & Alley Areas (Box + Cover = Cost) 1" Meter: 13.00 + 38.00 $51.008 2" Meter: 27.00 + 162.00 $189.00 Certificate of Compliance Fee (+100ei 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 EasemenWacationFee (+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 tRoa, A I1O(sb. - Permit Specialist Receipt No. flusers/pbw/sharedlencroachlmasters/ep front and back masters/ Rev. 1/5/2017 epfeesheet As -revised 10121/2016 LE( (11), AOOERL2 "P"°GIGAP WER** ORKSHEET FOR ENCROACHMENT PERMIT CITY OF NEWPO•,RTBEACH .. P.POLIC WORKS:DEPARTM9NT PROJECT DDRE85:127 JADE AVE DETAILED DESCRIPTION OF PROPOSED WORK: EXCAVATE 36 LN FT IN CONCRETE 3 SQ FT IN DIRT TO PLACE 42' 2-4aa DUCT 1 PFP-864 CABINET & 1 GROUND BED. APPLICANT: AT&T CALIFORNIA Phone: (714) 618-9132 Email Address: vk3921@att.com flAeAltp, Valentina Gipson, AT&T Liaison Mailing Address: 3939 E. CORONADO ST, 2ND FLOOR Cityl tatelZip: ANAHEIM CA 92807 Phone: EER: l Address: Mailing Address: CitylStatefZip: ALL CONTRACTOR INFORMATION IS REQUIRED PLEASE COMPLETE CONTRACTOR: Office Phone: Company (if different): lJobsite Phone: Other Phone: Email Address: Mailing Address: CitylStatelZip: State License Number & Class: Expires: City Business License Number: Expires: WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code) Company: Policy No: Expires: R�FUN9ASC2ReAOs'Ir.........:T: A:...::::::::.:::::.:::::::.::::.:..:::::::c,: :.:;:::•:.;::::.::::. ..1NF.ORMA. JQN. !C . pf2 rcable.k <: ><:%s>; > z s>:;r >s>::z :<::»»:<•;>:.;::>:<>.:>:=>:=<>: >: fteiundt?a.able-TD;J:i>:::i:`::::.>:::::..:.;.....-...:: :..`................. NI�1Ctieftiffd'To :i `?: ::5 :: r ::; :: " := : `::? > :...... ?:[: ? : i :: ...... FOR OFFICE USE ONLY Special Conditions of Permit:-ik--j.�� �h ��at w��cv�•d u -`Gea°r'E'%,✓`. i:5�ru �`s�li wig;;' V; Fr'C�:rrvl ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS Utilities: General Services: Traffic: Fire: Other: Engineering Technician: u': v.•.�v Public Works Specialist: Date: 4 .v4-n Permit No. 114201-1-0440 fauwvapQWlhareftnmoaU astorma w"heaws Public Works Department 949-644-3311 EXCAlvATION DATA OPL, 1-954FP CAEINET AD AD ALcovoanTE P RAD 1,C TcAe NO, OPL, 422-4' DUCT 9L GPM <i NH 11R9 10 FFP, vERLLY lD' NSED OIF A OR FT. p 6 LRou"D VACI NCTAll I COPPER GRarvD RDOs I-EDOM ., D uM LENGTR ry P - R TLECID PREUItICN MINDND A EN TO RE .1 mENCH As PtroPoElN I. THE PFP-S64 CABINET ii Rt ESE wee Y CONSTRUCTION NOTES t. GGCE CR AM FOR SIRUCCC A 11AwG LINELOw ExLP E ALL IR.. MNRMAIION IN 'AN NAM IA. FROM LCRC9 AWMLABIE IC AND APPRCEDATE vEP M1RLO IN ROD BEFORE EXCAVATING CALL: n U.G. SERVICE ALERT 811 THE WA,TC,H. AND OCO CTO ALFORDACCORDANCE TO/x IN TKO, vIws a%L MPLEEDENT ALL FiLT MAAMAMEUEWNI CI¢EM (DMF'a AN REDWRED RE NO. CWPWNCE SRNES FE6RWRI IT. I., 'OR. WATER 1(0111)A x,NO IN AlCORRANCE MN WTHENuttCLEAi WATER ACT (1965) Nb 0 CA CF PARK AVE. ME 1., a R., Iry 19R,q, D n5 MWrlr[o iL/L OF —E AVE. r N an wD oO.vxc CLIRVE Oq Tq C t35� 90 DETE CWN�TRDIlCN TO VERIiY PROPER EICT a.a"io s� s cw-u5 TOO KNOCKOUTS ®ETO Ia+esnzrrr O�'T ALL .NNO sEO s.MC.L -T DETAIL A sotto a'E 0 SLATE : I 2C 1U11 cn _ u,s CO. —MR) 69 1P '�\y\DAI_ TDI L TREE — DRAWING R SCALE at&t s•Naw n) 6 uAP,.. .. T{� en -.Z DO NOT REDUCE ""'" 11 Spy Consulting LLC "/" - - --' — DURING REPRODUC11ON California woraor�r. --- 5 c� LE(I 7) AOOERL2 (9191 t50-OCM /IxM (949) 350-0006 oni Tt069f OWG. L-1 10/23/2617 City of Newport Beach Page 12 of 16 6 34:24AM INSP150 - Daily Inspection Request Report SubType: Status: APPROVED OWNER: LONG JOHN K Phone : 0 APPLICANT: ATBT CALIFORNIA Phone : 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Avenue adiacent to address. Pavement restoration per Citv Standards. --- Item: 10200%,,_ PRE JOB - PW Requested Time: 10/23/201 , ... -00 Requestor: Entered By: WEBUSER I Comments: ANY -afternoon meeting if possible Assigned to : zzzzz�%zzzzzz' � \/U� g` ©'.- Inspector: V Date: ��% 1-7 Comments: F: \Users\PB W \S ha red\ENCROACH \MASTERS\FORMS\I n soectorSheet. doc WEBUSER ,._._C G4LL_CS 1 909-997-3639 r GvC- go � p� Time: / - OS__ AM PM 5 111.43%2017 City of Newport Beach Page 4 of 12 6:34:16AM INSP15O - Daily Inspection Request Report Requested Inspection Date : 11/13/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 127 JADE AVE Activity : N2017-0416 SubType: Status : APPROVED OWNER: LONG JOHN K Phone: 0 APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Item: 10210 PUBLIC WORKS Requested Time: 11/13/2017 12:00:OOAM Requestor: WEBUSER 9515204200 Entered By: WEBUSER Comments: ANY -traffic control for fiber placing Assigned to: }}uz 777 zzzzz` I // Inspector: �J y' Date: fI 113 / 17 Time: AM PM Comments: Pe�v"t-� Del 4✓rG�s7" W. F:\Users\PBVV\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc '11/1312017 City of Newport Beach Page 5 of 18 4:30:31•PM INSP150 - Daily Inspection Request Report Requested Inspection Date : 11/14/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 127 JADE AVE Activity : N2017-0416 SubType: Status : APPROVED OWNER: LONG JOHN K Phone: 0 APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Avenue adiacent to address. Pavement restoration Der City Standards. Item: 10205 GENERAL SERVICE Requested Time: 11/14/2017 12:00:OOAM Requestor: WEBUSER 9515204200 Entered By: WEBUSER Comments: ANY -traffic control for fiber placing !` ►G�'� La Assigned to: zzzzzzzzzzz" 'E"30 A-�,u �l1 �l age 25 a5 G}v1�V�1�v31 Cloq_ CtC(�7�-1 l -DGww� Mvvl - 4C i rvv4IV4eKtjnC-e L4vac,+ar �O►^wt -t 'P01)vr)'v1 I r' CAA C(Ab<V\-P,* U,) -l+ hejnn Mj,,d _PGC, 1-10690 1�251 n vi CA S-e- f' C q jo r r r�yi�Lv�,se p lci I SubType : Status : APPROVED OWNER: LONG JOHN K Phone: o APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Avenue adiacent to address. Pavement restoration Der Citv Standards. item: 10000 EXCAVATION & PIPE INSTALL-UTIL Requested Time: 11/15/2017 12:00:OOAM Requestor: WEBUSER 9515204200 Entered By: WEBUSER Comments: ANY -traffic control for fiber placing Assigned to : zuzzzzzzzz' Inspector: C\ , `/ Time: PM Comments: t Date: � 15' 1 .►et Logged v�qs F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc REPT131 Run Id 4018 11/15/2017 City of Newport Beach Page 1 of 4 4:30:1rAPM INSP150 - Daily Inspection Request Report Requested Inspection Date: 11/16/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 127 JADE AVE Activity : N2017-0416 SubType: Status : APPROVED OWNER: LONG JOHN K Phone: 0 APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Item: Requested Time: 11/16/2017 12:00:OOAM Requestor: WEBUSER 9515204200 Entered By: WEBUSER Comments: ANY -traffic control for fiber placing Assigned to: zz1zzizz�zuzz' Inspector: Date: t� Time: 1(7!31) A PM Comments: Afe %S- CI O/L/ =G- F:\Usem\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc 5 37AvT`W. REPT131. Run Id: 4018 11/16/2017 4:30:27PM Activity : SubType : Status : OWNER APPLICANT Description : City of Newport Beach INSP150 - Daily Inspection Request Report Requested Inspection Date : 11/17/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 127 JADE AVE Page 4 of 11 LONG JOHN K Phone: 0 AT&T CALIFORNIA Phone : 714-618-9132 Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Avenue adiacent to address. Pavement restoration Der Citv Standards. item: 10030 CLEAN -OUT Requested Time: 11/17/2017 12:00:OOAM Requestor: WEBUSER 9515204200 Entered By: WEBUSER Comments: ANY -traffic control for fiber placing Assigned to: zzzzzzzzzzz- Inspector: Comments J V Date: l 1 ZI-71 ( -7 Time: AM PM XeA-ztJ f%, I E �i - 0,5 = 4i1o2 Logged F:\Users\PBVNS hared\ENCROACH\MASTERS\FORMS\InsoectorS heet. doc REPT131. Run Id: 4018 11/20/2017 City of Newport Beach Page 8 of 16 A:30:61PM INSP150 - Daily Inspection Request Report 3 Requested Inspection Date : 11/21/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 127 JADE AVE ,����w�� ,. �,.,cs�^:k'�^"�s+ �h .3$•^�.`fir�zR^�-.,������� �'i�` .� E .. `.S P.+::4 eh�;t�', '���'�a�r.^a Activity : N2017-0416 SubType: Status: APPROVED OWNER: LONG JOHN K Phone: 0 APPLICANT: AT&T CALIFORNIA Phone: 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Avenue adiacent to address. Pavement restoration per City Standards. Item: 10210 PUBLIC WORKS Requested Time: 11/21/2017 12:00:OOAM Entered By: WEBUSER Comments: ANY -bay front & rear marina (fiber plc) Assigned to: zzzzzzzzzzz' Requestor: WEBUSER Inspector: 3 V Date: ti 7—( (�% Comments: F:\Users\PB W\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc 9517682632 Time 0 REPT131 Run Id 4018 11/27/z0'17 City of Newport Beach Page 4 of 12 s:34' :27Ane INSPI60 - Daily Inspection Request Report Requested Inspection Date : 11/27/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 127 JADE AVE AI'PID'Infonnation: ' Activity : N2017-0416 SubType: Status: APPROVED OWNER: LONG JOHN K Phone: 0 APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Avenue adjacent to address. Pavement restoration per City Standards. Requested Inspections),,'�� Item: 10210 PUBLIC WORKS t 5 T6A/L 3 [o ^ a77 —�a 3 � Requested Time: 11/27/2017 12:OO:OOAM Requestor: WEBUSER 951-768-2632 Entered By: WEBUSER Comments: AM-N Bay front & Marie av fiber pi Assigned to: zzzzzzzzzzz' Inspector: " � V Date: (( Z-7/ t 7 Time: 9 3" — Xle o r� Comments: P�, C6�4 M 44- . F:\Users\PBW \S ha red\ENCROACH\MASTERS\FORMS\I nsoecto rSheet. doe AM PM t7g-' �e/z's/z17 City of Newport Beach Page 6 of 11 6:34:36AM INSP150 -Daily Inspection Request Report f Requested Inspection Date: 11/28/2017 Inspection Type: ENCROACH Inspection Area : PW Ste Address': 127 JADE AVE Activit y N2017-0416 SubType: Status : APPROVED OWNER: LONG JOHN K: Phone p APPLICANT : AT&T CALIFORNIA Phone : 714-618-9132 Description : Install42 LF of 4-inch duct, install 1 above ground pedestal, and ground becibn Park Averiue.ad'acent to address. ; Pavement restoration perCij Standards. Item: 10080 SERVICE CONNECTION - UTIL Requested Time: 11/28/2017 12:00:OOAM Requestor: WEBUSER 951,768-2632 Entered By: WEBUSER Comments: AM-N Bay front & Marie av fiber.pl Assigned to : zzzzz»»»* Inspector: �, Date: t AlTime: AM PM Comments: tra14- - Logged BWe e F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc i 11129/2017 City of Newport Beach Page 9 of 12 6:34:18AM INSP15O - Daily Inspection Request Report Requested Inspection Date : 11/29/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 127 JADE AVE A/P/D.Information: Activity : N2017-0416 SubType: Status: APPROVED OWNER: LONG JOHN K Phone: 0 APPLICANT: AT&T CALIFORNIA Phone: 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Avenue adjacent to address. Pavement restoration per City Standards. Requested Inspection(s) Item: 10210 PUBLIC WORKS Requested Time: 11/29/2017 12:00:OOAM Entered By: WEBUSER Comments: AM -bay front & marina (fiber plc) Assigned to : ZZZZZzzzzzz` Requestor: WEBUSER 310-879-9039 Inspector: Date: Time: 2'.30 AM PfVll Comments: !VO Oif/t: 0141— S 17- CA! 1 ���_ s� a F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet doc 11/i0/2017 City of Newport Beach Page 7 of 10 6:34:26AM INSP150 - Daily Inspection Request Report Requested Inspection Date : 11/30/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 127 JADE AVE A/P/D Information:' Activity : N2017-041C SubType: Status: APPROVED OWNER: LONG JOHN K Phone: 0 APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Item: 10210 PUBLIC WORKS Requested Time: 11/30/2017 12:00:OOAM Entered By: WEBUSER Comments: AM -park ave & lade ave Assigned to : zzzzzzz zzz' Inspector: JAI �i' So I Date: a� Requestor: WEBUSER 310-879-9039 ctfx.cs�� Time: AM PM Comments: ��/�i (P�t ILLS 4 ilae-dX-f_� Ll1 `all I F:\Users\PBV\RShared\ENCROACHXMASTERS\FORMS\InspectorSheet.doc 12/4/2017 City of Newport Beach Page 8 of 13 4:30:53PM INSP150 - Daily Inspection Request Report Requested Inspection Date: 12/05/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 127 JADE AVE Activity : N2017-0416 SubType: Status: APPROVED OWNER: LONG JOHN K Phone: 0 APPLICANT: AT&T CALIFORNIA Phone: 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Avenue adjacent to address. Pavement restoration per Citv Standards. Item: 10210 PUBLIC WORKS Requested Time: 12/5/2017 12:00:OOAM Requestor: WEBUSER 310-879-9039 Entered By: WEBUSER Comments: AM -park ave & jade ave plc fiber Assigned to: zu`zzzzuzz* / Inspector: Date: / /Z Time: AM PM Comments: C WC10 61L'e� wile F:\Users\PBVIAShared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc REPT131 Run Id: 4018 12119/2017 City of Newport Beach Page 3 of 9 4:30:12PM INSP150 - Daily Inspection Request Report Requested Inspection Date : 12/20/2017 Inspection Type : ENCROACH Inspection Area: PW Site Address : 127 JADE AVE Activity : N2017-0416 SubType : Status : APPROVED OWNER: LONG JOHN K Phone: 0 APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Avenue adiacent to address. Pavement restoration oer Citv Standards. Item: 10230 INSPECTION - UTIL Requested Time: 12/20/2017 12:00:OOAM Requestor: WEBUSER 310-879-9039 Entered By: WEBUSER Comments: AM -jade ave parks fiber pl Assigned to: zzzzzzzzzzz" Inspector: la Date: I Z Z� %� Time: A PM Comments: C i `'POA )vvG w a'e- t'Jo-t k e d F6 r e tM e_ o C Q F:\Users\PB\MS hared\E N C ROACH\MASTERS\FORMS\InspectorS heet.doc REPT131. Run Id: 4018 12/18/2017 City of Newport Beach Page 5 of 12 4:30:13PM INSP150 - Daily Inspection Request Report Requested Inspection Date : 12/19/2017 Inspection Type: ENCROACH Inspection Area : PW Site Address : 127 JADE AVE Activity : N2017-0416 SubType : Status : APPROVED OWNER: LONG JOHN K Phone: 0 APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Install 42 LF of 4-inch duct, install 1 above ground pedestal, and ground bed on Park Avenue adiacent to address. Pavement restoration per City Standards. Item: 10210 PUBLIC WORKS Requested Time: 12/19/2017 12:00:OOAM Requestor: WEBUSER 310-879-9039 Entered By: WEBUSER Comments: AM -jade ave parks fiber pl Assigned to: zzzzzzzzzzz` Inspector: 1� Jq Date: Time: AM PM Comments: Refrle F:\Users\PB W \Sha red\ENCROACH\MASTERS\FO RMS\I ns oectorS heet.do c REPT131 Run Id: 4018 1/812018 City of Newport Beach Page 4 of 5 4:30:35PM INSP150 - Daily Inspection Request Report Requested Inspection Date : 01/09/2018 Inspection Type: ENCROACH Inspection Area: PW Site Address : 127JADE AVE Activity : N2017-0416 SubType: Status: APPROVED OWNER: LONG JOHN K Phone APPLIGANT: Ai&T-CALIFUHNIA -_ Phone : 714-618-9132 Description : Install 42 LF of 4-inch duct, install I above ground pedestal, and ground bed on Park Avenue adiacent to address. Pavement restoration Der Citv Standards. Entered By: WEBUSER Comments: AM -park ave & jade ave plc fiber 101 — -71 -7 — 3 (a,3 Assigned to zzzzzzzzzzz* Inspector: Date: S Time: AM PM 'OV457 C> Comments: AGr-tpL t4o2ic- /A? BA--l—ago 60— WMERS Ak EYE. ALI) tt' ery��' 7. 't F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.do REPT131 Run Id: 4018