HomeMy WebLinkAboutN2017-0314City of Newport Beach
1IIIIII1111111111111111111111111111111p 11 Permit No: N2017-0114o0 Civicenter DNewport Beach, CA sz6so I1111111
Permit Counter Phone (949)644-3311 Project No : 2039-2015�/� s\ 1E
Online Inspection Request- www.newportbeachca.gov/Online SCANNED
11
Services
Inspection Requests Phone (949)644.3255
Job Address : 621 MALABAR DR NB Thomas:Guide: 919D1
Description : EA FOR COLORED CONCRETE AND SYNTHETIC GRASS DRIVEWAY APPROACH, STONE ENTRY WALK
Parcel # :
0502-911-3 -
Legal Desc :
N TR 1701 LOT 75
Owner:
ZAHEDI PEGGY & MOSHEN
Phone:
Address :
621 MALABAR DR
CORONA DEL MAR, CA 92625
Applicant:
TEAM ULTIMO REAL ESTATE
Phone:
949-689-5293 [
Address:
1529 MAXWELL WAY
COSTA MESA CA 92627
Special Cond.: PRE -CONSTRUCTION MEETING REQUIRED
fir ;:
1. �tm i i�
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, 2017
Business License:
BT30036733
Business Expire :
08 31, 2017
Workers' Compensation Insurance - -
Carrier :
STATE COMP
Policy No:
9051279
W. C. Expire:
04 01, 2017
Permit Processing Fee :
$0.00
Sewer Connection:
$0.00
Total Fee :
$982.00
Agreement Fee:
$817.00
4TT Box Cover:
$0.00
Paid :
$982.00
Traffic control Plan Check :
$0.00
Total Water Meters :
$0.00
Balance:
$0.00
Inspection Fee :
$165.00
Water Meter Connection :
$0.00
Receipt No:
Refundable Deposit:
$0.00
Total Water Meter Box :
$0.00
Street Tree Fee :
$0.00
Adjustment :
$0.00
Processed By:
Date : _/ /
Other Department :
Date
Utilities Approval :
Date: _/_/
Permit Denied
-Date: _/_/_
Traffic Approval,
Date: _/ /
4
Issued Permit : 7
✓'7
Date : / /7 /_L7
General Services Approval :
Date
ski e
COMPLETE T14E BELOW INFORMATION
DETAILED DESCRIPTION OF PROPOSED WORK:
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(52rzilss 6k, pvvelv#y tdlTHiN OC IWIZtE FE —r FROM s L77'EW L/L
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APPLICANT: 'rr-AM VL-TIMO RcAIL ESr 4 D�
Phone: —rZ`I3
Email Address: Fv"1K@1-Etrt4"ut-Lh-l6.6o
Mailing Address:
IS-7NIYLXWELL e✓lIY
City/State/Zip:
Or'SA of
OWNER: pE M0148EtJ 79<+14Eb/ Phone:
Email Address:
Mailing Address: City/State/Zip:
GZI hRt-5VVN-T?- PrL-- C-o17eX)F bEL MA-Z ep 'Zz625-
bi P ',"ST r-N; ft
CONTRACTOR: TEAM VLTINIO (ZEAL Es'i beV
Office Phone:
Company (if different):
Jobsite Phone:
Other Phone:
Email Address: plzgAlk Z�-i' R" uLTIMo. 60tq
Mailing Address:
trZ9 MY+ WELL wH
City/State/Zip:
cxTPV MESA 6f} 1,2�
State License Number & Class:
Expires:
City Business License Number:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: Policy No: Expires:
Municipal Oeratinns: 949-644-3066
Utilities: 949444-3011
Urban Forest ": 949.644-3083
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Special Conditions of Permit:
hr lli BQ$l:'�- . P tO;il711L 1 i.',CIkEI u'" MM -1 N: �i Wl�KI( 9,ISAiZ llll , ,, t ' e.
Utilities: Traffic: Fire:
Municipal Operations Other:
Engineering Technician:
Permit Sp eia 'st
at :
Permit No.
N2017-(
f/users/pbw/shamdtencroach/masters/epwotksheet.xls ^2 3q—L;�—C) IS —
Public Works Department 949-644-3311
100 Civic Center Drive, Newport Beach, CA 92660
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APPLICANT•
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PxNL Es14
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Permit Processing Fee:
Q
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:
Preparation of Report/Agreement
Document Recordation Fee
$817.00
$192.00
Water Quality/Artificial Turf Inspection
Refundable Deposit:
$108.00
TBDB
Monitoring Wells
$502.00P
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
$250.00
24" x 36"
$143.00=
4TT Box & Cover
$64.00
Certificate of Compliance Fee (+100% of hrly over 3 hrs)
Development Services Fee (Plan check hourly)
Final Tract Map Checking Fee
Final Parcel Map Checking Fee - Moderate
Lot Line Adjustment Fee
Park Dedication Fee Zone
Street EasemenWacation Fee (+100% of hriy over 4 hrs)
Street Tree Fee ($700 Planting Fee)
$288.00
$155.00
$2,488.00
$2,488.00
$1,079.00
TBD
$1,022.00
TBDI
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
a 9'�' 2r ,
Per tt Sp cialist
Receipt No.
��
Rev. 1/5/2017
(mD �x—t j /
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fdusers/pbw/sharedlencroach/mastemlep front and back masters/
epfeesheetxls-revised 1021/2016
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 hamlless 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 Slate 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 fie: 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 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.
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 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.
B1f =AlICr8NSEQ- CONTRACTOR
ri1Fe of An xcatiatI aY 00 422=4133.
WORKER'S COMPENSATION INSURANCE (Section 3300 Labor Code)
I cavity at 1 have a Certificate of consent to self -insure, Certificate of Worker's
Cc ':pe sation Insurance, or a Certified Co y ereof
Date 7 Signatur
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 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. 1 shall indemnify
and hold the City harmless for any liability associated with the minor
encroachments.
Date: Signature:
24-hour notice for Encroachmen Permit Inspection is required by calling
Public Works at 949-644-3311
15. Any above ground utility facilili ill require documented approval from the adjacent
affected property owner(s):
16. Homeowner, contractors, and subcontracobs 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 $25,000 and/or up to three years in Stale
prison plus the full cost to clean up an illegal discharge or spill.
17. If a refundable deposit was paid, applicant must submit a Soils Compaction
Certificate or Evidence of a Slurried Backfill and request a final inspection from the
Public Works Department. Monies may be held for six months after final inspection
before a refund will be processed.
18. No trees in the public right-of-way shall be planted, removed, trimmed, or relocated
without approval from the General Services Department.
19. All work in the public right-of-way must meet the approval of the Public Works
Department or corrections will be required (i.e. removals, exposing connections,
etc.). Additional inspection fees may be required.
20. Permit is for standard materials in the public right-of-way only, unless previously
approved by Public Works and an Encroachment Agreement has been processed.
21. Permit is valid for "description' of work noted on front only. Additional work
performed may require issuance of a separate permit and/or additional fees.
'FIDELITY NATIONAL TITLE COMPANY
SUBDMSION DEPARTMENT '
RECORDING REQUESTED BY:
Fidelity National Title
AND WHEN RECORDED MAIL TO:
Mohsen Zahedi
621 Malabar Drive
Corona del Mar, CA 92625
Recorded in Official Records, Orange County
Hugh Nguyen, Clerk -Recorder
SIM
+$ R 0 0 0 7 2 1 8 3 3 7$+
2015OW011678 3:57 pm 01112115
90 402 G02 4 07
1045.001045.00 0.00 0.00 9.00 0.00 0.00 0.00
THIS SPACE FOR RECORDER'S USE ONLY;
Title Order No.: 23066923-KC GRANT DEED Escrow No.: 400-006864-SM
THE UNDERSIGNED GRANTOR(S) DECLARE(S)
DOCUMENTARY TRANSFER TAX is $2,090.00
[X] computed on full value of property conveyed, or
( ] computed on full value less value of liens or encumbrances remaining at time of sale.
[ ] Unincorporated area [XI City of Newport Beach
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
Lori L. Livingston, Richard G. Winder and Stephen D. Winder, Successor Trustees of
the G & V Winder Trust dated 2123/08
hereby GRANT(s) to:
Mohsen Zahedi and Peggy Zahedi, husband and wife as joint tenants
the real property in the City of Newport Beach, County of Orange, State of California,
described as:
LEGAL DESCRIPTION ATTACHED HERETO AS EXHIBIT "A" AND MADE A PART
HEREOF
Also Known as: 621 Malabar, Newport Beach (Area of Corona del Mar), CA 92625
AP#: 050-291-13
DATED: December 30, 2014
Signature Page attached hereto
and made a part hereof
MAIL TAX STATEMENTS TO PARTY SHOWN BELOW; IF NO PARTY SHOWN, MAIL AS DIRECTED ABOVE;
Title Order No.: 23056923
Escrow No.: 400-006864-SM
A.P. # 050-291-13
Signature Page
G & V W'rl er Trus ate 123/08
BY: ` ) a
Lo ' . Livingston, uccessor yr stee J
jV
BY:
r
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the
document to which this certificate is attached and not the.truthfulness, accuracy, or validity of that document.
STATE OF CALIFORNIA
COUNTY OF
On I l
before me, K. ft. aril _.
A Notary Public personally appeared
W1 Y10t4J"
who proved to me on the basis of satisfactory evidence to be the persons) whose name(e) is/ark subscribed to the within
instrument and acknowledged to me that he/sheRhey, executed the same in hislherA it authorized capacity(fes), and that by
histbanAheir signatureL*on the instrument the person(a), or the entity upon behalf of which the person(e}acted, executed the
instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correcL
WITNESS my hand and official seal.
Signature �
(Seal)
R. H.R. H. B`�j
COMM.1977059
M)TARYMMIXIMMA
4yTiinaip WY11,2011 j.
G
H
4
x+
I
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of �j )
On ,11016 � before me, [oYt ( L• N1�5�pT�((m�PU}�ic
�C (insert name and title of the officer)
personally appeared
who proved to me on the basis of satisfacto vidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
�mNNE L. THOMPSON Commission # 1925002
p v;a
� is Notary Public - California i
WITNESS m hand and official seal. z ';z=> n
y Orange County
n n • • e" - My Comm. Expires Feb 10, 2015
Signature bU5C� MA-p (Seal)
EXHIBIT A
LEGAL DESCRIPTION
THE LAND REFERRED TO HEREIN BELOW IS SITUATED IN THE COUNTY OF ORANGE, STATE OF
CALIFORNIA, AND IS DESCRIBED AS FOLLOWS:
LOT 75 OF TRACT NO, 1701, IN THE CITY OF NEWPORT BEACH, COUNTY OF ORANGE, STATE OF
CALIFORNIA, AS PER MAP RECORDED IN BOOK 52, PAGES 9 AND 10 OF MISCELLANEOUS MAPS, IN THE
OFFICE OF THE COUNTY RECORDER OF SAID COUNTY.
EXCEPT ALL OIL, OIL RIGHTS, MINERALS, MINERAL RIGHTS, NATURAL GAS RIGHTS, AND OTHER
HYDROCARBONS BY WHATSOEVER NAME KNOWN THAT MAY BE WITHIN OR UNDER THE PARCEL OF
LAND HEREINABOVE DESCRIBED, TOGETHER WITH THE PERPETUAL RIGHT OF DRILLING, MINING,
EXPLORING AND OPERATING THEREFORE AND STORING IN AND REMOVING THE SAME FROM SAID LAND
OR ANY OTHER LAND, INCLUDING THE RIGHT TO WHIPSTOCK OR DIRECTIONALLY DRILL AND MINE
FROM LANDS OTHER THAN THOSE HEREINABOVE DESCRIBED, OIL OR GAS WELLS, TUNNELS AND
SHAFTS INTO, THROUGH OR ACROSS THE SUBSURFACE OF THE LAND HEREINABOVE DESCRIBED, AND
TO BOTTOM SUCH WHIPSTOCKED OR DIRECTIONALLY DRILLED WELLS, TUNNELS AND SHAFTS UNDER
AND BENEATH OR BEYOND THE EXTERIOR LIMITS THEREOF, AND TO REDRILL, RETUNNEL, EQUIP,
MAINTAIN, REPAIR, DEEPEN AND OPERATE ANY SUCH WELLS OR MINES, WITHOUT, HOWEVER, THE
RIGHT TO DRILL, MINE, STORE, EXPLORE AND OPERATE THROUGH THE SURFACE OR THE UPPER 500 FEET
OF THE SUBSURFACE OF THE LAND HEREINABOVE DESCRIBED, AS RESERVED BY THE IRVINE COMPANY,
A MISSOURI CORPORATION, IN DEED RECORDED OCTOBER 14, 1977 IN BOOK 12415, PAGE 997, OF
OFFICIAL RECORDS, AND AS RESERVED IN DEED RECORDED AUGUST 31, 1984 AS INSTRUMENT NO. 84-
365365, OF OFFICIAL RECORDS.
APN: 050-291-13
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9/15/2017 City of Newport Beach Page 5 of 13
4:30:37PM INSP150 - Daily Inspection Request Report
Requested Inspection Date :
08/16/2017
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address :
621 MALABAR DR
Activity :
N2017-0314
SubType:
NEW
Status :
APPROVED
OWNER:
ZAHEDI PEGGY & MOSHEN Phone:
APPLICANT:
TEAM ULTIMO REAL ESTATE Phone : 949-689-5293
Description :
EA FOR COLORED CONCRETE AND SYNTHETIC GRASS DRIVEWAY APPROACH,
STONE ENTRY WALK
Item: 10250 FINAL -PW
Requested Time: 8/16/2017 12:00:OOAM Requestor: NBIVR
9497950648
Entered By: NBIVR
Comments: AM
Assigned to:
Inspector: Date: / 1% Time: LAM PM
Comments: fet r-Oy t p fz- 7'0 ! Z(5: , IS ,/
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
REPT131. Run Id: 4018