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HomeMy WebLinkAboutN2017-0403c y�'W4y� 9 0Civic City icCenter Dport Beach rive, NewportBach, CA 92660 III II III IIIII IIIII IIIII I'�I I IIIII IIIII II IIII II Permit Counter Phone (949)644-3311 Online Inspection Request- www.newportbeachca.gov/Online Services Permit No: N2017-0403� Project No Inspection Requests Phone (949)644-3255 Job Address : 2401 BLACKTHORN ST NB Thomas:Guide: 889E4 Description: Pothole to repair damaged CATV conduit. Pavement restoration per City Standards. Parcel # : 4400-440-1 - Legal Desc : N TR 4893 LOT 78 Owner: KRUSEJOHNW Phone: 0 Address: Applicant: CHARTER COMMUNICATIONS Phone: 714-681-3554 [ Address: 7142 CHAPMAN AVENUE GARDEN GROVE, CA 92841 Special Cond. : SCANNED ID 1 COMPUTEDContractor: CABLE COM OF CALIFORNIA, INC. Phone: 714-666-2400 Address: 1251 N.JEFFERSON STREET ANAHEIM, CA Contractor State Lic: 826295 License Expire: 07 31, 2019 Business License: BT30033430 Business Expire: 10 31, 2017 Workers' Compensation Insurance - - Carrier: LM INSURANCE Policy No: WA563DO04260037 W. C. Expire: 07 31, 2018 Permit Processing Fee : $241.00 Sewer Connection: $0.00 Agreement Fee: $0.00 4TT Box Cover: $0.00 Traffic control Plan Check : $0.00 Total Water Meters : $0.00 Inspection Fee : $165.00 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 Total Fee $406.00 Paid: $406.00 Balance: $0.00 Receipt No: OZO6 Other Department : Date : _/ / Permit Denied Date: _/_/_ Issued Permit : Date : L/[) / [ I 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 dale of issuance. 2. 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. 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 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. 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 (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 41T box over the riser. 9. Property lighted barricades must be provided and maintained around all trenches, excavations and obstructions. All signs, flags, lights and other warning and safely 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 days by 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. usyq,A I'C I I EIS; ONTRACTOR of'Anyr vatio ai0fl0-42-? 133 WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code) Ycertify that I have a Certificate of consent to self-insur Certificate of Worker's Compensation Insurance, or a Certified Copy th Date: It Signature: _,�' e 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. I shall indemnify and hold the City harmless for any liability associated with the minor encroachments. Date: Signature: 1 hour notice for Encroachment Permit Insp c ion is required by calling ublic Works at 949-644-3311. 15. Any above ground utility facilities will require documen ed approval from the adjacent affected property owneds). 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 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 nt only. Additional work performed may require issuance of a separate permit nd *,additional fees. FESAI f H °k L ' �x 8 `# '�`'2G'. n � "y}E f sv .Y+ms i2r .v tr � a i x ar }n � y{ s' v}y � t� i'� q � (l• �ff? y:� All Fees Are Non -Refundable Unless Otherwise Stated PROJECT ADDRESS: PERMIT l 3lockklnisr n Si-,7 N2017- 0�103 2.40 NUMBER: A PLICA T: ble0. Permit Processing Fee: Qtv. Inspection Fee: Q Public Works Only $241.00 I I Public Works Field Inspection $165.00 0 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: TBD Monitoring Wells $502.00 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 Additional I THE FOLLOWING ITEMSRE APPROVAL FROM THE Revenue Division - t REVENUE DIVISION PRIOR TO -PAYMENT OF FEES Approval: R,TCr � 1 Qty. Qty. (Water Meter: Installation Charge $528.00" 'I 13/4" Meter $50.25 Water Meter Boxes: II" Meter $121.50 For Parkway & Sidewalk Area (Box + Cover= Cast 1 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 1 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 1 14" Meter $4,730.00 2" Meter: 27.00 + 162.00 $189.00P! Certificate of Compliance Fee (+100% 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 Easement/Vacation Fee (+100% of hrly over 4 hrs) $1,022.00 5200-5031 Street Tree Fee ($700 Planting Fee) TBD 030-2284 Engineering Tech: Total Amount Due: For Finance Use only Permit Specialist Receipt No. flusers/pbw/sharedlencmach/mastemlep front and back masteml Rev. 1/5/2017 epfeesheetbs-revised 1021/2016 ' Almendralo, Rodi From: Noble, Brian <brian.noble@cablecomllc.net> Sent: Thursday, August 03, 2017 7:16 AM To: Almendralo, Rodi Subject: 2401 Blackthorn St, Newport Beach Permit Request Attachments: 2401 Blackthorn St, Newport Beach SOWjpg Good morning Rodi, I need to get a permit to open up the street and fix a damage conduit in the SOW i am sending over I think the tree is damaging the conduit system. Brian Noble Field Supervisor CableCom of California, Inc 1251 N Jefferson St. Anaheim Ca. 92807 Cell: 714-681-3554 Phone:714 666 2400 Ext. 240 Fax: Email: brian.noble@cablecomllc.net This email, and any documents which may accompany it contain information which is intended for use only by the individual to whom it is addressed, and may contain information that is privileged, confidential and/or exempt from disclosure under applicable law. If the reader of this message is not the intended recipient any review, disclosure, dissemination, distribution, copying or other use of this message or its substance is strictly prohibited. If you have received this message in error, please contact me immediately to arrange for return or destruction. Thank you. This email message, and any documents which may accompany it, contain information which is intended for use only by the intended recipient(s), and may contain information that is privileged and/or confidential. If you are not the intended recipient of this message you are hereby notified that any review, disclosure, dissemination, distribution, copy or other use of this message or its attachments is strictly prohibited. If you have received this message in error, please notify the sender by reply email, delete the email from your computer and destroy all copies of the communication and any attachments. W101-1- 01+03 6/14/2017 City of Newport Beach Page 5 of 5 6:34:26AM INSP150 - Daily Inspection Request Report Requested Inspection Date : 08/14/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address: 2401 BLACKTHORN ST A/PID Information: Activity : N2017-0403 SubType: Status : APPROVED OWNER: KRUSE JOHN W Phone: 0 APPLICANT: CHARTER COMMUNICATIONS Phone : 714-681-3554 Description : Pothole to repair damaged CATV conduit. Pavement restoration per City Standards. Requested Inspection(s) Item: 10050 EXCAVATION- PW Requested Time: 8/14/2017 12:00:00AM Requestor: WEBUSER 714-448-7472 Entered By: WEBUSER Comments: ANY -Asphalt pot hole fix conduit Assigned to: zzzzzzzzuz` I Inspector: i Date: r I g 17 Time: b l 5� A PM Comments: l iAAk6i bb-0-1J IE - <�L i-4,F-D' `h -I ITIA F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet doc 8/16/2017 City of Newport Beach Page 3 of 11 4:30:34PM INSP150 - Daily Inspection Request Report Requested Inspection Date : 08/17/2017 Inspection Type: ENCROACH 'd Inspection Area: PW Site Address : 2401 BLACKTHORN ST SubType: Status: APPROVED OWNER: KRUSE JOHN W Phone: 0 APPLICANT: CHARTER COMMUNICATIONS Phone : 714-681-3554 )escriotion : Pothole to repair damaged CATV conduit. Pavement restoration per City Standards. Item: 10050 EXCAVATION- PW Requested Time: 8/17/2017 12:00:OOAM Requestor: WEBUSER 714-448-7472 Entered By: WEBUSER Comments: ANY -Asphalt pot hole fix conduit Assigned to: zzzzzzzzzzz' Inspector: Date: W 1-7 Time: AM PM Comments: file F:\Users\PB W\SharedlENCROACH\MASTERS\FORMS\InsaectorSheet.doc REPT131 Run Id: 4018 Vulcan Materials Company Calmat Co. SANTA ANA HMA 1401 E WARNER AVENUE Shipping Location: SANTA ANA, CA 92705 714-546-0622 Danger Read important health information on reverse. Peligro Lease la informacitin importante pare la salud an el reverso. RECEIVED BY: WEIGHMASTER: X RYAN SHADE DATE: 8/24/2017 TIME: 9:42AM PLANT: ' 4948-221 SANTA ANA HMA TICKET NO: 19005834 WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was Welgfi7� ored, ieasu or counted by a welghmaster, whose signature is on this certificate, who is a recognised authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the California Business and Professions Code, administered by the Division of Measurement Standards of the California Department of Food and Agriculture. We make deliveries Inside the out line at the customers risk only and accept no responsibility ermsoeveriord amage rasuding lrom such aellvenes ALL SALES AND DELIVERS MADE SUBJECT TO SELLER'S GENERAL TERMS AND CONDMONS. AS CARRIERENCED BY SHALL BE RI SPONSIkURE E FORENOi�RNGFSELLLLERELLER'S FACUTY CARRIER WHEN ANY TRACK OR TRAILERRHASEDGES THAT CARRIER BEEN OVERLOADED SOSAS TOLRENDERRIT TBLE OUT OFRTHE ACCURACY OF COMPLIAN[ WITH ANYIS VEHICLE'S APPLICABLE WFGEWEIGHT HT LIMITS. OLTHEEIGHTS AND GROSS MAXIMUM EXTENT ALLOWED BY LAW, CARRIER SHALL INDEMNIFY SELLER FOR ANY LOSS CAUSED BY OVERLOADING. TRUCK TARE AND GROSS WEIGHTS ARE DETERMINED WITH THE DRIVER IN THE VEHICLE. CUSTOMER: 213975 CK#: CUSTOMER PURCHASE ORDER: GOVT CONTRACT. CABLECOM LLC 15061 ORDER: FOB SANTA ANA* ZONEJMILES: 32369 FOB SANTA ANA DESTINATION: FOB SANTA ANA* PICKED UP OR DELIVERED: BLACKTHORN FOB 2401 BLACKTHORN NEWPORT BEACH PICKED UP PRODUCT: 300807 COMMENTS: 203 3C3 PG64-10 TRUCK NO.: CBL LICENSE: 63776J1 CARRIER: WQ89 VEHICLE TYPE: 76A TRAILER I ID: CUSTOMER PICKED UP OUST-UNCL TRAILER 2 ID: TARE DATE: 012412017 TARE EXPIRES: 09/01/2017 GROSS LETS TARE LEIS Iseele 0) NET LBS • • aLOADS TODAY FREIGHT TYPE A AXLES 0 21,040 17,060 3,980 1.99` 1.9 ;;;'; 1 GROSS LGL WIT 26,000 GROSS kg TARE kg NET kg NET AVID Mg TODW',)rt "ARRIVE JOB TART UNLOAD FINISH UNLOAD CASH SALE ONLY MATERIAL HAUL aver as a JOB TIME DELAY TIME PER TON TOTAL Tax .{Z1 \\wcn4948xv Sly. SNApex\MPORTNv CrxienrCHLETTER.Re$TANDING/ HAUL TIME APPROVAL f;..,'(, VMC-1850,02P1 Rev. 06115 �, yz v� it f r Mezcla de Pavimentacion de Asfalto Asphalt Paving Mix DANGER May cause cancer (Inhalation) Suspected of damaging the unborn child May causes damage to organs 44> (lung/respiratory system, adrenals, bone marrow, liver, lymph nodes, kidney, stomach, and thymus) through prolonged or repeated exposure Prevention • Obtain special instructions before use. Do not handle until all safety precautions have been read and understood. • Do not breathe dust, fume, or vapors. Use only outdoors or in a well ventilated area. • Avoid contact during pregnancy and while nursing. • Wash hands thoroughly after handling. • Do not eat, drink or smoke when using this product. • Wear protective gloves, protective clothing, eye protection, and face protection. Response PELIGRO Puede causer cancer (Inhalaci6n) Sospecha de danar el feto Puede causer dano a 6rganos (pulmones/sistema respiratorio, glandulas suprarrenales, m6dula 6sea, higado, ganglios linfaticos, rinon, est6mago y timo) a travels de la exposici6n prolongada o repetida Prevencion • Obtenga instrucciones especiales antes del uso. No maneje haste qua haya leido y entendido todas las precauciones de seguridad. • No respire polvo, humo o vapores. User unicamente al afire libre o an 6reas bien ventiladas. • Evite el contacto durante el embarazo y la lactancia. • Lavese bien las manos despu6s del manejo. • No comer, baba ni fume cuando utilize este producto • Use guantes de protecci6n, rope de protecci6n, gafas de seguridad y protecci6n pare la care. Respuesta • Si expuestos o preocupados: Consiga consejo/atenci6n • If exposed or concerned: Get medical advice/attention. m6dico. • Get medical advice/attention if you feel unwell. • Lave Is ropa contaminada antes de reutilizar. • Wash contaminated clothing before reuse. Storage • Store locked up. Disposal • Dispose of contents/container in accordance with all local, regional, national, and international regulations. Heated materials can cause thermal burns. Fumes from heated asphalt may be irritating to the eye, nose, and throat. Crystalline silica is known to the State of California to cause cancer. Read the Safety Data Sheet (SDS) before handling this product to determine the appropriate ventilation or respiratory protection necessary to safeguard your health. The risk of silicosis or lung cancer depends upon the duration and levels of silica exposure in the workplace. SDS can be obtained at www.vulcanmaterials.com or by calling 1-866-401-5424. Almacenamiento • Almacenar bloqueado. Eliminaci6n • Deseche el contenido/contenedor de acuerdo con todos los reglamentos locales, regionales, nacionales e internacionales. Material caliente puede causer quemaduras t6rmicas. Los vapores del asfalto calentado pueden ser irritantes pare los ojos, la nariz y la garganta. Estado de California reconoce que la silice cristalina causa cancer. Lea la Hoja de Ficha de Datos de Seguridad (SDS) antes de tener contacto con este producto pare determiner la ventilaci6n apropiada o la protecci6n respiratoria necesari pare proteger su salud. El riesgo de Is silicosis o del cancer pulmonar depends de la duraci6n y de los niveles de exposici6n a la slice en el lugar de trabajo. Puede obtener un SDS an www.vulcanmaterials.com o llamando al 1-866.401-5424. 8/23/2017 City of Newport Beach Page 18 of 18 4:30:38PM INSP150 - Daily Inspection Request Report Requested Inspection Date : 08/24/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 2401 BLACKTHORN ST Activity : N2017-0403 SubType : Status: APPROVED OWNER: KRUSE JOHN W Phone : o APPLICANT: CHARTER COMMUNICATIONS Phone : 714-681-3554 )escription : Pothole to repair damaged CAN conduit. Pavement restoration per City Standards. Item: 10020 PERMANENT PAVING- PW Requested Time: 8/24/2017 12:00:OOAM Requestor: WEBUSER Entered By: USR Comments: `'PM- s Assigned to : zzzzZZzzzzz" a _t< Inspector: V Comments: 471P'9'7l1l77e- 714-453 7868 Date: Y 17 1117 Time: Logged etiie F:\Users\PB W\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc /dJiNUT1l ..._ ...... ...... REPT131. Run Id: 4018 9i512017 City of Newport Beach Page s of 11 634:25AM INSPI50'- Daily Inspection Request Report Requested Inspection bate: 09/05/2017 Inspection Type: ENCROACH' Inspection Area : PW Site Address: 2401 BLACKTHORN ST Activity : N2017-0403:- SubType: Status : APPROVED OWNER: KRUSE JOHN W Phone: 0 APPLICANT: CHARTER COMMUNICATIONS Phone': 714-681-3554 Description : Pothole to repair damaged CATV`conduit: Pavement` restoration per City Standards. Item: 10250 FINAL - PW Requested Time: 9/5/2017 12:00:OOAM Requestort - WEBUSER 714-681-3554` Entered By: WEBUSER Comments: ANY -Final Inspection permit close out Assigned to: z777777777* Inspector: Date: 1S` Time: AM M Comments: DIGS/lr/,aL F:\Users\PB\AAShared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc i