HomeMy WebLinkAboutN2017-0445� t City of Newport Beach 111p[l111111111111111111111111111111111g1 as 100 Civic Center Drive, Newport Beach, CA 92660 2 0 1 7 0 4 4 5
Permit Counter Phone (949)644-3311
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Online Inspection Request- www.newportbeachca.gov/Online
z. Services
�CravA�*�
Job Address:
4501 CAMDEN DR NB
Description:
ARTIFICIAL TURF IN PARKWAY
Parcel # :
4750-120-1 -
Legal Desc :
N TR 3357 LOT 140r
Owner:
SPINNAKER DEVELOPMENT
Phone:
Address:
428 32ND ST
NEWPORT BEACH CA 92663
Applicant:
INSTANT LANDSCAPES
Phone:
949-347-0700 [
Address :
28562 OSO PKWY #D-243
RSM CA 92688
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Permit Processing Fee : $0.00
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 :
$108.00
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:
Date:
_/_/
Utilities Approval :
Date:
Traffic Approval :
Date :
General Services Approval:
Date:
Permit No: N2017-0445
Project No: 0776-2014
SCANNED
Inspection Requests Phone (949)644-3255
Thomas:Guide: 919F4
Contractor : INSTANT LANDSCAPES
Phone: 949-347-0700
Address : 28562 OSO PKWY #D-243
RSM CA 92688
Contractor State Lic: 842586
License Expire: 07 31, 2018
Business License :
BT30011792
Business Expire:
10 31, 2017
Workers' Compensation Insurance - -
Carrier:
WESCOINSURANCE
Policy No:
WWC3225863
W. C. Expire:
08 31, 2017
Total Fee
Paid:
Balance
Receipt No:
$108.00
$108.00
$0.00
Other Department: Date:
Permit Denied Date
Issued Permit : Date : / ° / , 17
-11FIFORM
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PROJECT ADDRESME
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DETAILED DESCRIPTION OF PROPOSED WORK:
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APPLICANT: V--1'Z-1 bl 1 \
Phone:
Email Address:
Mailing Address
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City/State/Zi
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Phone:
OWNER: cvc �c yw }-
Email Address:
M iling Address: City/State/Zip:
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CONTRACTOR: LPr\-vqS =c-
Office Phone:
Company (if different):
lJobsite Phone:
Other Phone:
Email Address:
Mailing Address:
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City/State/Zip:
State License Number & Class:
F6 -1Z`5k(. Expires: <<�
City Busines License Number:
t C�Z3O\( iZ Expires:l� ��-
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800Labor Code)'
Company:We5cO rw v e Policy No: WwG'5ZZ-%5 Expires: GT I k
REFUNDA®LEEP45S1TINfQRMATION{ffApp/iyab/e) ............. ....'.:..
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..ail .Refund To
Special Conditions of Permit: _
J
"`,kD,D,ITIQAiL'kPPROVkL REQlI1RED„FRQNI fHE,POtLQWINCa_`SEPARTNIEII[3
Utilities: Traffic: Fire:
General Services: Other:
Engineering Technician:
Publ" r Specialist:
D
I
Permit No.
Flusers/pb,WsheretlfencmecNmasterslepworksheeLrJs
C 1. cell -7—Cf '{ Public Works Department949-644-3311
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
Street/Alley/Walk Closure:
Traffic Control Plan Check
8-1/2" x 11"
24" x 36"
Additional
THE FOLLOU RI IT
RFVFNI IF nIVIS.
tter•
r
ter
•bine Meter
N2017-
QtV.
Inspection Fee:
Q
$241.00
Public Works Field Inspection
$165.00
$275.00
Utilities Field Inspection
$121.00
General Services Inspection
$165.00
Water Quality/Artificial Turf Inspection
$108.00
$817.00
$192.00
rl
Refundable Deposit:
TBDB
$502.00
Improvements
TBD
$65.00= Newspaper Rack Inspection $108.00 =
$65.00
Sewer Connection Fee $250.00
$143.00
4TT Box & Cover
$64.00
EQUIRE APPROVAL FREUM THE `
]Approval:
---_--
Revenue Division 'I
tORTOPAYMENTOFFEES
i
Qty.
4hr• 1
Installation Charge
$528 00, I
$50.25=
Water Meter Boxes:
1"
Meter:
13.00+ 37.00
$50.00�'
2:Meter:
'27.00+61.25
$88.25
For Traffic & Alley Areas (Box +
Cover = Cost)
"
Meter.
13 00+ 3 .0
$51.00
2"
Meter:
'27.00 + 162.00
$189.00
Certificate of Compliance Fee (+100% of hriy 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/VacationFee (+100%ofhriyover 4hrs)
$1,022.00
5200-5031
Street Tree Fee ($700 Planting Fee)
TBD
030-2284
Engineering Tech:
Total Amount Due:
For Finance use Only
lob
Perm' ecialist
Receipt No.
f /users/pbw/shared/encroach/masters/ep front and back masters/
i Rev. 1/5/2017
epfeesheat As -revised 10/21/2016
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 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 tie: 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 lariats) 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.
WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code)
certify that I have a Certificate of consent to self-' ure, C ' icate of Worker's
Corripeirisation Insurance or a Certified Copy en
Date. ^3�( 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. I shall indemnify
and hold the City harmless for any liability associated with the minor
encroachments.
Date: Signature:
24-hour notice for Encroach en Pefrryit Inspection is required by calling
Public Works at 949-644-331t/O�—
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. 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 front only. Additional work
performed may require issuance of a separate permit and/or additional fees.
'Nr�y CITY OF NEWPORT BEACH
n Artificial Turf - Maintenance Standards and Installation Guidelines
e+c ruY}` a Council Policy L-6 Private Encroachments in Public Rights-Of-W
Permit Number:. Date : /f
The use of artificial turf shall be governed by the following standards:
(1) Materials Minimum Specifications.
a. Artificial turf shall be of a type known as cut pile infill and shall be manufactured
from polypropylene, polyethylene, or a blend of polypropylene and
polyethylene fibers stitched onto a polypropylene or polyurethane meshed or
hole -punched backing.
b. Hole -punched backings shall have holes spaced in a uniform grid pattern with
spacing not to exceed four inches by six inches on center.
c. Soil stabilizing filter fabrics shall be rated to perform for a minimum of 15 years.
d. See detailed specifications at www.asgi.us
(2) Installation.
Site preparation is extensive for artificial grass and should be done by a professional
installer. Pursuant to the Contractor's State License Board, synthetic grass installers
must have a classification "A" (General Engineering), "B" (General Contractor), C-27
(Landscaping), or C-61/0-12 (Synthetic Products) Contractor's License.
Artificial turf shall be installed in accordance with the manufacturer's specifications and
in accordance with the Association of Synthetic Grass Installers (ASGI) guidelines.
Artificial turf shall be maintained in a manner to mimic healthy living turf, including
the following:
a. Sod or existing groundcover shall be removed prior to installation of any
artificial turf.
b. Artificial turf shall be installed over a compacted and porous road base material
that is a minimum of two inches deep.
c. Underlayment fabric shall be no less than 4 ounces per sq. ft.
d. Artificial turf shall be anchored at all edges and seams.
e. All artificial turf seams shall be glued and not sewn.
Artificial turf shall be maintained by the property owner in a fashion so as
to mimic the appearance of a flourishing, maintained lawn without any of
the following:
fading
• visible seams
• gashes, dents or ruts
• damaged areas or stains
• worn-out unnatural appearance
• odors or a matted appearance
f. All parkway trees, new and existing, shall have the artificial turf cut and
anchored a distance no less than 24 inches around the tree base. A layer of mulch
shall be placed and maintained to cover the base of all parkway tree(s). All
parkway tree(s) shall be provided irrigation or hand watered during the tree(s)
establishment period and/or if the tree(s) are in need of watering. It is the
homeowners responsibility to maintain a sufficient watering schedule to
maintain the health of the tree(s).
(3) Maintenance.
Do: Clean, sanitize, brush, and remove debris.
a. Cleaning shall be done with non -toxic, biodegradable products. Any discharge
of wash/waste water or cleaning materials shall be prevented from entering the
gutter and storm drain system.
b. Hand rake worn turf areas.
c. Repair depressions to maintain an even visual surface.
d. Brush back any loose infill that has been washed or moved off the turf.
e. Eliminate any odors, flat or matted areas, weeds, loosened edges at seams or
elsewhere.
f. Replace artificial turf when maintenance or repair is unable to simulate a healthy
living turf.
Do Not: Install indoor/ outdoor carpet or allow runoff or weeds
a. Wash down artificial turf area so as to allow runoff.
b. Install artificial turf up to the base of the parkway tree(s) less th 24 inch
diameter around tree base.
c. Allow weeds to grow along perimeter or through any seem.
d. Install "indoor/outdoor' carpeting type material in lieu of artificial turf as set
forth in the Association of Synthetic Grass Installers (ASGI) guidelines.
References:
Landscape architects and installers: wwzo.cica.oro
Artificial turf installation guidelines: zowzo.asgi.us
Landscape rebates: www.watersneartnewport.org
I understand the information provided me and my responsibility as a homeowner to
install and maintain the parkway and tree(s) if any existing or future plantings in a
manner as written above and abides by council Policy Ir6.
Property Address: � C n�^ /� ✓ Date6'� �_ 30 � 1
Homeowner Si aturWDAVAJ—
Name: (71 6(Tj
�.
sa tr
City of Newport Beach IN I1Il�llgl1111 illl�lllpl�l
100 Civic Center Drive, Newport Beach, CA 92660 2 0 1 7 0 3 1 3gN
Permit Counter Phone(949)644-3311
Online Inspection Request- www.newportbeachca.gov/Online��a
Permit No: N2017-0318
Project No: 1320-201 5
�4
V�Services a V
Inspection Requests Phone (949)6443255
Job Address:
1606 LINCOLN LN NB
Thomas:Guide:
889C5
Description :
2 new curb cores per City Sid
Parcel # :
1176-210-5 -
Legal Desc :
N TR 3851 LOT 33
Owner:
Phone:
WHEELER JUSTIN
F
5�d
Contractor:
Phone:
INSTANTLANDSCAPES
949-347-0700
Address :
1606 LINCOLN LN
Address :
28562 OSO PKWY #D-243
NEWPORT BEACH, CA 92660
RSM CA 92688
Contractor State
Lic: 842586
Applicant:
INSTANT LANDSCAPES
License Expire :
07 31, 2018
Phone:
949-347-0700 [
Address :
28562 OSO PKWY #D-243
RSM CA 92688
-
Business License: BT30011792
Business Expire:
10 31, 2017
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation
Insurance - -
Carrier:
WESCOINSURANCE
Policy No :
WWC3225863
W. C. Expire:
08 15, 2017
Permit Processing Fee : $241.00
Sewer Connection: $0.00
Total Fee $406.00
Agreement Fee:
$0.00
4TT Box Cover: $0.00
Paid: $406.00
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: $0.00
Processed By:
Utilities Approval :
Traffic Approval :
General Services Approval
Date
Date
Date
Date
Other Department :
Permit Denied : Date : /_/_
Issued Permit: Date : &/
WORKS EET FOR ENCROACHMENT PERMIT
CITY 9F NEWPORT,BEACH a
PUBLIC WORKis=REPAk TMENT .;
PROJECT ADDRESS: 6 (� vt ry Z_yN
DETAILED DESCRIPTION OF PROPOSED WORK:
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APPLICANT: J 11 Phone:
Email Address:
Mailing Address: City/State/Zip:
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OWNER: ��S-T1 NJ W — Phone:
Email Address:
Mailing Address: Clty/State/Zip:
ZC6o PKwT DZ l3 S✓V� C�4 GlZE,B�
ALL CONTRACTOR INFORMATION IS REQUIRED
-PLEASE COMPLETE
CONTRACTOR: t,Y5T -V L r/ 1 —
Office Phone:
Company (if different):
Jobsite Phone:
Other Phone:
Email Address:
Mailing Address:
7�S�Z OSb (? J`r # D2">3
City/StatelZip:
CESAA Gt� �t26k5f
State License Number & Class: r/
-(Z G Expires:
City Business License Number:
OO ( rq 9'Z Expires: (U I
ORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company:VJ'C�-G i7 Policy No: WWC-S7-ZS`665Expires:05 II
............................ I ......,...., ..............:::::•.::.
FEFf)M1(UA@L:44PQ1$IT:INFORM�LTIQN:(ff Appl�C2#�/e►:::i :: i:2 :'i:=>i :`: is>::5:=>ii ;: :Yi:
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FOR OFFICE USE ONLY
Special Conditions of Permit: r
it —ti J
)
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
General Services:
Traffic: Fire: 0
F-1 Other:
Engineering Technician:
Public ecialist:
Date::
Permit No.
f:luserslpbw/shawdiencmacWmasWm(oprmrksheeWs { _
Public Works Department 949-644-334i
ra�oe,ot�#41' cx,�axayonar,.:auunwu-wtocr
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 otj
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 Pennittee 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 tie: 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 lariats) 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.
WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code) ,
yrti�ftra,t, I have a Certificate of consent to self -in e, Certificate of Worker's
rapon Insua Cart' led Copy there .e: } ignature:
CERTIFICATE OF EXE . TION (Section abor Code)
I certify that in the performance of the work under this permit, I shall not emplot
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 Compensatior
provisions of the State Labor Code, I must comply with the provisions of Sectior
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 at
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 th(
encroachments. I will be responsible for replacing the improvements if the Cit)
removes them for maintenance of utilities or other public need. 1 shall indemniy
and hold the City harmless for any liability associated with the minor
encroachments.
Date: Signature:
24pour notice for Encroachment mit Inspection is required by callinc
Pjlblic Works at 949-644-3311.
i5,,Any above ground utility facilities will require documented approval from the adjacen
affected property owner(s).
16. Homeowner, contractors, and subcontracoirs may each be liable for violations of Wate
Quality Laws. Best Management Practices will be enforced. It is against the law t(
discharge construction debris into the gutter and storm drain. Felony violations of Wale
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 Compactior
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 inspectior
before a refund will be processed.
18. No trees in the public right-of-way shall be planted, removed, trimmed, or relocate(
without approval from the General Services Department.
19. All work in the public right-of-way must meet the approval of the Public Work;
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 previouslt
approved by Public Works and an Encroachment Agreement has been processed.
21. Permit is valid for "description' of work noted on front only. Additional wort
performed may require issuance of a separate permit and/or additional fees.
rrcudca. i wuumr-00; rcrcm1
(( 0o(o ���/l /'FFi�. NUMBER: N2017- n3i
Permit Processing Fee:
Inspection Fee:
Public Works Only
$241.00
Public Works Field Inspection
$165.00
Other Department
$275.00piT
Utilities Field Inspection
$121.00
General Services Inspection
$165.00
Agreement Fee:
Water Quality/Artificial Turf Inspection
$108.00
Preparation of Report/Agreement
$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
___
THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE —_ Revenue Division �
1 REVENUE DIVISION PRIOR TO PAYMENT OF FEES JApproval:
J
1
tr�
(Water Meter:
Installation Charge
$528.00I I 7
I
13/4" Meter
$50.26
'
Water Meter Boxes:
l
11a Meter
$121.50
For Parkway & Sidewalk Area (Box
+ Cover = Cost
11 1/2" Meter
$285.00
1" Meter. 13.00 + 37.00
$50.00 )
11 112"' Turbine Meter
$700.00
2: Meter: 27.00 + 61.25
$88.25
12" Meter
$425,00
_
12" Turbine Meter
$845.00
For Traffic & Alley Areas (Box + Cover = Cost) 1
13" Meter
$3,310.00
1 ' Meter: 13 00 + 38.00
$51.00F
�4" Meter
$4,730.00
2" Meter: 27.00 + 162.00
$189.00
!6" Meter
$7 190 0a''
Certificate of Compliance Fee (+g00% 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/VacationFee (+100%ofhrlyover 4hrs)
$1,022.00
5200-5031
Street Tree Fee ($700 Planting Fee)
TBDI
030-2284
Engineering Tech:
Total Amount Due:
For Finance use only
ou
Permit Specialist
Receipt No.
f lusers/pbw/shared/encroach/masters/ep front and back masters/
Rev. 1/5/2017
epfeeshee6zls-revised 10121/2016
912012017 City of Newport Beach Page 3 of 16
4:30 37PM 1NSP150 - Daily Inspection Request Report
Requested Inspection Date: 09/21/2017'
Inspection Type: ENCROACH
Inspection Area: PV1l
Site Address : 1606 LINCOLN LN
Activity : N2017-031:8
SubType: NEW
Status : APPROVED
OWNER: WHEELER JUSTIN Phone:
APPLICANT: INSTANT LANDSCAPES Phone : 949-347-0700
Description : 2 new curb cores per City Std instantlandscape@aol.com
Item: 10250 FINAL - PW
Requested Time: 9/21/2017 12:00:OOAM Requestor: NBIVR
9497950648
Entered By: NBIVR
Comments: AM
Assigned to: ` I
Inspector: Date: `L� 1 Time: AM PM
Comments:
EI E
F;\Users\PBNAShared\ENCROACH\MASTERS\FORMS\Ins ectorSheetdoc - -
REPT131_ - Run Id: 4018