HomeMy WebLinkAboutN2017-0443� t City of Newport Beach 11�1111 111111111111111111111111111111111111111111111111
s9 100 Civic Center Drive, Newport Beach, CA 92660 N 2 0 1 7 0 4 4 3
a Permit Counter Phone (949)644-3311
.Online Inspection Request-www.newportbeachca.gov/Online
'rc:raiu' ` Services
Permit No: N2017-0443
Project No:
Inspection Requests Phone (949)6443255
Job Address : 1900 SANTIAGO DR NB Thomas:Guide: 889C4
Description : Pothole to repair damaged CAN conduit. Pavement restoration per City Standards.
Parcel # :
1176-421-1 -
Legal Desc :
N TR 4224 LOT 298
Owner:
HOROWITZ MARTHA E
Phone:
0
Address :
1900 SANTIAGO DR
NEWPORT BEACH, CA
Applicant: CHARTER COMMUNICATIONS
Phone: 714-681-3554 [
Address : 7142 CHPAMAN AVENUE
GARDEN GROVE, CA 92841
Special Cond. :
Contractor: CABLE COM OF CALIFORNIA, INC
Phone: 714-666-2400
^v, g
g
Address : 1251 N.JEFFERSON STREET
ANAHEIM, CA
Contractor State Lic: 826295
License Expire : 0731, 2019
Business License : BT30061352
Business Expire : 10 30, 2018
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 :
Date:
Utilities Approval :
Date:
Traffic Approval :
Date:
General Services Approval :
Date: _/_/
Total Fee : $406.00
Paid: $406.00
Balance: $0.00
Receipt No:
Other Department : Date :
Permit Denied : Date:
Issued Permit: Date : / /
v� City of Newport Beach *N2017-0443*
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3311
u Online Inspection Request- www.newportbeachca.gov/Online
"tirvak Services
.I
Permit No: N2017-04431-
Project No :
Inspection Requests Phone (949)644-3255
Job Address: 1900 SANTIAGO DR NB Thomas:Guide: 889C4
Description: Pothole to repair damaged CATV conduit. Pavement restoration per City Standards.
Parcel#:
1176-421-1 -
Legal Desc :
N TR 4224 LOT 298
Owner:
HOROWITZ MARTHA E
Phone:
0
Address :
1900 SANTIAGO DR
NEWPORT BEACH, CA
Applicant: CHARTER COMMUNICATIONS
Phone: 714-681-3554 [
Address : 7142 CHPAMAN AVENUE
GARDEN GROVE, CA 92841
Special Cond. :
COMPUTEDSCANNED Contractor: CABLE COM OF CALIFORNIA, INC.
Phone: 714-666-2400
Address : 1251 N.JEFFERSON STREET
ANAHEIM, CA
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 :
/
/
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
Total Fee
$406.00
Paid :
$406.00
Balance :
$0.00
Receipt No:
Other Department:
—Date:
Permit Denied :
Date:
g�
Issued Permit:
Date
: / /
2.
3.
4.
5.
i
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-34 is required. For construction or
connection to sewer lines a valid State Contractor License Class C-42 is required.
All trenching and/or resurfacing shall conform to City Standard 105-L for parkway/roadway and City Standard 140-11,
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
utilities, a b the Public Works Department. Locate and pothole
over or within 5 feet of any City hlities, unless approved , y p
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
4TT box over the riser.
Properly lighted barricades must be provided and maintained around all trenches, excavations and obstructions. All
signs, flags, lights and other warning and safety devices shall conform to the requirements of the current "Manual of
Warning Signs, Sights and Other Devices for the Use in Performance of Work Upon Highways', issued by the
California Department of Transportation. If needed, barricades can be obtained from the City at a charge of $10.00
per barricade per day, with a minimum charge of $35.00. It is the responsibility of the applicant to place barricades to
protect the general public. Access to fire hydrants must be maintained at all times.
Work within or near beach sensitive areas will not be allowed during, City holidays, spring break, Memorial Day
weekend, summer between June 15 and September 15, and during the holiday season from December 19 to
January 1, unless approved by the Public Works Department.
Any work that extends into traffic or parking lanes and impedes the normal flow of traffic requires the applicant to
acquire a Temporary Street Closure Permit from the Public Works Department. Access for fire, police and
emergency vehicles must be maintained at all times. Traffic Control must be per Work Area Traffic Control
Handbook (WATCH). No nighttime traffic lane closures, unless prior approval has been granted. Any lane(s) closure
on a major street will only be allowed between 9:00 a.m. and -3:00 p.m. (Monday thru Friday), unless approved by
the Public Works Department. Any work affecting the State Highway's traffic or within the State Highway right-of-way
will require a Caltrans Permit. All vehicles shall be lawfully parked.
This permit does not authorize the closure of sidewalks, streets, or alleys for construction access, storage of
materials, or parking of construction vehicles unless detailed on an attached Temporary Street Closure.
Applicant must notify USA at 1-800-227-2600 2 days before starting any underground construction. Applicant
must notify all affected residents 24 hours in advance of restricted access and any inconveniences.
Refuse or unused materials shall be removed within 24 hours after completion of the work. If not removed, the City
may remove and bill the applicant. Coordinate alley closures with City's refuse pick-up daysby calling 949-644-3066
for the collection schedule so service is not interrupted. To place a dumpster 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) '
I certify that I have a Certificate of consent to self -insure, Certificate of Worker's
Compensation Insurance, or a Certified Copy thereof.
Date: 7/-s/l % Signature:
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 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 owner(s):
16, Homeowner, contractors, and subcontmcoos 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.
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
THEFOLLOWINIT
REVENUE DIVIS
Q Inspection Fee:
$241.00 1 I Public Works Field Inspection
$275.00 Utilities Field Inspection
General Services Inspection
Water Quality/Artificial Turf Inspection
$.00�
$192.00 Refundable Deposit:
192
$502.00 Improvements
$65.00= Newspaper Rack Inspection
$1
r Meter:
Jleter
$5C
Ater
$121
' Meter--
$28
'Turbine Meter
$70C
aer
$42€
rbine Meter
; $84:
aer
$3,31C
aer
$4,73C
?ter
e47 1 GC
101 1 Sewer Connection Fee
,I—=-
0 4TT Box & Cover
E APPROVAL FROM THE 90 PAYMENT OF FEES 1Al
Qty.
Installation- Charge
5 Water Meter Boxes:
;OF- For Parkway & Sidewalk
Q .
$165.00
$121.00
$165.00
$108.00
TBDBTBD
$108.00 0
$.00" $64
$64.00
ision
at .
$528.00
cl
I"Meter: 13.00 + 37.00 $50
2: Meter: 27.00 + 61.25 $88
For Traffic & Alley Areas (Box + Cover = C
1"' Meter: 13.00 + 38.00 $51
2" Meter: '27.00 + 162.00 $189
Certificate of Compliance Fee (+100% of hrly over 3 hrs)
$288.0(
Development Services Fee (Plan check hourly)
$155.00
Final Tract Map Checking Fee
$2,488.0(
Final Parcel Map Checking Fee - Moderate
$2,488.0(
Lot Line Adjustment Fee
$1,079.0(
Park Dedication Fee Zone
TBC
_
Street Easement/Vacation Fee (+100% of hrly over4 hrs)
$1,022.0(
Street Tree Fee ($700 Planting Fee)
TBC
5200-5029
5200-5015
5200-5026
5200-5027
5200-5028
405-470
5200-5031
030-2284
= Cost) <I
15
10 I
1
30 1
Engineering Tech:
Total Amount Due:
For Finance use only
Qoat
4`0(0. —
?ArtD
Permit Specialist
Receipt No.
(may dr
R —.To I Is tp
f:/usemlpbw/shamWencroachlmastemlep Ront and back masters/
Rev. 1/5/2017
epfeesheeLbs-revised 1012112616
'�'Almendralo, Rodi
From:
Noble, Brian <brian.noble@cablecomllc.net>
Sent:
Tuesday, August 29, 2017 3:52 PM
To:
Almendralo, Rodi; Richard Vega
Subject:
1900 Santiago Dr, Newport Beach Permit request
Attachments:
1900 Santiago Dr, Newport Beach SOW.pdf
Good afternoon Rodi,
We will need a permit for this job to pot hole the street to repair the damage drop conduit.
Brian Noble
Field Supervisor
CableCom of California, Inc
1251 N Jefferson St.
Anaheim Ca. 92507
Cell: 714-661-3554
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.
t42,011- 0445
1901 s81 ago Dr
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This job requires a city permit to
repair broken conduit.
X
`917/2017 City of Newport Beach Pages ors
4:30:36PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 09/08/2017
Inspection Type : ENCROACH
Inspection Area : PW
Site Address : 1900 SANTIAGO DR
Activity : N2017-0443
SubType:
Status: APPROVED
OWNER: HOROWITZ MARTHA E Phone: 0
APPLICANT: CHARTER COMMUNICATIONS Phone: 714-681-3554
)ascription: Pothole to repair damaged CATV conduit. Pavement restoration per City Standards.
Item: 10050 EXCAVATION- PW 4AGIL45 &Oi/L-1
Requested Time: 9/8/2017 12:00:OOAM Requestor: WEBUSER
714-681-3554
Entered By: WEBUSER
Comments: ANY -Repair broken service conduit
Assigned to : zzzzzzzzzzz`
Inspector: mil`[ Date: 4-7 Time: � - �PM
Comments: VIA ' 0") G mwU*126&TjDA.)
Nam'
egged
i2 ,films
F:\Users\PB W \Shared\E NC ROACH\MASTERS\FORMS\I nsoectorS heet.doc
.------------..._._..___._-.--- _. ------. _. -----_ ............-----
REPT131 Run Id: 4018
�a14/zolr City. of Newport Beach
6:34:68AM INSP150 - Daily Inspection Request Report
Requested Inspection Date : 09/14/2017
Inspection Type: ENCROACH
Inspection Area PW
Site Address : 1900 SANTIAGO'DR
Page 10 of 10
Activity : N2017-0443
SubType_:
Status : APPROVED
OWNER: HOROWITZ MARTHA E Phone: 0
APPLICANT: CHARTER COMMUNICATIONS Phone : 714-681-3554
Description : Pothole to repair damaged CATV conduit. Pavement restoration per City Standards
Item: 10050 EXCAVATION- PW
Requested Time: 9/14/2017 12:00:OOAM Requestor: WEBUSER
714-681-3554
Entered By: WEBUSER
Comments`. AM -Work to start
Assigned to: zzCzizzzzzzz
/`
Inspector: c 7 V" Date: Time: lD PM
cm�✓YJN�I�%
Comments:
iry!� 7ZC
Logged
Refile
F:\Users\PBW \Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
1217/2017 City of Newport Beach Page 7 of 15
4:30:53PM INSP150 - Daily Inspection Request Report
Requested Inspection Date :
12/08/2017
Inspection Type :
ENCROACH
Inspection Area:
PW
Site Address :
1900 SANTIAGO DR
Activity :
SubType:
Status: APPROVED
OWNER: HOROWITZ MARTHA E Phone: 0
APPLICANT: CHARTER COMMUNICATIONS Phone : 714-681-3554
: Pothole to repair damaged CAN conduit. Pavement restoration per City-StaTtd
N2017
item: 10020 PERMANENT PAVING- PW
Requested Time: 12/8/2017 12:00:OOAM Requestor:
714-681-3554
Entered By: WEBUSER
Comments: AM -Pot hole restoration
Assigned to: zuzzzzzzzz`
J V 12-1e11'7
9,- �� L
11212018' City ofiNewpo'r
s:aa:a"saran IN$P150 Daily I`nspectia
WEB,USER