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HomeMy WebLinkAboutN2017-0367City of Newport Beach II�I�II�III�I����lllll�q II Permit No: N201 `T-036 G 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone(949)644-3311 Project No: 1924-2016 SCANE:. Online Inspection Request - www.newportbeachca.gov / Online t`�s x. Services ' r8F5 Inspection Requests Phone (949)644-3255 Job Address : 407 SNUG HARBOR RD NB Thomas:Guide: 889A6 Description : PLUG EXISTING DRIEVWAY APPROACH PER STD 165-L, CONSTRUCT NEW DRIVEWAY APPROACH PER STD 164-L, NEW CURB DRAIN PER STD 184-L, NEW 60" BOX TREE IN PARKWAY, NEW CONCRETE CARRIAGE WALK - STND GRAY. Parcel # : 0492-530-6 - Legal Desc : N TR 1218 LOT 136 Owner: SEDONA HOMES INC Contractor : GRAYSTONE CUSTOM BLDRS INC Phone: Phone: 949-466-0090 Address: 407 SNUG HARBOR RD Address : 3419 VIA LIDO STE 455 NEWPORT BEACH, CA 92663 NEWPORT BEACH CA 92663 Contractor State Lic: 971085 Applicant: GRAYSTONE CUSTOM BLDRS INC License Expire : 03 31, 2018 Phone: 949-466-0090 [ Address : 3419 VIA LIDO STE 455 NEWPORT BEACH CA 92663 Business License : BT30040057 Business Expire : 03 31, 2018 Special Cord.: PRE -CONSTRUCTION MEETING REQUIRED Workers' Compensation Insurance - - Carrier: WC EXEMPT Policy No: (NO EMPLOYEES) W. C. Expire: Permit Processing Fee : $241.00 Sewer Connection : $0.00 Total Fee $786.00 Agreement Fee: $0.00 4TT Box Cover: $0.00 Paid: $786.00 Traffic control Plan Check : $0.00 Total Water Meters : $0.00 Balance: $0.00 Inspection Fee : $495.00 Water Meter Connection : $0.00 Receipt No: Refundable Deposit: $0.00 Total Water Meter Box: $50.00 Street Tree Fee : $0.00 Adjustment : $0.00 Processed By: Date : _/_/_ Other Department : Date Utilities Approval : Date : /_/_ Permit Denied : J -Date: _/_/_ Permit Date: 7/t 3t� O Traffic Approval : Date : _/_/ Issued : General Services Approval : Date p R - - =- ^`�33 �Q E _-=R ry V PROJECT ADDRESS: Z DETAILED DESCRIPTION OF PROPOSED WORK: �rlv � Y.etc -�.-6 �ir�l � ✓ ak �z-c.. %� Cr�'L COxY.e-tom 2Y✓2 .c. dlJ2��� APPLICANT: g lPhone: g - d d • O 10 4— Email Address:. Mailin Addrgess: 3 Uo ,Gies <!Sr CitylStatet 'p: N 926<3 OWNER: .12Phone: Email Address: Mail Add %IQ y City/StatetZi� c�jr C# 9Z&C3 ALC G�OIVTRf�#�TOR INFORICAATIQNI!S.EE .VE©SEaQ[VIPI PTE CONTRACTQR: Office Phone: 9y7� �O t90 Company (if different ; ewyVll" eA3&n 641 0&64 Jobsite Phone: Other Phone: Email Address: 24 Z ho4" Mailinq Address: vie Lino yrs City/State/ 'p: .ruv icuC� 5�63 State License Number& ass: 9V% Q8'S' Expires: City Business License Number: 43-r3O0 C100S--2 Expires: WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code) Company: Policy No: Expires: REFUNDA LEbI.OMIT)NFQRIVIATILIN.(%fApp/l ab(e ..... ;.,: RePttnd �!a`able T�1 s _ .:..... ..... .:.....:. :.:;....._ .. ....... Ma{I Refund To :. 7777 ,FQRQFFICE,(J$EO,(YLY:n rr Special Conditions of Permit: - 7m /L,o ADDITI,QNAC AP,PR.OVAL` REQUIRED FROM T((E FOLCZ111�lING DEP�kRTf(IIEN FS F , .,,, Utilities: General Services: Traffic: Fire: �J Other: Engineering Technician: Publicaq! rks Specialist: (l Date II J Permit No. F.Nsersfpb�WsheretlkncroaclVmasfetsfepwarl¢heeLak Public Works Department 949-644.3311 Permit Processing Fee: Public Works Only Other Department Agreement Fee: Preparation of Report/Agreement Document Recordation Fee Monitoring Wells StreeVAlley/Walk Closure: Traffic Control Plan Check 8-1/2" x 11" 24" x 36" Additional THE FOLLOWING REVENUE DIVI! Inspection Fee: $241.00 Public Works Field Inspection $275.001t Utilities Field Inspection General Services Inspection Water Quality/Artificial Turf Inspection $817.00 $192.00 Refundable Deposit: $502.00 Improvements $65.000 Newspaper Rack Inspection $65.00 Sewer Connection Fee $143.00 4TT Box & Cover $1" 0 $121.00 $165.00 $108.00 TBD BTBD $108.00 $$64.00� 64.00 rislon RtY• City. 3 1 (Water Meter: Installation Charge $526.00 13/4" Meter $%25 Water Meter Boxes: 1 11" Meter $121,50 For Parkway & Sidewalk Area (Box +Cover = C t 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 1 12" Turbine Meter 13" Meter $845,00 $3,310.00 For Traffic ;& Alley Areas (Box +Cover = Cost) 1 1"' Meter. 13.00+38.00 $51,00� 1 I4" Meter $4,730.00 2" Meter: '27.00 + 162.00 $189.00 1 16" Meter $7,190.00 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/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 C�� Permit SpAciallist Receipt No. flusers/pbw/sharetl/encroach/masters/ep front and back masters/ Rev. 1/5/2017 epfeeshest xls-revised 10/21/2016 i�z�f-z�« L - 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 pennit. 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 whenhazardous 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 orderedipoured. 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. W. 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 ar 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)- " - certify that 1 have a Certificate of consent to self -insure, Certificate of Worker's Compensation Insurance, or a Certified Copy thereof. - Date: Signature: CERTIFICATE OF EXEMPTION (Section 3800 Labor Code) certify that in the performance of the work under this permit, I shall not employ any person so as to become subject to Califor ' rs compensation Laws. If, after signing this certificate I become subker's Compensation provision of the State Labor Code,Aff he rovisions of Section 3700 or is er it shall be deemed Date: /3 �� Sig—� CONTRACTOR LIC NSE XEMPTION As the Owner of the benefiting property, Ice fy 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: Signat 24-hour notice for Encroachment ermit s ction is required by calling Public Works at 949-644-3311.. 15. Any above ground utility facilities will r quire documented approval from the adjacent affected property owner(s). 16. Homeowner, contractors, and subcontra tis may each be liable for violations of Water Quality Laws. Best Management Prac ices 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 o t only. Additional work performed may require issuance of a separate permit and r additional fees. AND GUTTER, ANU ALLt f IQ I IAL" , , , .......... . INFRASTRUCTURE ARE DEEMED SUBSTANDARD, ANEW 1-INCH WATER SERVICE, WA I ER Mt I to DUA, LATERAL AND/OR CLEANOUT WITH BOX AND LID WILL BE REQUIRED. 100 % OF THE COST SHALL BE BORNE BY THE PROPERTY OWNER (MUNICIPAL CODES 14.24.020 AND 14.08.030). SAID DETERMINATION AND THE EXTENT OF THE REPAIR WORK SHALL BE MADE AT THE DISCRETION OF THE PUBLIC WORKS INSPECTOR. 2. SEPARATE PERMIT FOR FENCES AND WALLS SHALL BE OBTAINED AT THE SAME TIME AS THE BUILDING PERMIT 3, ALL WORK RELATED TO WASTEWATER IN THE PUBLIC RIGHT -OF- WAY SHALL BE PERFORMED BY A C42 LICENSED SANITATION SEWER CONTRACTOR OR AN A LICENSED GENERAL ENGINEERING CONTRACTOR. 4, AN APPROVED ENCROACHMENT PERMIT IS REQUIRED FOR ALL WORK ACTIVITIES WITHIN THE PUBLIC RIGHT-OF-WAY. 5. AN ENCROACHMENT AGREEMENT IS REQUIRED FOR ALL NON-STANDARD IMPROVEMENTS WITHIN THE PUBLIC RIGHT OF WAY. ALL NON-STANDARD IMPROVEMENTS SHALL COMPLY WITH CITY COUNCIL POLICY L-6 AND L-18. 6. ISSUANCE OF A BUILDING PERMIT BY THE CITY OF NEWPORT BEACH DOES NOT RELIEVE APPLICANTS OF THE LEGAL REQUIREMENTS TO OBSERVE COVENANTS, CONDITIONS AND RESTRICTIONS WHICH MAY BE RECORDED AGAINST THE PROPERTY OR TO OBTAIN PLANS. YOU SHOULD CONTACT YOUR COMMUNITY ASSOCIATIONS PRIOR TO COMMENCEMENT OF ANY CONSTRUCTION AUTHORIZED BY THIS PERMIT CONSTRUCTION NOTES: (J1 CONSTRUCT 6" MIN CONCRETE DRIVEWAY O CONSTRUCT 4" MIN CONCRETE HARDSCAPE. �3 INSTALL 4" SQ GRATE DRAIN ® INSTALL 4" ATRIUM GRATE DRAIN O5 INTALL 8" SQ GRATE DRAIN © CONSTRUCT BIO-RETENTION PLANTER PER DETAIL O CONSTRUCT 3"0 DRAIN THRU CURB PER CNB STD PLAN 184-L ® INSTALL 4" PVC SDR 35 DRAIN LINE, S=0.01 MIN �9 INSTALL 4" WIDE CHANNEL DRAIN 10 CONSTRUCT CONCRETE DRIVEWAY APPROACH PER STD PLAN 164-L 11 REMOVE & PLUG EAST CONCRETE DRIVEWAY PER STD PLAN 165-L. 12 INSTALL NEW SEWER CLEANOUT PER STD-406-L ON EXISTING SEWER LATERAL. FIELD VERIFY 13 PLACE TRAFFIC RATED BOX AND COVER ON EXIST WATER METERS. 14 PLANT 60" BOX MAGNOLIA "SAINT MARY" TREE SNUG HARBOR ROAD IS ON THE CITY'S STREET/ALLEY-CUT MORATORIUM LIST. TRENCHING INTO SAID STREET AS A PART OF THIS DEVELOPMENT WILL REQUIRE EXTENSIVE STREET REPAIR WORK. DETAILS OF SUCH REPAIR WORK MAY BE OBTAINED FROM THE PUBLIC WORKS DEPARTMENT. I EXIST GROUND-1 EXCAVATION I iv UPSTREAM GRATE BIO-RETENTION SECTION C-C 1 "=4' z DROUGHT TOLERANT PLANTING — �o g PERFORATED PIPE FG 3" MULCH 77777 GLUED UPSTREAM JOINTS—TYP qAC J /JJjfJJ/ IOF MX OF S,�IJD,J J 4" DRAIN LINE WAND, ORGANIC MATERIA✓�/ RETAINING CURB 3" DRAIN TO CURB 3/4"CRUSHED ROCK WRAPPED IN FILTER CLOTH EX EXIST GF ELEVATION CURB --1 4" ATRIUM DRAIN f GROUND rw rn I SrAR,GWE_ ..__ FD Nl-11 \ SWALE DETAIL 1"=4' 01(4F .29 EXIST GROUND 30' /I NEW CURB I LAWN3FI= N EXIST LA —R ELD VERIFY INS, Kommi / LAWN 101.10 TG 4 100.38 IE PA FD NT43. 19, WATER I CURB DRAIN I IE'--- RELOCATE GAS METER ONTO PRIVATE PROPERTY I I I I I I A ' 12 Q I� I0 0 m I Q ENTIRE LANDSCAPING I WITHIN THE PUBLIC RIGHT OF Wqy SHALL BE DROUGHT TOLERANT U) W TREE 14 I �.t .. 3& „r I _ 2' ROLLED CURB T.B.M. TEMPORARY BENC TC TOP OF, CURB TF fop br .FOOTING TG TOP QE GRATE TOC TOP OF CJNCRET TS TOP OF SEAL TIN TOP OF WALL. F.F. z 5" CONCRETE m� 2" SAND PLA`K, FILT d z 4" CRUSHED ROC N � TYPICAL EXTERIOR FINISH GRADE NTS t 1 EDff ('T PROPERTY V MIN HEIGHT 2 BAGS MIN. GRAVEL BAG DETAIL NTS 8' MIN EXISTING GROUND PROVIDE APPROPRIATE TRANSITION BETWEEN STABILIZED CONSTRUCTION ENTRANCE AND STREET CONSTRUCTION ENTRANCE NTS N 110=81 100.00 ELEVATION LEGAL DESCRIPTION: LOT 136 OF TRACT NO. 1218 PRECISE GRADING PLAN 407 SNUG HARBOR RD. sl 7/1312017' City of Newport Beach Page 14 of 14 ` "4:31:01PM INSP150 - Daily Inspection Request Report Requested Inspection Date : 07/14/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 407SNUG HARBOR RD Activity: N2017-0367 SubType: NEW Status : APPROVED- OWNER: SEDONA HOMES INC Phone': APPLICANT: GRAYSTONE CUSTOM BLORS INC Phone : 949-466-0090 -` Description : PLUG EXISTING DRIEVWAY APPROACH PER STD 165-L, CONSTRUCT NEW DRIVEWAY APPROACH PER STD 164-L; NEW CURB DRAIN PER STD 184-L; NEW 60" BOX TREE IN PARKWAY, NEW CONCRETE CARRIAGE WALK - STND GRAY. Item: 10200 PRE JOB - P Requested Time: 7/14120 Requestor:` WEBUSER Entered By: WEBUSER Comments: AM - Assigned to: zzzzzzzzzzz* Inspector: Date: Time: q ;M Comments: ' —: N D T ctl- i% -=>T P az , Lore Refiile S 5 c MA cI P-A-y s 1aAvS; t 04rya to 1 L ucles rzz F:1Users\FBW1Shared\E CN ROACHIMASTERS\F� MSllnsoectorSheet doc REPT131 Run-3d: 4018 NTOQ wP03 4 STP49 = Pbwopy "wosc*Ps 4iq - �i8- �ayZ Inspector: Date: G l i / Time: !30M A p (ice/ �'GlL . GG G �Lw i41�P�2p9 Crf Comments: _u H Logged Refiie FilUsers\PBMSharedlENCROACHIMASTERSIFORMS\Ins ectorSheet.doc REPT131 ---- - Run Id: 4018 r 5/2017 City of Newport Beach Page a of 14 �•'6:34:33aM INSP150 - Daily Inspection Request Report Requested Inspection Date: 07/25/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 407'SNUG HARBOR RD Jill Activity : N2017-0367 SubType: NEW Status : APPROVED OWNER: SEDONA HOMES INC Phone APPLICANT: GRAYSTONE;CUSTOM BLDRS INC Phone : 949-466-0090 Description : PLUG EXISTING DRIEVWAY APPROACH PER STD 165-L, CONSTRUCT NEW DRIVEWAY APPROACH PER STD 164-L,.NEW CURB DRAIN PER STD 184-L, NEW 60" BOX TREE IN PARKWAY, NEW CONCRETE CARRIAGE WALK- STND GRAY. - Item: i ia'H'lS', 44^1i'. Requested Time: 7/25/2017 12:00:OOAM Requestor: NBIVR Entered By: NBIVR 9494660900r, Comments: AM Assigned to r Inspector: ly Date: 7 �Z /' Time: f S` A PM Comments: � ` 17 17/7.,! :g,.... ILI- A/01 c i i�`(�' G G Svc rze.le- Lowed Refile F:\Usem\PBW\Shared\ENCROACH\MAST ERS\FORMS\InspectorSheet.do FORMS\Ins e ctorShe o et.doc Permit Processing Fee: Q Inspection Fee: Qt . 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: Water Quality/Artificial Turf inspection $108.00 Preparation of Report/Agreement $817.00 9 Document Recordation Fee $192.00 Refundable Deposit: TBDP Monitoring Wells $502.00 Improvements TBD Street/Alley/Walk Closure: $65.00= 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 ___ ___ j THE FOLLQWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division lApproval: 1 REVENUE DIVISION PRIOR TO PAYMENT OP. FEES j 1 Qty. rat "] 1Water Meter: Installation Charge ' `I $528.00 I I 13/4" Meter $50,25 ' Water Meter Boxes: 11" Meter $121,50 For Parkway & Sidewalk Area (Box + Cover = Cost) 111/2"Meter $285.00 : 1"Meter. .1300+37.00 $50.00� 11 1/2"Turbine Meter $700.00 2: Meter: 27.00+ 61.25 1 $88.25 1 12" Meter $425,00 12" Turbine Mete 13" Meter $845,00 $3,310.00 For Traffic & Alley Areas (Box + Cover = Cost) 1 1" Meter: 13.00 + 38.00 $51.00 �4" Meter $4,730.00 2" Meter: 27.00 + 162,00 $189.00� i6" Meter $7,190.00 .` i 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/VacationFee (+100%ofhriyover 4hrs) $1,022.00 5200-5031 Street Tree Fee ($700 Planting Fee) TBDI 030-2284 Engineering Tech: Total Amount Due: For Finance use only ;2o ; oil-?. — ?A -ID Spy -1 j Permit Specialist Receipt No. 14 R - ��9 Elusers/pbwlsharetl/encroach/masters/ep front and back masters/ W3 Rev. 1/5/2017 epfeesheetAs-ravised 10/21/2016 Orlveway approotlo eo„sirucled wi�b I Inal colored concre{p yyi}}� a liyh}ly e><po9¢d . �`� " I a59re9ode �tnlsh . I I I O En4'y wolkwoy 0 G -" �4nswuc}ea wii'h m 9r41 coloreacencftl-, Q WA G liq'%41 elpoSed 2 �99�eyo}C Cnish. I j Z c I Exhibit "A" I Sheet 1 of 1 I State of California S W� Secretary g. of State a Statement of Information F150461 (Domestic Stock and Agricultural Cooperative Corporations) FEES (Filing and Disclosure): $25.00. ' LE D FILED If this is an amendment, see instructions. IMPORTANT — READ INSTRUCTIONS BEFORE COMPLETING THIS FORM In the office of the Secretary of State of the State of California 1. CORPORATE NAME SEDONA HOMES, INC. SEP-23 2014 2. CALIFORNIA CORPORATE NUMBER C1978559 This Space for Filing Use Only No Change Statement (Not applicable if agent address of record is a P.O. Box address. See instructions.) 3. If there have been any changes to the information contained in the last Statement of Information filed with the California Secretary of State, or no statement of information has been previously filed, this form must be completed in its entirety. If there has been no change in any of the information contained in the last Statement of Information filed with the California Secretary of State, check the box and proceed to Item 17. Complete Addresses for the Following (Do not abbreviate the name of the city. Items 4 and 5 cannot be P.O. Boxes.) 4. STREET ADDRESS OF PRINCIPAL EXECUTIVE OFFICE CITY STATE ZIP CODE 1536 DOLPHIN TERRACE, CORONA DEL MAR, CA 92625 5. STREET ADDRESS OF PRINCIPAL BUSINESS OFFICE IN CALIFORNIA, IF ANY CITY STATE ZIPCODE 73540 DALEA LANE, PALM DESERT, CA 92260 6. MAILING ADDRESS OF CORPORATION, IF DIFFERENT THAN ITEM 4 CITY STATE ZIP CODE 40101 MONTEREY AVE. 131-214, RANCHO MIRAGE, CA 92270 Names and Complete Addresses of the Following Officers (The corporation must list these three officers. A comparable title for the specific officer may be added; however, the preprinted titles on this form must not be altered.) 7. CHIEF EXECUTIVE OFFICER/ ADDRESS CITY STATE ZIP CODE LANCE ALACANO 1536 DOLPHIN TERRACE, CORONA DEL MAR, CA 92625 8. SECRETARY ADDRESS CITY STATE ZIP CODE ELISHA ALACANO 1536 DOLPHIN TERRACE 131-214, CORONA DEL MAR, CA 92625 9. CHIEF FINANCIAL OFFICER/ ADDRESS CITY STATE ZIP CODE LANCE ALACANO 1536 DOLPHIN TERRACE, CORONA DEL MAR, CA 92625 Names and Complete Addresses of All Directors, Including Directors Who are Also Officers (The corporation must have at least one director. Attach additional pages, if necessary.) 10. NAME ADDRESS CITY STATE ZIPCODE LANCE ALACANO 1536 DOLPHIN TERRACE, CORONA DEL MAR, CA 92625 11. NAME ADDRESS CITY STATE ZIP CODE 12. NAME ADDRESS CITY STATE ZIPCODE 13. NUMBER OF VACANCIES ON THE BOARD OF DIRECTORS, IF ANY: Agent for Service of Process If the agent is an individual, the agent must reside in California and Item 15 must be completed with a California street address, a P.O. Box address is not acceptable. If the agent is another corporation, the agent must have on file with the California Secretary of Stale a certificate pursuant to California Corporations Code section 1505 and Item 15 must be left blank. 14. NAME OF AGENT FOR SERVICE OF PROCESS LANCE ALACANO 15. STREET ADDRESS OF AGENT FOR SERVICE OF PROCESS IN CALIFORNIA, IF AN INDIVIDUAL CITY STATE ZIP CODE 1536 DOLPHIN TERRACE, CORONA DEL MAR, CA 92625 Type of Business 16. DESCRIBE THE TYPE OF BUSINESS OF THE CORPORATION SINGLE FAMILY HOME CONSTRUCTIO 17. BY SUBMITTING THIS STATEMENT OF INFORMATION TO THE CALIFORNIA SECRETARY OF STATE, THE CORPORATION CERTIFIES THE INFORMATION CONTAINED HEREIN, INCLUDING ANY ATTACHMENTS, IS TRUE AND CORRECT. 09/23/2014 JENNY MCINTIRE ADMIN. ASSISTANT DATE TYPE/PRINT NAME OF PERSON COMPLETING FORM TITLE SIGNATURE SI-200 (REV 01/2013) Page 1 of t APPROVED BY SECRETARY OF STATE Results Detail https://businessfilings.sos.ca.gov/&mDetail.asp?CorpID=01978559&... Last statement filed on: 9/23/2016 Results Detail review this information to determine fiyou have located Search Results : Continue Filing I,New; loft 09/05/2017, 4:09 pm 91,1/2017 City of Newport Beach Page 6 of 6 6:34:1OAM INSP150 - Daily Inspection Request Report Requested Inspection Date: 09/11/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 407 SNUG HARBOR RD A/PID Information: Activity : N2017-0367 SubType: NEW Status: APPROVED OWNER: SEDONA HOMES INC Phone: APPLICANT: GRAYSTONE CUSTOM BLDRS INC Phone : 949-466-0090 Description : PLUG EXISTING DRIEVWAY APPROACH PER STD 165-L, CONSTRUCT NEW DRIVEWAY APPROACH PER STD 164-L, NEW CURB DRAIN PER STD 184-L, NEW 601, BOX TREE IN PARKWAY, NEW CONCRETE CARRIAGE WALK - STND GRAY. Updated 09-05-17 - Decorative driveway approach and entry walkway with lightly exposed aggregate finish. Requestedlnspection(s) Item: 10250 FINAL - PW Requested Time: 9/11/2017 12:00:OOAM Requestor: WEBUSER 949-466-0900 Entered By: WEBUSER Comments: AM -Please call to confirm. Assigned to: zzzzzzzzzzz' �? /1_Z_/I-�2 I Ii bhVdU ,a ik I 1 n SI 1 !: 1 � i � J: :� . � � � >� . .m\ � .�. \ � as:. �\� � /^� _ _ . . ..,� ,� .. . .�.z ate... .� / � � �»: /\� �� �� � \— � \�� � ±� .� � � �:2\ ^�������?� ..� . . � . � � � � � ? © _ . . - ... . .. I : � � -- -\<��<. . . . . . . . . � � � .� d\� � � \� �� \\�`� \� � . � < § \ \ \ \ \�� � � � . � � � .. � : . . . .��« .� d � . ,� ��� � . « . . � \�� � / �\� �\ \� \� � � � ` \� y \\» 2 . \� � ±mƒ ° » « �� \-y � . � � . . .: ��}: �� © «�. ». � w- �� « - - © «� � . � � . . . ¢: � . . a <a2 a «� .. \\ \� >� � . . . . � «m: :� � d© - /� � � \� : /;� � . .�� . �. . . . \ %�� \� �� � ����� .� �� Ky ��y�� : � �� . .� .� . .. _. . . . \ � � �� . . \� � �\d \. .� � . .. ..�. � r '/14/2017 City of Newport Beach Page s of 11 4:30:13P�M INSP150 = Daily Inspection Request Report s,, Requested Inspection Date: 09/15/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 407 SNUG HARBOR RD Activity : N2017-0367 SubType: NEW I Status : APPROVED OWNER: SEDONA HOMES INC Phone APPLICANT. GRAYSTONE CUSTOM BLDRS INC Phone : 949-466-0090 Description : PLUG EXISTING DRIVEVWAY APPROACH PER STD 165-L, CONSTRUCT NEW DRIVEWAY APPROACH PER STD 164-L, NEW CURB DRAIN PER STD 184-L, NEW60 BOX TREE IN PARKWAY, NEW CONCRETE CARRIAGE WALK - STND GRAY. Updated 09-05-17 - Decorative driveway approach and entry walkway with lightly exposed aggregatE finish. Item: 10250 FINAL - PW Requested Time: 9/15/2017 12:00:OOAM Requestor WEBUSER' Entered By: WEBUSER Comments: AM- ed to : zzzzzzzzzzz* InsV I ��,X/ ADate-ND C+c� / l 7orV Time: 7 �"n(!�)PM Comments: GVI Ile E /4,, Sl5 T-`S 7v v✓ 6�T. � � to oy1 L_. PK dyt l.6,/ �i_ 116t;2/.,css7— it f RIAI 0) rZyl V&. T iy fro 19W5 tT:6k '"` m A'ir < <5 �II�Tf%T4'/2 L I r� F:\Users\PBNAShaied\ENCROACH\MASTERS\FORMS\I nsoectorSheet.doc REPT131- Run Id: 4018 §/18/2017 6:34:07AM City of Newport Beach Page 9 of 15 INSP150 - Daily Inspection Request Report �i Requested Inspection Date : 09/18/2017 Inspection Type : ENCROACH Inspection Area : PW Site Address : 407 SNUG HARBOR RD AtP/D Information:: Activity : N2017-0367 SubType: NEW Status : APPROVED OWNER: SEDONA HOMES INC Phone: APPLICANT: GRAYSTONE CUSTOM BLDRS INC Phone : 949466-0090 Description : PLUG EXISTING DRIVEVWAY APPROACH PER STD 165-L, CONSTRUCT NEW DRIVEWAY APPROACH PER STD 164-L, NEW CURB DRAIN PER STD 184-L, NEW 60" BOX TREE IN PARKWAY, NEW CONCRETE CARRIAGE WALK - STND GRAY. Updated 09-05-17 - Decorative driveway approach and entry walkway with lightly exposed aggregate finish. Requested Inspection(s) ` Item: Requested Time: 10250 FINAL - PW 1 9/18/2017 12:00:OOAM Requestor: WEBUSR Entered By: WEBUSER Comments: AM -Please to confirm. Inspector: cal Date: ! ' lg Zi Time: A PM Assign o Comments: A5" 2-5�autrL NJ � F �%� '� 7Z) AeF V 166 -/ cc, xa �d e « VU `f7S) PPOUbt5 l / Uc L�_n� ram-'/'���p� Logged F: \Users\PBW \Shared\ENCROACH\MASTERS\FORMS\I n soecto rS heet. doc Y 10/2/2047' City of Newport Beach Page 9 of 11 a:ao:OSPM INSP150 - Daily Inspection Request Report V Requested Inspection Date : 10103/2017 Inspection Type. ENCROACH Inspection Area: PW Site Address : 407 SNUG HARBOR'RD Activity : N2017-0367 SubType: NEW Status : APPROVED OWNER: SEDONA HOMES INC Phone: APPLICANT: GRAYSTONE CUSTOM 'BLDRS'INC Phone : 949-466-0090 Description : PLUG EXISTING DRIVEVWAY APPROACH PER STD 165-L,'CONSTRUCT NEW DRIVEWAY APPROACH PER STD 164-L, NEW CURB DRAIN PER STD 184-L, NEW 60" BOX TREE IN PARKWAY, NEW CONCRETE CARRIAGE WALK - STND GRAY. 'Updated 09-05-17 - Decorative driveway approach and entry walkway with lightly exposed aggregatE _ finish. Item: 10110 CONCRETE PUBLIC WORKS Requested Time: 10/3/2017 '12:00:OOAM Requestor: WEBUSER 949-466-0900 ' Entered By: WEBUSER Comments: AM -Please call to confirm. ins ogipdWed to: zzzzzzzzzzz* J Y Date: 7 Time: q' AM PM Comments: « Z_ - � S P�7 _ z Loggi3d_ Refile - F:\Users\PB\MShared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc: REPT131. Run Id: 4018 10/4/2017 City of Newport Beach Page 11 of 11 6:34:06AM INSP150 - Daily Inspection Request Report Requested Inspection Date : 10/04/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 407 SNUG HARBOR RD A/P/D Information: Activity : N2017-0367 SubType: NEW Status : APPROVED OWNER: SEDONA HOMES INC Phone : APPLICANT: GRAYSTONE CUSTOM BLDRS INC Phone : 949-466-0090 Description : PLUG EXISTING DRIVEVWAY APPROACH PER STD 165-L, CONSTRUCT NEW DRIVEWAY APPROACH PER STD 164-11, NEW CURB DRAIN PER STD 184-L, NEW 60" BOX TREE IN PARKWAY, NEW CONCRETE CARRIAGE WALK - STND GRAY. Updated 09-05-17 - Decorative driveway approach and entry walkway with lightly exposed aggregate Item: Requested Time: finish. Requested Inspections) 10250 FINAL - PW 10/4/2017 12:00:OOAM Entered By: WEBUSER Comments: AM-Pleap arcall to confirm. Inspector: j Y Date Assigne o : zzzzzzzzzzz- Comments: F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc Requestor: WEBUSER 9494660900 Time: : `"w`' A 4M 10/412017 City of Newport Beach Page 9 of 11 4130:36PM INSP150 - Daily Inspection Request Report Requested Inspection Date : 10/05/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 407 SNUG HARBOR RD Activity : N2017-0367 SubType: NEW Status: APPROVED OWNER: SEDONA HOMES INC Phone: APPLICANT: GRAYSTONE CUSTOM BLDRS INC Phone : 949-466-0090 Description : PLUG EXISTING DRIVEVWAY APPROACH PER STD 165-L, CONSTRUCT NEW DRIVEWAY APPROACH PER STD 164-L, NEW CURB DRAIN PER STD 184-L, NEW 60" BOX TREE IN PARKWAY, NEW CONCRETE CARRIAGE WALK - STND GRAY. Updated 09-05-17 - Decorative driveway approach and entry walkway with lightly exposed aggregate finish. Item: 10250 FINAL- PW lU '. ) V .\''"V Requested Time: 10/5/2017 12:00:OOAM Requestor. WEBUSER � � VA r Entered By: WEBUSER 949-466-0900 Comments: to: AM -Please call to confirm. zuuzzz=* �% InsAMF%?ed V Y Date: Time: Comments: D F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.do REPT131 Run Id: 4018