HomeMy WebLinkAboutN2017-0460t*,N�City of Newport Beach IIIII100 Civic Center Drive, Newport Beach, CA 92660 �JpiiN 2 0 1 7 0 4 6 0
I� Permit Counter Phone (949)644-3311
x,," Online Inspection Request - www.newportbeachca gov / Online
Services
Job Address
Description :
Parcel #
Legal Desc
Owner:
Phone:
Address
Permit No: N2017-0460
Project No : 1876-2015
SCANNED
Inspection Requests Phone (949)644-3255
510 LARKSPUR AVE NB Thomas:Guide: 919F2
REMOVE AND REPLACE EXISTING CONCRETE SIDEWALK PER STD 180-L. *UPDATED 9/20/17 - INSTALL NEW 36" AUSTRALIAN WILLOW STREET TREE"
4591-960-6 -
CORONA DEL MAR BLK 538 LOT 12
WALZ JOHN
510 LARKSPUR AVE
CORONA DEL MAR CA 92625
Applicant: KEEGAN'S CONCRETE
Phone: 949-650-6991 949-290-8615[
Address : 788 W 16TH STREET
COSTA MESA CA 92627
Special Cond.: PRE -CONSTRUCTION MEETING REQUIRED
COMPLETED
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 ,
$330 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: KEEGAN'S CONCRETE
Phone : 949-650-6991 949-290-8615
Address : 788 W 16TH STREET
COSTA MESA CA 92627
Contractor State Lic: 632315
License Expire : 05 31, 2019
Business License : BT98041837
Business Expire:
04 30, 2018
Workers' Compensation Insurance - -
Carrier :
NORGUARD INS
Policy No :
KEWC631922
W. C. Expire:
03 19, 2018
Total Fee
Paid :
Balance
Receipt No:
$571.00
$571.00
$0.00
Other Department : Date: _/_/,
Permit Denied / Date:
Issued Permit Date
��wrry� City of Newport Beach IIIIIIIIIIIIIIIIIIIillillIIIIIIIIIIIIIIIIIIlIIIIII II
106 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3311
Online Inspection Request- www.newportbeachca.gov I Online
nMZrsiia'�k°. Services
Job Address : 510 LARKSPUR AVE NB Thomas:Guide:
Description: REMOVE AND REPLACE EXISTING CONCRETE SIDEWALK PER STD 180-L.
Permit No: N2617-04LR0
Project No : 1876-2015 SCANNED
11
Inspection Requests Phone (949)6443255 -
919F2
Parcel # :
4591-960-6 -
Legal Desc :
CORONA DEL MAR BLK 538 LOT 12
Owner:
WALZ JOHN -
Contractor : KEEGAN'S CONCRETE
Phone:
Phone: 949-650-6991 949-290-8615
Address:
510 LARKSPUR AVE
Address : 788 W 16TH STREET
CORONA DEL MAR CA 92625
COSTA MESA CA 92627
Contractor State Lic: 632315
Applicant:
KEEGAN'S CONCRETE
License Expire : 05 31, 2019
Phone:
949-650-6991 949-290-8615[
Address :
788 W 16TH STREET
COSTA MESA CA 92627
Business License: BT98041837
Business Expire: 04 30, 2018
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation Insurance --
Carrier: NORGUARD INS
Policy No: KEWC631922
W. C. Expire: 03 19, 2018
Permit Processing Fee :
$241.00
Sewer Connection : $0.00
Total Fee
$571.00
Agreement Fee:
$0.00
4TT Box Cover: $0.00
Paid:
$0.00
Traffic control Plan Check :
$0.00
Total Water Meters : $0.00
Balance :
$571.00
Inspection Fee :
$330.00
Water Meter Connection : $0.00
Receipt No:
Refundable Deposit:
$0.00
Total Water Meter Box: $0.00
Street Tree Fee :
$0.00
Adjustment : $0.00
Processed By :
Date : _/_/_
Other Department : Date
Utilities Approval :
Date : _/_/_
Permit Denied Date
: _/
/_
Traffic Approval :
Date : _/ /
Issued Permit : Date:
q/
Z! a 7
General Services Approval : Date: _/ /
COMPLETE THE BELOW INFORMATION
PROJECTADDRESS: r�5 v� �✓(
DETAILED DESCRIPTION OF PROPOSED WORK:
APPLICANT: eu Uc cQe �i - ed
Phone: ' !4{
Email Address:
Mailing Address:
City/State/Zip:
OWNER:
Phone:
Email Address:
Mailing Address: City/State/Zip:
s.
CONTRACTOR: crci
✓1.G Office Phone:' YWq-L jC- 4(30
Company (if different): Jobsite Phone:
Other Phone:
Email Address:
Mailing Address:
City/State/Zip:
State License Number & Class:
Expires:
City Business License Number:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: Policy No: Expires:
Municipal 0 rations: 949-644-3055
Utilities: 949:64 "3011
Urban Forestry: 949-644-3083
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Special Conditions of Permit:
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Utilities:
Municipal Operations
Traffic: Fire: 0
Other:
Engineering Technician:
Pe rmi cialist
Da •
7
Permit No.
N2017-
Husemipbw/sham&encroach/mastemlepwor sheetzls
Public Works Department 949-644-3311
100 Civic Center Drive, Newport Beach, CA 92660
N2017-
Permit Processing Fee: Inspection Fee:
Public Works Only $241.0 Public Works Field Inspection $165.0
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 Report/Agreement $817.00
Document Recordation Fee $192.00 Refundable Deposit: TBDB
Monitoring Wells $502.00 Improvements TBD
Street/Alley/Walk Closure: $65.00= Newspaper Rack Inspection $108.00 0
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 FOLLOWINGITEMS REQUIRE APPROVAL FROM THE Revenue Division I
REVENUE DIVISION PRIOR TO PAYMENT OF FEES ' Approval: 1
( Qty. Q I
(Water Meter: Installation Charge $526.00
13/4" Meter $50.25 Water Meter Boxes: 1
11" Meter $121,50 For Parkway& Sidewalk Area (Box + Cover cCost)
11 1/21' 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
12" Meter $425,00
12" Turbine Meter $845,00 For Traffic & Alley Areas (Box + Cover z Cost) I
13" Meter $3,810.00 1" Meter: 13 00+ 38.00 $51.00=
�4" Meter $4,730.00 2" Meter: 27.00 + 162.00 $189.00 I
!6" Meter Q7 190 00
Certificate of Compliance Fee (+100%of hrly over 3 Inns)
$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 EasemenWacationFee (+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
'7r , o�
Permi list
Receipt No.
f:/users/pbwlsharedlencroech/masters/ep front and back mastersl
Rev. 1/5/2017
epfeesheetxls-revised 1012112016
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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-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.
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
h Public Works Department. Locate and pothole
over or within 5 feet of an City utilities unless approved b the P b
Y Y PP Y P P
existing City -owned utilities fe: 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.
ER'S COMPENSATION INSURANCE (Section 3800 Labor Code)
I have a Certificate of consent to/selllnn re, Certifi to of Worker's
nJ=urance, or a Certified Copy tjlhereo -
CERTIFICATE OF EXEMPTION (Section 3800 Labor Code)
I certify that in the performance of the work under this permit, I shall not employ
any person so as to become subject to California Worker's Compensation Laws. If,
after signing this certificate I become subject to the Worker's Compensation
provisions of the State Labor Code, I must comply with the provisions of Section
3700 or this permit shall be deemed revoked.
Date: Signature:
CONTRACTOR LICENSE EXEMPTION
As the Owner of the benefiting property, I certify I am personally performing all
work in the Public Right -of -Way.
Date: Signature:
HOLD HARMLESS STATEMENT
I understand that I am locating minor encroachments within the City Right-of-
Way/Easement. As property owner it is my responsibility to maintain the
encroachments. I will be responsible for replacing the improvements if the City
removes them for maintenance of utilities or other public need. 1 shall indemnify
and hold the City harmless for any liability associated with the minor
encroachments.
Date: Signature:
24-hour notice for Encroachme t Permit Inspection is required by calling
Public Works at 949-644-33t1.
nZZ
15, Any above ground utility faci �s will require documented approval from the adjacent
affected property owner(s):
16. Homeowner, contractors, and subcomracotrs 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 stone 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.
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510 Larkspur Avenue
Corona del Mar, CA 92625
949336.5977
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(STENDIC.ARPL'S SHJUATUS) PFR,
CiiAPTER 3 OF THE %'BIAC
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510 Larkspur Ave., Corona del filar
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,
917/2017
City of Newport Beach Page of
a:30s5Pm _
INSP150 - Daily Inspection Request Report
Requested Inspection Date: 09/08/2017
Inspection Type : ENCROACH
Inspection Area : PW
Site Address : 510 LARKSPUR AVE
Activity,:
N2017-0460
SubType:
NEW
Status :
APPROVED
OWNER:
WALZ JOHN Phone:
APPLICANT:
KEEGAN'S CONCRETE Phone : 949-650-6991
949-290-8615'
Description :
II'
REMOVE AND REPLACE EXISTING CONCRETE SIDEWALK PER STD 180-L.
Item:
y
1020,PRE JOB - PW r�
Requested Time:
9/8/201 Requestor: NBIVR
9494564,301
Entered By:
NBIVR
Comments:
AM
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Inspector:
Dates 7 X0 i7 Time: ,3 �P.M
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MPT131 Run Id: 4018
9/12/2017
'''4:30:32PP4
City of Newport Beach Page 4 of 11
INSP150 - Daily Inspection Request Report
Requested InspectionDate : 09/13/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 51 O LARKSPUR AVE
Activity :
N2U17-0460
SubType:
Status :
NEW
APPROVED
OWNER:
WALZ JOHN Phone:
APPLICANT:
KEEGAN'S CONCRETE Phone : 949-650-6991
Description :
949-290-8615
REMOVE AND REPLACE EXISTING CONCRETE SIDEWALK PER STD 180-L
Item:.-4
Requested Time-
9/13/2017 12:00:OOAM Requestor: NBIVR
-
9494564301
Entered By:
NBIVR
Comments:
AM
Assigned to
Inspector:
p
`� Date: - I 1-7 Time: 9 M . M
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Run Id: 4018 ,
9/19/2017 City of Newport Beach Page a of 19
6:34:40AM INSP150 - Daily inspection Request Report
J Requested Inspection Date : 09/19/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 510 LARKSPUR AVE.
Activity. : N2017-0460
SubType: NEW
Status APPROVED
OWNER: WALZ JOHN Phone
APPLICANT: KEEGAN'S CONCRETE Phone : 949-650-6991 -
949-290-8615
Description : REMOVE AND REPLACE EXISTING CONCRETE SIDEWALK PER STD 180-L s
Item:
Requested Time: 9/19/2017 12:00:OOAM Requestor: NBIVR
Entered By: NBIVR
Comments: AM
Assigned to
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Inspector: �I Date: 1%G 1-7 Time: 9: 5'r- A M
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