HomeMy WebLinkAboutN2017-0427City of Newport Beach$111111111111111�1111111011�1111111111111111
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3311
Online Inspection Request- www.newportbeachca.gov/Online
Services
Job Address : 121 HARBOR ISLAND RD NB Thomas:Guide:
Description: EA FOR BRICK RIBBONS IN DRIVEWAY APRON
Parcel#:
0504-712-1 -
Legal Desc :
N TR 3283 LOT 20
Owner:
JANES DONNA & DAVID
Phone:
Address:
121 HARBOR ISLAND RD
NEWPORT BEACH, CA 92660
Applicant: ALKAY ENTERPRISES INC
Phone: 714-662-2300 [
Address : 1848 KENTUCKY PLACE
COSTA MESA CA 92626
Permit No: N2017-0427
Project No : 2009-2016CAN N E -
Inspection Requests Phone (949)644-3255
919C1
Contractor : ALKAY ENTERPRISES INC
Phone: 714-662-2300
Address : 1848 KENTUCKY PLACE
COSTA MESA CA 92626
Contractor State Lic: 481895
License Expire : 02 28, 2018
Business License: BT30053189
Business Expire
: 11 30, 2017
Special Cond.: PRE -CONSTRUCTION
MEETING REQUIRED
Workers' Compensation
Insurance --
Carrier :
STATE FUND
Policy No:
1857473
W. C. Expire:
08 01, 2018
Permit Processing Fee :
$0.00
Sewer Connection:
$0.00
Total Fee
$982.00
Agreement Fee:
$817.00
4TT Box Cover:
$0.00
Paid:
$0.00
Traffic control Plan Check :
$0.00
Total Water Meters :
$0.00
Balance :
$982.00
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 :
Date : _/_/_
Other Department :
—Date: _/_/_
Utilities Approval:
Date : _/ /
Permit Denied
Date :: I /
Date
Issued Permit
�
Date : / �� v�1U
Traffic Approval :
: _/_/_
:
General Services Approval:
Date: i/_/_
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PROJECT ADDRESS: /?/ RGd >'ISLAP OA OiQT' A0jJ
DETAILED DESCRIPTION OF PROPOSED WORK:
APPLICANT: A L KA Y j5NT.
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I Phone:? 1s 6 .r ` • 2 6
Email Address: R V/'Y AN
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M d a s:
pgn AdNTULKY LCOsTi�4'lM6Spc
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OWNER: ID NES
Phone: ?-67 -0/Es
EmailA dress: nbn//V/ Nr=5.1@MAc-.CO
Milli A dress: Cit /StatelZip:
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CONTRACTOR. 10/4JAIZ W YMAIVOffice
Phone:714.6 62-230 0
Company (if different);
AL K A y ;tj�T Ate ,
Jobsite Phone: •--
Other Phone:714, 745' 230
Emall Address: RWYMA9 IVAIr i
ailing ddress:
99 �NrDCI<% LPL �
Cit Statelz :
�vsr Als C-A, qz2 26
State License Number & Class:
$/ Expires:
City Business License Nu 'ber:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: � iJt4D PR, No:19574 2616 Expires:e.
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yuNDAi34E.DAP.oST)N#�ORMATION.(Ifzpppca4l .............. ........ ........... +;
fti!d Pa'.ftT�s,.... ....... . ....... ..:......... ........ .
Mall Refund:To. ......
5. ," FOROFFICE USE ONI-Y `� t� r
Special Conditions of Permit:-
,,, , AbDITIONAL APPE?01/AJ REQUIRED, FRQT0NETEV,GCS .at
Utilities:
General Services:
Traffic: Fire:
Other:
Engineering Technician:
Public s Specialist:
Date:
Permit No.
f:usersfpbw/shereNenmaGUmasterefepivmksheeFkis
?rc)" Z501
j
Public Works Department 949-644.3311
Permit Processing Fee:
Q
Inspection Fee:
t .
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:
Preparation of Report/Agreement
Document Recordation Fee
$817.00
$192.00
Water Quality/Artificial Turf Inspection
Refundable Deposit:
$108.00
TBDB
Monitoring Wells
$502.00FE1
Improvements
TBD
Street/Alley/Walk Closure:
$65.000
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
T_ev_enue_ _ ivision ___
HE FOLLQINING ITEMS REQUIRE APPROVAL FROM THE RD'I
REVENUE DIVISION PRIOR TO PAYMENT OF FEES ` lApproval:
I
1
Qty.
Qty.
IWatecMeter:
Installation! Charge ,
$528.00 J
13/4" Meter
$5026
Water Meter Boxes:
1
11" Meter
11 1/2" Meter
$121,50
$285,00
For Parkway & Sidewalk Area (Box
1" Meter: 13.00 + 37,00
+ Cover = Cost) 1
$50.ODB 1
11 1/2" Turbine Meter
12" Meter
12" Turbine Meter
13" Meter
$700.00
$425,00
$845,00
$3,310.00
2: Meter: 27.00 + 61,25 $88.25 1
1
For Traffic & Alley Areas (Box + Cover = Cost) 1
1" Meter. 13.00+ 38.00 $51.00
11 11, Meter
$4,730.00
2" Meter: 27.00 + 162.00
$189.00 1
,
16" Meter $7,190.00
l
Certificate of Compliance Fee (+t00%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 EasementlVacationFee (+100%ofhrlyover4hrs)
$1,022.00
5200-5031
Street Tree Fee ($700 Planting Fee)
TBDI
030-2284
Engineering Tech:
Total Amount Due:
For Finance use only
kU
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Permit Specialist
Receipt No.
f:/users/pbw/sharedlencroachlmastem/ep front and back mastersl
Rev. 1/5/2017
epfeesheetxls-revised 10/212016
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, liabill y, 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 Slate 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 0-34 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 maybe 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 (is: 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. Ail
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 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 Caitrans 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)
I certify that I have a Certificate of consent to self -insure, Certificate of Worker's
Compegiiiatioalnsuranpe, or a Certified Copy thgfeof!T ! - -
D ` , 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 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 orlos permit shall be deemed revoked.
Date: 1.
A 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 Encroachme t P I Inspectio. is required by calling
Public Works at 949-644-3311
15. Any above ground utility facilities will require documented appro from the adjacent
affected property owners):
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 Anal 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.
I
EXISTING SIDEINALK
UNCHG./PROTECT
EXISTING UNUSED SEWER O-
LATERAL, INSTALL NEW
GAP. ENCROACHMENT ivv
PERMIT REQUIRED X
.�yr?
EXISTING DECORATIVE y
BRICK RIBBONS (2) TO �i
REMAIN. ENCROACHMENT
PERMIT 8 AGREEMENT
REQUIRED
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RECORDING 11FOUES'I'F.D aY:
Mariners Escrow Corporation
Order No, 15-1.0465
Escrow No. 48471-JH
Parcel No. 050-47.1-21
AND WHEN RECORDED MAH, TO:
DONNA L. DAVIS
121 1IAR.BOR ISLAND RD.
NEWPORT BEACII, CA 92660
Recorded in Official Records, Orange County
Hugh Nguyen, Clerk -Recorder
lllll l l lllill 111 lllll lllll lllll lllll lllll lllll lilll illll illll llll l l 111 llll 12.00
* $ R 0 0 0 7 4 0 6 1 0 2$
201500016370412:07 pm 03131115
143 401 G02 F13 2
0.00 0.00 0.00 0.00 3.00 0.00 0.00 0.00
GRANT DEED
THE UNDERSIGNED GRANTOR(S) DECLARE(S) TI44T DOCUMENTARY TRANSFER TAX 1S None
® computed on full value of property conveyed, or
❑ computed on full valueless liens or encumbrances remaining at the time of sale.
❑ unincorporated area: ® Newport Beach, and
Donna L. Janes who acquired title as
\ FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged,
llmma L. Davis, or successor Trustec(s) ns Trustee of The DAJ 1999 QPRT, dated August 2,1999, as to an undivided
one-half (112) interest an Donna L. Davis, or successor Trustce(s) as Trustee of The DLD 1999 QPRT, dated August 2,
1999, as to an undividedie-half (1/2) interest
Donna L. Janes, who acquired title as
hereby GRANT(S) to David A. Janes, Sr. and Donna L. Janes, as Trustees of the ORION TRUST, dated April 22,
1998, as amended and restated
the following described real property in the County of Orange, State of California:
Complete legal description attached hereto as Exhibit "A" and made apart hereof
More commonly known as: 121 Harbor Island Rd., Newport Beach, CA 92660
Date March 24, 2015
Borrower's Signature
The DAJ 1999 QPRT, dated August 2, 1999, as to an
undivid one-half (1/2) interests
By: Uotma L. Jane , ustee
'v,r{aej(-j e;tnr�,
The DLD 1999 QPRT, dated August 2, 1999, as to an
undivided age -half (1/2) interest )
_ r s✓
By: Donna L.'Janes, Tru
A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document
to which this certificate is attached, and not the truthfulness accuracy, or validity of that document
STATE OF CALIFOR IA
COUNTY OF+y� C' / }S.S•
On JYoFU' befgye me, •i ��il �t �U�1 IL°�ir r"C I''+�
evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/sheithey
executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and
correct.
JENNIFC-- ER A. HUGHES
(Seal) 'xa.y% •?�,,. Commission # 196221
x
x :o ^ f.��,' :G Notary Public •California �
Orange County
My Comm. Expires Dac 25, 2015 J
EXHIBIT "A"
LOT 20, TRACT NO. 3283, IN THE CITY OF NEWPORT BEACH, COUNTY OF ORANGE, STATE OF
CALIFORNIA, AS PER MAP FILED IN BOOK 101, PAGES 33 AND 34, MISCELLANEOUS MAPS, IN
THE OFFICE OF THE COUNTY RECORDER OF ORANGE COUNTY.
EXCEPT ALL OIL, OIL RIGHTS, MINERALS, MINERAL RIGHTS, NATURAL GAS RIGHTS, AND
OTHER HYDROCARBONS BY WHATSOEVER NAME KNOWN THAT MAY BE WITHIN OR UNDER
THE PARCEL OF LAND HEREINABOVE DESCRIBED, TOGETHER WITH THE PERPETUAL RIGHT
OF DRILLING, MINING, EXPLORING, AND OPERATING THEREFOR AND STORING IN AND
REMOVING THE SAME FROM SAID LAND OR ANY OTHER LAND, INCLUDING THE RIGHT TO
WHIPSTOCK OR DIRECTION ALLY DRILLAND MINE FROM LANDS OTHER THAN THOSE
HEREINABOVE DESCRIBED, OIL OR GAS WELLS, TUNNELS AND SHAFTS INTO, THROUGH OR
ACROSS THE SUBSURFACE OF THE LAND HEREIN DESCRIBED, AND TO BOTTOM SUCH
WHIPSTOCKED OR DIRECTIONALLY DRILLED WELLS, TUNNELS AND SHAFTS UNDERAND
BENEATH OR BEYOND THE EXTERIOR LIMITS THEREOF, AND TO REDRILL, RETUNNEL, EQUIP,
MAINTAIN, REPAIR, DEEPEN AND OPERATE ANY SUCH WELLS OR MINES, WITHOUT,
HOWEVER, THE RIGHT TO DRILL, MINE, STORE, EXPLORE AND OPERATE THROUGH THE
SURFACE OR THE UPPER 500 FEET OF THE SUBSURFACE OF THE LAND HEREIN DESCRIBED,
AS RESERVED IN A DEED RECORDED OCTOBER 14, 1977 IN BOOK 12415. PAGE 997, OF
OFFICIAL RECORDS.
ALSO EXCEPTING ALL WATER RIGHTS OR INTERESTS IN WATER RIGHTS AND ANY, AND ALL
GEOTHERMAL RIGHTS OR INTEREST IN GEOTHERMAL RIGHTS, NO MATTER HOW ACQUIRED
BY THE IRVINE COMPANY, AND OWNED OR USED BY THE IRVINE COMPANY IN CONNECTION
WITH OR WITH RESPECT TO THE PROPERTY CONVEYED HEREBY, WHETHER SUCH WATER
RIGHTS SHALL BE RIPARIAN, OVERLYING APPROPRIATIVE, PERCOLATING, PRESCRIPTIVE OR
CONTRACTUAL, TOGETHER WITH FULL RIGHT AND POWER, AMONG OTHERS, TO TRANSFER
OR ASSIGN TO OTHERS OR TO USE OR UTILIZE ON ANY OTHER PROPERTY OWNED OR
LEASED PROVIDED, HOWEVER, THAT THE EXCEPTION AND RESERVATION MADE HEREIN
SHALL NOT RESERVE TO OR FOR THE BENEFIT OF THE IRVINE COMPANY ANY RIGHT TO
ENTER UPON THE SURFACE OF THE PROPERTY DESCRIBED HEREIN IN THE EXERCISE OF
SUCH RIGHTS, AS RESERVED IN A DEED RECORDED NOVEMBER 14, 1980 IN BOOK 13835,
PAGE 626, OF OFFICIAL RECORDS.
APN. 060-471.21
Sep 0717 05:37p Alkay Enterprises, Inc 714-662-2300 p.2
Aug 2917. OTC p
p.1
RESTATED ORION TRUST
THIS RESTATED TRUST AGREEMENT is made this 12th day of July, 2012, by and
between DAv1D A. JaNEs, SR. and DONNA L. JANES, of the City of Newport Beach, County of
Orange, and State of California, as Trustors and as Trustees,
1.0. RECITALS
1.1 Trustors established the ORronr TRUST ("Orion Trust^) on April 22, 1999.
1.2 Pursuant to Subsection 19.3 of the Orion Trust, the Trustees, subject to the veto
power of the Committee, by any notarizcd written instrument, may change the Governing
Jurisdiction of the Trust and may amend the Trust to make such consequential alterations in the
Trust powers and provisions of this Trust as necessary to provide that the Trust is valid and
effective under the laws of the new Governing Jurisdiction.
1.3 Trustees and Trustors desire to now completely amend and restate the Trust;
provided, nothing herein shall be construed to affect the ownership of assets presently held by
the Trustees.
1.4 Alt capitalized terms in this Trust shall have the meaning set forth in Section 17.0.
NOW, THEREFORE, IT IS AGREED by and between the parties hereto that the terms of
the ORION TRusT are deleted in their entirety and replaced with the following:
2.0 TRUSTEES
2.1 Original Trustees: The office of Trustee shall initially be filled by the Trustors. It
one of the Trustors ceases to act as Trustee, then the other Trustor shall have the right to act as
sole Trustee, except as to the Disclaimer Trust as provided in Subsection I0.4(B).
2.2 Trustors' Right to Designate Trustee: The Trustors shall have the right to remove
and replace the acting Trustee and to change the designation of successor Trustees. If a Trustor
is Incapacitated, the other Trustor may exercise this power. After the Decedent's death, the
Survivor may exercise this power except as to the Credit -Shelter Trust, Marital Trust and
Disclaimer Trust.
2.3 Successor Trustee: Subject to the provisions of Subsection 2.2;
(A) If both Tnrstors fail or cease to act as Trustee, then NORTHERN TRUST
N.A., shall act as Trustee.
4830.000"&R Orion Trust
504322 3
** INBOUND NOTIFICATION : FAX RECEIVED
SUCCESSFULLY
**
TIME RECEIVED
REMOTE CSID
DURATION
PAGES
STATUS
September 7, 2017
10:32:08 AM PDT 714 662 2300
194
4
Received
aep u / I ( Uo:3op AIKay tn[erprises, Ino 114-862-23OU p.1
817 W_ 160 Street, UnIt d
Newport Beach, CA 926M
Phone/Far 714862-23D0 ALKAY
Cell: 714-745-2230
T. ` 1 6�`1 /, V 0 F/� �' Fram: Ran Wyman
Pages:
Phone: k Date: �- 3 0 r -7 0VC, PAY
❑ Urgent X For Review ❑ Please Comment 13 Please Reply ❑ Please Recycle
Sep 07`1177 0`5':3�7p
r
9
Alkay Enterprises, Inc
714-662-2300 p.4
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EXISTINS SIDEWALK \
UNC46./PROTEGT \
EXISTING UNU5ED SEWER \
LATERAL, INSTALL NEW
GAP.ENCROArHMENT
PERMIT REGUIRED/
EX15TiNS DECORATIVE y\
BRICK RIBBONS (2) TO S
REMAIN. ENCROACHMENT \
PERMITS AGREEMENT
REQUIRED
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Sep 071705:37p Alkay Enterprises, Inc 714-662-2300 p.3
Aug 2917, 07:01 p
p.2
Drive, Irvine, California, Telephone (949) 474-7369. Either copy may be used as an original
without the other and if only one COPY Of this trust instrument can be found, then it sball be
considered as the original and the missing copy will be presumed inadvertently lost. Any
clarifications or instructions concerning this trust instnuent may be obtained by calling IEEE
Busch FIRM, who is requested to do everything necessary to implement the provisions of this
Trust. The location of the duplicate original or the designation of the attorney to contact, or both,
may be changed by the Trustee at any time_
Dated: July 12, 2012
46" U
DAVID IANES,
a
DONNA L. JANES
"TRUSTORS" and "TRUSTEES"
state of California
County of Orange
On July 12, 2012, before me, Catherine L. Danker, a Notary Public, personally appeared
DAYm A. JANes, SR. and DONNA 1. JANEs, who proved to me on the basis of satisfactory
evidence to be the persons) whose names) is/are subscribed to the within instrument and
acknowledged to me that he/she/they executed the same in his/herltheir authorized capacity(ies),
and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of
which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that
the foregoing paragraph is true and correct.
WITNESS ray hand and official seal. )�catatettulELouttstt
,r JCUWY . #py M
I � s
� tHNYtEeOW(IY �`
�f � M�TER. Ja1Q 30. �F�
Signature—l�ir'\.�...- ll�• _ .Y, / (Seal)
4830.0000U8-R Orion Trost 52
.U111 n
9/25/2017 City of Newport Beach Page 11 of 11
6:34:33AM INSP15O - Daily Inspection Request Report
Requested Inspection Date : 09/25/2017
Inspection Type: ENCROACH
Inspection Area : PW
Site Address: 121 HARBOR ISLAND RD
A/P/D Information:
Activity :
N2017-0427 _
SubType:
NEW
Status :
APPROVED
OWNER:
JANES DONNA & DAVID Phone:
APPLICANT:
ALKAY ENTERPRISES INC Phone : 714-662-2300
Description :
EA FOR BRICK RIBBONS IN DRIVEWAY APRON
Requested Inspection(s)
Item:
10250 FINAL - PW
Requested Time:
9/25/2017 12:00:OOAM Requestor: WEBUSER
Entered By: WEBUSER
Comments: PM -Existing condition
Assigned to : zzzzzzzzzzz'
714-745-2230 -- &vNp-L- j
Inspector: .1J Date: ' -"—Wl Time: PM
Comments: O.c1"� Td noegjZ�
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet doc