HomeMy WebLinkAboutN2017-0087# wry$ City
lVo cNewenter Dport Beacorth
CA 92660 Ilfll llllllllllllllllllllllllllllllllllllll�llll II Permit No: N2O1 7-6087
Permit Counter Phone (949)644-3311 Project No : 1620-2fl�§:-�,
ci. Online Inspection Request - www.newportbeachca.gov / Online (A
n"�<xgu'k Services
Inspection Requests Phone (949)644-3255
Job Address : 2815 PEBBLE DR NB Thomas:Guide: 919F1
Description : INSTALL SEWER CLEAN OUT PER STD 406-L, ABANDON EXISTING 3/4" WATER SVC AND INSTALL NEW 1" WATER SERVICE AT MAIN PER STD 502-L.
Parcel # :
4586-620-5 -
Legal Desc :
N TR 3660 LOT 39
OwnePhone: r:
ERIC AND ADRIANA OLSEN TRUST
Contractor:
TBWOAT6ER & POTTC Y-^-`
COAST
phone
OAS �r I
EWE®
Address:
2815 PEBBLE DR
Address:
P O BOX 3341
CORONA DEL MAR CA 92625
NEWPORT BEACH CA 92659
(�
CU__
Contractor StateLic:
738400
Applicant:
COAST WATER & POWER
License Expire :
07 31, 2017
Phone:
949-548-0106 [
Address:
P O BOX 3341
NEWPORT BEACH CA 92659
Business License : BT96014951
Business Expire
: 12 31, 2017
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation Insurance --
Carrier :
STATE COMP INS FUND
Policy No:
9087110
W. C. Expire:
10 01, 2017
Permit Processing Fee : $241.00
Sewer Connection :
$0.00
Total Fee $1,564.50
Agreement Fee:
$0.00
4TT Box Cover,
$64.00
Paid : $1,564.50
Traffic control Plan
Check : $65.00
Total Water Meters :
$649.50
Balance: $0.00
Inspection Fee :
$495.00
Water Meter Connection : $528.00
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
Date
Traffic Approval :
Date: _/_/
Issued Permit :
Date 3 1,7
General Services
Approval:
Date
RECEIVED REMOTE CSID
ary 22, 2017 3:20:08 PM PsT
DURATION PAGES
171 5
PLEASE COMPLETE THE FOLLOWING INFORMATION
PROJECT ADDRESS:
2815 PEBBLE DR
DESCRIPTION OF WORK:
INSTALL SEWER CLEAN OUT 4 0 6 - L
INSTALL 1" WATER SERVICE 5 0 2 - L
ABANDON EXISTING 314 " WATER SERVICE AT WATERMAIN
APPLICANT: MIKE KILBRIDE Phone: 949-289-0078
Mailing Address:
PO BOX 3341
City/StatelZip:
NEWPORT BEACH, CA 92659
OWNER: Phone:
Mailing Address:
City/State :lp:
CONTRACTOR: MIKE KILBRIDE
lOffire Phone: 949-548-0106
Company (if ditferent):
COAST WATER AND POWER
lJobsite Phone: 949-289-0078
10thor Phone; FAX: 949-548-1616
Mailing Address:
PO BOX 3341
Gity/Stata2ip;
NEWPORT BEACH CA 92659
State License Number & Class:
73.400 A B C-10
City Business License Number:
BT9601491 FRCP=12-31 2017
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Com an STATE FUND Policy No:90$7110-14-2 Expires: 10/1/201
REFUNDABLE DEPOSIT INFORMATION lfA !/cable)
Made Payable To: MIKE KII,BRIDE Vendor No: 9333
Mailing Address: PO BOX 3341, NEWPORT BEACH, CA 92659
Special Conditions of Permit:
�. /
Utilities: Traffic:
General Services: Other:
Engineering Technician:
Public W Specialist:
Dater: ry
pG � `l
Permit No.
N2017 �
CITY OF NEWPORT BEACH
APPLICATION FOR WATER METER OR HYDRANT METER
REQUESTED BY K i l br; d
(entity who is requesting meter and/or would get
MAILING ADDRESS_?Q Oa o X W3 Lj ) _RECEIPT#
CITY/STATEIZIP N% Ctg:(p 5 PHONE # - S 04% - d (0 (.
SERVICE ADDRESS__ a7815 0,6 b le
,0
( ) Hydrant Meter
Deposit required
(tapping order)
( ) New Meter
New service address
(tapping order)
(vio'M eter Upgrade
Existing service address
(work order)
( ) New Meter at existing service address (► Irrigation only
(tapping order)
( ) Commercial Location (d�esidential Location O Fire Connection Fee $
(vj`Meter Size i • Fee $ �a/• 5 0_ (�44TT Box Fee
(/Meter box S Lid - Alley/Traffic Area Fee $ or Parkways/Sidewalk Fee $ (� .
Total Fees $ Encroachment Permit Number;
Customer Name (property owner) 25'
0� Billing Address 15 lihMe. Dr. City/Zip—dN
Residence Phone # Business Phone #
E-Mail Address
Social Security # or CA Drivers License
FOR OFFICE USE ONLY
CLERK DATE BUS LIC # M10#
DATE UTILITIES COMPLETED DATE HYDRANT METER CLOSED
NEW ACCOUNT NUMBER NOTES
WORK/TAPPING ORDER NUMBER
f/userslrev/shared/waterlwater meter sery app 05/23/16
City of Newport Beach
Newport Beach Police Dispatch
MIKE KILBRIDE AvPLICANT INFORM/
my Name: COAST WATER & POWER
s: P.O. BOX 3341
NEWPORT BEACH, CA 92659-8341 phone: Day
Location at Encroachment: dSl S Pa IL
Public Works Department
Night
•—w aucor eouaea or approximate number of feet from n �� sorest vrtersection)
Reason for Encroachment: UTILITY NOTE: No work on holidIMPROVEMENTS - Generally one day between dates below_
ay(sJ or weekends.
Date Closure to Begin;
aximum 1
Data Closure to End_
islDDays) `
olarweaa r r,.-.T..... __ __.__
Time of Closure: 7:00 AM to 5;00 PM
NJ
4
C-1`a C gA Cat,
Q
W
i
RV
C9A C.i6
vRA
--'-"" • uym vr-4a.
2) Provide access to emergency Yehlcles if needed. 3) Notify adjacent residents 4$-ftC$ prior to closure,
4 Place delineators around construction area. 5 Plate and backfill excavations durin nen-Gonstructiure
on
CITY RESERV> S THE RIGHT TO REVOKE QR MODIFY CON ]Ti NSA pNY TIME
t, III) hereby certify the in bftnation provided is true and cot and I wri Ions on file front and back of this perrnit. Permitea guarantees to indemn f ee i0 Ur 1 3fy with the terms and Encmawnem rr-�� Va:
ha gain any Claims. liabil' , or . dgme s ify and hold the City of Newport Beach ' t ^�• O'
XML� _ fqr mages arising out of pertnitee'S aotivities, jY
Approved by: A..3
Date:
e;�arwaanreaimagringap,�M�qqr ITemaaren mmmn FAeswa
awm.lEawx549aayremp gyaal W`eaypppylm�iOa IUIMtlOFpyaen, r$pagl _,
CITY OF NEWPORT BEACH CASH RECEIPT
FINANCE DEPARTMENT
100 Civic Center Drive, Newport Beach, CA 92660
P.O. BOX 1768, Newport Beach, CA 92658-8915
Permit Number: N2017-0087 Plan Check Number: 1620-2016
Today's Date : Mar 15, 2017 Receipt Number: R000075879
Job Address: 2815 PEBBLE DR NB
Description: INSTALL SEWER CLEAN OUT PER STD 406-L, ABANDON EXISTING
Owner : ERIC AND ADRIANA OLSEN TRUST
Applicant: COAST WATER & POWER
Date Paid: Mar,15,2017 11:01 AM Total Paid : $1,564.50
Notation: KILBRIDE
Initial: DE
Description Payment Type Check Number Card Type Tendered
Payment
Credit Crd
FOR PLAN CHECKS ONLY:
TARGET DATE:
VISA
$1, 564.50
For status, please log on to www.newportbeachca.gov/building, and select PLAN CHECK STATUS or
call (949) 644-325S
NOTICE: PLAN CHECK EXPIRES 180 DAYS FROM DATE OF SUBMITTAL
311512017 City of Newport Beach Page 6 or 13
4:30:46PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 03/16/2017
Inspection Type : ENCROACH
Inspection Area: PW
Site Address : 2815 PEBBLE DR
Activity :
N2017-0087
SubType :
NEW
- _ Status :-APPROVED
- --- -- - - -- -
OWNER: ERIC AND ADRIANA OLSEN TRUST Phone :
APPLICANT: COAST WATER & POWER Phone: 949-548-0106
mikekilbride@live.com
Description: INSTALL SEWER CLEAN OUT PER STD 406-L, ABANDON EXISTING 3/4" WATER SVC
AND INSTALL NEW 1" WATER SERVICE AT MAIN PER STD 502-L.
Item:
Requested Time: 3/16/2017 12:00:OOAM
Entered By: WEBUSER
Comments: AM-
Requestor: WEBUSER
949-548-0106
Assigned to : zzzuzzzz}z* '
Inspector: �3V Date: 7 11c7 /� Time: /,�O AM PM
Comments:1i�1�12sTl�-st°fo-
ttkld .n-r� i 5 lysc notii • �ZiT G ti�� .c.�
AcCT IV67- 1,1V e-&t./ 0 1570 tic/ f��17`
2:
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet doc
REPT131- Run Id. 4018
4/16/2018 City of Newport Beach Page 7 of 10
6:34:36AM INSP15O - Daily Inspection Request Report
Requested Inspection Date :
04/16/2018
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address :
2815 PEBBLE DR
Activity : N2017-0087
SubType: NEW
Status: APPROVED
OWNER: ERIC AND ADRIANA OLSEN TRUST Phone:
APPLICANT: COAST WATER & POWER Phone : 949-548-0106
mikekilbride@live.com
Description: INSTALL SEWER CLEAN OUT PER STD 406-L, ABANDON EXISTING 3/4" WATER SVC
AND INSTALL NEW 1" WATER SERVICE AT MAIN PER STD 502-L.
Item: 10250 FINAL - PW
Requested Time: 4/16/2018 12:00:OOAM
Entered By: WEBUSER
Comments: AM -
Assigned to: zzzzzzzzzzz`
34/3`/
Requestor: WEBUSER
9495480106