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HomeMy WebLinkAboutN2017-0065w,y,� City of Newport Beach lllllllllllllll�llllllllVlllllllllllull II II Permit No: N2O17-0065 100 Civic Center Drive, Newport CA N 2 0 1 7 0 0 6 5 t� Beach, 92660 N '�, u.. Permit Counter Phone (949)644-3311 Online Inspection Request- www.newportbeachca.gov/Online Project No ' 4- 16 ' "tltltl �NE® n,�;:. '. Services ,.. _. Inspection Requests Phone (949)644-3255 Job Address : 503 POINSETTIA AVE NB Thomas:Guide: 919F3 Description : New sewer lateral, two (2) sewer cleanouts per STD-406-L, one (1) new water service/meter per STD-502-L, one (1) 36-inch box street tree (bottle tree), removal of all non-standard improvements, repair of damaged sidewalk/curb/gutter and one (1) curb drain per STD-184-L. f ! a EWED Parcel # : 4592-162-0 -t Legal Desc : CORONA DEL MAR LOT 3 BLK 542 SWLY 27 FT Owner: BAHADORSIAVASH Contractor: SHORELINE DEVELOPERS Phone: 0 Phone: 949-697-3993 Address : 1990 S COAST HWY #5 Address : P O BOX 551 LAGUNA BEACH, CA IF NEWPORT BEACH CA 92661 �� Contractor StateLic: 890871 Applicant: SHORELINE DEVELOPERS License Expire : 01 31, 2019 Phone: 949-697-3993 [ Address: P O BOX 551 NEWPORT BEACH CA 92661 Business License: BT30041079 Business Expire: 10 31, 2017 Special Cond.: PRECONSTRUCTION MEETING REQUIRED WITH Workers' Compensation Insurance -- PUBLIC WORKS INSPECTOR. Carrier : STATE COMP Policy No: 9038773 W. C. Expire: 01 01, 2018 Permit Processing Fee : $241.00 Sewer Connection: $250.00 Total Fee $1,979.50 Agreement Fee: $0.00 4TT Box Cover: $128.00 Paid: $1,979.50 Traffic control Plan Check : $0.00 Total Water Meters : $649.50 Balance : $0.00 Inspection Fee : $660.00 Water Meter Connection : $528.00 Receipt No: R� -�� 7-3Refundable Deposit: $0.00 Total Water Meter Box: $51.00 ^ 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 : I /-T / General Services Approval: Date �x RK&HFPT FQi� N �4 H�VI NT PER�lI1T IT1+f�wpF�IEWg4y��+t�11-11, yttr�1'txt n x :.' 7+'F�,p yz ,.�UEL�I✓'iIl11�Rl�'S=b� .�1RiIN��"', yn v '� 's { �` r 1 s COMPLETE THE BELOW INFORMATION DETAILED DESCRIPTION OF PROPOSED WORK: Ci 1 w' cE Y�tiLl Jt'�Pr J +rCe r�U r>o U 4et- s<d-- &Q.rb �r-c-t�\ Phone: (c�4`t) Q7-391,4.3 APPLICANT:( Q, - rf; (r< EmailAddress: J ltw '2) Mailj (7��AdrIrress: City/State/Zip: .V. OWNER: k ,L 0ISM Phone: qgy)30�0-?6LID Email Address: Mailing Address: CitylStatelZip: ALLOONTRA(;TUR"INFCIRAAATION`[S'R�QUIRED=RLEASE C.dMpLETE , CONTRACTOR: S�Cr � oa�'e-� . s ) VXL, -- Office Phone(,�'O) L s - -2sq 3 Company (if different): Jobsite Phone: `Ty�`i7 �943 Other Phone: Email Address: JG2 �it hprt�t�.c� n� , GC" Mailing Addres jVl3 �2(D(0 CitylStatelZip: /�)(3 Ck 92q' State License Number & Class: A( 6, F- of 7 ( Expires: ) I3 I City Business License Number: F, ( -3 o Expires: (O 31 I'7 WORKERS COMPENSATION INSURANCE - Ceficate of Insurance (Section 3800 Labor Code) Company: Policy No: Expires: Municipal Operations: 949.644.3065 Utilities: 949-644-3011;' Urban Forestry.: 949-644-3083 'FOR OFFICE USE -ONLY .. r. Special Conditions of Permit: 71 AL?DITIONAL'APpROVAL REGIUII�ED FROM THE,�OLLOWIMG DEPARTMENTA Utilities: Municipal Operations Ic Traffic: Fire: Other: Engineering Technician: Permit Specialist Date: 2-('ZI ! 1-1 Permit No. N2017- 00(9,r Nse.1pbw/sharetl/encr6ac imastem/epworksheet.xls Public Works Department 949-644-3311 100 Civic Center Drive, Newport Beach, CA 92660 GWA 20l(-, Permit Processing Fee: Inspection Fee: Public Works Only $241.00 a I Public Works Field Inspection $165.00 3 Other Department $275.001 Utilities Field Inspection $121.00 General Services Inspection $165.00 1 Agreement Fee: Water Quality/Artificial Turf Inspection $108.00 Preparation of Report/Agreement $817.00 Document Recordation Fee $192.00 Refundable Deposit: TBD Monitoring Wells $502.00 Improvements TBD StreetiAlleyMalk Closure: $65.00= Newspaper Rack Inspection $108.00 0 Traffic Control Plan Check 8-1/2" x 11" $65.00 Sewer Connection Fee $250.00k 24" x 36" $143.00 4TT Box &Cover $64.00 z Additional _______-- ---- THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division ' OFt/FRII IF MVICIf51U ORiftR TP1 DIIVM FRIT-(1F FFFC' IIrfornv9l' deter $700.00 2: Meter: 27.00 + 61.25 $88.25= $425.00 sr $845,001 For Traffic & Alley Areas (Box + Cover = Cost) Certificate of Compliance Fee (+100% of hrly over3 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 # olo-�o Permit Specialist Receipt No. f./users/pbw/shared/encroach/masters/ep front and back masters/ Rev. 1/5/2017 epfeesheetAs-revised 1012112016 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 rejectiommne. City reserves the right to void permit if work does not commence within 3,p)�yS 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. Permitlee 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 hag -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 subgrede 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 inspections by the Municipal Operations Department 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 over or within 5 feet of any City utilities, unless approved by the Public Works Department. Locale and pothole existing City -owned utilities lie: water, sewer, or street lighting conduits) to verify locations. Maintain a one -foot dearance 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 b t¢e California Department of Transportation. If needed, barricades can be obtained from the City at a charge of $lyd0 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 limes. 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 Slate 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. All USA marks shall be removed prior to Final Public Works Inspection. 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 dumpsler 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 I certify that I have a Certificate of copse Compensation Insurance, or a Certified opy the; Date:'2.1 -?)t? Signature:_ 3800 Labor Code) ,. Certificate of Worker's CERTIFICATE OF EXEMPTION (Se%ion 3800 Labor Code) I certify that in the performance of the work under this permit, 1 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: 15. All above ground facilities shall comply with the Municipal Code, including but not limited to Chapter 13.20. 16. Homeowner, contractors, and subcontractors 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 $25,000 and/or up to three years in State prison plus the full cost to clean up an illegal discharge or spill. 17. If a refundable deposit was paid, applicant must submit a Soils Compaction Certificate or Evidence of a Slurried Backfill and request a final inspection from the Public Works Department. Monies may be held for six months after final inspection before a refund will be processed. 18. No trees in the public right-of-way shall be planted, removed, trimmed, or relocated without approval from the Municipal Operations Department, Parks and Street Trees Division. 19. All work in the public right-of-way must meet the approval of the Public Works Department or corrections will be required (i.e. removals, exposing connections, etc.). Additional inspection fees may be required, 20. Permit is for standard materials in the public right-of-way only, unless previously approved by Public Works and an Encroachment Agreement has been processed. 21. Permit is valid for "description" of work noted on front only. Additional work performed may require issuance of a separate permit and/or additional fees. RU 15 pr-'P't' or I'"CH DRAT F UARE !°"CET OF JA'IPERVjot7S.SURF 1GE? NAIL & 'TAG To U8 SGT NAIL & TA(, TG %$t SE DIRT QUANTITY ESTIMAJ T'AGTO BE SET & TAG TO BE SET .l lb GP )MPFRVJ(,)US SUPVAM 4.5 F0 6T LONG TRENCH ORAIN 2M2017, City of Newport Beach Page 2 of 6 4:310:57PM INSP150 - Daily inspection Request Report Requested Inspection Date:. 02/08/2017 Inspection Type : ENCROACH Inspection Area : P1N Site Address : 503 POINSETTIA AVE Activity : N2017-0065 SubType: Status : APPROVED OWNER: BAHADOR SIAVASH Phone: 0 APPLICANT: SHORELINE DEVELOPERS Phone : 949-697-3993 Description : New sewer lateral, two (2) sewer cleanouts per STD-406-L, one (1) new water service/meter per STD-502-L, one (1) 36-inch box street tree (bottle tree), removal of all non-standard "improvements, repair of damaged sidewalk/curb/gutter and one (1) curb drain per STD=184-L. Item: 10200 PRE JOB - PW Requested Time: 2/8/2017 12:00:OOAM ' Requestor: NBIVR 9496776697� `s Entered By: NBIVR ' Comments: AM` Ir Awarwo to : � Date: 2�d / Time: 8: 30 4aPM -OWComments: 1 WAI R o7%1 Mff-rC 41rxowro-w- sere lw-ar-Nt P'4'44ss sers &- ' et r/ 42f2 r a=mIe Rccr, 5� /Y6. 14Y7L ctniE 1AZss*-c j .AW &+Ac a4 A 24 FOx So77Z6 7WAqFSir7�G✓sfGlc i, .� �s�sayrrc 621LI I ffiDAf-_f 7t7 9 e XZ= lgff /g (' 11t 4000;t- c5 � h.4� DGIe eonlc.Exn/ o?i cOirrST.�i4Tioiy f�irirr.p-.cE' w rUyF w �c� a%r t,✓z&nv u� ©�►o� ailf, B . /o G4 f'/ems o i F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc�i - i REPT131. ..:..-.--- —..:::._... �-----._ ..:::---- Run Id: 4018 4/11/2017 City of Newport Beach Page 2 of 10 6:34:20AM INSP150 - Daily Inspection Request Report Requested Inspection Date : 04/11/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 503 POINSETTIA AVE AMID Informations Activity : N2017-0065 SubType: Status: APPROVED OWNER: BAHADOR SIAVASH Phone: 0 APPLICANT: SHORELINE DEVELOPERS Phone : 949-697-3993 Description : New sewer lateral, two (2) sewer cleanouts per STD-406-L, one (1) new water service/meter per STD-502-L, one (1) 36-inch box street tree (bottle tree), removal of all non-standard improvements, repair of damaged sidewalk/curb/gutter and one (1) curb drain per STD-184-L. Requested Inspection(s) Item: 10215 ROUGH UTIL Requested Time: 4/11/2017 12:00:OOAM Requestor: WEBUSER Entered By: WEBUSER Comments: AM - Assigned to : zzzzzzzzzzz* Inspector: Date: q�a / Time: "13c) M PM F:\Users\PBMShared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc REPT131. Run Id 4018 2/28/2018 City of Newport Beach Page 15 of 18 6:34:36AM INSP150 - Daily Inspection Request Report Requested Inspection Date : 02/28/2018 Inspection Type: ENCROACH Inspection Area: PW Site Address : 503 POINSETTIA AVE Activity : N2017-006E SubType: Status: APPROVED OWNER: BAHADOR SIAVASH Phone : 0 APPLICANT: SHORELINE DEVELOPERS Phone : 949-697-3993 Description : New sewer lateral, two (2) sewer cleanouts per STD-406-L, one (1) new water service/meter per STD-502-L, one (1) 36-inch box street tree (bottle tree), removal of all non-standard improvements, repair of damaged sidewalk/curb/gutter and one (1) curb drain Item: 10200 PRE JOB - PW Requested Time: 2/28/2018 12:00:OOAM Entered By: WEBUSER Comments: ANY - Assigned to: ZZzzzzzzzzz" /1'`5 'i Requestor: WEBUSER 9496973993 Logged Refle 3/15/2018 City of Newport Beach Page 16 of 16 6:34:21AM INSP150 - Daily Inspection Request Report Requested Inspection Date : 03/15/2018 Inspection Type: ENCROACH Inspection Area: PW Site Address : 503 POINSETTIA AVE A%P/D Itlforfnation: . Activity : N2017-0065 SubType: Status : APPROVED OWNER: BAHADOR SIAVASH Phone: 0 APPLICANT: SHORELINE DEVELOPERS Phone : 949-697-3993 Description : New sewer lateral, two (2) sewer cleanouts per STD-406-L, one (1) new water service/meter per STD-502-L, one (1) 36-inch box street tree (bottle tree), removal of all non-standard improvements, repair of damaged sidewalk/curb/gutter and one (1) curb drain per STD-184-L. Item: 10110 CONCRETE PUBLIC WORKS Requested Time: 3/15/2018 12:00:OOAM Requestor: WEBUSER Entered By: WEBUSER 9496973993 Comments: ANY - Assigned to: zzzzzzzzzzz* 'f/� 411212018 City of Newport Beach Page 7 of 13 4:30:48PM INSP150 - Daily Inspection Request Report Requested InspectionDate: 04/13/2018 Inspection Type: ENCROACH Inspection Area : PW Site Address : '503 POINSETTIA AVE Activity : N2017-0065 --SubType : - - Status : APPROVED OWNER: BAHADOR SIAVASH Phone: 0 APPLICANT: SHORELINE DEVELOPERS Phone : 949-697-3993 Description : New sewer lateral, two (2) sewer cleanouts per STD-406-L one (1) new water service/meterper STD-502-L, one (1) 36-inch box street tree (bottle tree), removal of all non-standard improvements, repair of damaged sidewalk/curb/gutterand one (1) curb drain per STD-184-L. Item: 10255 FINAL - Utilities Requested Time: 4/13/2018 12:00:OOAM Requestor: WEBUSER 9496973993 Entered By: WEBUSER Comments: ANY- Assi ned to: u uzzz* InspecTor. "(; Date: a-13- I$ Time: rve M PM Comments: CFF CF 2 tab NHS C&4CZa1t: REPU�c�D�FtLPAu ARcv,.t� S CtFa+our. L GM gt. t;. f F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc REPT131. Run Id: 4018 s 4/16/2018 City of Newport Beach Page 9 of 10 6:34:36AM INSP150 - Daily Inspection Request Report SubType: Status: APPROVED OWNER: BAHADOR SIAVASH f91T4ri a APPLICANT: SHORELINE DEVELOPERS Phone : 949-697-3993 Description : New sewer lateral, two (2) sewer cleanouts per STD-406-L, one (1) new water service/meter per STD-502-L, one (1) 36-inch box street tree (bottle tree), removal of all non-standard improvements, repair of damaged sidewalk/curb/gutter and one (1) curb drain per STD- 184-L. Item Requested Time: 10250 FINAL - PW 4/16/2018 12:00:OOAM Entered By: WEBUSER Comments: ANY - Assigned to : zzzzzzzzzzz* 1 Requestor: WEBUSER 9496973993 p�,