HomeMy WebLinkAboutN2017-0509City of Newport Beach
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N2017-0509 "
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Permit No:
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100 Civic Center Drive, Newport Beach, CA 92660
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Permit Counter Phone (949)644-3311
Project No : SCANNED
Online Inspection Request - www.newportbeachca.gov
/ Online
/ `
Services
Inspection Requests Phone (949)644-3255
Job Address :
1332 SUSSEX LN NB
Thomas:Guide: 889135
Description :
Install 45 LF of 2-inch conduit for new CATV
service. Pavement restoration per
City Standards.
Parcel # :
4250-520-5 -
Legal Desc :
N TR 1896 LOT 59
Owner:
JABER KHALIL N
Contractor : CABLE COM OF CALIFORNIA INC.
Phone:
0
Phone: 714-666-2400
Address :
3 SHELLPRINT CT
Address : 1251 N.JEFFERSON STREET
NEWPORT BEACH, CA
ANAHEIM, CA
Contractor State Lic: 826295
Applicant:
CHARTER COMMUNICATIONS
License Expire : 07 31, 2019
Phone:
[
Address :
7142 CHAPMAN AVENUE
GARDEN GROVE, CA 92841
Business License: BT30033430
Business Expire: 10 31, 2017
Special Cond.:
Workers' Compensation Insurance - -
Carrier : LM INSURANCE
Policy No: WA563DO04260037
W. C. Expire: 07 31, 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:
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 lb /11 /1q-
General Services
Approval :
Date : / /
�-2' - �. 11
ALL UNDERGROUND WORK SHALL BE PERFORMED BY A LICENSED CONTRACTOR
Contact "Underground Service Alert" At Least 48-Hours in Advance of Any Excavation at 800-422-4133
TERMS AND CONDITIONS OF ENCROACHMENT PERMIT
WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code)
1
Encroachment Permits may be taken out by the owner of benefited property or a licensed contractor. A licensed
I certify that I have a Certificate of consent to self -insure, Certificate of Worker's
contractor must provide a "Letter of Authorization" to allow another party to pull a permit. An approved copy of the
Compensation Insurance, or a Certified Copy thereof.
permit and construction plan shall be kept at the job site at all times. Work, which has been done prior to issuance of
/ Oat /tl ? Signature:
a perrnit, is subject to rejection/fine. City reserves the right to void permit if work does not commence within 30 days
ate:
after date of issuance.
CERTIFICATE OF EXEMPTION (Section 3800 Labor Code)
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
I certify that in the performance of the work under this permit, I shall not employ
or damage to persons or property occurring as a result of work undertaken under this permit.
any person so as to become subject to California Worker's Compensation Laws. If,
3.
All work shall be done in accordance with the approved plans, Standard Special Provisions and Standard Drawings
after signing this certificate I become subject to the Worker's Compensation
of the City of Newport Beach, and in compliance with all applicable State laws and City ordinances.
provisions of the State Labor Code, I must comply with the provisions of Section
4.
Permittee guarantees all work performed under this permit to be free of hidden and latent defects. Any failures shall
3700 or this permit shall be deemed revoked.
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
Date: Signature:
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
CONTRACTOR LICENSE EXEMPTION
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,
As the Owner of the benefiting property, I certify I am personally performing all
in the alley, where a minimum half -alley width resurfacing shall be provided, unless otherwise directed by the Public
work in the Public Right -of -Way.
Works Dept. Contractors shall obtain permits to perform excavation or trench work from the California Division of
Date: Signature:
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.
HOLD HARMLESS STATEMENT
7
The Public Works Department Inspectors must inspect all work in the Public right-of-way. Forms and subgrade must
I understand that I am locating minor encroachments within the City Right -of -
be inspected and approved before concrete is ordered/poured. Sewer, pipelines, and subgrade construction must be
Way/Easement. As property owner it is my responsibility to maintain the
inspected and approved before backfilling, or applicant may be required to excavate site. Separate Utilities
encroachments. 1 will be responsible for replacing the improvements if the City
Department or General Services Department inspections may be required depending on scope of work performed,
removes them for maintenance of utilities or other public need. I shall indemnify
8.
All trench restoration must be inspected by the Public Works Department. No utility installation(s) shall be allowed
and hold the City harmless for any liability associated with the minor
over or within 5 feet of any City utilities. unless approved by the Public Works Department. Locate and pothole
encroachments.
existing City -owned utilities (ie. 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
Date: Signature:
4TT box over the riser.
24-hour notice for Encroachment Permit Inspection is required by calling
9 Properly lighted barricades must be provided and maintained around all trenches, excavations and obstructions. All
"Manual
signs, flags, lights and other warning and safety devices shall conform to the requirements of the current of
Public Works at 949-644-3311.
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
15 Any above ground utility facilities will require documented approval from the adjacent
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.
affected property owner(s).
10
Work within or near beach sensitive areas will not be allowed during, City holidays, spring break, Memorial Day
16. Homeowner, contractors. and subcontracotrs may each be liable for violations of Water
weekend, summer between June 15 and September 15, and during the holiday season from December 19 to
Quality Laws. Best Management Practices will be enforced. It is against the law to
11.
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
discharge construction debris into the gutter and storm drain. Felony violations of Water
acquire a Temporary Street Closure Permit from the Public Works Department. Access for fire, police and
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.
emergency vehicles must be maintained at all times. Traffic Control must be per Work Area Traffic Control
17. If a refundable deposit was paid, applicant must submit a Soils Compaction
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
Certificate or Evidence of a Slurried Backfill and request a final inspection from the
the Public Works Department. Any work affecting the State Highway's traffic or within the State Highway right-of-way
Public Works Department. Monies may be held for six months after final inspection
will require a Caltrans Permit. All vehicles shall be lawfully parked.
before a refund will be processed.
12.
This permit does not authorize the closure of sidewalks, streets, or alleys for construction access, storage of
18. No trees in the public right-of-way shall be planted, removed, trimmed, or relocated
materials, or parking of construction vehicles unless detailed on an attached Temporary Street Closure.
without approval from the General Services Department.
13
Applicant must notify USA at 1-800-227-2600 2 days before starting any underground construction. Applicant
19. All work in the public right-of-way must meet the approval of the Public Work,
must notify all affected residents 24 hours in advance of restricted access and any inconveniences.
Department or corrections will be required (i.e. removals, exposing connections,
14.
Refuse or unused materials shall be removed within 24 hours after completion of the work. If riot removed, the City
etc.). Additional inspection fees may be required.
may remove and bill the applicant. Coordinate alley closures with City's refuse pick-up days by calling 949-644-3066
20. Permit is for standard materials in the public right-of-way only, unless previously
for the collection schedule so service is not interrupted. To place a dumpster or materials in the public right-of-way, a
approved by Public Works and an Encroachment Agreement has been processed.
Temporary Street Closure Permit must be obtained from the Public Works Department,
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.
No work related to this encroachment permit 4hall be performed until the Public Works Department has issued this permit. Applicant hereby acknowledges he/she has read and understands the terms and
conditions of this permit and he/she agrees to abide by them. Permit Is void if work is not commenced within 30 days after Issuance.
Permit fees - Date:�%i'!�,�/7 :
are nonrefundable.
__�5ignatur
FEE WORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
All Fees Are Non -Refundable Unless Otherwise Stated
PROJECT ADDRESS:
PERMIT
;332 SvSsex L.%
N2017- O SD9
NUMBER:
APPLICANT:
Permit Processing Fee:
Qty.
Inspection Fee:
Qty.
Public Works Only
$241.00
i
Public Works Field Inspection
$165.00
3
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:
TBD
Monitoring Wells
$502.00
Improvements
TBD
Street/Alley/Walk Closure: $65.00Newspaper 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
1 THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division 1
REVENUE DIVISION PRIOR TO PAYMENT OF FEES ]Approval:
Qty.
(Water Meter:
Installation Charge
$528.00
13/4" Meter
$50.25
Water Meter Boxes:
11" Meter
$121.50
For Parkway & Sidewalk Area (Box + Cover = Cost)
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
12" Meter
$425.00
'2„ Turbine Meter
13 Meter
$845.00
$3,310.00
For Traffic & Alley Areas (Box +
1 Meter: 13.00 + 38.00
Cover = Cost)
$51.00
14" Meter
$4,730.00
2" Meter: 27.00 + 162.00
$189.00
6" Meter
$7,190.00
MISCELLANEOUS
FEES
City.
Budget Number
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/Vacation Fee (+100% of My over 4 hrs)
$1,022.00
5200-5031
Street Tree Fee ($700 Planting Fee)
TBD1
030-2284
Engineering Tech:
Total Amount Due:
For Finance Use Only
Permit Specialist
Receipt No.
f /users/pbw/shared/encroach/masters/ep front and back masters/
Rev. 1/5/2017
epfeesheet ids -revised 10/21/2016
'Almendralo, Rodi
From:
Noble, Brian <brian.noble@cablecomllc.net>
Sent:
Tuesday, September 26, 2017 7:43 AM
To:
Almendralo, Rodi; Richard Vega
Subject:
1332 Sussex Ln, Newport Beach Permit request
Attachments:
1332 Sussex Ln, Newport Beach SOW jpg
Good morning Rodi,
We need to place a new drop conduit from a hand hole to a vault to service a customer this is a 2" conduit 45ft
in length.
Brian Noble
Field Supervisor
CableCom of California, Inc
1251 N Jefferson St.
Anaheim Ca. 92807
Cell: 714-681-3554
Phone:714 666 2400 Ext. 240
Fax:
Email: brian.noble(i4cablecomllc.net
This email, and any documents which may accompany it, contain information which is intended for use only by the
individual to whom it is addressed, and may contain information that is privileged, confidential and/or exempt from
disclosure under applicable law. If the reader of this message is not the intended recipient any review, disclosure,
dissemination, distribution, copying or other use of this message or its substance is strictly prohibited. If you have
received this message in error, please contact me immediately to arrange for return or destruction. Thank you.
This email message, and any documents which may accompany it, contain information which is intended for use only by the intended
recipient(s), and may contain information that is privileged and/or confidential. If you are not the intended recipient of this message
you are hereby notified that any review, disclosure, dissemination, distribution, copy or other use of this message or its attachments is
strictly prohibited. If you have received this message in error, please notify the sender by reply email, delete the email from your
computer and destroy all copies of the communication and any attachments.
N ZO%i -- Osbct
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Google
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CITY OF NEWPORT BEACH CASH RECEIPT
'vy a FINANCE DEPARTMENT
`A
Xt
? = 100 Civic Center Drive, Newport Beach, CA 92660
P.O. BOX 1768, Newport Beach, CA 92658-8915
Permit Number: N2017-0509 Plan Check Number:
Today's Date : Oct 11, 2017 Receipt Number: R000081828
Job Address: 1332 SUSSEX LN NB
Description: Install 45 LF of 2-inch conduit for new CATV service.
Owner : JABER KHALIL N
Applicant: CHARTER COMMUNICATIONS
Date Paid : Oct,11,2017 11:23 AM Total Paid : $571.00
Notation:
Initial: RA
Description Payment Type
Payment Check
FOR PLAN CHECKS ONLY:
TARGET DATE:
Check Number
289778
Card Type
$571.00
For status, please log on to www.newportbeachca.gov/building, and select PLAN CHECK STATUS or
call (949) 644-3255
NOTICE: PLAN CHECK EXPIRES 180 DAYS FROM DATE OF SUBMITTAL
10,116/2017 City of Newport Beach Page 4 of 18
4:30:47PM INSP1 SO - Daily Inspection Request Report
Requested Inspection Date:
10/17/2017
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address:
1332 SUSSEX LN
Activity :
N2017-0509
SubType :
Status :
APPROVED
OWNER:
JABER KHALIL N
Phone: p
APPLICANT:
CHARTER COMMUNICATIONS
Phone : 714-681-3554
Description :
Install 45 LF of 2-inch conduit for new
CAN service.
Pavement restoration per City
Standards.
Item:
10050 EXCAVATION- PW
Requested Time:
10/17/2017 12:00:OOAM
Requestor:
WEBUSER
714-681-3554
Entered By: WEBUSER
Comments: ANY -Bore work to start
Assigned to: 77777777777*
Inspector: rt / ✓4 Date: 0 Time: ( 0 ',, 40P8 PM
Comments: CMy"ID -'s 1 oyy `�� e
C �11 v� rm� f
4e
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsvectorSheet_doc
REPT131 Run Id: 4018
• 10M8/2017 City of Newport Beach Page 21 of 21
4:30:10PM INSP150 - Daily Inspection Request Report
Requested Inspection Date:
10/19/2017
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address:
1332 SUSSEX LN
Activity :
N2017-0509
SubType :
Status :
APPROVED
OWNER:
JABER KHALIL N
Phone: 0
APPLICANT:
CHARTER COMMUNICATIONS
Phone : 714-681-3554
Description :
Install 45 LF of 2-inch conduit for new
CAN service.
Pavement restoration per City
Standards.
Item:
10050 EXCAVATION- PW
Requested Time:
10/19/2017 12:00:OOAM
Requestor:
WEBUSER
714-681-3554
Entered By: WEBUSER
Comments: AM -Work to start
Assigned to 77777777777*
Inspector: a Date: b 1Ot (I Time: D U PM
Comments: kr'e'-c o) , Y1 C, I-yx A
Refile
F_\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131 Run Id: 4018
10,23/2017 City of Newport Beach Page 6 of 7
4:30:49PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 10/24/2017
Inspection Type : ENCROACH
Inspection Area : PW
Site Address : 1332 SU�SSEX LN
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Activity :
N2017-0509
SubType :
Status :
APPROVED
OWNER:
JABER KHALIL N Phone: 0
APPLICANT:
CHARTER COMMUNICATIONS Phone : 714-681-3554
Description :
Install 45 LF of 2-inch conduit for new CAN service. Pavement restoration per City
Standards
. 7 � :: +v r.4 .s.\7 y7 �� '�. • t r q�r
Item:
10020 PERMANENT PAVING- PW
Requested Time:
10/24/2017 12:00:OOAM Requestor: WEBUSER
714-681-3554
Entered By: WEBUSER
Comments: ANY -Restoration
Assigned to: zzzz7777777*
Inspector: "6,C+ Sly �til� Date: IC-2 z -7 Time: I' AM �
Comments: Cask rr r 217 -A
/�; � �{- �C, j�k �G yl - L/ o✓t �v G< <-tv �'' S�� 1-� GC . � l� i Yt � C Gt � �t � inG
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
REPT131 Run Id: 4018
• ' 171? /2017 City of Newport Beach Page 9 of 15
4:30:53PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 12/08/2017
Inspection Type: ENCROACH
Inspection Area : PW
Site Address : 1332 SUSSEX LN
gt
pJN flit.:: +.•ir�'r]4r+i'�?. "v3, i ''3°,..r ,44
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Activity :
N2017-0509
SubType :
Status :
APPROVED
OWNER:
JABER KHALIL N Phone: o
APPLICANT:
CHARTER COMMUNICATIONS Phone : 714-681-3554
Description :
Install 45 LF of 2-inch conduit for new CAN service. Pavement restoration per City
Standards.
}
n..�Ht<
_... a Y �K.:, "2bt+rt n�.:�►4�&X%• S.,.,.•hx.'-.'.�'.
Item:
10250 FINAL - PW
Requested Time:
12/8/2017 12:00:OOAM Requestor: WEBUSER
714-681-3554
Entered By: WEBUSER
Comments: ANY -Final inspection permit close out
Assigned to: zzzzzzzzzzz*
Inspector: Q V Date: o Time: b` AM PM
01
Comments:
COMPLETED
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
REPT131 Run Id: 4018