HomeMy WebLinkAboutN2018-0314{ PeN r•o4 P 00 Civic
ic Center
Dport Beach rive, NewportBach, CA 92660 IIf II11I II IIIII IIIIIIII II II III�II IIII4 II
h Permit Counter Phone (949)644-3311
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Online Inspection Request - www.newportbeachca.gov /Online
n 't' Services
Permit No: N2018-0314
Project No :
Inspection Requests Phone (949)644-3255
Job Address : 416 HAZEL DR NB Thomas:Guide: 919173
Description : INSTALL 48-INCH BOX KENTIA PALM STREET TREE PER CITY STANDARDS.
Parcel # :
4591-230-8 -
Legal Desc :
N TR 673 BLK B LOT 42
Owner:
IMPEY WALTER
Phone:
0
Address :
416 HAZEL DR
CORONA DEL MAR, CA
Applicant: MARC STRADWICK
Phone: 714-318-2645 [
Address : 34145 PACIFIC COAST HIGHWAY #161
DANA POINT, CA 92629
Special Cond. :
SCANNED
Contractor:
MARC STRADWICK
Phone:
714-318-2645
�O�oU��ppppb6'1FF//11
COMPLIED
Address :
34145 PACIFIC COAST HIGHWAY #161
DANA POINT, CA 92649
Contractor State Lic:
License Expire :
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 :
$165.00
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:
Business License
Business Expire :
Workers' Compensation Insurance - -
Carrier :
Policy No
W. C. Expire:
Total Fee
Paid :
Balance
Receipt No:
Other Department :
$406.00
$406.00
$0.00
2 . gsty4
Permit Denied Date: _/_/
Issued Permit : Date: ro / O / t 4
C/27/1 g
I ALL UNDERGROUND. WORK SHALL BE PERFORMED BY -A LICE NSED',CONTRACTOR I
Contact "Underground Service Alert" At Least 48-Hours in Advance of Any Excavation at $00-422-4133
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
pemlit and construction plan shall be kept al the job site at all times. Work, which has been done prior to issuance_at
a permit, is subject to rejectionlflne. City reserves the right to void permit if work does not commence within 30 days
after date of issuance.
2. The Permitlee agrees to defend, indemnify anti hold the City, its authorized agent, officers, representatives anti
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 perrnll.
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 Stale laws and City ordinances.
4. 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.
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 Slate Contractor License Class A can perform any work in the public right-of-way. For
construction or connection to water lines a valid Stale Contractor License Class C-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 Slate law. Walls and faces of all
excavations over 5 feet in depth shall be protected by a sharing system, sloping of the ground, or other equivatent
means. Trenches less than 5 feet in depth shall be guarded when hazardous ground movement may be 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 feel of any City utilities, unless approved by the Public Works Department. Locate and pothole
existing City -owned utilities fie, water, sewer, or street lighting conduits) to verify locations. Maintain a one -foot
clearance over of under existing City -awned utilities. Sewer cleanouts require VCP or PVC SDR35 be used with a
4TT boy over the riser.
9. Properly lighted barricades must be provided and maintained around all trenches, excavations and obstructions. All
signs. flags, lights and other warning and solely devices shall conform to the requirements of One 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 boll the City at a charge of $10.00
per barricade per day, with a minimum charge of S35.00. 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, smnmer between June 15 and September 15, and during the holiday season from December 19 to
January 1, unless approved by the Public Works Department.
1 I. 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 anti
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
Oil 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 Slate Highways traffic or within the Slate Highway right-of-way
will require a Caltrans 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 most 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 riot interrupted. To place a dunlpster or materials in the public right-of-way, a
Temporary Street Closure Permit must he obtained from the Public Works Department.
No work, related toa,this encroachment permit shall be performed until the Public Works Department has issued
conditions of this permit and he/she4greesto abide,by them. Permit Is void if work 'Is -mot commenced within 30
Permit fees are.nonrefundable. ; i
WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code)
I certify that I have a Certificate of consent to self -insure, Certificate of Worker's
Compensation Insurance, or a Certified Copy thereof,
Date:Signature:' _vim
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. I shall indemnify
and hold the City harmless for any liability associated with the minor
encroachments.
Date: Signature:
24-hour notice for Encroachment Permit Inspection is required by calling
Public Works at 949-644-3311.
15. Any above ground utility facilities will require documented approval from the adjacent
affected property owners).
16. Homeowner, contractors, and subcontracolrs 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 S25,000 and/or up to three years in Slate
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 play 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, hirnmed, or relocated
without approval from the General Services Department.
19. All work in the public right-of-way must meet the approval of the Pu lie Woks
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.
ermit'AApphcant acknowledgesihelshe'has:readantl understands theiterms•and';
after.issuance: -
(! - .Date:2//�X' Sianafure':_ :/ ---
FEE WORKSHEET FOR ENCROACHMENT PERMIT,..
• ` CITY•OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
All Fees Are Non -Refundable Unless Otherwise Stated
PROJECT ADDRESS: PERMIT
HI(p Ao2el 064,0 NUMBER: N2018-Q3r�l
PPLICANT:
Mo,.k 5�-rvdvicl�
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
Street/Alley/Walk Closure:
Traffic Control Plan Check
Q Inspection Fee:
$241.00Public Works Field Inspection
$275.00 Utilities Field Inspection
General Services Inspection
Water Quality/Artificial Turf Inspection
$.00
$192192.00 Refundable Deposit:
$502.00 Improvements
$65.000 Newspaper Rack Inspection
Q .
$165.00 I
$121.00
$165.00
$108.00
TBDBTBD
$108.00 0
8-1/2" x 11" $65.00= Sewer Connection Fee $250.00
24" x 36" $143.00 4TT Box & Cover $64.00
---- Additional-
-------- ---------
I THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division 1
Qty.
Qt .
[Water Meter:
Installation Charge $528.00
1314" Meter
$50.25
11" Meter
$121.50
Water Meter Boxes:
11 1/2" Meter
$285.00
1" DFW Meter Box $96.66
11 1/2" Turbine Meter
$700.00
2" DFW Meter Box $203.24 B
12" Meter
$425.00
12" Turbine Meter
$845.00
13" Meter
14"
$3,310.00
Meter
$4,730.00
16" Meter
$7,190.00
Certificate of Compliance Fee (+100% of hrly over 3 hrs) $288.00
Development Services Fee (Plan check hourly) $155.00
Final Tract Map Checking Fee $2,488.00
Final Parcel Map Checking Fee - Moderate $2,488.00
Lot Line Adjustment Fee $1,079.00
Park Dedication Fee Zone _ TBD
Street EasemenWacationFee (+100%ofhrlyover 4hrs) $1,022.00
Street Tree Fee ($700 Planting Fee) TBDI
5200-5029
5200-5015
5200-5026
5200-5027
5200-5028
405-470_
5200-5031
030-2284
Engineering Tech:
Total Amount Due:
For Finance Use Only
Permit Specialist
Receipt No.
O
(�O
P, 46
f:1.wrsfPb 1Sh.mwenwaWmastersep front and back masters)
p'�
Rev. 12/18/2017
—,Sslu
epfeesheet xls-revised 11017
-WORKSHEET FOR'ENCROACHMENT PERMIT, e
'1 }4 CITY,OF NEINP�OR7�BEACHfi wk�k a
"°?'!tr
-• ., ., a:PUBLIC;-WORKS DEPARTMEN�T:i�,r�;
O PL :E : :BELOW: I.O O :: >: is>,
PROJECT ADDRESS: l Ze. L GOiZD tti (_ ��r�ry!/2
DETAILED DESCRIPTION OF PROPOSED WORK:
P,aLvi
4-A00 9`6- inrat huc {�*1iu Pv1m saveek +vac .
APPLICANT: A&L `JT/�/Jp4Ji�l�
Phone: /�f `//B Z6'/5'
Email Address: A*-7ALO_L �S7•��rpL�GO-���r2✓ZTto��. Ge
Mailing Address: City/State/Zip:
OWNER: .����
Phone:
Email Address:
Mailing Address: City/State/Zip:
ALL CONTRACTOR_ INFORMATIONiIS _REQUIRED
-PLEASE: COMPLETE
CONTRACTOR: �L
Office Phone:
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:
12EFUNDABC DEPOSIT.INFORMATIO . 1(A livable :::::2 i i::2-`<'ii i%i ii ii: : ; >:>::
_._ E.. . . _... N.(...PR
__ _. . _.
Refund Payable To ..: - - .....: ..... ......:.::...... ..... ..... ..... .
Mail Refund fp
- - - -- -- - 'FOR`OFFICE USE ONLY
Special Conditions of Permit:
ADDITIONAL_ 'APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
General Services:
Traffic: Fire:
Other:
Engineering Technician:
Public Works Specialist:
Date:
1
Permit No.
1 N201's-0316
fAL... veMSlmrMkiwoarivma:eislam onwael#s
Public Works Department 949-644-3311
6/27/2018 City of Newport Beach
6:34:22AM INSP150 - Daily Inspection Request Report
Requested Inspection Date :
06/27/2018
Inspection Type:
ENCROACH
Inspection Area :
PW
Site Address :
416 HAZEL DR
Activity : N2018-0314
SubType:
Status: APPROVED
Page 5 of 17
OWNER: IMPEY WALTER Phone : 0
APPLICANT: MARC STRADWICK Phone : 714-318-2645
Description: INSTALL 48-INCH BOX KENTIA PALM STREET TREE PER CITY STANDARDS.
Requested Inspection(s)
Item: 10250 FINAL - PW
Requested Time: 6/27/2018 12:00:OOAM Requestor: NBIVR
7143182645
Entered By: NBIVR
Comments: AM `
Assigned to : �!� e22 -7
comPLEE®