HomeMy WebLinkAboutN2018-0711'
City
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Permit No:N2018-0711ooiv
~ iTL
cr DveNewport Bach, CA 92660
Permit Counter Phone
Project No 1680-2018
(949)644-3311
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Online Inspection Request - www.newportbeachca.gov
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Services
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Inspection Requests Phone (949)644-3255
Job Address:
393 HOSPITAL RD NB
Thomas:Guide: 888G5
Description :
REPAIR A PORTION OF DAMAGED STORM DRAIN ON PRIVATE PROPERTY, IN CITY EASEMENT, PER STD 313-L.
Parcel # :
4252-610-4 -
Legal Desc :
IRVINE SUB LOT 169 BLK 2 POR OF LOT
Owner:
NEWPORT BEACH PROPCO LP
rt
Contractor : R - 3 CONTRACTORS
Phone :
�J
Phone : 714-224-0430
Address :
300 EAST MARKET ST #100
Address : 800 E ORANGEFAIR LN
LOUSIVILLE, KY 40202
ANAHEIM, CA 92801
Contractor State Lic: 630433
Applicant:
SMITH JOSHUA
License Expire: 04 30, 2019
Phone :
949-720-3850 [
Address :
19000 MACARTHUR BLVD #500
IRVINE CA 92612
Business License : BT30065079
Business Expire: 11 30, 2019
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation Insurance - -
Carrier : TRAVELERS CASUALTY CO OF CONNE
Policy No: UB61<0557931826G
W. C. Expire: 04 01, 2019
Permit Processing Fee : $257.00
Sewer Connection :
$0.00
Total Fee $785.00
Agreement Fee:
$0.00
4TT Box Cover:
$0.00
Paid : $785.00
Traffic control Plan Check : $0.00
Total Water Meters :
$0.00
Balance : $0.00
Inspection Fee :
$528.00
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
Date
Issued Permit: Date
Traffic Approval :
: _/_/
General Services
Approval :
Date
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PROJECT ADDRESS: -013 �11 CIt
DETAILED DESCRIPTION OF PROPOSED WORK:
c4u
<�-544
APPLICANT: LQ-e S _ p v\ Phone:
Email Address: Law* , d p pp � , C p-k1
Mailing Address:
CitylState2ip:
'T7-(c I L4
OWNER: NLweeI4 D CL3 Phone: 911D
-50- 1
Email Address:
3 vvmL
Wiling -Address: 5t-
10 f 30b
City/State/zip:
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ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE CQMPM;,, �w
CONTRACTOR: q�Tc>(c�
Office Phone:
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Company (if different):
Jobsite Phone:
Other Phone:
Email Address:
MailinrAddress: J Z
City/S itel p:
State LicenseyN`umbei�,& Class:
Expires: /
City Business Licen_se u
, v06,r "7
er: '
Expires: 1 I 0 /
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: Policy No: Expires:
.........................................................................................................................
RtrFUNDP►SI:E:DEP4SIT iNfOltMATIQI:�J{ 'pNsa4� ::::::::::::::::::::::: :::::::::::::::::::::::
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............:
FOR OFFICE USE ONLY
Special Conditions of Permit:
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
General Services:
Traffic: Fire:
Other:
Enging Technician:
PuSpecialist:
b'
Date:
t . 2i
�
Perntit�lo.
OU cI
elusers/pavrshercarenuoaawnas woAaheet.bs
Public Works Department 949-644-3311
All Fees Are Non -Refundable unless Otherwise Stated
PROJECT ADDRESS: 0
c
0
PERMIT
NUMBER: N2018-
APPLICANT:
Permit Processing Fee:
Inspection Fee:
Public Works Only
$257.00
Public Works Field Inspection
$176.0
Other Department
$293.00
Utilities Field Inspection
$129.00
Agreement Fee:
Water Quality/Artificial Turf Inspection
$115.00
Preparation of Report/Agreement
$871.00
Document Recordation Fee
$204.00
Refundable Deposit:
TBDe
Monitoring Wells
$535.00
Improvements
TBD
Street/Alley/Walk Closure: $70.000 Newspaper Rack Inspection $115.00 0
Traffic Control Plan Check
8-1/2" x 11" $70.00 Sewer Connection Fee $250.00
24" x 36" $152.00 4TT Box & Cover $64.00
1
Additional _ _ _ _
--------- -----
THE FOLLOWING ITEMSRECtUIRE APPROVAL FROM THE Revenue Division
1 REVENUE DIVISION PRIOR TO PAYMENT OF FEES Approval: 1
Water Meter:
Qty.
Q
Installation Charge $563.00�
3/4" Meter
$50.25
11" Meter
$121.50
Water Meter Boxes:
11 1/2" Meter
$285.00
1" DFW Meter Box $96.66 e
11 1 /2" Turbine Meter
$700.00
2" DFW Meter Box $203.24
12" Meter
$425.00
12" Turbine Meter
$845.00
13" Meter
$3,310.00
14" Meter
$4,730.00'
16" Meter
$7,190.00
Development Services Fee (Plan check hourly)
$165.00
5200-5015
Final Tract Map Checking Fee
$2,653.00
5200-5026
Final Parcel Map Checking Fee - Moderate
$2,653.00
5200-5027
Lot Line Adjustment Fee
$1,151.00
5200-5028
Park Dedication Fee Zone
TBD
405-470
Street Easement/Vacation Fee (+100% of hrly over 4 hrs)
$1,089.00
5200-5031
Street Tree Fee ($700 Planting Fee)
TBD
030-2284
Engineering Tech:
Total Amount Due:
For Finance Use Only
g,7 . ') D
Peimlit Specialist
Receipt No.
(Tb
fJusers pbw/sher"encroachlmasterslep front and back masters/
Rev. 9/13/20181
1epfeesheetAs-revised 9/13118
1(060,2o%5
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
permit and construction plan shall be kept at the job site at all times. Work, which has been done prior to issuance of
C mpe satin Insura ce, or a Certified Co y ereo
f % 'yL
a permit, is subject to rejection/fine Gty reserves the right to void permit if work does not commence within 30 days
Da ) Signature'
after date of issuance
CERTIFICATE OF EXEMPTION (Section 3800 Labor Code)
2. The Permitlee 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
4
of the City of Newport Beach, and in compliance with all applicable State laws and City ordinances.
Permittee guarantees all work performed under this permit to be free of hidden and latent defects. Any failures shall
provprov
provisions of the State Labor Code, I must comply with the provisions of Section
be corrected within two weeks after notification to the satisfaction of the Public Works Director.
3700 or this permit shall be deemed revoked.
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 Stale 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. I 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 Encroachme t 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
Warning Signs, Sights and Other Devices for the Use in Performance of Work Upon Highways", issued by the
Public Works at 949-644-3 11 = )�
California Department of Transportation. If needed, barricades can be obtained from the City at a charge of $10.00
15. Any above ground fa iliti s 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.
ner(y
affected property owners,
10
Work within or near beach sensitive areas will not be allowed during, City holidays, spring break, Memorial Day
16. Homeowner, contractors, and rs 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
ent Practices
I I
January 1, unless approved by the Public Works Department.
Arty 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
$charge and/or up to three years in State
emergency vehicles must be maintained at all times Traffic Control must be per Work Area Traffic Control
eg l
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
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 Slate 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, er 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 Works
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 not 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 dumpsler 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 ;hall be performed until the Public Works Department has Issued this permit. Applicant hereby ackno ledges he/she h read and derstands 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 are nonrefundable.
Date i21�." .ISignature:
E o
R 3 :C 3
CONTRACTORS INC.
License No. 630433 A-HAZ
December 21, 2018
800 E. OrangeFair Lane, Anaheim, CA 92801
Phone: 714.224.0430
Fax: 714.776.8875
Web: www.R3co.com
Letter of Authorization
To: City of Newport Beach
Re: ATRIA Senior Living Facility
R3 Job # 421
To Whom It May Concern —
Gary Micheloni is a project manager for R3 Contractors, Inc., and has our approval to pull an
encroachment permit for the ATRIA project in Newport Beach
Best,
Alan Rock
alan@r3co.com
R3 Contractors, Inc.
714-224-0430
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900
344 CIRCULAR TIES
#4 a 12'
NOTES.-
1. A CONCRETE COLLAR IS REQUIRED WHERE THE CHANGE IN GRADE EXCEEDS 0.10 FT. PER FT.
2. WHERE PIPES OF DIFFERENT DIAMETERS ARE JOINED WITH A CONCRETE COLLAR, L AND T SHALL
BE THOSE OF THE LARGER PIPE D = D 10R D 2WHICHEVER IS GREATER.
3. FOR PIPES LARGER THAN 66' A SPECIAL COLLAR DETAIL IS REQUIRED,
4. FOR PIPE SIZE NOT LISTED USE NEXT SIZE LARGER.
5. OMIT REINFORCING ON PIPES 24' AND LESS IN DIAMETER AND ON ALL PIPES WHERE ANGLE A
IS LESS THAN 10. °
6. WHERE REINFORCING IS RQUIRED THE DIAMETER OF THE CIRCULAR TIES SHALL BE D +
(2 X WALL THICKNESS) + 81.
Z WHEN D 1 IS EQUAL TO OR LESS THAN D 2 JOIN INVERTS AND WHEN D 1 IS GREATER THAN D 2
JOIN SOFFITS.
8, PIPE MAY BE CORRUGATED METAL PIPE, CONCRETE PIPE OR REINFORCED CONCRETE PIPE.
REV. 9/93 1
PUBLIC WORKS DEPARTMENT
CONCRETE PIPE CALL Aft R.CEC OR 280 UBLIC WORKS
FOR PIPES 12 THRU 6611 3 Dec 1993SCALE N.T.S.
DRAWN M. GRACIA STD — 313 — L
1/9/2019 City of Newport Beach Page 4 of 19
4:30:09PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 01/10/2019
Inspection Type : ENCROACH
Inspection Area: PW
Site Address : 393 HOSPITAL RD
Activity : N2018-0711
SubType :
Status : APPROVED
OWNER: NEWPORT BEACH PROPCO LP Phone
APPLICANT: SMITH JOSHUA Phone : 949-720-3850
JOSHUAS@PANCAKEARCI
Description : REPAIR A PORTION OF DAMAGED STORM DRAIN ON PRIVATE PROPERTY, IN CITY
EASEMENT, PER STD 313-L.
a`+. 6 w..-:w
Item: 10060 PIPE INSTALLATION - UTIL
Requested Time: 1/10/2019 12:00:OOAM Requestor: NBIVR
9493799496
Entered By:
NBIVR
Comments:
AM
Assigned to:
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1/10/2019 City of Newport Beach Page 11 of 12
4:30:07PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 01/11/2019
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 393 HOSPITAL RD
Activity : N2018-0711
SubType :
Status : APPROVED
OWNER: NEWPORT BEACH PROPCO LP Phone
APPLICANT: SMITH JOSHUA Phone : 949-720-3850
JOSHUAS@PANCAKEARCI
Description : REPAIR A PORTION OF DAMAGED STORM DRAIN ON PRIVATE PROPERTY, IN CITY
EASEMENT, PER STD 313-L.
Item: 10010 BACKFILL / COMPACTION- PW
Requested Time: 1/11/2019 12:00:OOAM Requestor: WEBUSER
949-379-9496
Entered By: WEBUSER
Comments: AM -
Assigned to : 77777777777` J \/ 4 G l"j
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4051 PATRICE RD 4�1
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AGREED TO µD RECEIVED BY CUSTOMER_ PO BOX 3600 CORONA, CA 92878-3600
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Job #;=1=
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Job Location
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Date: ( - r f ' `"
--� I P.O. #: —LL //
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Truck #: _
Reference #: 2C�
Gross Wt:
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Net Wt: c�
Commodio: C
Other Notes:
Plant: + C.
lrrkal Time:
Time Deparled:
1 nlal Tintc:
Time Allowed:
Excess Time:
Reason For Standby:
&Ureries shall be made where rustomer designates. Cusmmt r berbv assumes responsibility fo
of time odelivery pr damage inside rnrb
orprWdY fine. ,1 n) and all rlaim.s for,dmgage mtd/or quality of rodrtrt delivered will not be allowed unless nutdr
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