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HomeMy WebLinkAboutN2018-0222Bea Neic IIII�IIIIIIII�III�IIIIIIII"III"IIIIIIIIIIIIIIIIIIIIIIII Permit No: N2018-0222 ,.',4'`� oity'vof wport rive, NewportBhacn,CA926so t� Permit Counter Phone (949)644-3311 Project No: 2459-2016 Online Inspection Request - www.newportbeachca.gov / Online Services Inspection Requests Phone (949)644-3255 Job Address: 3815 INLET ISLE DR NB Thomas:Guide: 919G2 Description: REMOVE PAVING IN PARKWAY AND INSTALL CITY STANDARD CONCRETE PER STD-180-L. `CANNED Parcel # : 4580-511-5 - Legal Desc : N TR 6425 LOT 56 Owner: GAEDE TRACEY L Contractor: MASONRY PLUS Phone: 0 Phone: 714-381-5997 Address : 3815 INLET ISLE DR Address : 1079 CORONA LANE CORONA DEL MAR, CA COSTA MESA CA 92626 Contractor State Lic: 553711 Applicant: GAEDE TRACEY L� License Expire : 01 31, 2019 Phone: [ Address Business License: BT00016674 Business Expire: 11 30, 2018 Special Cond.: PRE -CONSTRUCTION MEETING REQUIRED Workers' Compensation Insurance - - Carrier : STATE COMP Policy No: 9027621 W. C. Expire: 10 01, 2018 Permit Processing Fee : $241.00 Sewer Connection : $0.00 Total Fee $406.00 Agreement Fee: $0.00 4TT Box Cover: $0.00 Paid : $406.00 Traffic control Plan Check : $0.00 Total Water Meters: $0.00 Balance : $0.00 Inspection Fee : $165.00 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: General Services Approval : Date: _/_/ 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 thereo . 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 rejection/fine. City reserves the right to void permit if work does not commence within 30 days ate: �c_(o l Signature: after date of issuance 11 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. 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 fie 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 Per fTlltlinsinection is required by c)lling 9. 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 by the / Public Works at 949-644-3311 California Department of Transportation. If needed, barricades can be obtained from the City at a charge of $10.00 . 15Any above ground utilityfacilities will required m uenled 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 own 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 a Water weekend, summer between June 15 and September 15. and during the holiday season from December 19 to Quality Laws. Best Management Practices will enforced. It i 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 Wafer 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 VVork 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 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 shall be performed until the Public Works Department has Issued this permit. Applicant hereby acknowledges he/she has read un the terms and &erstands 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:�26't ,_ gnature: _ .t i �•.':Y . + `r7 _ PROJECT ADDRESS: a Ze DETAILED DESCRIPTION OF PROPOSED WORK: aykLki� ^PG �ts�C -20110 APPLICANT: R 4 Phone- 714 3 5 Email Address: �- CG Vn Mailing Address: t 0-7 4 Gc.(-o r a (-n City/StateMp: I C' s' a.. me-5 2 C OWNER: r a-C a Phone: 3 3 - 20 `3 Email Address: Mailing Address: 38i 5 fin( -S(e City/State/Zip: C. D. /►'I. ALL CONTRACTOR INFORMATION WREQ IRISEkP,��SEr4A CONTRACTOR: a.�,i a Office Phone: 7/4 546 r2-7 5 Company (if different): M At, S 6lei to' P L U 5 Jobsite Phone: Other Phone:7/4 ;;�61 Email Address: ray cL Q, U s - co Mailing Address: Io7 C' ��n� l-✓l 'city/ / t l5ia mesa Cam . 7 262W State License Number & Class: $- 8 C8 C- 217 Expires: City Business License Number: 6/,66 Expires: WORKERS COMPENSATION INSYRANCE - Certificate of Insurance (Section 3800 Labor Code) Company: S = �' FU Vl Policy No: Expires: .....:.......:....=. ::::: ::::::::::::::::::: : :::REFU00ALEpl*POSMINFOR�A�� ....p...l../...C...�...4..1.:�......:..::.....'........................................:...........:..=..... .....::. I. Pa..y.a..b ..a.:...:.:.: <:::::::`::.:::.:'.:":::.::...........::...................::::::....::: ......:....:..:..:..:.:.:....:..:..:.�f..A........................................ :::: ::: :::><:<:<::.................. :. :::: : ::: :::::::::::::::. :::>:::::::= = 'il:Rbfu4dTo : FOR OFFICE USE ONLY ' Special Conditions of Permit: ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS Utilities: General Services: Traffic: 0 Fire: 0 Other: Public Works Specialist: Date, Pennit No. 1�1 ?mil$ —b2Z2 t/�r—w%mmadumaslersl ee As Public Works Department 9494"-3311 4/26/2018 City of Newport Beach Page 3 of 13 4:30:28PM INSP150 - Daily Inspection Request Report Requested Inspection Date: 04/27/2018 Inspection Type : ENCROACH Inspection Area : PW Site Address : 3815 INLET ISLE DR Activity : N2018-0222 SubType : Status: APPROVED OWNER: GAEDE TRACEY L Phone: p Description : REMOVE PAVING IN PARKWAY AND INSTALL CITY STANDARD CONCRETE PER STD-180-L. _. ,Igs� Item: 10200 PRE JOB - PW Requested Time: 4/27/2018 12:00:OOAM Requestor: NBIVR 7143815997 Entered By: NBIVR Comments: AM Assigned to: Inspector: I?S Date: q - Z) - I $ Time: 10 : o o AM PM Comments: P=- Jo{, w -,)a aA^6y, w v, rir—wC 02EQ! ac�E �.► Ma y 30 18 �F c5-- S Al D C4src.F- -0ti; fi 1 F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\Insoectorsheet.doc REPT131 Run Id: 4018 5/7/2018 City of Newport Beach Page 8 of 8 6:34:07AM INSP150 - Daily Inspection Request Report Requested Inspection Date: 05/07/2018 Inspection TVDe : ENCROACH Inspection Area : PW Site Address : 3815 INLET ISLE DR A/P/D Information: Activity : N2018-0222 SubType : Status : APPROVED OWNER: GAEDE TRACEY L Phone: p Description: REMOVE PAVING IN PARKWAY AND INSTALL CITY STANDARD CONCRETE PER STD-180-L. Requested Inspection(s) Item: 10250 FINAL - PW Requested Time: 5/7/2018 12:00:OOAM Requestor: Entered By: WEBUSER Comments: ANY -parkway work is complete Assigned to: zzzzzzzzzzz* 3S 5_ 7_ i� 1:10�� Vi Arl L cam•. P19TV COMPLETED WEBUSER 714 381-5997 NewH_ Beach GIS U f i O rEV/�RT O C�Li.o0.Y.r •* A I © Disclaimer: Every reasonable effort has been made to assure the accuracy of the data provided, however, The City of Newport Beach and its employees and agents 0 20 40 disclaim any and all responsibility from or relating to any results obtained in its use. Feet me