HomeMy WebLinkAboutN2017-0006City of Newport Beach IIII��������������IIIII
100 Civic Center Drive Newport Beach CA 92660
Permit Counter Phone (949)644-3311
v �,�. Online Inspection Request - www.newportbeachca.gov / Online
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Permit No: N2017-0006
Project No : 1118-2014
Inspection Requests Phone (949)644-3255
Job Address : 1009 E BALBOA BLVD NB Thomas:Guide: 919C2
Description : Reconstruction of existing drive approach and portion of sidewalk. Plug any portion of old abandoned drive approach.
Parcel # : 0481-440-5 -
Legal Desc : BALBOA TR EAST SIDE ADD BLK 16 LOT 5
Owner: SELL DORTHA J THE
Phone : 0
Address : 1009 BALBOA BLVD E
NEWPORT BEACH, CA
Applicant: KEEGAN'S CONCRETE
Phone : 949-650-6991 949-290-8615[
Address : 788 W 16TH STREET
COSTA MESA CA 92627
Special Cond.: Preconstruction meeting required with
Public Works inspector.
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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 :
$330.00
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
Contractor: KEEGAN'S CONCRETE
Phone : 949-650-6991 949-290-8615
Address : 788 W 16TH STREET
COSTA MESA CA 92627
Contractor State Lic: 632315
License Expire : 05 31, 2017
Business License: BT98041837
Business Expire:
04 30, 2017
Workers' Compensation Insurance - -
Carrier :
NORGUARD INS
Policy No:
KEWC631922
W. C. Expire:
03 19, 2017
Total Fee $571.00
Paid : $571.00
Balance : $0.00
Receipt No:
Date: _/_/ Other Department : -Date:
Date : _/_/ Permit Denied Date:
Date : / / Issued Permit : 1,'t_.L�. Date : {• / �' / f .
Date:
JEER T!11
MAMMA
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E:SELOWANFORMAT.ION:::"""�:::::::::::::::::::::: :
PROJECT ADDRESS: 0, 1,6 P Ae
DET ED DESCRIPTION OF P POSED WORK: / 1
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Ale -�/%�' O r L E G G
Phone:
E[EmallAddress:
ss:
City/State/Zip:
OWNER:
Phone:
Email Address:
Mailing Address:
City/State/Zip:
ALL CONTRACTORINFORMATION IS REQUIRED=PLEASE°GOMPLETF
CONTRACTOR: !<:�e'eG C." �-5 O10- c 04-e.
Office Phone: -N `r
Company (if different):
Jobsite Phone:
Other Phone: tL'q o -Y' Ce-
Email Address: �« ��c. Cst s v.1we 4--e'"
Mailing7dreV 6
City/State/Zip:
State License Number & Class:
Ex ires:5 -/ 7 0
City Business License Number:
Expires:
WO RS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Co any: �— Policy No: Expires:
.................................................. .
-3055:::.::::::::::::::::::::::. :::::::::::::::::::::::: ; ;::::::::::::.:.: :
Munici :al.?0 :eratioris:;::949-f44.. .....................................................................................
....
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Special Conditions of Permit: t -ua,♦� �� t� �. s w \r�s cam-"
ADDITIONAL~APPROVAL'RE4UIREDfROM'HE'FOLOWINCi°DEPARTMENTS'°r
Municipal Operations
Other:
Engineering Technician:
Permit Specialist
Date:
1
Permit No.
N201 J- 000(0
f:/users/pbw/shared/encroach/masten/epwaksheet. xis
Public Works Department 9494"-3311
100 Civic Center Drive, Newport Beach, CA 92660
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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 rejection/fine. City reserves the right to void permit if work does not commence within 30 days
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.
Permittee 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 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 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 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 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 installations) shall be allowed
over or within 5 feet of any City utilities, unless approved by the Public Works Department. Locate and pothole
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
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 by the
California Department of Transportation. If needed, barricades can be obtained from the City at a charge of $10.00
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 times. 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 State 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 dumpster 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 (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: ✓��"'/��
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 indemnity
and hold the City harmless for any liability associated with the minor
encroachments.
Date:
Riii quat
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.
Permit Processing Fee:
Public Works Only $241.00 1
Other Department $275.00
Agreement Fee:
Preparation of Report/Agreement $817.00
Document Recordation Fee $192.00
Monitoring Wells $502.00
Inspection Fee:
Qty-
Public Works Field Inspection $165.00
Utilities Field Inspection $121.00
General Services Inspection $165.00
Water Quality/Artificial Turf Inspection $108.00
Refundable Deposit:
Improvements
Street/AlleylWalk Closure: $65.000 Newspaper Rack Inspection
Traffic Control Plan Check
8-1/2" x 11" $65.00 Sewer Connection Fee
24" x 36" $143.00 4TT Box & Cover
Additional
THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE R
REVENUE DIVISION PRIOR TO PAYMENT OF FEES A
TBDeTBD
$108.00 Q
$250.00
$64.00
--------
venue Dlvislon 1
(Water Meter.
13/4" Meter $50.25
11" Meter $121.50
11 1/2" Meter $285.00
11 1/2" Turbine Meter $700.00
12" Meter $425.00
12" Turbine Meter $845.00
13" Meter $3,310.00
14" Meter $4,730.00
i6" Meter $7,190.00
Installation Charge $528.001 I 1
Water Meter Boxes:
For Parkway & Sidewalk Area (Box + Cover = Cost 1
1" Meter: 13,00 + 37.00 $50.00
2: Meter. 27.00 + 61.25 $88.25
1
For Traffic & Alley Areas (Box + Cover = Cost) 1
1" Meter: 13.00 + 38.00 $51.00 F:::]
2" Meter: 27.00 + 162.00 $189.00
1
Certificate of Compliance Fee (+100% of My 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 EasementlVacation Fee (+100% of hry over 4 hrs)
$1,022.00
5200-5031
Street Tree Fee ($700 Planting Fee)
---.._.._ ....
TBD
....
_....
_.._
030-2284
...._........
Engineering Tech: Total Amount Due: For Finance Use Only
Permit Specialist Receipt No.
C1UwWpbW*har"9naoechlmaaten/ep hart and back maate w
Rev. 10/21/2016 eprew0xW.x1s-revi9ed 10/21/2016
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REPT131 Run Id: 4018
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F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\( nsoectorSheet.doc
REPT131 Run Id: 4018
2/2812017 City of Newport Beach Page 2 of 11
6:34:03AM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 02/28/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 1009 BALBOA BLVD E
A/P/D Information:
Activity :
N2017-0006
SubType :
NEW
Status :
APPROVED
APPLICANT:
KEEGAN'S CONCRETE Phone : 949-650-6991
949-290-8615
OWNER:
SELL DORTHA J THE Phone: 0
Description :
Reconstruction of existing drive approach and portion of sidewalk. Plug any portion of old
abandoned drive approach.
Requested Inspection(s)
Item:
10250 FINAL - PW
Requested Time:
2/28/2017 12:00:OOAM Requestor: NBIVR
Entered By: NBIVR
Comments: AM
Assigned to:
9097300555 —S1E-VL
Inspector: ..i Date: 1 7 Time: l 6'•' �f AM
ZZ9✓ j PM
Comments: O k TV dt—�'-t (1) C;
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Run Id: 4018