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Home My WebLink AboutN2017-0141`rEM�•4T' City Newport Beach 1111111111111111111111111111111111111111111111111111111111 Permit No:N2017-0141,'Vf Each, CA J2660 i '•'., ... '.L Permit Counter Phone (949)644-3311 Project No 2285-2016 v Online Inspection Request - www.newportbeachca.gov / Online In4Or+'`� Services Inspection =- Requests Phon 644�33�5 Job Address: 1000 BRISTOL ST NB St: 1 FI: 1 Unit: 28 Thomas:Guide: Description : INSTALL NEW RP BACKFLOW DEVICE FOR DOMESTIC WATER METER PROTECTION Parcel # : Legal Desc : Owner: LSW LTD Contractor : GILMORE RYAN Phone : Phone : Address : 1000 BRISTOL ST N Address : 1996 DAWN RIDGE DRIVE NEWPORT BEACH CA 92660 rf CORONA CA Contractor State Lic: 883547 Applicant: GILMORE RYAN License Expire : 08 31, 2018 Phone: 714-448-1066 [ Address : 1996 DAWN RIDGE DRIVE CORONA CA 92882 Business License: BT30058478 Business Expire: 03 31, 2018 Special Cond.: PRE -CONSTRUCTION MEETING REQUIRED Workers' Compensation Insurance - - Carrier : FARMERS INS CO Policy No: 605035425 W. C. Expire: 08 01. 2017 Permit Processing Fee : $241.00 Sewer Connection : $0.00 Total Fee $527.00 Agreement Fee: $0.00 4TT Box Cover: $0.00 Paid : $527.00 Traffic control Plan Check : $0.00 Total Water Meters : $0.00 Balance : $0.00 Inspection Fee : $286.00 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: _/_/ WORK& RT.F R C NT RAAIT Y- 1►c! ' R BLOC COMPLETE THE BELOW INFORMATION PROJECT ADDRESS: idim j3r? DETAILED DESCRIPTION OF PROPOSED WORK: APPLICANT: Phone: Email Address: Mailing Address: 1 wr r-) City/State2ip: 882 OWNER: o Phone: Email Address: Mailing Address: City/State/Zip: ALL CONTRACTOR INFORMATION 13 REQUIRE"LEASE COMPLETE CONTRACTOR: � e Office Phone: /O —U& Company (if different(. f Jobsite Phone: Other Phone: Email Address: » �� Mailing Address: , . City/State/Zip: State L' ense Number & Class: Ex ires: 3lI S $ 54-7 / City Business Lic rise Number- I D?>S% �7 Expires: �I I WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code) Company: !'r,►P. ys Policy No: aso3syzs Expires: >7 Municipal Orations: 949-644-3055 Utilities: 949-644-3011 Urban Forestry: 949-644-3083 FOR OFFICE USE ONLY Special Conditions of Permit: i 1 ' tL ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS Utilities: Municipal Operations Traffic: Fire: Other: Engineering Technician: Permit ialist LI)! Dat 'qj 7 I Permit No. IN2017- f lusers/pbwi3har"encr ad*na3terWepworkaheet.As r% Public Works Department 949444-3311 100 Civic Center Drive, Newport Beach, CA 92660 Permit Processing Fee: Public Works Only Other Department Agreement Fee: Preparation of Report/Agreement Document Recordation Fee Monitoring Wells Inspection Fee: $241.0 Public Works Field Inspection $165.0 $275.00 Utilities Field Inspection $121.00 General Services Inspection $165.00 Water Quality/Artificial Turf Inspection $108.00 $817.00 $192,001 1 Refundable Deposit: TBDe $502.00 Improvements TBD Street/Alley/Walk Closure: $65.000 Newspaper Rack Inspection $108.00 Q Traffic Control Plan Check 8-1/2" x 11" $65.00 Sewer Connection Fee $250.00 24" x 36" $143.00 4TT Box S Cover $64.00 Additional THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division I REVENUE DIVISION PRIOR TO PAYMENT OF FEES Approval: I I aty• I Water Meter: Installation Charge $528.00 � 13/4" Meter $50.25 Water Meter Boxes: 1 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 12" Turbine Meter $845.00 For Traffic & Alley Areas (Box + Cover = Cost) 13" Meter $3,310.00 V Meter: 13.00 + 38.00 $51.00 4" Meter $4,730.00 2" Meter: 27.00 + 162.00 $189.00 6" Meter $7,190.00 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 Permi ecialist Receipt No. f:/userslpbw/shared/encroachlmasters/ep front and back masters) Rev. 1/5/20171 epfeesheet As -revised 10/21/2016 ;Z4s - 3C 1( 'P4- 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 1 Encroachment Permits may be. taken oul by the owner of benefited property or a licensed contractor A licensed contractor most provide i I eller of Authorization to allow another party to pull a permit An approved copy of the permit and construction plan shall be. kept at the lob site at all times V%coik which has been done prior to issuance off a permit, is sublecl to selection tine City reserves the right to void permit if work does not commence within 30 days after date of issuance 2. The Permdtee agrees to defend, indemnify and hold the Cily. 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 :3 All work shall be done in accordance with the approved plans. Standard Special Provisions raid Standard Drawings of the City of Newport Beach. and in compliance with all applicable State laws and City ordinances 4 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. 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 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 Stale 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 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 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 feet of any City utilities. unless approved by the Public Works Department Locate and pothole existing City -owned utilities lie water sewer. or street lighting conduits) to verify locations Maintain a one -foot clearance over or under existing Gtv-owned utilities Sewer cleanouts require VCP or PVC SDR35 be used with a 4TT box 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 safely 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 fransportalion If needed. barricades can be obtained from 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 most be maintained at all times 10 Work within or near beach sensitive areas will not be allowed during. City holidays. spnnq break. Memorial Day weekend, summer hetween June 15 and September 15, and during the holiday season front December 19 to January 1. unless approved by the Public Works Department I 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 and emergency vehicles must be. maintained at all times 1 rafhc Control must be per Work Area Traffic Control Handbook (WATCH) No nighllime traffic lane closures unless prior approval has been granted Any lane(s) closure on a manor 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 Slate Highway right-of-way will require a Callrans Permil All vehicles shall be lawfully parked 12 This perms) does not aulhonze the closure of sidewalks streets, or alleys for construction access, storage of materials or parking of construction vehicles unless detailed on an attached Tenporary 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 not interrupted to place a dumpsler or materials in the public right-of-way. a Temporary Street CIOSUre Permit must be obtained from the Public Works Department. WORKER'S COMPENSATION INSURANCE (Secti I certify that I have a Certificate of consent to self -in Compensation l�surance, or a Certified Copy the) Date: Signature: Code) of Worker's 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 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: 2 -hour notice for Encroachment Per '—s ion is required by calling I blic Works at 949-644-3311. 15 Any above ground utility facilities will require documented approval from the adla(enl Affected properly owners) 16 Homeowner. contractors, and subconlracotrs may each be liable for violations of W,iler Quality Laws Best Management Practices will be enforced II is agalnsl the laiw to discharge construction debris into the gutter and slorm drain f elnny violations of W:dctr Quality Laws are punishable by fines up to S25 000 and or up to Ihnoe vend; ei tilnlc prison plus the full cost to clean up an illegal discharge or spill 17. If a refundable deposit was paid. applicant Hurst subnmt a Soils Conrli;rctic•n Certificate or Evidence of a Slurried Backfill alld raquest a final inspection ffnm tlnct Public Works Department. Monies may be held for six months after final inspechurn before a refund will be processed. 18 No trees in the public: right-of-way shall be planted. femoved. Ininrned or mlwu iilod without approval from the General Services Department. 19. All work in the public right-of-way must meet the approval of the Pc;bla: Wink Department or corrections will be required Ile. removals. (:xposinq contwO,ow— etc.). Additional inspection fees may be required. 20. Permit is for standard materials in the public: right-of-way only, unless previowiv Approved by Public Works and an Encroachment Agreement has heen procf�ssed 21. Permit is valid for description of work noted on front only IA1115hnl work performed may require issuance of a separate permit and or a ion• ees No work related to this encroachment permit shall be performed until the Public Works Department has issued this permit. Applicant hereby a kno ledges he/she has re n stands 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 i uance. Permit fees are nonrefundable. \ 7' Date: �� %7 I nature: PLAN NOTES ElSEE SHEET P2.0 FOR CONTINUATION. 2� EXISTING WATER SERVICE LATERAL TO EXISTING WATER MAIN IN NORTH BRISTOL STREET - FIELD VERIFY EXISTING 2" WATER METER IN CONCRETE METER BOX - FIELD VERIFY. aEXISTING 2" COLD WATER PIPING BELOW GRADE - FIELD VERIFY. aSUPPLY & INSTALL APOLLO #RPLF-4A, 2" (RP) SACKFLOW PREVENTER ® +24" A.F.G. BACKFLOW DEVICE SHALL BE INSTALLED PER STD-520-L-A. (MINIMUM) - Submittals 10/ 26, 2016 BUILDI\G HEALTH DEPT RESUBUTTAL 0 0 0 0 These drawings are instruments of sem-ce and are die propert% of Avanti Restaurant Solutions. Thee are protected b% con -non cop%right law. All designs and other information on the drawings are for use on the specified project and ;hall not be used otherwise without the express written permission of Ai anti Restaurant Solutions. gokobra design herman jack ajamian hja a'kobradesign.net 714.3 13.68 15 ■ EXTERIOR DESIGN ■ ,MASTER PLANNING ■ INTERIOR DESIGN ■ SPACE PLANNING ENGINEERING GROUP, INC 0, . 18652 F; Mechanical Electncal Plumbing HUNTING TOB ACHRCALIFOR ' IA 2648 PHONE (714)847-7100 FAX (714)841-6000 MAIN PROJECT CONTACT: CONRAD ORR, JR CRC) PROJECT NUMBER: 1 12-009 , W 00 CV U' �l (E)11 /2"CW ---C - (E)11 /2"CW - F- F; a-(E)2"CW (E)2°cw a N a n 41 U1 3/21/2017 City of Newport Beach Page 1 of 5 4:30:18PM INSP150 - Daily Inspection Request Report Requested Inspection Date: 03/22/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 1000 BRISTOL ST 1 Floor 1 Unit 2. 3-', Activity: N2017-0141 SubType : NEW Status : APPROVED OWNER: LSW LTD Phone : APPLICANT: GILMORE RYAN Phone : 714448-1066 GILMORESBACKFLOW@GI Description: INSTALL NEW RP BACKFLOW DEVICE FOR DOMESTIC WATER METER PROTECTION Item: 10085 BACKFLOW DEVICE INSTALL - UTIL Requested Time: 3/22/2017 12:00:OOAM Requestor: NBIVR 7144481066 S Entered By: NBIVR ��-tom ' / Comments: AM T M Assigned to: Z. 3v Inspector: Date: '� l Time: PM Comments:�i�T�'�'�-T f /tiST.rt�-o 3 7� wtlwiys /LI° MIJ F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc REPT131 Run Id: 4018 312W2017 City of Newport Beach Page s or 13 4:30A312M INSP150 - Daily Inspection Request Report Requested Inspection Date: 03/23/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address: 1000 BRISTOL ST 1 Floor 1 Unit 2; Activity : N2017-0141 SubType : NEW Status : APPROVED OWNER: LSW LTD Phone : APPLICANT: GILMORE RYAN Phone : 714-448-1066 GILMORESBACKFLOW@GI Description : INSTALL NEW RP BACKFLOW DEVICE FOR DOMESTIC WATER METER - PROTECTION , r Item: Requested Time: 3/23/2017 12:00:OOAM Requestor: NBIVR � , • :3� Entered By: NBIVR 7144481066 Comments: AM Assigned to: 11117 Inspector: Date: Z3 17 Time: M M Comments: Y-v F=I o:. 4. i' i'�I�' �_ I V F F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.do REPT131 Run Id: 4018