HomeMy WebLinkAboutN2017-0510City of Newport Beach I IIIII��I I��II ��I�� I��II I��I ��I�� �II�I ����I ���I IIII
• T 100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3311
. �z- Online Inspection Request - www.newportbeachca.gov / Online
Services
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Permit No: N2017-0510`
Project N-O,:
Inspection Requests Phone (949)644-3255
Job Address : 4343 MACARTHUR BLVD NB Thomas:Guide: 859F7
Description : Install 5 LF of 3-inch conduit in planted parkway behind sidewalk on Corinthian Way for new CAN service.
Parcel # :
4271-740-3 -
Legal Desc :
P BK 287 PG 37 PAR 2
Owner:
ALISON CO
Phone:
0
Address :
4341 MACARTHUR BLVD #A
NEWPORT BEACH, CA
Applicant: COX COMMUNICATIONS
Phone : 310-265-5875 [
Address : 27121 TOWNE CENTER DRIVE
FOOTHILL RANCH, CA 92610
Special Cond. :
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:
Contractor: INLAND ENGINEERING SERVICES INC
Phone: 951-277-0800
Address : 4160 TEMESCAL CANYON RD #205
CORONA, CA 92883
Contractor State Lic: 931684
License Expire: 04 30, 2019
Business License : BT30057874
Business Expire :
01 31, 2018
Workers' Compensation
Insurance - -
Carrier :
TWIN CITY FIRE INSURANCE CO
Policy No:
72WEAZI7519
W. C. Expire:
05 01. 2018
Total Fee
$406.00
Paid :
$406.00
Balance:
$0.00
Receipt No:
Other Department : Date
Permit Denied Date
Issued Permit : !`, ---Date: 10/ 40 / 4_
(CB00336 )
WORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
-COMPLETE THE BELOW INFORMATION.
PROJECT ADDRESS: 4343 Macarthur Blvd (work is on Corithian Way)
DETAILED DESCRIPTION OF PROPOSED WORK:
5' dirt trench to place (1) 3" duct, exiting R/O/W
APPLICANT: Cox Communications Phone: 310-265-5875
Email Address: sina.muckenfuss@cox.com
Mailing Address: 27121 Towne Centre Dr
City/State/Zip: Foothill Ranch, CA 92610
OWNER: See above Phone:
Email Address:
Mailing Address: City/State/Zip:
ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE COMPLETE
CONTRACTOR:
Office Phone: 951-277-0800
Company (if different):
Inland Engineering Services
Jobsite Phone:
Other Phone:
Email Address:
Mailing Address:
4160 Temescal Canyon Rd #205
City/State/Zip:
Corona, CA 92883
State License Number & Class:
931684 A Expires. 4/31/19
City Business License Number:
BT30057874 Expires: 1/31/18
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: Twin City Fire Insurance Company Policy No: 72WEAZI7519 Expires: 5/01/18
.......................................................................................................................
REF(JNOABI.E:DEPOS.IT INFORMRYION:(/fAP0caible :...:...:... .
Refund Payable. To Sir;a:Mu&- ,enFtv4 Cox Coiatmurticatlaiis <
Mad Refund.To :.... 3415 Ka biwa:St, Tdrr&q&; CA:90505
FOR OFFICE USE ONLY
Special Conditions of Permit: jc-
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
General Services:
Traffic: Fire:
Other:
Engineering Technician:
_Z06;
Public Works Specialist:
Date:
10-5-1-7
Permit No.
1 N2.o1'1- 0510
IYdsers/pb%Wshared/encroachlmaslers/epworksheet x1s
Public Works Department 949-644-3311
FEE WORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
All Fees Are Non -Refundable Unless Otherwise Stated
PROJECT ADDRESS:
43,43 fy6c. (•,Awr Blvd
PERMIT
N2017- O 510
NUMBER:
APPLICANT:
Cow, Q oM w+vv-�Go 4-i Cr"S
lu Its
Permit Processing Fee:
Q
Public Works Only
$241.00 i
Other Department
$275.00
Agreement Fee:
Preparation of Report/Agreement
$81'
Document Recordation Fee
$192.00
Monitoring Wells
$502.00
Inspection Fee:
Public Works Field Inspection
Utilities Field Inspection
General Services Inspection
Water Quality/Artificial Turf Inspection
Refundable Deposit:
Improvements
Qtv.
$165.00 l
$121.00
$165.00
$108.00
TBD
TBD
Street/Alley/Walk Closure: $65.00= Newspaper Rack Inspection $108.00 0
Traffic Control Plan Check
8-1/2" x 11" $65.00 Sewer Connection Fee $250.00
24" x 36" $143.00 4TT Box & Cover $64.00
Additional _ _ _
THE LO FOLWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division 1
REVENUE DIVISION PRIOR TO PAYMENT OF FEES ]Approval:
Qty.
(Water Meter:
Installation Charge $528.00Q
13/4" Meter
$50.25
Water Meter Boxes:
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
13" Meter
$845.00
$3,310.00
For Traffic & Alley Areas (Box + Cover = Cost)
1" Meter: 13.00 + 38.00 $51.00
�4" Meter
$4,730.00
2" Meter: 27.00 + 162.00 $189.00�
16" Meter
$7,190.00
Qty.
Budget Number
Certificate of Compliance Fee (+100% of hrly 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
$1,079100
5200-5028
Park Dedication Fee Zone
TBD
405-470
Street Easement/Vacation Fee (+100% of hrly 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
.0 - to - I-)
Permit Specialist
Receipt No.
R- v i .'-i ir
f /users/pbw/shared/encroach/masters/ep front and back masters/
Rev. 1/5120171
lepfeesheet ids -revised 1o21nom
ALL UNDERGROUND WORK SHALL BE PERFORMED BY A LICENSE D.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 properly 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 thereof.
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
Date: Signature:
after date of issuance.
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 Slate 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
6.
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,
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 feel 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 -fool
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 Permit Inspection is red by calling
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
�re)l
Public Works at 949-644-3311. �n
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
15. Any above ground utility facilities 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.
affected property owner(s).
10.
Work within or near beach sensitive areas will not be allowed during, City holidays, spring break, Memorial Day
16. Homeowner, contractors, and subcontracolrs 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
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 Water
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 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, 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 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 ackn wledges he/she has read and understand 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 a -
��
Permit
fees are nonrefundable.
Date: J .1Q .Signature:
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10/26/2017 City of Newport Beach Page 2 of 3
4:30:51PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 10/27/2017
Inspection Type : ENCROACH
Inspection Area: PW
Site Address : 4343 MACARTHUR BLVD
Activity : N2017-0510
SubType :
Status : APPROVED
OWNER: ALISON CO Phone: 0
APPLICANT: COX COMMUNICATIONS Phone : 310-265-5875
Description : Install 5 LF of 3-inch conduit in planted parkway behind sidewalk on Corinthian Way for ne%
CATV service.
Item: 10200 PRE JOB - PW
Requested Time: 10/27/2017 12:00:OOAM Requestor: WEBUSER
Entered By: WE13USER
Comments: AM -
Assigned to: 77777777777*
Inspector:
Comments: S
,A
951-367-7822 -- A�Z4 4.Vke)
Date: 0 27 l ? Time: 'T 5-0 �PIVI
1SC-ZtS
4 J 104-fz lG /—/��./ 4-I i P /✓ / L L A,,,0 7` 9 -oG
Gt-/ 3 0-/ 11 -7
Logged
Defile
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131 Run Id: 4018
/0190/2017 City of Newport Beach Page 3 of 13
6,:34:40AM INSPI60 - Daily Inspection Request Report
Requested Inspection Date: 10/30/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 4343 MACARTHUR BLVD
Activity : N2017-0510
SubType :
Status : APPROVED
OWNER: ALISON CO Phone: 0
APPLICANT: COX COMMUNICATIONS Phone : 310-265-5875
Description : Install 5 LF of 3-inch conduit in planted parkway behind sidewalk on Corinthian Way for ne%
CATV service.
Item: 10050 EXCAVATION- PW
Requested Time: 10/30/2017 12:00:OOAM Requestor: WEBUSER
Entered By: WEBUSER
Comments: PM -commencing work- 1 day job
Assigned to: 7777777/7777`
Inspector:
951-367-7822
Date: 103017 Time: AM PM
Comments: Chi T `4I,-g rAqLL —
r,
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
1111312017 City of Newport Beach Page 7 of 18
4:30:31PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/14/2017
Inspection Type : ENCROACH
Inspection Area: PW
Site Address : 4343 MACARTHUR BLVD
Activity : N2017-0510
SubType :
Status : APPROVED
OWNER: ALISON CO Phone • 0
APPLICANT: COX COMMUNICATIONS Phone : 310-265-5875
Description : Install 5 LF of 3-inch conduit in planted parkway behind sidewalk on Corinthian Way for neH
CATV service.
Item: 10250 FINAL - PW
Requested Time: 11/14/2017 12:00:OOAM Requestor: WEBUSER
951-367-7822
Entered By: WEBUSER
Comments: AM -
Assigned to: 777777a7777*
p
Ins ector: ^3 Date: 1 ( / V / -7 Time: AM PM
Comments: T-ZD Ee^:Ld2c
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131 Run Id: 4018