HomeMy WebLinkAboutN2017-0276City of Newport Beach IIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII1IIIIIIIIIIIIIIIIIIIIIII
Permit No: N2017-0276
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100 Civic Center Drive, Newport Beach, CA 92660
.
Permit Counter Phone (949)644-3311
Project No : 2254-2015
Online Inspection Request - www.newportbeachca.gov /Online
Services
Inspection Requests Phone (949)644-3255
Job Address:
706 PARK AVE NB
Thomas:Guide: 919C1
Description :
Removal of existing decorative improvements within the Park Avenue right-of-way, one
curb drain, sidewalk/curb/gutter repair (extent per Public Works
inspector).
Parcel # :
0500-921-4 -
SCANNED
Legal Desc :
ISLAND SEC 2 LOT 17 BLK 10 E1/2(AND E1/2 LOT 18 BLK 10
Owner:
OPEN HOUSE REALTY & INVS INC
Contractor : STUDIO MATRIX
Phone:
562-376-8212
Phone: 714-813-4756
Address :
12440 E IMPERIAL HWY #135
Address : 4351 E ALDERDALE AV
NORWALK CA 90650
ANAHEIM CA 92807
Contractor State Lic: 974410
Applicant:
HERZOG FRED
License Expire: 06 30, 2018
Phone:
714-813-4756 [
Address :
4351 E. ALDERDALE AVE
ANAHEIM CA 92807
Business License: BT30043978
Business Expire: 07 31, 2017
Special Cond.:
PRECONSTRUCTION MEETING REQUIRED
Workers' Compensation Insurance - -
WITH PUBLIC WORKS INSPECTOR.
Carrier: NORGUARD INS CO
Policy No: PRWC760360
W. C. Expire: 09 01, 2017
Permit Processing Fee : $241.00 Sewer Connection :
$0.00
Total Fee $736.00
Agreement Fee:
$0.00 4TT Box Cover:
$0.00
Paid: $736.00
Traffic control Plan Check : $0.00 Total Water Meters :
$0.00
Balance : $0.00
Inspection Fee :
$495.00 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
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COMPLETE THE BELOW INFORMATION
PROJECT ADDRESS: -10 G J1\/
DETAILED DESCRIPTION OF PROPOSED WORK: CVPZ n e
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APPLICANT:
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Email Address: S {,��)
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Mailing Address:,\,5I jG .�+ A L%;t/� -�
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City/State2ip: `1 J�
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Phone:
OWNER: .A 1/
Email Address: q'
Mailing Address:
City/State/Zip:
ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE OMPLETE
CONTRACTOR: aL�-Z�l
Office Phone:. 00,47
Company (if differe�j4 �}J�� 11J
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Jobsite Phone
Other Phone:
Email Address: S 0v
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Mailing Address:,�� /�14�WJA?.
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City/State/Zip:4A
State License Number & Class: flilvi
Expires: 6,130M,
City Business License Num
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: " at- Cx Polic No: Ex ices: `'I 1 I
Municipal Orations: %9444-3055
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
FOR OPFICE WE OILY >.
Special Conditions of Permit:
ADDITIONAL APPROVAL RE RED FROM THE FOLLOWING DEPARTMENT8
Utilities:
Municipal Operations
Traffic: Fire: 0
Other:
Engi eering Technician:
�All
Permit Specialist
Date:
Permit No.
N2017. U�
fuserVpbw13hepwoftnee As
Public Works Department 949-W-3311
100 Civic Center Drive, Newport Beach, CA 92660
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of ReporVAgreement
Document Recordation Fee
Monitoring Wells
out., INUMBER: N2017- C?f(c
Inspection Fee:
$241.00 Public Works Field Inspection $165.00
$275.00[]�� Utilities Field Inspection $121.00
General Services Inspection $165.00
Water Quality/Artificial Turf Inspection $108.00
$817.00
$192.00 Refundable Deposit: TBDB
$502.00 Improvements TBD
StreoVAlleylWalk 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 & Cover $64.00
Additional
1 THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division I
1 REVENUE DIVISION PRIOR TO PAYMENT OF FEES Approval: 1
1►•
. Qhf• ,
(Water Meter:
Installation Charge $528.00
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 1
12" Meter
$425.00
1
12" Turbine Meter
$845.00
For Traffic & Alley Areas (Box + Cover = Cost) 1
13" Meter
$3,310.00
1" Meter: 13.00 + 38.00 $51.00
14" Meter
$4,730.00
2" Meter: 27.00 + 162.00 $189.00
16" 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
405470
Street EasemenWacation Fee (+100% of hry over 4 hrs) $1,022.00
5200-5031
Street Tree Fee ($700 Planting Fee) TBD
_.. ...... _.._ ....z..............-----......
030-2284
Engineering Tech:
Total Amount Due:
For Finance Use Only
`13(o cc;
Permit Specialist
Receipt No.
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Rev. 1/5/2017
epfeesheetAs+evised 10/21/2016
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I ALL UNDERGROUND WORK SHALL BE PERFORMED BY A LICENSED CONTRACTOR / I
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 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.
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
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 and 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 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,
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 (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.
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
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.
10. 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.
11. 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.
12. 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.
13. 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.
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 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 de)
I certify that I have a Certificate of consent to self-' ure, Certificate f Worker's
Compensation jinsurance, or a Certified Copy the
Date:
Signature:
CERTIFICATE OF EXEMPTION (Section 3800 Labor Coi'fe)
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 indemnify
and hold the City harmless for any liability associated with the minor
encroachments.
Date: Signature:
24-hour notice for Encroachment I rmit Ins ction is required by calling
Public Works at 949-644-3311.
15. Any above ground utility facilities will require documented approval from the adjacent
affected property owner(s).
16. Homeowner, contractors, and subcontracotrs 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 General Services Department.
19. All work in the public right-of-way must meet the approval of the Public Work:
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.
No work related to this encroachment permit shall be performed until the Public Works Department has issued this permit. Applicant herebyjc owle ges he/she has rea d unde hands 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. 4, Date' Signature'
:RT OR
bATIONS
OFF -SITE:
21 REMOVE ALL EXISTING LANDSCAPE ELEMENTS (WALL, BRICK STEPS ETC.)
22 EXISTING PROPERTY LINE WALL TO REMAIN - PROTECT -IN -PLACE
23 EXISTING CONCRETE SIDEI^IALK - PROTECT -IN -PLACE
24 NOT USED
25 REPAIR EXISTING DAMAGED CURB, GUTTER AND 51DEWALK; 5TD-180-L;
PER CITY STANDARD 5TD 152-L. SEE GENERAL NOTE -1
26 INSTALL NEW SEYVER GLEAN -OUT ON EXISTING SEWER LATERAL PER CITY
GSTANDARD 5TD-406-L.
GINSTALL NEW WATER METER ON EXISTING SERVICE LATERAL PER CITY OF NEWPORT BEACH
STANDARD 5TO-502-L
28 REMOVE AND RE -INSTALL NEW GAS METER PER GAS COMPANY STANDARDS
32 REMOVE EXISTING DAMAGED PAVEMENT IN ALLEY AND RECONSTRUCT ALLEY PER CITY
STANDARD 5TD 140-L. SEE GENERAL NOTE I
33 CONSTRUCT PRIVATE CURB DRAIN PER CITY OF NEWPORT BEACH STANDARD DETAIL 154-L
W-O"
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EXISTING BUILDING
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,ARAGE 5.5
I (FwY NOTES:
W-HIC SuR\jF-Y 5HOYIN ON
5 PLAN SET FOR REFERENCE
E5 ONLY.
iRAPHIC SURVEY PREPARED BY:
AND SURVEYING, INC.
GTON BEACH, CALIFORNIA 412646
'14) 4bb-5006 FAX: ('714) 555-4440
0
3. 5URvF-yOR TO FILE A CORNER RECORD OR RECORD OF
5URvEY WITH THE OFFICE OF COUNTY 5URVF-Yop-'
evIpENCE OF FILING SHALL E SUMITTECD TO BUILDING
-TION.
INSPECTOR PRIOR TO FOUNDABTION IBN5PF
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6.301 INV 2,
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ALL EXISTING CONCRETE
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RIGHT OF WAY ARE TO 9.oq
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SET SIVEYARD SKkLE
FLOrLINE 12" FROM
PROPERTY LINE
T05 PER PLAN
T05 PER PLAN
FIN15HED SURFACE
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EARTH
CONCRETE
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5/26/2017 City of Newport Beach Page 2 of 18
6:34:53AM INSPI60 - Daily Inspection Request Report
Requested Inspection Date: 05/25/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 706 PARK AVE
AIPID Ii11i0O/C
Activity : N2017-0276
SubType :
Status : APPROVED
OWNER: OPEN HOUSE REALTY & INVS INC Phone : 562-376-8212
APPLICANT: HERZOG FRED Phone : 714-813-4756
studiomatdx7@aol.com
Description : Removal of existing decorative improvements within the Park Avenue right-of-way, one curt_
drain, sidewalk/curb/gutter repair (extent per Public Works inspector). ~
run
Item: 10200 RE B - P
;�
Requested Time: 5/25/2017 12:00:OOAM Requestor: NBIVR _ \
7148134756
Entered By: NBIVR
Comments: AM
Inspectof ianed to: �l/ Date: �Z S� 7 Time:
Comments: 72
�✓ ,2 t 2 �� r--S �j�! S . Ple-- ry c . s
Logged
Refile
F:\Users\PBw\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet. doc
REPT131 Run Id: 4018
7/19/2017 City of Newport Beach Page 2 of 3
4:33:11PM INSP150 - Daily Inspection Request Report
Requested Inspection Date:
07/20/2017
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address :
706 PARK AVE
Activity : N2017-0276
SubType :
Status : APPROVED
OWNER: OPEN HOUSE REALTY & INVS INC Phone : 562-376-8212
APPLICANT: HERZOG FRED Phone : 714-813-4756
studiomatrix7@aol.com
Description : Removal of existing decorative improvements within the Park Avenue right-of-way, one curt
drain, sidewalk/curb/gutter repair (extent per Public Works inspector).
item: 10100 FORMS WITH COMPACTION - PW
Requested Time: 7/20/2017 12:00:OOAM Requestor:
Entered By: WEBUSER
Comments: ANY -
Assigned to: 77777777777-
Inspector: �� V
Comments: �
Date:
PV
v
N—A D C.
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
S
WEBUSER
/a10�
Time: 10 • is (;�i PM
REPT131 Run Id: 4018
'9112/2017 City of Newport Beach Page 3 of 11
4:30:32PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 09/13/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 706 PARK AVE
Activity : N2017-0276
SubType :
Status : APPROVED
OWNER: OPEN HOUSE REALTY & INVS INC Phone : 562-376-8212
APPLICANT: HERZOG FRED Phone : 714-813-4756
studiomatrix7@aol.com
Description : Removal of existing decorative improvements within the Park Avenue right-of-way, one curt
drain, sidewalk/curb/gutter repair (extent per Public Works inspector).
Item: s 1t=-11V --
Requested Time: 9/13/2017 12:00:OOAM Requestor: NBIVR
7148134756
Entered By: NBIVR
Comments: AM
Assigned to:
Inspector: _,� v Date: 3 /7 Time: =sA PM
Comments: G t4 g \ r7 5 /C-i r-oiZ
7 - O AQ 7Z� s� / z
COMPLETED
F:\Users\PBW\Shared\ENCROACH\MASTERSkFORMSkinspectorSheet.doc
MPT131 Run Id: 4018