HomeMy WebLinkAboutN2017-0411N�.okA
City of Newport Beach
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Permit No: N2017-0411
100 Civic Center Drive, Newport Beach, CA 92660
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Project No: 2075-20C n ^' C p
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Permit Counter Phone (949)644-3311
Online Inspection Request - www.newportbeachca.gov / Online
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Services
Inspection Requests Phone (949)644-3255
Job Address:
2061 OCEAN BLVD NB
Thomas:Guide: 919132
Description :
EP FOR 4 NEW TREES, 2 IN EACH PARKWAY.
Parcel # :
0482-621-5 -
Legal Desc :
N TR 518 BLK D LOT 16
Owner:
JACKSON DOUG
Contractor: K M K DEVELOPMENT
Phone:
Phone: 949-322-5179
Address :
2061 E OCEAN BLVD
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Address : 26455 VIA GAVIOTA
NEWPORT BEACH, CA 92661
MISSION VIEJO CA 92691
Contractor State Lic: 866080
Applicant:
K M K DEVELOPMENT
License Expire: 10 31, 2017
Phone:
949-322-5179 [
Address :
26455 VIA GAVIOTA
MISSION VIEJO CA 92691
Business License : BT30017909
Business Expire: 11 30, 2017
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation Insurance - -
Carrier : W/C EXEMPT
Policy No: (NO EMPLOYEES)
W. C. Expire:
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 :
$0.00
Processed By:
Date : _/_/
Other Department: Date
Utilities Approval
:
Date : _/ /
Permit Denied Date
Traffic Approval
Date : /
Issued Permit:
:
_/
General Services
Approval :
Date
-W ....... .....
FFR5-J—ECT ADDRESS:
DETAILED DESCRIPTION OF PROPOSED WORK:
07
,
PPLICANT: Pq tA �r-Wifff-OiC*4 - VW%�7Phone:
Email Address: 'DarA e- Yvv,\L- _3)1avvLxv%-,e-AT
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Mailing Apdress-
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OWNER: 3)Mv U- -V.-\ Phone:
Email Address:
Mailing Address:
City/State0p:
ALL;CONTRACTOR INFORM ATION j;WWQ—U11W--e-LE0
CONTRACTOR: V. 'D %r L-&ewer-47'
Office Phone:
Company (if different):
Jobsite Phone:
Other Phone:
Email Address: b0t4 LV IkYv, DLI—O—A C 0 -'C--
Mailing ddress:
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State License Number a class:
q ovo Expires:
City Business License Number:
Expires:
lORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: Policy No: Expires:
............................................ . .............. ................................
..................................................
REFUNPAI$LE:D.r;PO$jT�INFORMA-TIO ......
................................................... .... ..........
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..............................
. . Refund ....... ......................................................... ...................................
.........
FOR OFFICE WE ONLY
Special Conditions of Permit:
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
General Services:
Traffic: Fire,
Other.
Engineering Technician:
Pubgp*(,prks Specialist:
Date:
Pe it No.
U./uswsVbvW*mmdtencroad*msM(&%pwodcsheeL)ds
Public Works Department 949-W-3311
FEE WQRKSI•IF, ': OR NQR0A,CIMENT PERMIT
YF NEMVP'�RT:AG BEH
PUBLIC.WOWS DEPAR'!*9W
All Fees Are Non -Refundable Unless Otherwise Stated
PROJECT ADDRESS: /
0 �� Li�L- I L l�
PERMIT N2017-
NUMBER:
APPLICANT:
TO BE Go WORKS OF-PARTIMM'
Permit Processing Fee:
Public Works Only $241.00
Other Department $275.00
Agreement Fee:
Preparation of Report/Agreement $817.00
Document Recordation Fee $192.00
Monitoring Wells $502.00
Inspection Fee:
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: TBD
Improvements TBD
Street/Alley/Walk Closure: $65.00Newspaper 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
I THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE ,Revenue Division I
(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
16" Meter $7,190.00
Installation Charge $528.001 I
Water Meter Boxes:
For Parkway & Sidewalk Area (Box + Cover =Cost
1" Meter: 13.00 + 37.00 $50.00
2: Meter: 27.00 + 61.25 $88.25
For Traffic & Alley Areas (Box + Cover = Cost)
1" Meter: 13.00 + 38.00 $51.00
2" Meter: 27.00 + 162.00 $189.00
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 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
14-4lL' 6,
Permit Specialist
Receipt No.
f./users/pbw/shar"envoach/masters/ep front and back masters/
" Rev. 1/5/2017
epfeesheetAs-revised 100/2016
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 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 shal! 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 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. Locale and pothole
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
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 S35.00. 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 limes. 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 Slate Highway's traffic or within the Slate 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 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 orP—t permit shall be deemed revoked.
Date\/91 /0 1 11 Sionature:� / J
CONTRACTOR LICENS$ 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 Encroachme t Permit Inspection is required by calling
Public Works at 949-644-331
15 Any above ground utility facilities ill require documented approval from the adjacent
affected properly owner(s)
16. Homeowner. contractors, and subcontracotrs may each be liable for violations of Walel
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 Stale
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, er 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 hereby acknowledges he/she has read and understay ds 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. Signature
Dat / 4//Q �% /
Permit fees are nonrefundable.
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7/12/2018 City of Newport Beach Page 3 of 17
6:34:29AM INSP150 - Daily Inspection Request Report
Requested Inspection Date : 07/12/2018
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 2061 OCEAN BLVD
AMA) Infomation:
Activity :
N2017-0411
SubType :
NEW
Status :
APPROVED
OWNER:
JACKSON DOUG
APPLICANT:
K M K DEVELOPMENT
Description :
EP FOR 4 NEW TREES, 2 IN EACH PARKWAY.
Requested Inspections)
Item:
10250 FINAL - PW
Requested Time:
7/12/2018 12:00:OOAM Requestor:
Entered By: NBIVR
Comments: AM
Assigned to: ZS 7- i2- 1% Z oa P"`
Phone :
Phone : 949-322-5179
NBIVR
9493225179