HomeMy WebLinkAboutN2017-0383t <; City of Newport Beach II�I��II�III�II�I��II�I�I�I�III��I�� �II���I�IIIIII
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100 Civic Center Drive. Newport Beach, CA 92660 I I N 2 0 1 7 0 3 8 3
Permit Counter Phone (949)644-3311
, Wt Online Inspection Request - www.newportbeachca.gov / Online
Services
Permit No: N2017.0383
Project No
CANNED
Inspection Requests Phone (949)644-3255
Job Address : 227 VIA EBOLI NB Thomas:Guide: 888117
Description : Bore 37 LF of conduit to repair CAN service. Pavement restoration per City Standards.
Parcel # :
4231-540-2 -
Legal Desc :
N TR 907 LOT 995
Owner:
SHEPPHIRD JOHN
Phone:
0
Address :
227 VIA EBOLI
NEWPORT BEACH, CA
Applicant: CHARTER COMMUNICATIONS
Phone : 714-681-3554 [
Address : 7142 CHAPMAN AVENUE
GARDEN GROVE, CA 92841
Special Cond.: PRE -CONSTRUCTION MEETING REQUIRED
Contractor : CABLE COM OF CALIFORNIA, INC.
�¢
Phone: 714-666-2400
Address : 1251 N.JEFFERSON STREET
ANAHEIM, CA
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 :
$0.00
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 State Lic: 826295
License Expire : 07 31, 2017
Business License :
BT30033430
Business Expire :
10 31, 2017
Workers' Compensation Insurance - -
Carrier :
LIBERTY INSURANCE
Policy No:
WA763DO042600
W. C. Expire:
07 31, 2017
Total Fee $241.00
Paid: $241.00
Balance: $0.00
Receipt No:
Date : _/_/ Other Department : Date:
Date: _/_/ Permit Denied Date:
Date: `
_/_/ Issued Permit : Date : / / 1/.-) c 1
Date: / /
FEE WORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
All Fees Are Non -Refundable Unless Otherwise Stated
PROJECT ADDRESS:
PERMIT N2017- 0335
22*1 Vco Ebo1,
NUMBER:
APPLICAN .
Cbolr+Q r �,n,rM� Ie o 4: 0-"S / C0b1c, Cows
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
Q Inspection Fee:
$241.00 Public Works Field Inspection
$275.00 Utilities Field Inspection
General Services Inspection
Water Quality/Artificial Turf Inspection
$817.00
$192.00 Refundable Deposit:
$502.00 Improvements
Street/Alley/Walk Closure: $65.00Newspaper 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
Qtv.
$165.00
$121.00
$165.00
$108.00
TBD
TBD
$108.00
$$64.00 e
64.00
---
venue Division I
Qty.
ah� . 1
IWater 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
'2" Turbine Meter
$845.00
For Trarc &Alley Areas (Box +Cover =Cost)
Meter
$3,310.00
1" Meter: 13.00 + 38.00 $51.00
13"
14" Meter
$4,730.00
1
2" Meter: 27.00 + 162.00 $189.00 1
!6" Meter
$7,190.00
Certificate of Compliance Fee (+140% 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 $1,079.00
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
-2o a^
0 2y} 1. -
Per Specialist
Receipt No.
f lusers/pbw/shared/encroach/masterslep front and back masters/
Rev. 1/5120171
lepfeesheet As -revised 10/21/2016
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 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 tie: 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 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 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 Code) -
I certify that I have a Certificate of consent to self -insure, Certificate of Worker's
Comp�atio
snInsurance, or a Certified Coy hereof.
Data.7/3l T 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 indemnify
and hold the City harmless for any liability associated with the minor
encroachments.
Date: Signature:
24-hour notice for Encroachm t Permit Inspection is required by calling
Public Works at 949-644-331 .
15. Any above ground utility faciliti s wi I require documented approval from the adjacent
affected property owner(s).
16 Homeowner, contractors, and subcontracolrs 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 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, 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 Vlork<;
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 hereb acknowledges he/she has r ad and understands 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. A%111//7' f
Permit fees are nonrefundable. Dat@. _ Slgnatur@'� / ��
Google
Almendralo, Rodi
From: Noble, Brian <brian.noble@cablecomllc.net>
Sent: Monday, July 24, 2017 9:57 AM
To: Almendralo, Rodi; Richard Vega
Subject: 227 Via Eboli, Newport Beach Permit request
Attachments: 227 Via Eboli, Newport Beach SOW jpg
Good morning Rodi,
We are going to need a permit for this locaiton the conduit is damaged beyond repair we will need to bore 37ft
from the vault to the customers home for a new service drop.
Brian Noble
Field Supervisor
CableCom of California, Inc
1251 N Jefferson St.
Anaheim Ca. 92807
Cell: 714-681-3554
Phone:714 666 2400 Ext. 240
Fax:
Email: brian,nobledcablecomlic.net
This email, and any documents which may accompany it, contain information which is intended for use only by the
individual to whom it is addressed, and may contain information that is privileged, confidential and/or exempt from
disclosure under applicable law. If the reader of this message is not the intended recipient any review, disclosure,
dissemination, distribution, copying or other use of this message or its substance is strictly prohibited. If you have
received this message in error, please contact me immediately to arrange for return or destruction. Thank you.
This email message, and any documents which may accompany it, contain information which is intended for use only by the intended
recipient(s), and may contain information that is privileged and/or confidential. If you are not the intended recipient of this message
you are hereby notified that any review, disclosure, dissemination, distribution, copy or other use of this message or its attachments is
strictly prohibited. If you have received this message in error, please notify the sender by reply email, delete the email from your
computer and destroy all copies of the communication and any attachments.
8/7/2017 City of Newport Beach Page 5 of 11
6:34:43AM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 08/07/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 227 VIA EBOLI
Activity : N2017-0383
SubType : NEW
Status : APPROVED
OWNER: SHEPPHIRD JOHN Phone: 0
APPLICANT CHARTER COMMUNICATIONS Phone: 714-M-3554
Description : Bore 37 LF of conduit to repair CATV service. Pavement restoration per City Standards.
m i por-donNs►
Item: 10000 EXCAVATION & PIPE INSTALL-UTIL
Requested Time: 8/7/2017 12:00:OOAM Requestor: WEBUSER
714-681-3554 _, g R I � A,?Entered By: WEBUSER
Comments: AM -Bore work for a service drop condui C)-10
Assigned to: 77777777777* >
-0, 7
Inspector: Date: 2, ( -7 1-7Time: oo 9PM
Comments: 5c)r o!t�wi- C3 7 fT) D/v
11-6 PEA A/A rzG �/..
LOaaed
Refile
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131 Run Id: 4018
• SANTA ANA HMA
1401 E WARNER AVENUE
Vulcan •
Materials Company
Calmat Cp.
Shipping Location: SANTA ANA, CA 92705
714-546-0622
Danger
Read important health information on reverse.
Peligro
Lease la information importante para la salud en el reverso.
RECEIVED BY.
WEIGHMASTER:
X
RYAN SHADE
DATE
TIME:
PLANT:
TICKET NO
8/24/2017
9:42AM
I
4948-221 SANTA ANA HMA
I 19005834
WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed, measured,
or counted by a weighmaster, whose signature Is on this certificate, who Is a recognized authority of accuracy, as
prescribed by Chapter 7 (commencing with Section 12700) of Division S of the California Business and Professions
Code, administered by the Division of Measurement Standards of the California Department of Food and Agriculture.
We make deliveries inside the curt line at the customer's ask only and acted no responsibility whatsoever for damage resulting from such deliveries
LIMITED WARRANTY AND WARRANTY DISCLAIMER: Seller warrants for a period of one (1) year from date of deliveryry and that the material sold hereunder subsiontially comylies with Seller's specification for said
material or the specifications set forth in Seller's quotation. SELLER HEREBY EXCLUDES All WARRANTIES OF MERCHANTABILITY AND FITNESS FOR ANY PURPOSE, AND All OTHER WARRANTIES EXPRESS
OR IMPLIED, OF THE MATERIAL SOLD HEREUNDER, OTHER THAN THE EXPRESS WARRANTY STATED ABOVE. In addition, except to the extent otherwise set orth in the specification described above, Seller
makes no warranty whatsoever with respect to specific gravity, absorption, whether the material is innocuous, nan-deleterious or non -reactive or whether the material is in conformance with ant ens other ssppecificalions
regulations ordinances statutes, or other standards a�gplIicabk to customer's lob or to said material as used by customer, SEIIE� SHAH IN NO EIENT BE RESPONSIBLE FOR ANY INCIOENTAI OR CONSEO ENIIAL DAMAGE CAUSEfi
BY NON COMPLIANCE bF THE MATERIAL WITH SPECIFI(�(TION, OR FOR ANY DEFECTS IN THE MATERIALS SOLO HEREUNDER.
ALL SALES AND DELIVERS MADE SUBJECT TO SELLER'S GENERAL TERMS AND CONDITIONS.
AS EVIDENCED BY SIGNATURE, OR DEPARTURE FROM SELLER'S FACILITY, CARRIER ACKNOWLEOGES THAT CARRIER IS SOLELY RESPONSIBLE FOR THE ACCURACY OF THIS VEHICLE'S TARE WEIGHT AXLE WEIGHTS AND GROSS WEIGHT.
CARRIER SHALL BE RESPONSIBLE FOR NOTIFYING SELLER WHEN ANY TRUCK OR TRAILER HAS BEEN OVERLOADED 50 AS TO RENDER IT OUT OF COMPLIANCE WITH ANY APPLICABLE WEIGHT LIMITS. TO THE MAXIMUM EXTENT ALLOWED
BY LAW, CARRIER SHAH INDEMNIFY SELLER FOR ANY LOSS CAUSED BY OVERLOADING.
TRUCK TARE AND GROSS WEIGHTS ARE DETERMINED WITH THE DRIVER IN THE VEHICLE.
CUSTOMER: 213975
CK#:
CUSTOMER PURCHASE ORDER:
GOVT CONTRACT:
CABLECOM LLC
15061
ORDER: FOB SANTA ANA'
ZONE/MILES:
32369 FOB SANTA ANA
DESTINATION:
FOB SANTA ANA'
PICKED UP OR DELIVERED:
BLACKTHORN
FOB 2401 BLACKTHORN
NEWPORT BEACH
PICKED UP
PRODUCT: 300807
COMMENTS:
203 3C3 PG64-10
TRUCK NO.:
CBL LICENSE: 63776J1
CARRIER: W089 VEHICLE TYPE:
76J1
TRAILER, ID:
CUSTOMER PICKED UP CUST•UNCL
TRAILER 2 ID:
TARE DATE: 08/24/2017 TARE EXPIRES: 09/01/2017
GROSS LBS
TARE LBS (Scale 0)
NET LBS
LOADS TODAY
FREIGHT TYPE A AXLES 0
1.99
21,040
17,060
3,980
1.99 1
GROSS LGL WT 26.000
GROSS kg
TARE kg
NET kg
NET Mg
Mg TOOAY ARRIVE JOB
TART UNLOAD
FINISH UNLOAD
CASH SALE ONLY
MATERIAL
HAUL
her
• •
JOB TIME
DELAY TIME
PER TON
TOTAL
I
Tax
:..a +ex';.n:;, rs,.Frew.4Fl,Ikr.vNC71< l BAMW.ETTEA. av'STANDING f HAUL TIME APPROVAL
VMC-1850-02C-1 Rev. 06115
•
Asphalt Paving Mix
•
Mezcla de Pavimentacion de Asfalto
DANGER
May cause cancer (Inhalation)
Suspected of damaging the unborn child
May causes damage to organs
(lung/respiratory system, adrenals, bone
marrow, liver, lymph nodes, kidney,
stomach, and thymus) through
prolonged or repeated exposure
Prevention
• Obtain special instructions before use. Do not handle
until all safety precautions have been read and
understood.
• Do not breathe dust, fume, or vapors. Use only outdoors
or in a well ventilated area.
• Avoid contact during pregnancy and while nursing.
• Wash hands thoroughly after handling.
• Do not eat, drink or smoke when using this product.
• Wear protective gloves, protective clothing, eye
protection, and face protection.
Response
• If exposed or concerned: Get medical advice/attention
• Get medical advice/attention if you feel unwell.
• Wash contaminated clothing before reuse.
Storage
• Store locked up.
Disposal
• Dispose of contents/container in accordance with all
local, regional, national, and international regulations.
Heated materials can cause thermal burns. Fumes from
heated asphalt may be irritating to the eye, nose, and
throat.
Crystalline silica is known to the State of California to cause
cancer.
Read the Safety Data Sheet (SDS) before handling this
product to determine the appropriate ventilation or respiratory
protection necessary to safeguard your health. The risk of
silicosis or lung cancer depends upon the duration and levels
of silica exposure in the workplace.
SDS can be obtained at
www.vulcanmaterials.com or by calling
1-866-401-5424.
PELIGRO
Puede causar cancer (Inhalaci6n)
Sospecha de danar el feto
Puede causar dano a 6rganos (pulmones/sistema
respiratorio, glandulas suprarrenales, medula 6sea,
higado, ganglios linfaticos, rinon, est6mago y timo) a
traves de la exposici6n prolongada o repetida
Prevencion
• Obtenga instrucciones especiales antes del uso. No
maneje hasta que haya leido y entendido todas las
precauciones de seguridad.
• No respire polvo, humo o vapores. Usar unicamente al
aire libre o en areas bien ventiladas.
• Evite el contacto durante el embarazo y la lactancia.
• Lavese bien las manos despues del manejo.
• No comer, beba ni fume cuando utiliza este producto
• Use guantes de protecci6n, ropa de protecci6n, gafas de
seguridad y protecci6n para la cars.
Respuesta
• Si expuestos o preocupados: Consiga consejo/atenci6n
medico.
• Lave la ropa contaminada antes de reutilizar.
Almacenamiento
• Almacenar bloqueado.
Eliminaci6n
• Deseche el contenido/contenedor de acuerdo con todos
los reglamentos locales, regionales, nacionales e
internacionales.
Material caliente puede causar quemaduras t6rmicas. Los
vapores del asfalto calentado pueden ser irritantes para
los ojos, la nariz y la garganta.
Estado de California reconoce que la silice cristalina causa
cancer.
Lea la Hoja de Ficha de Datos de Seguridad (SDS) antes
de tener contacto con este producto para determinar la
ventilaci6n apropiada o la protecci6n respiratoria necesari
para proteger su salud. El riesgo de la silicosis o del cancer
pulmonar depende de la duraci6n y de los niveles de
exposici6n a la silice en el lugar de trabajo.
Puede obtener un SDS en
www.vuleanmaterials.com o Ilamando al
1-866-401-5424.
. 8/23/1017 City of Newport Beach Page 16 of 18
4:30:38PM INSP15O - Daily Inspection Request Report
Requested Inspection Date: 08/24/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 227 VIA EBOLI
x! k.
�Kaiir. F�sS'
Activity : N2017-0383
SubType : NEW
Status : APPROVED
OWNER: SHEPPHIRD JOHN Phone : 0
APPLICANT: CHARTER COMMUNICATIONS Phone : 714-681-3554
)escriution : Bore 37 LF of conduit to repair CAN service. Pavement restoration per City Standards.
Item: 10020 PERMANENT PAVING- PW
Requested Time: 8/24/2017 12:00:OOAM Requestor: WEBUSER
714-681-3554
Entered By: WEBUSER
Comments: ANY -Final asphalt restoration
Assigned to: 77777777777*
Inspector: �� V Date: 2 �� Time:
Comments: C� iM-eu7✓� e- r / 0�
Loaqocl
Kole
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
AM PM
REPT131 Run Id: 4018
10/30/2017 City of Newport Beach Page 11 of 13
6:34:40AM INSP15O - Daily Inspection Request Report
Requested Inspection Date: 10/30/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 227 VIA EBOLI
Activity : N2017-0383
SubType : NEW
Status : APPROVED
OWNER: SHEPPHIRD JOHN Phone : 0
APPLICANT: CHARTER COMMUNICATIONS Phone : 714-681-3554
Description : Bore 37 LF of conduit to repair CAN service. Pavement restoration per City Standards.
Item: 10250 FINAL - PW
Requested Time: 10/30/2017 12:00:OOAM Requestor: WEBUSER
Entered By: WEBUSER 714-681-3554 — AWAO OV
Comments: ANY -Final Inspection permit close out 49=09'4t.-* C.401,0"
Assigned to: 77777777777`
Inspector: ��1 Date: Ib3v 17 Time: /- AM PM
Comments: 4 %X4 �
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc