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City of Newport Beach IIIIIIIIIIIIIIIIIIIIIIIIIIII�IIINIIIIIIIIIIIIIIIIII�IIII
100 Civic Center Drive, Newport Beach, CA 92660
Permit Counter Phone (949)644-3311
Online Inspection Request - www.newportbeachca.gov / Online
Services
r Permit No: IVZG'� 8-0270
Project No: 0145-2017
Q NNFO
Inspection Requests Phone (949)644-3255
Job Address:
707 CAMPHOR ST NB
Thomas:Guide: 889E3
Description :
CONSTRUCT NEW CURB & GUTTER PER STD, REMOVE HARDSCAPE
IN PARKWAY AND RE -LANDSCAPE, NEW 36" BOX BRAZILIAN PEPPER TREE, NEW
CURB CORE PER STD 184-L.
Parcel # :
4400-642-2 -
Legal Desc :
N TR 4892 LOT 35
Owner:
MONTGOMERY ROBERT
Contractor: INSTANT LANDSCAPES
Phone:
Phone: 949-347-0700
Address :
3630 CATAMARAN r�
Address : 28562 OSO PKWY #D-243
NEWPORT BEACH CA 92625
RSM CA 92688
Contractor State Lic: 842586
Applicant:
INSTANT LANDSCAPES
License Expire : 07 31, 2018
Phone:
949-347-0700 [
Address :
28562 OSO PKWY #D-243
RSM CA 92688
Business License: BT30053469
Business Expire : 10 31, 2018
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation Insurance - -
Carrier : WESCO INSURANCE
Policy No: WWC3299902
W. C. Expire: 08 15, 2018
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
COMPLETE THE BELOW INFORMATION
PROJECT ADDRESS:
DETAILED DESCRIPTION OF PROPOSED WORK:
L ko� re. AA~e- o -F
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PPLICANT:
Phone:
Email Address:
Mailing Address:
2156Z c6o `C Z`��
CitylStatelzip:
SV%A 0—or- g7-64-Z-3"
OWNER: O'0 9-fG Phone:
Email Address:
Mailing Address:
O 11GfC
City/State/Zip:
or
-ALL CONTRITQROMRMATM IS .. COMPLETE
CONTRACTOR: `iSt 5 S
Office Phone:
Company (if different):
Jobsite Phone:
Other Phone:
Email Address:
Mailing Address:
Z- � 2 a•-�`t t�
City/Stat�2\ :
State License Number & Class:
ITF �ZS Expires:
City Business License Number: d
�%t2 Expires: f
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: �v S Policy No: U/i1JL57i0(0C'[47-Expires: "'t �i
Municipal Orations: 949-644-3055
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
FOR GFFWE USE OWY
Special Conditions of Permit:
ADDITIONAL APPROVAL REOL111RED FROM THE FOLLOW NG DEPARTMEI FM
Utilities:
Municipal Operations
Traffic: 0 Fire: 0
Other:
Engineering Technician:
Pe ialist
Date:
Z
Permit No.
N2018-
f:/users/pbw/shared/encroach/masters/epworksheet.xls
2z 17 Public Works Department 949444-3311
rr 100 Civic Center Drive, Newport Beach, CA 92660
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:
Improvements
Street/Alley/Walk Closure: $65.000 Newspaper Rack Inspection
Traffic Control Plan Check
8-1/2" x 11" $65.00E Sewer Connection Fee
24" x 36" $143.00 4TT Box & Cover
Additional _ _ _
THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE R
I REVENUE DIVISION PRIOR TO PAYMENT OF FEES Al
TBD
TBD
$108.00 0
$ $64.00
1
64.00
------
venue Division 1
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
6" Meter $7,190.00
Installation Charge $528.001 1
1
Water Meter Boxes: 1
1" DFW Meter Box $96.66 e 1
2" DFW Meter Box $203.24 1
1
1
1
71
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 $1,079.00
5200-5028
Park Dedication Fee Zone TBD
405-470
Street Easement/Vacation Fee (+100% of My 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
-C / _ LC z5v
Pe cialist
Receipt No.
flusers/pbw/shared/encroa masterslep front and back masters/
Rev. 12118/2017
epfeesheet xls-revised 11 /8/17
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
3
5.
8.
9.
10
12
13
14
TERMS AND CONDITIONS OF ENCROACHMENT PERMIT
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.
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.
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.
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.
A valid State licensed contractor must perform all construction within the public right-of-way, unless waived by the
Public Works Director. A valid Stale 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.
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.
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.
All trench restoration must be inspected by the Public Works Department. No utility installation(s) shall be allowed
over or within 5 feel 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 -fool
clearance over or under existing City -owned utilities. Sewer cleanouls require VCP or PVC SDR35 be used with a
4TT box over the riser.
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.
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.
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 Stale Highway right-of-way
will require a Caltrans Permit. All vehicles shall be lawfully parked.
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
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.
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 INSURAN on 3800 Labor Code)
I certify that I have a Certificate of consent o self-insu , Certificate of Worker's
Compeensa r Insurance a Certified Cop th eof.
Date: LJZ ( 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 Encroachment Per spection is required by calling
Public Works at 949-644-3311.
15. Any above ground utility facilities will req pproval 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, 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 a,pknowledges he/she has read unders nds the terms and
conditions of this permit and he/she agrees to ablde by them. Permit is void if work is not commenced within 30 days after Issuance. /i
Permit fees are nonrefundable. Date' Z� _filature: �. __.,_ _,_.__._,___.__._,
/AT!ON ,5 A55UMED TO BE BASED ON ARCHITECTURAL
BAN WITH AT _EAST 5" CONCRETE SLAB OVER 2" SAND
,4.L VAPOR BARRIER OVER 2" SAND OVER 4' GLEAN
'ER 501_5 REPORT AND STRUCTURAL FOUNDATION
ONTRAGTOR TO VERIFY WITH LATEST APPROVED
'CRT AND STRUCTURAL ENGINEER FOR EXACT SLAB
:ND.AT'0N5.
I0RK5 DEPARTMENT ENCROACHMENT PERMIT
i 15 RE xI IRrD BEFORE THE BUILDING DEPARTMEN-
A- GAN BE 'SSUED. AT -HE TIME OF PUBLIC WORKS
NT INSPECTION, IF ANY OF THE EXISTING PUBLIC
=NTS SJRROUNDING THE SIT= 15 DAMAGED, NEW
51DEAALK, CJRB AND GUT -ER, AND ALLEY/5-REF-
WILL BE REQUIRED. ADDITIONALLY, IF EXISTING
'RAS-RJGTJRE ARE DEEMED SUBS-ANDARD, A
PATER SERVICE, WATER METER BOX, SEWER
VD/OR CLEANOUT WITH BOX AND LID WILL BE
100010 OF THE COST SHALL BE BORNE BY THE
OWNER (MI,NIGiPA_ CODES '4.24.020 AND
SAID DETERMINATION AND THE EXTENT OF THE
ZK SHALL BE MADE A- THE DISCRETION OF THE
:<5 INSPECTOR.
6HMENT AGREEMENT 15 REQUIRED FOR ALL
ARD IMPROVEMENTS WITHIN -HE PUBLIC RIGHT OF
iON-STANDARD IMPROVEMENTS SHALL COMPLY
OUNCIL POLICY L-6 AND L-18.
RE ATED TO IA A7E IN THE PUBL,G RIGHT -Or -RAY
PERFORMED BY A C-34 :_ LENSED PIPELINE
�R OR AN A LICENSED GENERAL ENGINEERING
iR.
RELATED TO AASTE,JNA7ER IN -HE PUBLIC
,A" 5r7A_L 3E PERFORMED BY A G-42 _IGENSED
SEWER SON'RAGTOR OR AN A _CEN5E0
�G N=�RiNG CONTRACTOR,
=i. ENCROACHuEN- P=RM,- 5 REQUIRED FOR ALL
oIJBLIG RIGHT OF AA(.
CONSTRUCTION NOTES:
ON -SITE:
O1 NSTALL 12" 50 GA -CH BA51N PER ND5 1200 Ai H GRATE OR
GI? AP=ROVED EQUAL
OINSTALL 6" SGUARE GRATE I ADAPTER, NOS 640 OR EQUAL
OIN57ALL 6" = AN -ER DRAIN W/ ATRIUM GRATE, NDS 80 OR EGUA,_
OIN5TALL 4" DRAIN PIPE, 5OR 35 PVC OR EQUAL
OCONNECT ROOF DOWNS* GUT T'ED D'RECT." TO 5'-*E DRAINAGE PIPING AS PER
SOILS REPORT RECOMMENDATIONS
INSTALL SUMP PUMP ASSEMBLY =0R REAR PROPER' LINE RETAINING
WALL SUBRAIN SYTEv- SEE DETAIL ON 6-02
OIN57ALL BOTT0MLE55 TRENCH DRAIN AT BOTTOM OF DRIVENA" AS PER C!'^' OF
NEWPORT BEACH STANDARD. SEE DETAIL ON 6-03 d GENERA" NO-E 11
ONOT USED
OINSTALL 15 ' (MIN) 4" FRENCH DRA N IN 0RJ5HED RWR OCK BED AFOW WITH FILTER
CLOTH PER DE -AIL ON 6-03 FOR DRY-AEATI-ER RJN-OFF AND MINOR RAIN EVEN-5.
10 NEW REAR PROPERTY LINE RETAINING WALLS PER S-RJCTJRAL PLAN AND
DETAILS
OCONSTRUCT 5" GONG. FLATWORK ON GRADE PER 5O1L5 REPORT
REC0MMENDATI0N5.PROV VE DRAINAGE 5AALE ON CONCRETE F_A T /NORK
12 CONSTRUCT 5" THICK DRIVEWAY BASE PER 501L5 R=_FORT RECOMMENDATiONS..
DRIVEWAY =ROFILE -0 CONFORM TO =R CiTY 5-V-160-L-G ('"PE B)
0NEW PROPERT" LINE /HALL (MAX 6 �0' ABV N.G.) EX'ERICR FN!5H AND TREA'MEN- =ER
0 ARC-I1 T EC-'.RAL PLAN AND DETALS.
OFF -SITE:
21 REMOVE ALL EXISTING LANDSCAPE ELEMENTS (HALL, BRICK 5T=P5 ETC.)
22 EXISTING =ROPERTY LINE WALL; PROTECT -IN -PLACE
23 REC0N5TRLGT GONGRE T E S+DEWALK PER CITY STANDARD 5TD 180-L
24
PLANT NEW 36" 3
0X STREET TREE PER Sr-APTER 13 OF -HE CITY MUNICIPAL CODE P3 11-
o
OREPAIR EXISTING DAMAGED CURB,GUTTER AND 51DEWAL-K PER G T Y
25 STANDARD 5TD 182-L. SEE GENERAL NOTE '7
26 EXSTING SEWER _ATERA� TO BE ABANDONED AND SHALL BE CJT AND CAPPED AT THE
AYE. EXISTING BOX, COVER, RISER I VVE SHALL BE REMOVED.
GREMOVE EXISTING WATER METER 5ERVIGE
21 TO 3E GAPPED AT MAIN Ai-H CORPORA -ION STOP
28 CONSTRUCT NEW WATER METER AND SERVICE LATERAL PER CITY CE NEWPORT BEAGrl
G
STANDARD DRAWING 577-502-1-
29 REMOVE EK5TING GAS METER PER GA5 COMPANY STANDDARDS
G
FROM PUBLIC RIGHT OF ;`1AY
00NSTALL NEA 645 METER =ER GAS COMPANY STANDARDS
ON PRIVa - =Y�OPERTY
5?
FLn,v_ DROI,G�IT TOL-RANT LCW GROWING GROUND COVER
PER NEWPOR- BEACH STANDARDS 5TD-406-L
>- 32
'
NSTALL NEA SERER LA-ERAL
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NIA 92660 DRAWINGS, CONSULTANT COORDINATION, GOVERNMENT
AGENCIES COORDINATION, AND DURING CONSTRUCTION
SITE VISITS.
() l
OVEREXGA ATION
sEcT1
92656
5/22/2018 City of Newport Beach Page 1 of 14
4:30:18PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 05/23/2018
Inspection Type : ENCROACH
Inspection Area: PW
Site Address : 707 CAMPHOR ST
r ,.
i . .L Nw '
Activity N2018-0270�
SubType : NEW
Status : APPROVED
OWNER: MONTGOMERY ROBERT Phone
APPLICANT: INSTANT LANDSCAPES Phone : 949-347-0700
instantlandscape@aol.com
Description : CONSTRUCT NEW CURB & GUTTER PER STD, REMOVE HARDSCAPE IN PARKWAY
AND RE -LANDSCAPE, NEW 36" BOX BRAZILIAN PEPPER TREE, NEW CURB CORE
PER STD 184 L. }� _
,r f � o ♦ 'is:Ih,, �Y.�Y.H..��Ypp��.. i, � :1.. ,1i[eI�aOQ��-�� 4 •4.di as y.i �' fr '.'S a +a.i`sT71` .r:=F J°'
.: i'.. . ba..r'� �.iC���7.T.v�i►:S,v�� � .'� � �8' • ar -,%, i.'h .t {:; � �. i:i
. ., r.3...Y'i ., a 4tirr, S`_k ��,.w+�.'•M°�.'.+, � .• �i,.Yf.'i.•.:R �,ce?br� r.A!::,
Item: 10200 PRE JOB - PW
Requested Time: 5/23/2018 12:00:OOAM
Entered By: NBIVR
Comments: AM
Assigned to:
Inspector: Ut, 6-t Date:
Comments:
\fv
a -a
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
Requestor: NBIVR
9497950648
Z 3 Time: PM
REPT131 Run Id: 4018
• 5/29/2018 City of Newport Beach Page 3 of 16
4:30:09PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 05/30/2018
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 707 CAMPHOR ST
Activity : N2018-0270
SubType : NEW
Status : APPROVED
OWNER: MONTGOMERY ROBERT Phone:
APPLICANT: INSTANT LANDSCAPES Phone • 949-347-0700
instantlandscape@aol.com
Description : CONSTRUCT NEW CURB & GUTTER PER STD, REMOVE HARDSCAPE IN PARKWAY
AND RE -LANDSCAPE, NEW 36" BOX BRAZILIAN PEPPER TREE, NEW CURB CORE
PER STD 184-L.
Item:
10100 FORMS WITH COMPACTION - PW
Requested Time:
5/30/2018 12:00:OOAM
Requestor:
NBIVR
9497950648
Entered By:
NBIVR
Comments:
AM
Assigned to:
/
51341
Inspector:
%�_ G1 Date:
$
Time: AM PM
Comments:
low -It Aa—
�nSnfCIA e-,
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131 Run Id: 4018
8/30/2018 City of Newport Beach Page 1 of 17
6:34:44AM INSP150 - Daily Inspection Request Report
Requested Inspection Date : 08/30/2018
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 707 CAMPHOR ST
A/P/D Information:
Activity : N2018-0270
SubType : NEW
Status : APPROVED
OWNER: MONTGOMERY ROBERT Phone :
APPLICANT: INSTANT LANDSCAPES Phone : 949-347-0700
instantlandscape@aol.com
Description: CONSTRUCT NEW CURB & GUTTER PER STD, REMOVE HARDSCAPE IN PARKWAY
AND RE -LANDSCAPE, NEW 36" BOX BRAZILIAN PEPPER TREE, NEW CURB CORE
PER STD 184-L.
Requested Inspection(s)
Item: 10250 FINAL - PW
Requested Time: 8/30/2018 12:00:OOAM Requestor: NBIVR
Entered By: NBIVR 9497950648
Comments: AM
Assigned to: f/3
�
C�G � TED