HomeMy WebLinkAboutN2017-0560100
CityofO Center Drive,
Sport Beach, CA 92660 IIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIII�III�IIII
Permit Counter Phone (949)644-3311
Online Inspection Request - www.newportbeachca.gov / Online
Services
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Permit No: N2017-0560
Project No: 2087-2016 _
Inspection Requests Phone (949)644-3255
Job Address:
120 41ST ST NB
Thomas:Guide: 888G6
Description :
REMOVE AND REPLACE SIDEWALK, CURB, AND GUTTER PER CITY STANDARDS
Parcel # :
4233-120-5 -
Legal Desc :
RIVER SECTION BILK 40 LOT 9
Owner:
RLR PROPERTIES I LLC
Contractor: QUICKEL PAVING INC
Phone:
Phone:
Address :
204 AVENIDA FABRICATE
Address : 27071 CABOT ROAD STE 130
SAN CLEMENTE CA 92672 r
LAGUNA HILLS CA
Contractor State Lic: 767964
Applicant:
QUICKEL PAVING
License Expire : 08 31, 2018
Phone:
949-548-3588
Address
Business License: BT30045605
Business Expire : 09 30, 2018
Special Cond.:
PRE CON MEETING REQUIRED WITH PW
Workers' Compensation Insurance - -
INSPECTOR
Carrier : TORUS NATIONAL
Policy No: T10150014
W. C. Expire: 04 01, 2018
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 :
$330.00
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
.'SCANNED
Total Fee $571.00
Paid : $571.00
Balance: $0.00
Receipt No:
Date : _/_/ Other Department: Date:
Date : / / Permit Denied Date :
Date: _/ / Issued Permit: u, Date : l /
Date :
//,
TETHEBELOW-INFORMn ....... ..... .
11PROJECT ADDRESS:
_LC)
DETAILED DESCRIPTION OF PROPOSED WORK: e
5 6, � f .f 33
APPLICANT: UIL'ktl Phone: 3 TIS
Email Address: r_-<1
at\) ;,q C 0 vv-1
Mailing Address: 1 1
J�� 0 -7,
City4Stafoop
14),11f 12-(rC'3
OWNER: b Ck v\LAL-l<i Phone: 15") r
Email Address:
Mailing Address:
tatelzi
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_4ALLCONTRACTOR INFORAAATION IS -REQUIRE FLE0910
CONTRACTOR: U%A IL e,A\J i
1
Office Phone: .916, 2 - I S-
Company (if different).
Jobske Phone: 1401 --
Other Phone:-1 I
Email Address: 0A\1 15 tl! Lett V_\) IA
Co eV,-)
Mailing Address:
Ca. � A
City/Slate/Flp: L
924-57--7
State License
mb r &Class:
Expires:
City Business License Number:
Expires:
WORKERS COMPENSATION INSURANVE - Certificate of Insurance (Section 3800 Labor Code)
k e , '
Company: FAIJ.'t af� Policy No: - v , W 4 t, OvIvires: 10- I -
..........................................
................................. ...........
'0#o 061"S' jT: 1140. 0-JR,M-0, ... 0, R, ....... ..................... ............. ...........
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.................................................... ... . .........
. ................ . ......................................... . .. . - ........................
iI:R4fdhd:Td,;;-..... ... .................... ............................................
................. ................................ ........ ........
FOR OFFICE USE ONLY
Special Conditions of Permit: —4e COY(41 kk0+qv1
J,
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DERARTIVIENTS.
Utilities:
General Services:
Traffic: Fire:
Other.
Engineering Technician:
I
Public Works Specialist:
I A�,
Date:
Itko //-I
I /I I
Permit No.
INZ11 -0p 1
fAmr*bwhhweftnaoaftmasWSVPWO*MeeLAS
Public Works Department 949-644-3311
17)U
20U - 20l(o
AH Fees Are Non -Refundable Unless • r Stated-
PROJECTADDRESS:
[A PPLICAN
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 12-1
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" $65.00 Sewer Connection Fee
24" x 36" $143.00 4TT Box 8t Cover
Additional
_ _ _
THE POLLOWING ITEMS REQUIRE APPROVAL FROM THE
I REVENUE DIVISION PRIOR TO PAYMENT OF FEES 146,
TBDBTBD
$108.00 0
$.00 e $64
$64.00
---
venue 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
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 (f100% of hry 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
5 ;'1, 0C)
Permit Specialist lRecelot No.
f /users/pbw/shared/encroadVmasten/ep front and back masters/
Rev. 1/5/20171 epfeesheeUds-revised 10/21Q016
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
WORKER'S COMPENSATION INSURANC Secti 00 Labor Code)
1
Encroachment Permits may be taken out by the owner of benefited property or a licensed contractor. A licensed
I certify that I have a Certificate of consent t elf -ins of Worker's
contractor must provide a "Letter of Authorization" to allow another party to pull a permit. An approved copy of the
I,certificate
Compensa ion Insurance, or a Certified Copy reof. -
permit and construction plan shall be kept at the job site at all times. Work, which has been done prior to issuance of
i
a permit, is subject to rejection/fine City reserves the right to void permit if work does not cornmence within 30 days
Date: \Signatur Y
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 State 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 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.
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 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
Date: Signature:
4TT box over the riser.
24-hour notice for Encroachment Permit Inspection is required by calling
9. Properly lighted barricades must be provided and maintained around all trenches, excavations and obstructions. All
"Manual
signs. flags, lights and other warning and safety devices shall conform to the requirements of the current of
Public Works at 949-644-3311.
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
I I
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
Certificate or Evidence of a Slurried Backfill and request a final inspection from the
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 Slate 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 dumpster or materials in the public right-of-way, a
approved by Public Works and an Encroachment Agreement has b n 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 separat rmit and/or ad onal fees.
No work related to this encroachment permit $hall be performed until the Public Works Department has Issued this permit. Appli�t erms hereby c owledgps he/she h ead a de tan the 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 Issue
Ignat
Permit
fees are nonrefundable.
Date .�
�v -r ..-ice v N N'%vG I
NEWPORT BEACH, CA
ital to 1 vertical. 2. Fill slopes shall
ompaction to the finished surface.
win of 90 percent approved by the
I approximately every two feet in
he overall compaction effort applied to p�;'i�yL� Cj��•eWC�� S4 6 ft
tion and debris, sacrified and
It//. C �,,1, f 5+d __ i c -2 / 1Y�3
W
a 7i
�ineer er or removed befor any
removed, or crushed in and
y
place
ill, after clearing and prior to the
-areas of adverse stability and
. .
:cumulation of, subsurface water or
instructed prior to the placement of fill
eyed in the field for line and
t
ut to a minimum of 90 percent relative
�1 j c j ,
NEER. The Building Department may 2
A Z6'69 M„6Z0Za9£N
UP TF
+sled backfills to facilitate testing.
proved by the City Grading-
m W
N•
_ --
ccordance with Chapter 15 of the
p o
ao
=u
="
id after grading by an
m 2
►,
M
UP-
J
oblem exists. Should excavation
- __--=
geologist shall recommend and
Engineer for approval.
- -- -
slopes is determined to be necessary
soils engineer will obtain approval of
rading Engineer prior to construction,
Tall inspect and test the construction A - - - -- __ __ — - -- - =
slope and adjacent structures upon t -
-gineering geologist shall determine if '
U readily transmit water. If considered
jineer, a compacted fill blanket will be "
inspections during grading.
fulfilling their resposibility, the
geologist or the testing agency finds
with the approved grading plans, the
riting to the person in charge of
recommendations for corrective ADDITIONAL NOTES
Grading Engineer for approval. -- --
1. A PUBLIC WORKS DEPARTMENT ENCROACHMENT PERMIT INSPECTION IS REQUIRED BEFORE THE BUILDING DEPARTMENT
PERMIT FINAL CAN BE ISSUED. AT THE TIME OF PUBLIC WORKS DEPARTMENT INSPECTION, IF ANY OF THE EXISTING
PUBLIC IMPROVEMENTS SURROUNDING THE SITE IS DAMAGED, NEW CONCRETE SIDEWALK, CURB AND GUTTER, AND
ALLEY/STREET PAVEMENT WILL BE REQUIRED. ADDITIONALLY, IF EXISTING UTILITIES INFRASTRUCTURE ARE DEEMED
SUBSTANDARD, A NEW 1-INCH WATER SERVICE, WATER METER BOX, SEWER LATERAL AND/OR CLEANOUT WITH BOX AND
LID WILL BE REQUIRED. 100% OF THE COST SHALL BE BORNE BY THE PROPERTY OWNER (MUNICIPAL CODES 14.24.020
AND 14.08.030). SAID DETERMINATION AND THE EXTENT OF THE REPAIR WORK SHALL BE MADE AT THE DISCRETION OF
THE PUBLIC WORKS INSPECTOR.
2
/ •
i
0a
a
W
J
J
Q
1
4" 0 FRENCH DRA,
PERFORATION C
BOTTOM
314'I CRUSHED ROCk
FILTER CLOTH
LAP 12" @ TOP
• A PERF
TREE
DIMENSIONS DETERMINED BY 6"Fi
GRATE FRAME DIMENSIONS. OI
USE FRAME AS A FORM. W
� i V -
•19/14/2017 City of Newport Beach Page 1 of 12
4:30:36PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/15/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 120 41 ST ST
Activity : N2017-0560
SubType :
Status : APPROVED
APPLICANT: QUICKEL PAVING
OWNER: RLR PROPERTIES I LLC
Description: REMOVE ANDRW.L&
Item:
Requested Time:
Entered By: NBIVR
Comments: PM
Assigned to:
Phone : 949-548-3588
BMCMANN@QUICKELPAVI
Phone :
CURB, AND GUTTER PER CITY STANDARDS
Inspector: e1 Date: Time: M PM
Comments:
Refife
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131 Run Id: 4018
•
THIS IS NOT -TICKET NO. ROBERTSON'S
CONTROL
•
NUMBER { Phone 800/834-7557 San Diego 800/870-1220
m ` o lul
Y1 RIVERSIDE- 6120 20th ST w13 IRWINDALE - 13631 LIVE OAK LANE
M2 MQRENO VALLEY - 14250 Old 215 Frontage Road 4r14 PASADENA - 1420 N. LINCOLN AVE. OPENOPEN DAYS 7 DAYS
•
•3 REDLANDS - 8353 ALABAMA ST. t15 VERNON-LOS ANGELES - 3365 E. 26TH ST.
N4 FONTANA• 13792 SLOVER AVE. Ar16 ANAHEIM - 201 E. COMMERCIAL ST N25 GARDENA - 301 W. ROSECRANS AVE. w34 LUCERNE - 36555 HWY 18 M43 BAKER • 56500 BAKER BLVD.
•
'Y5 "MONA - 2470 POMONA BLVO. M17 SANTA ANA - 310 N. TOWNSEND 51 w26 THOUSAND PALMS • 72460 VARNER RD. N35 BIG BEAR LAKE - 42025 GARSTIN OR. M44 FT IRWIN • 58825 RD.
'
M6 HEMET/SAN JACINTO - 1675 STATE ST Y18 LAKE FOREST - 25931 TOWN CENTRE OR. #27 MURRIETA • 26190 ADAMS AVE. w36 ESCONDIDO - 1310 SIMPSON WAY N45 BARSTOW - 2700 E. MAIN ST
♦� BEAUMONT - 452 W. LUIS ESTRADA RD. Y19 ADELANTO - 12203 VIOLET RD. w28 OTAY MESA • 7961 AIRWAY RD. w37 INDIO - 88110 FARGO CANYON RD ♦46 CAL -CITY - 7900 MOSS AVE.
18 SUN CITY - 27050 WATSON RD. w20 SAN CLEMENTE - 116 RINCON CT w29 EL CAJON - 215 CYPRESS LN. #36 RIOGECREST - 21571NYOKERN RD. M47 PORT OF LONG BEACH.1602 W. PIER 0 ST.
•
19
ARROWHEAD - 29750 HWY 18 u21 IRVINE - 16081 CONSTRUCTION CIR. WEST N30 CORONA - 1540 SHERBORN ST N39 PALMDALE - 37790 75TH ST. EAST M51 SIMI VALLEY - 400 W. LOS ANGELES AVE. N 10 SANTA FE SPRINGS - 12311 GREENSTONE AVE. w22 NO. HOLLYWOOD - 13132 RAYMER ST. N31 HESPERIA - 9661 C AVE. #40 ARTESIA - 13949 E. STAGE ROAD M52 NATIONAL CITY - COMING SOON
•
1 n CAMON - 13990 APACHE TRAIL N23 PARAMOUNT - 7277 E. ROSECRANS AVE. M32 UPLAND - 1975 N. BENSON I41 MOJAVE - 140 E. HWY 58 #53 SAN JUAN CAPISTRANO - COMING SOON
N 12 SAN BERNARDINO - 1955 W. 9TH ST. A24 RIALTO . 2601 N. ALDER AVE. 033 MIRAMAR • 5692 EASTGATE OR. M42 VICTORVILLE - 16952 N. 0 ST Y54 OXNARD - COMING SOON
PLANT DATE CUSTOMER NO. SOLD TO MAP PAGE TICKET NO.
•
•
TX CO DELIVERY ADDRESS 8 INSTRUCTIONS CUSTOMER PO / JOB OR LOT #
• j 1
ORDER NO. METER READING TIME TYPED TRUCK LIC NO.
M
•
•
LOAD NO. SLUMP TRUCK DRIVER
•
DRUM
REVS. Job -site Cylinder Test: ❑ Yes
•
TO JOB TIME ON JOB MIN. CHECK N
ON JOB Water added on job at STAND BY MIN. CHECK ❑
Customer's request: AMOUNT By
•
START POUR gals t0 FUII Ld. RATE OF X $ PER MIN. CASH ❑
•
AMOUNT By
gals to 2/3 Ld.
FINISH POUR $ PLANT MGR SIG
gals to 1/3 Ld. OVERTIME CHARGE
4 min. per yd. unloading time allowed. ADJ. Meter
LEAVE JOB
•
Additional unloading time charged at current hourly truck rate.
•
ARRIVE PLANT Additional w ileradded to this concrete will reduce its strength. Any water added exceeding the design water is at customer's own risk.
e ,
Signature certifying under penalty of perjury that the Information contained in this written time record is true and correct.
' ell >;I
.
EMPJ1 SIGNATURE TERMS AND CONDITIONS OF SALE
•
Customer agrees that the described material has been chosen solely by Customer without Robertson's direction, or review of any plans or specifications relating to the pr%t(s) where the material is to be used
Customer further agrees that it shall be solely responsible for the delivery location, discharge/placement material the including the direction Robertson's
and of on lob site, on -site of vehicles to the designated
location Customers review and approval the described material shall be evidenced by Customers signature and/or placement of the described material on the job site. Inconsideration of the above. Customer
releases and agrees to defend. indemnify and hold Robertson's and its employees and agents harmless from any and all losses, damages, liabilities, costs and claims asserted by Customer or any third party,
arising from (i)) material being inappropriate, incompatible, improper or inconsistent with plans and specifications, or with the ground soils or conditions on the land where the material Is utilized, and (Ii) the
movement gobertson's delivery location. fails
•
- vehicles upon or about the Solely to the extent Customer to timely pay for the described materials, in the event Robertson's retains the services of an attorney,
Customer agrees to pay such reasonable attorney's fees incurred by Robertson's in furtherance of such collection efforts. Robertson's and Customer disclaim attorney's fees arising from any
•
other context.
Customer agrees to pay a time price differential of 1 Y2 % per month on any amounts owed to Robertson's for more than thirty (30) days. Color Disclaimer Due to irregularities and/or inconsistency of materials
Robertson's is not responsible for the results of any concrete where the coloring agent has been added at the request of the customer. either at our plant or on the job site.
LID CITY CUM OTY ORD CITY PROD CODE MIX AND COMMODITY UOM UNIT PR AMT
•
WBIGHMASTER CBRTOICATE
•
THIS IS TO CERTIFY that the following described commodity was weighed, TAX
measured. or counted by a weighmaster, whose signature i5 on this certificate.
who is a recognized authority of accuracy. as prescribed by Chapter 7
(commencing with Section 12700) of Division 5 of the California Business and PREVIOUS
Professions Code, administered by the Division of Measurement Standards of the BALANCE
•
Califomia Department of Food and Agriculture.
•
ROBERTSON'S SUB
WEIGHMASTER TOTAL
•
STAND BY
•
BY DEPUTY
CHARGE
UOM CONVERSION CY=YAROS3 4=POUND5 GL=GALLONS 1`0=0UNCE5 CU=METERS3 KG=KILOGRAM L•LITERS ML=MILLLLITERS
CONCRETE DELIVERY TICKET TOTAL
•
PO BOX 3600 CORONA, CA 92878-3600
AGREED TO AND RECEIVED BY CUSTOMER
1111612017 City of Newport Beach Page 3 of 11
4:30:27PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/17/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 120 41 ST ST
Activity : N2017-0560
SubType :
Status : APPROVED
APPLICANT: QUICKEL PAVING Phone : 949-548-3588
BMCMANN@QUICKELPAVI
OWNER: RLR PROPERTIES I LLC Phone:
Description: REMOVE AND REPLACE SIDEWALK, CURB, AND GUTTER PER CITY STA�
Item: 10110 CONCRETE PUBLIC WORKS ( '
Requested Time: 11/17/2017 12:00:OOAM Requestor: NBIVR \ ��
Entered By: NBIVR
Comments: AM
Assigned to:
Inspector:
Date: 1 !Z 7 i
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
Time:
1�G-L
M
REPT131 Run Id: 4018
11/20/2017 City of Newport Beach Page 2 of 16
4:30:51PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/21/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 120 41 ST ST
Activity: N2017-0560
SubType :
Status : APPROVED
APPLICANT: QUICKEL PAVING Phone : 949-548-3588
BMCMANN@QUICKELPAVI
OWNER: RLR PROPERTIES I LLC Phone
)escrintion : REMOVE AND REPLACE SIDEWALK, CURB, AND GUTTER PER CITY STANDARDS
Item: 10110 CONCRETE PUBLIC WORKS
Requested Time: 11/21/2017 12:00:OOAM Requestor:
Entered By: NBIVR
Comments: AM
Assigned to:
Inspector: ' Vf
Date: R Z I (1
Comments: bh=l' f4 y 7-U
NBIVR
9495843588
Time: �.,00 A PM
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F:\UserslPBW\Shared\ENCROACH\MASTERS\FORMS\Insnectorsheet.doc
REPT131 Run Id: 4018