HomeMy WebLinkAboutN2018-0278t rV~A City ; OO Civic Center Drive,
Beach Beach, CA 92660 IIII�IIIIII IIIIIIIIII IIIII II�III�III�I II�III�I II�IIII
Permit Counter Phone (949)644-3311
Online Inspection Request - www.newportbeachca.gov / Online
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Job Address
Description
Parcel # :
Legal Desc :
Owner:
Phone :
Address
Applicant:
Phone :
Address
Permit No: N2018-0278
Project No
NED
Inspection Requests Pfione (949j644-3255
626 SEAWARD RD NB Thomas:Guide: 919G3
DECORATIVE DRIVEWAY, CARRIAGE WALK AND WALK WAY. REVISED WALL TO COMPLY WITH L-6
4591-414-1 -
TRACT NO 1237 LOT 164 AND TRACT NO 14795 LOT 18
UEBERROTH JOSEPH J
0
626 SEAWARD RD
CORONA DEL MAR, CA 0
UEBERROTH JOSEPH J
f
Special Cond.: PRE -CONSTRUCTION MEETING REQUIRED
Permit Processing Fee :
$0.00
Sewer Connection:
$0.00
Agreement Fee:
$817.00
4TT Box Cover:
$0.00
Traffic control Plan Check :
$0.00
Total Water Meters :
$0.00
Inspection Fee:
$165.00
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
Date
Date
Date
Date
Contractor: MIKE DELAVAN GEN CONT INC
Phone: 949-640-7983
Address : 711 MARGUERITE AVE
CORONA DEL MAR CA 92625
Contractor State Lic: 672341
License Expire: 06 30, 2019
Business License: BT00013893
Business Expire: 11 30, 2018
Workers' Compensation Insurance - -
Carrier : EXEMPT
Policy No: NO EMPLOYEES
W. C. Expire:
Total Fee $982.00
Paid : $982.00
Balance : $0.00
Receipt No:
Other Department: Date:
Permit Denied Date :
Issued Permit :YDate : ' /7 � O
I COMPLETE THE BELOW INFORMATION
PROJECT ADDRESS: & 2 ., { .A lyzelzit
DETAILED PESCRIPTION OF PROPOSED WORK:
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PPLICANT: rM; at/.p% G 4. Z-gC
Phone: 9j(4Y-eA7-,341t7
Email Address:
Mailing Address: h , � �
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OWNER: kPhone:
Email Address: 1- 44 - P'1 ri h e
Mailing Add Ci /State2ip-
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CONTRACTOR: � � G %
Office Phone: 94' i0-17--*41i'
Company (if different):
Jobs'te Phone:
hone: 9SF`3-1v97 61417
Email Address: ; ` ,4 h
L—/n C . GfJ%-
Mailin A dress: f -
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Ci /State/Zipti� I - �� 9 ZG
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State License Ntdnber & Class:
% Expires: f/D /
City Business License Number:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: at YOf Policy No: Expires:
Municipal Oerations: 949-644.3055
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
«0!� I ill.
Special Conditions of Permit:
C'h
ADDITIONAL APPROVAL QED FROM T FOLLOW NG OEP
Utilities:
Municipal Operations
Traffic: 0 Fire: 0
Other:
Engineering Technician:
Permit S cialist
Date:
I
Permit No. cc
N2018- �)02`� O
f./users/pbw/shared/encroach/masters/epworksheet.xls �-
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Public Works Department 949-644-3311
100 Civic Center Drive, Newport Beach, CA 92660
0
IM
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 INSURANCE (Section 3800 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 to self -insure, Certificate of Worker's
contractor must provide a I. etter of Authorization to allow another party to pull a permit An approved copy of the
Compensation Insurance, or a Certified Copy thereof.
permit and construction plan shall be kept at the job site at all limes 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
Date: Signature: _
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 comp) ith he
4
Permittee guarantees all work performed under this permit to be free of hidden and latent defects. Any failures shall
�rovisionson
3700 or this permit hall 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 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
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 miror
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 PermIn a tion 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 ill require documented approval from the adjacent
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.
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 subcontracotrs 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
1 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 Wa er
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 Slate
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 Compacti.in
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
Certificate or Evidence of a Slurried Backfill and request a final inspection from tie
the Public Works Department. Any work affecting the State Highway's traffic or within the Stale Highway right-of-way
Public Works Department. Monies may be held for six months after final inspecti�jn
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. cr 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 VJor<
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 previou�;Iy
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 been 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 separate permit and/or additional fees.
No work related to this encroachment permit 4hall be performed until the Public Works Department has Issued this permit. Applicant hereby apknEwpdges he/she has rea a un rs 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.
Dat ' (/ IZSignature:
Permit
fees are nonrefundable.
_._
Certification of Trust for the
Ueberroth Community Trust
dated November 12, 2003
BROWN & STREZA, LLP
ESTATE PLANNING - BUSINESS PLANNING - INCOME TAX PLANNING - CHARITABLE SECTOR - MERGERS & ACQUISITIONS
40 PACIFICA. SUITE 1500
IRVINE. CALIFORNIA 92618
The Ueberroth Community Trust (the Trust) was established on November 12, 2003 and
restated on February 24, 2015. The Trustors of the Trust are Joseph J. Ueberroth and
Polly V. Ueberroth. The Trustees of the Trust are Joseph J. Ueberroth and Polly V.
Ueberroth (referred to collectively as the Trustee).
The signature of any Trustee is sufficient to exercise the powers of the Trustee.
This Trust is revocable and amendable by Joseph J. Ueberroth and Polly V. Ueberroth,
acting jointly.
The tax identification number of the Trust is the Social Security number of either Trustor.
Title to assets in the Trust will be taken as follows:
Joseph J. Ueberroth and Polly V. Ueberroth, Trustees of the Ueberroth
Community Trust dated November 12, 2003.
In addition, for titling purposes, any description referring to the Trust is effective if it
includes the name of the Trust, the name of at least one initial or successor Trustee, and
any reference indicating that property is being held by our Trustee in a fiduciary capacity.
The Trustees under the trust are authorized to acquire, sell, convey, encumber, lease,
borrow, manage, and otherwise deal with interests in real and personal property in the
trust name.
The Ueberroth Community Trust has not been revoked, modified, or amended in any way
that would cause the representations in this Certification of Trust to be incorrect.
By signing below, we each declare under penalty of perjury under the laws of the State of
California that the foregoing declarations are true.
RELIANCE ON THIS CERTIFICATION
This certification is made under California Probate Code Section 18100.5 and California
Commercial Code Section 8402(a)(2)-(5) and is signed by all the currently acting
Trustees. Any transaction entered into by a person acting in reliance on this certification
is enforceable against the trust assets.
PROBATE CODE SECTION 18100.5(h) PROVIDES THAT ANY PERSON WHO
REFUSES TO ACCEPT THIS CERTIFICATION IN LIEU OF THE ORIGINAL TRUST
DOCUMENT WILL BE LIABLE FOR DAMAGES, INCLUDING ATTORNEYS' FEES,
INCURRED AS A RESULT OF THAT REFUSAL, IF THE COURT DETERMINES THAT
THE PERSON ACTED IN BAD FAITH IN REQUESTING THE TRUST DOCUMENT.
Certification of Trust for the Ueberroth Community Trust
Page 1
February 24, 2015
Polly V. eberroth, Trustee
A notary public or other officer completing this certificate verifies only the identity of the individual
who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or
validity of that document.
State of California
County of Orange
On February 24, 2015 before me, Dylann Sierra White, a Notary Public, personally
appeared Joseph J. Ueberroth and Polly V. Ueberroth, who proved to me on the basis of
satisfactory evidence to be the persons whose• names are subscribed to the within
instrument and acknowledged to me that they executed the same in their authorized
capacities, and that by their signatures on the instrument the persons, or the entity upon
behalf of which the persons acted, executed the instrument.
I certify under PENALTY of PERJURY under the laws of the State of California that the
foregoing paragraph is true and correct.
WITNESS my hand and official seal.
Wim—MMM
COMM" 120603
NO* Y Fdit • OWN"
OMM UM
Cow WNW AW 1 2018
Signa a (Seal)
Certification of Trust for the Ueberroth Community Trust
Page 2
.. QEBERROTH RESIDENCE
626 SEAWARD RD. o CORONA DEL MAR, GA 92625
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7/18/2018 City of Newport Beach Page 17 of 20
4:30:43PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 07/19/2018
Inspection Type : ENCROACH
Inspection Area: PW
Site Address : 626 SEAWARD RD
Activity : N2018-0278
SubType : NEW
Status : APPROVED
OWNER: UEBERROTH JOSEPH J Phone : p
Description : DECORATIVE DRIVEWAY, CARRIAGE WALK AND WALK WAY. REVISED WALL TO
COMPLY WITH L-6
Item: 10250 FINAL - PW
Requested Time: 7/19/2018 12:00:OOAM Requestor: WEBUSER
949-697-3417
Entered By: WEBUSER
Comments: AM -
Assigned to: 77777777777-
Inspector:
Comments:
Date: Time: AM PM
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131 Run Id: 4018