HomeMy WebLinkAboutN2017-0219t ;.t +' 4'-
•�"
City
cofNewport Beach Illl�llllllllllllll�lllllllullllllllllllllllllll
o�v��P Beach, CA 92660 lllllllll
Permit Counter Phone (949)644-3311
Online Inspection Request - www.newportbeachca.gov / Online
Services
Permit No: N2017-0219 .�
Project No : 0367-2017
ti CANNED
Inspection Requests Phone (949)644-3255
Job Address:
1732 ORCHARD DR NB
Thomas:Guide:
Description :
CONSTRUCT DRIVEWAY APPROACH PER CITY STD 162-L, (W=10', X=3'), CONSTRUCT 3" CURB DRAIN PER CITY STD 184-L.
Parcel # :
legal Desc :
Owner:
STIEVE DAVIS T ry �, f
Contractor : DICKENS JOHN INCORPORATED
Phone:
949-278-1174 r ;, ; : i . ;: •.,
Phone: 949-795-0995
Address :
1731 ORHCARD DR
Address : P O BOX 1882
NEWPORT BEACH CA 92660
COSTA MESA CA 92628
Contractor State Lic: 355981
Applicant:
DICKENS JOHN INCORPORATED
License Expire: 07 31, 2017
Phone:
949-795-0995
Address :
P O BOX 1882
COSTA MESA CA 92628
Business License: BT00002899
Business Expire : 07 31, 2017
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation Insurance - -
Carrier : EVEREST NATIONAL INSURANCE COM
Policy No: 7600015590
W. C. Expire: 10 01, 2017
Permit Processing Fee :
$241.00
Sewer Connection :
$0.00
Total Fee
$571.00
Agreement Fee:
$0.00
4TT Box Cover:
$0.00
Paid :
$571.00
Traffic control Plan Check :
$0.00
Total Water Meters :
$0.00
Balance :
$0.00
Inspection Fee :
$330.00
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 : _/ /
i
A.
COMPLETE THE BELOW INFORMATION
PROJECT ADDRESS: 73 Z d R c 14,912 r7 l--) R., P, /3, 9 L 6 6
DETAILED DESCRIPTION OF PROPOSED WORK:
�v N c r2 �r—c: /7R r ✓� w f7 y
L-�rZr3 �r� � ` �� i✓s
i
APPLICANT: 1%AVC Tic V is
Phone: 5 �/'1Z 7d' %
Email Address: /��i/E STiFvEC Y.-M-0D. C vM
Mailing Address:
/ 73 / O9c/f�gJ 1'•2,
Cit�yy/StatefZip:
/V c'w:'vn/ /jE�9 c// 1)%� �i Z 66 d
Phone:
OWNER: ' 4 rN%
Email Address:
Mailing Address:
City/State/Zip:
ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE COMPLETE
CONTRACTOR: aT0,1�.0 /7 / c /4cLti S
Office Phone:
Company (if different):
_
Jobsite Phone: § 'y'/ �7 9S - 6 9 9
Other Phone:
Email Address: %'j- /4-+
Mailing Address:
-iJ,04' 2
City/State/Zip:
9 z 6 ze
State License Number & Class:
3 S S 5 ('/ Expires: 'Y. 3 / - / 7
City Business License Number:
/3 T,O0 0 0 Z(Yy 9 Expires: 7'3 / / 7
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: /,-c Policy No: 660016 oodiSS`% Expires: /0"/-/7
Municipal Orations: 949-644-3065
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
FOR OFFICE USE ONLY
Special Conditions of Pe it:
r
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
Municipal Operations
Traffic: Fire: 0
Other:
Engineering Technician:
tic,
Pe ecialist
1 .1
Date:
�I ►1
Permit No.
N2017• l
f:/uaers/pbw/shared/encroach/masteralepworksheet.xls ^" --% ._ J' 7
Public Works Department 949-644-3311
100 Civic Center Drive, Newport Beach, CA 92660
Permit Processing Fee:
Qty-
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.
9 4 'N
Utilities Field Inspection $121.
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 & Cover
Additional -q
I THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE �R
I REVENUE DIVISION PRIOR TO PAYMENT OF FEES A
TBDeTBD
$108.00 0
$.00 e
$64
$64.00
------
revue 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
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 $51.00e
2" Meter: 27.00 + 162.00 $189.00
Certificate of Compliance Fee (+100% of hriy 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
L (�, It 57, 6 &-v
Permit S ciallst Receipt No.
ffusers pbw/shared/encoadVrn"erV9p front and hack mestersl
Rev. 1152017 epfeeaheet.xis-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 t-ncroac.hment Permits may be taken out by the owner of benefited property or a licensed contractor. A licensed
contractor must provide I Leller 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 limes. Work, which has been done prior to issuance of
a permit, is subject to rejection tine 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 Slate 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 Stale 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 shalt 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 (to water, sewer or street lighting conduitst to verify locations Maintain a one -fool
clearance over or under existing City -owned utilities Sewer cleanouts require VCP or PVC SDR35 be used with a
4 rT boy 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 I lighways", 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 nunimum 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 frorn December 19 to
January 1. unless approved by the Public: Works Department
I I Any work that extends into traffic or parking lanes and Impedes the normal flow of traffic requlres the applicant to
acquire a Temporary Street Closure Permit from the Public Works Department Access for fire. police and
emergency vehicles most be. maintained at all tunes Traffic Control must be per Work Area Traffic Control
Handbook (WATCH) No nightlunne traffic lane closures unless prior approval has been granted Any lane(s) closure
on a major street will only he 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 Stale ITighway's traffic or within the Stale Highway nghl-of-wav
will require a Callrans 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 bc, 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 Co`
I certify that I have a Certificate of cons o s ins , Cer f
compensation Insurance, or a C�fied opy thereo _
Date: % '-3 Signat _
CERTIFICATE OF EXEMPTIO�tion 3800 Labor Code)
1 certify that in the performance of the 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. 1 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:
3urptilifice for cro chment Permit Inspection is required by calling
is YVorks at 9-644 31J.
15 Any round utility facilities will require ctocunrented approval from the adlacenl
affected property owners)
16 Homeowner, contractors, and subconlracotrs may each be liable for wola(iow, of 4Valer
Quality Laws Best Management Practices will be enforced 11 is against the law Icy
discharge construction debris into the gutter and storm drain f elony violations of
Quality Laws are punishable by fines up to $25.000 andior up to three years :n 51a1r,
prison plus the full cost to clean up an illegal discharge or spill
17 If a refundable deposit was paid, applicant must submit it Soils Compaction
Certificate or Evidence of a Slurried Backfill and request a final insper.tion from thc!
Public Works Department. Monies may be held for six months after final inspectioo
before a refund will be processed
18. No trees in the public right-of-way shall be planted, rernoved. trimmed. of tMo,: h d
without approval from the General Services Department.
19 All work in the public right-of-way must meet the approval of the Public Vdark
Department or corrections will be required (i.e. removals. exposing e;nnneecbcr,ls.
etc.) Additional inspection fees may be required.
20. Permit is for standard materials in the public right-of-way only, unless previously
approved by Public Works and an Encroachment Agreement has been processed
21. Permit is valid for "description' of work noted on front only. Additional work
performed may require issuance of a separate permit andor additional fens.
No work related to this encroachment permit shall be performed until the Public Works Department has issued this permit. Applicyfit hereby acknowledge It h' has �rierSLiiRUs�p+ �terms an
conditions of this permit and he/she agrees to abide by them. Permit is void if work is not commenced within 30 days after issue c .
Permit fees are nonrefundable. Dat �-J
I I
1
�slIGU,1t I
1.
94.........,T 47.
i. y, yr• /fi 69 Tf�
u, 1 UG'. •r
rY r ro Muir i // I /
T Q a FOG
rf; �"; 1 G /GU00
rW�
Z...
... 18'
�o
J
} . t
3
4` r 93 to
1 ..._ U$
n4.
Xi
. r .Sam ) :i, _ • • tS )q '
6 %!` 1 6r
• • f,
V. I t •
117.4
U
Tw
.zoe
a I
E;.
der
9 �
i
r '/y
ly 9
e
J 9�.
4%
Y /&.y to
\ s w�
t--'ONS-TRUCTION NOTES:
C0NSTRUc'I' ON -SITE: GRAVEL
S(1BGRADE, SHALL BEPER SL FNG NEFR.'S Rf-;CUM IuIENDATIUN5.
('UNSTRUC"I' 6" f)IA. Al2f;A DRAIN INLET
T (I)OME:E) GRATE). NUS MODEL 80,
(D CONSTRUCT 4" l:)IA. P, V.C, (SCH 40 OR SDR-35) .DRAIN PIPE AT 1 oa MIN. SLOPE:
INSTALL SINGLE ROW OF GR.AVLE BAGGS
CONTROL. BMP Sf -6 t2 BAGS HIGfI) FOR EROSION
('(:>NSTRUCT 4" I:1IA. PER%. A.V.C. (SCH40 OR SDR-3'
PfPE TO BE INSTALLED WITH PERT. HOLES FACING DOWN &IW AT 1 °/' MIN. SLOPE,
FILTER FABRIC PER DETAIL HEREON RAPPED WITH
C'()NS'I'KUC'I' 3" CURB DRAIN PER CI
(PUBLIC WORKS PERMIT REQUIRED] �Y OF NI;WP(.�R7� BEACH STD 184-L
PROTECT EXISTING WALL IN PLACE
08. CONSTRUCT LOW FENCE
CONNECT ROUT~ CaC)WNSPOC)T'TO UNDERGROUND DRAINAGE SYS'I'FM
(10.
N('•W OR EXISTING GRASS AREA
CONSTRUCTNEW DRIVE
APPROACH PER CITY STD. 162-L (MODIFiEU)
• tY'i
` 8M712017 City of Newport Beach Page 1 of 6
' 4:30:43PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 08/18/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 1732 ORCHARD DR
Activity : N2017-0219
SubType : NEW
Status : APPROVED
OWNER: STIEVE DAVIS Phone
949-278-1174 davestieve@yahoo.com
APPLICANT: DICKENS JOHN INCORPORATED Phone : 949-795-0995
Description: CONSTRUCT DRIVEWAY APPROACH PER CITY STD 162-L, (W=10', X=3'),
CONSTRUCT 3" CURB DRAIN PER CITY STD 184-L.
Item: 10200
Requ t d T' 8/18/2�,
es a ime. • . -� Requestor: ..
9492781174 �a�/td
Entered By: NBIVR
Comments: AM *V
NBIVR
Assigned to:
Inspector: Date: Time: �� AM PM
Comments:
/vimtTS -i' ,e1V/,
. Q�25- 1672--Z- 4 2
Logged
e e
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
—C?u7— 1
REPT131 Run Id: 4018
8/22/2017 City of Newport Beach Page 1 of 7
4:30:11PM INSP150 - Daily Inspection Request Report
Requested Inspection Date:
08/23/2017
Inspection Type :
ENCROACH
Inspection Area:
PW
Site Address :
1732 ORCHARD DR
Activity : N2017-0219
SubType : NEW
Status : APPROVED
OWNER: STIEVE DAVIS Phone
949-278-1174 davestieve@yahoo.com
APPLICANT: DICKENS JOHN INCORPORATED Phone : 949-795-0995
Description: CONSTRUCT DRIVEWAY APPROACH PER CITY STD 162-L, (W=10', X=3'),
CONSTRUCT 3" CURB DRAIN PER CITY STD 184-L.
Item: 10100 FORMS WITH COMPACTION - PW
Requested Time: 8/23/2017 12:00:OOAM Requestor: N ' 4:1—
9492781174, �4-V,6-
Entered By: bLBIVR
Comments: P
Assigned to:
Inspector:y Date: 3 �7 Time: �Z= `� �A PM
Comments:
' L
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131 Run Id: 4018
4/29/2017 City of Newport Beach Page 1 of 22
6:34:35AM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 08/29/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 1732 ORCHARD DR
IP111r
Activity : N2017-0219
SubType : NEW
Status : APPROVED
OWNER: STIEVE DAVIS Phone:
949-278-1174 davestieve@yahoo.com
APPLICANT: DICKENS JOHN INCORPORATED Phone : 949-795-0995
Description: CONSTRUCT DRIVEWAY APPROACH PER CITY STD 162-L, (W=10', X=3'),
CONSTRUCT 3" CURB DRAIN PER CITY STD 184-L.
Item: 10250 FINAL - PW
Requested Time: 8/29/2017 12:00:OOAM Requestor: NBIVR
9492781174
Entered By: NBIVR
Comments: AM
Assigned to: \ I
Inspector: V Date: Time: /0 -'��PM
Comments:
COMPLETED
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc