HomeMy WebLinkAboutN2017-0449KwN�,`r4r. City
�Civic O CDrive,enter Newport Be8 Beach, CA 92660 IIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIII
Permit Counter Phone (949)644-3311
. Online Inspection Request - www.newportbeachca.gov /Online
Services
Permit No: N2017-0449
Project No: 1229-2017
Inspection Requests Phone (949)644-3255 V
Job Address:
2036 SANTIAGO DR NB
Thomas:Guide: 889C3
Description :
INSTALL SEWER CLEAN OUT PER STD 406-L.
Parcel # :
1176-040-7 -
Legal Desc :
N TR 4224 LOT 7
Owner:
FAHY TIM
Contractor : KISLING DONOVAN M
Phone:
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Phone:
Address :
2036 SANTIAGO DR •J
Address : 25571 VESUVIA AVE
NEWPORT BEACH, CA 92660
MISSION VIEJO CA
Contractor State Lic: 873678
Applicant:
KISLING DONOVAN M
License Expire: 03 31, 2018
Phone:
[
Address :
25571 VESUVIA AVE
MISSION VIEJO CA
Business License: BT30056485
Business Expire: 09 30, 2017
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation Insurance - -
Carrier : STATE FUND
Policy No : 91747727
W. C. Expire: 12 19, 2017
Permit Processing Fee :
$241.00
Sewer Connection :
$0.00
Agreement Fee:
$0.00
4TT Box Cover:
$64.00
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
Total Fee $635.00
Paid : $0.00
Balance: $635.00
Receipt No:
Date : _/ / Other Department: Date:
Date : _/_/ Permit Denied Date
Date : / / Issued Permit : Date
Date
COMPLETE THE BELOW INFORMATION
PROJECT ADDRESS: T03CO 5
C ii
DETAILED DESCRIPTION OF PROPOSED WORK:
uw - c 1 cat ow A--
4% -- L
APPLICANT: Ming - It
Phone:
Email Address: p rlo `
Mailing Address:
ity/StatelZip:
WNER: ' m e,
Phone: —
[Email
Address:ailing
Address:
City/State/Zip:
CONTRACTOR:
Office Phone: 2q.4-3 Z
Company (if different):
l 0 GO 'h-vc.�-7tn
Jobsite Phone:
Other Phone:
Email Address:
M%ailliing/Address: nA`
City/State0p:
State License Number 19 Class:
3 (0 78 Expires: 3 x(
City Business License Number:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 38M Labor Code)
Com an ,P, Pi4 Polic No: q 144 -7 2,2 Expires: C
Municipal Orations: 949-644-3055
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
Special Conditions of Permit:
Utilities: Traffic:
Municipal Operations Other:
Fire: 0
Engineering Technician:
Permit ialist
Date:
Permit No.
N2017- /q
/ r/userWPOwisnamG/erICroecmmasterwepworKsneec)as
22.'� - c ( -1
Public Works Department 949-644-3311
100 Civic Center Drive, Newport Beach, CA 92660
FEE WORKSHEET FOR ENCRIPACHMONT PERMIT
..,CrrY OF NEWFORT MACH
PU%WOWS DEPARTUgHT
All Fees Are Non -Refundable Unless Otherwise Stated
PROJECT ADDRESS: � � � � �
ERMIT NUMBER:
N2017-
APPLICANT:
TO UIE CONVILIETIED BY PUBLIC WORKS OF-PARTMIE-1fr'
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
Inspection Fee:
$241.00
Public Works Field Inspection
$165.00
$275.00
Utilities Field Inspection
$121.00
General Services Inspection
$165.00
Water Quality/Artificial Turf Inspection
$108.00
$81',
$192.00
Refundable Deposit:
TBDB
$502.00
Improvements
TBD
Street/Alley/Walk Closure: $65.000 Newspaper Rack Inspection $108.00
Traffic Control Plan Check
8-1/2" x 11" $65.00 Sewer Connection Fee $250.00
24" x 36" $143.00 4TT Box S Cover $64.0Q;�J
Additional
I THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE ,Revenue Division I
1
may
9st. 1
(Water 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
12" Turbine Meter
$845.00
For Traffic & Alley Areas (Box + Cover = CosfJ 1
13" Meter
$3,310.00
1" Meter: 13.00 + 38.00 $51.00
14" Meter
$4,730.00
2" Meter: 27.00 + 162.00 $189.00
16" Meter
$7,190.00
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 EasementNacation 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
e4 C0�s I �Z,
Permit S ecialist
Receipt No.
f:/users/plydshared/encroach/masters/ep front and back masters/
i Rev. 1/5/20171
epfeasheet.xis-revised 10n1n0+e
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 Teller of Authorization' to allow another party to pull a permit. An approved copy of the
Compen ation Insura ce, or a Certified Copythen
permit and construction plan shall be kept at the job site at all times. Work, which has been done prior to issuance of
q�
I ?gnature:
a permit, is subject to rejection/fine. City reserves the right to void permit if work does not commence within 30 days
Date: /VCJ
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, 1 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 Slate Contractor License Class C-34 is required. For construction or
CONTRACTOR LICENSE EXEMPTION
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,
As the Owner of the benefiting property, I certify I am personalty 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
1 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 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
Date: Signature:
4TT box over the riser.
24-hour notice for Encroachm t Permit Inspection is requir 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
Warning Signs, Sights and Other Devices for the Use in Performance of Work Upon Highways", issued by the
Public Works at 949-644-331
California Department of Transportation. If needed barricades can be obtained from the City at a charge of $10.00
15 Any above ground utility faciliti s will require documented approval f t 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 subcontracotrs may each be liable for ations 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
11.
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 Slate
emergency vehicles must be maintained at all times Traffic Control must be per Work Area Traffic Control
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
applicant
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 ll and request a final inspection from the
the Public Works Department. Any work affecting the State Highway's traffic or within the State 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 Work
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 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 $hall be performed until the Public Works Department has issued this permit. Applicant hereby acknowled es he/she has r and understands the terms and
conditions of this permit and helshe agrees to abide by them. Permit Is void If work Is not commenced within 30 days after Issuance. '
Permit fees are nonrefundable. , , Date( ___ .n' ture: C%_ .
Chisel "S" on face of concrete
IL' 10 curb over lateral. 3" high
7 1 letter. Y.' deep.
Curb &gutter
Sidewalk (or alley surface)
a
Riser, Coulder or Fernco coupling
& stopper to be installed 6'
below finshed grade.
Minimum Slope: Ya' per linear foot
or 2.00%
Finished street surface
SPECIAL NOTE: Under rag circumstances shall ASS pipe or fittings
be allowed! All sewer laterals shall be inspected by the Utilities Dept.
and be replaced if necessary to meet current city standards. Sewer lateral connection
per STD-405—L
CONSTRUCTION NOTES:
OInstall sewer cleanout cover per applicable
portions of STD-511—L. Triangular cover with
"S" on top.
O 4" (or 6") SDR-35 PVC sewer pipe with
gasketed, integral bell and spigot joints.
O 4" (or 6") SDR-35 PVC 45' bend.
O 4'x 4" (or 6'x 6") SOR-35 PVC wye branch
fitting.
O4" (or 6") ASS stopper (where laterals are
stubbed)
O 4" (or 6") short piece, SOR-35 PVC, 6"
long.
O4' (or 6") rubber mechanical banded seal
clamp. Femco or City approved equal.
O4" (or 6") private sewer pipe.
O 8"x 4' (or 6") wye branch fitting. SOR-35
PVC.
10 Install ASS stopper in rubber coupling. Use
Mission Clay Products stopper or approved
equal.
11 Sidewalk replacement shall be in full panel.
GENERAL NOTES:
1. For slope less than Ya per foot a 6' lateral shall be used with a minimum
slope - W per foot.
2. A cleanout shall be installed on all sewer lateral connections.
3. Cleanout shall be installed at property line.
4. Sewer cleanout covers shall be Brooks products No. 4TT or J.&R. No. 4T
marked sewer.
5. Cleanout covers placed in sidewalks may be Brooks Products No.1 —RB
and No.1—R (concrete cover) or J.&R. No. 1—R by special permission only.
6. Sewer cleanout riser pipe material shall be SOR-35 PVC except where
existing sewer main is VCP in which case VCP pipe and fittings shall be
used.
7. PVC shall be SDR-35 per ASTM 3034.
8. PVC pipe and fittings shall be bedded with 3'i" crushed rock material.
In areas of ground water or tide water %" crushed rock.
9. Where VCP materials are used, bedding shall be standard.
10. Single family residences shall be 4' diameter all others shall be 6
11. Saddle type connections to sewer mains are prohibitied, except by special
permission from the Utilities Superintendent. (Then only on old concrete
mains with heavy flows.)
12. Glue or solvent joints are prohibited.
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
SEWER LATERAL WITH
APPROVED:
RCE NO. 36106 PUBLIC WORKS DIRECTOR
CLEANOUT
1011312017 City of Newport Beach Page 6 of 15
8:34:2gAM INSPI60 - Daily Inspection Request Report
Requested Inspection Date: 10/13/2017
Inspection Type : ENCROACH
Inspection Area: PW
Site Address: 2036 SANTIAGO DR
Activity : N2017-0449
SubType : NEW
Status : APPROVED
OWNER: FAHY TIM Phone:
APPLICANT: KISLING DONOVAN M Phone:
Description: INSTALL SEWER CLEAN OUT PER STD 406-L.
Item: 10220 PRE JOB - UTIL
Requested Time: 10/13/2017 12:00:OOAM
Entered By: NBIVR
Comments: AM
oq' 30 ^- w1
Requestor: NBIVR r01.1liey
9493742941
Assigned to:
Inspector: J y Date: toi 3 Time:
Comments:
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F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
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PM
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10/26/2017 City of Newport Beach Page 9 of 10
6:34M2UM INSPI60 - Daily Inspection Request Report
Requested Inspection Date: 10/26/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 2036 SANTIAGO OR
Activity : N2017-0449
SubType : NEW
Status : APPROVED
OWNER: FAHY TIM Phone :
APPLICANT: KISLING DONOVAN M Phone :
Description: INSTALL SEWER CLEAN OUT PER STD 406-L.
Item: 10000 EXCAVATION & PIPE INSTALL-UTIL
Requested Time: 10/26/2017 12:00:OOAM Requestor: WEBUSER
9493742941
Entered By: WEBUSER
Comments: ANY -dig out and wye installation
Assigned to: 77777777777*
Inspector: V V Date: &, /24�, ZI Time:
Comments: ,f 5,
Ref#le
F: \Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
AM PM
10/27/2017 City of Newport Beach Page 7 of 7
6:34:58AM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 10/27/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 2036 SANTIAGO DR
Activity : N2017-0449
SubType : NEW
Status : APPROVED
OWNER: FAHY TIM Phone:
APPLICANT: KISLING DONOVAN M Phone:
)escrig)tion : INSTALL SEWER CLEAN OUT PER STD 406-L.
Item: 10030 CLEAN -OUT
Requested Time: 10/27/2017 12:00:OOAM Requestor: WEBUSER
9493742941
Entered By: WEBUSER
Comments: ANY -
Assigned to: 7777777777
Inspector: `/ Date: l 0L Time: AM PM
Comments: ,' /1 C-11V E 4-0,e_ AL"
i i 44,-v r,- <. 114i $
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
10/30/2017 City of Newport Beach Page 12 of 13
6:34:40AM• INSPI60 - Daily Inspection Request Report
Requested Inspection Date:
10/30/2017
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address:
2036 SANTIAGO DR
Activity :
N2017-0449
SubType :
NEW
Status :
APPROVED
OWNER: FAHY TIM
Phone:
APPLICANT: KISLING DONOVAN M
Phone:
Description : INSTALL SEWER CLEAN OUT PER STD 406-L.
' ,1 .... ...
f
.. ., . i..+>.k%!ws
r
.. v !'•. �a .. , .
Item: 10030 CLEAN -OUT
Requested Time: 10/30/2017 12:00:OOAM
Requestor:
WEBUSER
9493742941
Entered By: WEBUSER
Comments: AM -
Assigned to: 77777777777*
Inspector: ' V Date:
30
Time: AM PM
Comments: 05I C7 ;E �
4
e
�c't"C l2 Al _ LAt2 '`
l�-T-I, L /
P"k-U r> , S
Q PSG
Loggeu
F:\Users\PBW\SharedXENCROACH\MASTERS\FORMS\InspectorSheet.doc
10/31/2017 City of Newport Beach Page 10 of 12
6:34:a8AM. INSPI60 - Daily Inspection Request Report
Requested Inspection Date: 10/31/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 2036 SANTIAGO DR
t +„Ia;t
Activity : N2017-0449
SubType : NEW
Status : APPROVED
OWNER: FAHY TIM Phone :
APPLICANT: KISLING DONOVAN M Phone :
Description : INSTALL SEWER CLEAN OUT PER STD 406-L.
Item: 10100 FORMS WITH COMPACTION - PW
Requested Time: 10/31/2017 12:00:OOAM Requestor:
Entered By: WEBUSER
Comments: ANY -
Assigned to: 77777777777*
Inspector:
Date:
F: %Users%PBW\Shared\ENCROACH WIASTERS\FORMSUnsoectorSheet.doc
WEBUSER
9493742941
Time: % - M PM
11/1/2017 City of Newport Beach Page 4 of 6
6:34:16AM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/01/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 2036 SANTIAGO DR
Activity : N2017-0449
SubType : NEW
Status : APPROVED
OWNER: FAHY TIM Phone :
APPLICANT: KISLING DONOVAN M Phone:
Description : INSTALL SEWER CLEAN OUT PER STD 406-L.
4 �,0a;'
Item: 10010 BACKFILL / COMPACTION- PW
Requested Time: 11/1/2017 12:00:OOAM Requestor: WEBUSER
9493742941
Entered By: WE13USER
Comments: ANY-
Assigned to: 77777777777`
Inspector: 1�13 `( Date: Time: AM PM
Comments: C MG Ecz e� C �� 2
cc)
T2
J
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMSMnspectorSheet.doc
11/2/2017
6:34:53.AM
City of Newport Beach Page 12 of 13
INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/02/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 2036 SANTIAGO DR
Activity :,
N2017-0449
SubType :
NEW
Status :
APPROVED
OWNER:
FAHY TIM Phone:
APPLICANT:
KISLING DONOVAN M Phone:
Description :
INSTALL SEWER CLEAN OUT PER STD 406-L.
Item:
10100 FORMS WITH COMPACTION - PW
Requested Time:
11/2/2017 12:00:OOAM Requestor: WEBUSER
9493742941
Entered By:
WEB
Comments:
A - r
Assigned to:
77777777777*
Inspector: V Date: (t /Z-�� Time: /- /a cm�m
Comments: J� C� 7
f`AtN
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
11/6/2017 City of Newport Beach Page 8 of I I
6:34:07AM, INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/06/2017
Inspection Type : ENCROACH
Inspection Area: PW
Site Address: 2036 SANTIAGO DR
♦ ,k NOW S.
Activity : N2017-0449
SubType : NEW
Status : APPROVED
OWNER: FAHY TIM
APPLICANT: KISLING DONOVAN M
Description: INSTALL SEWER CLEAN OUT PER STD 406-L.
Item: 10100 FORMS WITH COMPACTION - PW
Requested Time: 11/6/2017 12:00:OOAM Requestor:
Entered By: WEBUSER
Comments: ANY -
Assigned to : 7777777777
Phone :
Phone :
WEBUSER
9493742941
Inspector: Date: v V, Time: AM PM
Comments: G��G ALL D ?�� L L Sal �o•c�-s
&Lv,-y
q- 604.04- , 6+ s .
Refile
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
11/7/2017 City of Newport Beach Page 12 of 13
6:34:55AMF INSP150 - Daily Inspection Request Report
Requested Inspection Date:
11/07/2017
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address :
2036 SANTIAGO DR
Activity :
N2017-0449
SubType :
NEW
Status :
APPROVED
OWNER:
FAHY TIM
Phone:
APPLICANT:
KISLING DONOVAN M
Phone:
Description :
INSTALL SEWER CLEAN OUT PER STD 406-L.
Item:
10100 FORMS WITH COMPACTION - PW
Requested Time:
11/7/2017 12:00:OOAM
Requestor:
WEBUSER
9493742941
Entered By:
WEBUSER
Comments:
ANY -
Assigned to:
77777777777*
Inspector: Date: Time: AM PM
Comments:
0OT
0% of onion 44
Y�4J •r
F: \Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsuectorSheet.doc
11/8/2017
City of Newport Beach Page 10 of 12
• 6:34.19A*
INSP150 - Daily Inspection Request Report
•
Requested Inspection Date: 11/08/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 2036 SANTIAGO DR
Activity :
N2017-0449
SubType :
NEW
Status :
APPROVED
OWNER:
FAHY TIM Phone:
APPLICANT:
KISLING DONOVAN M Phone:
Description :
INSTALL SEWER CLEAN OUT PER STD 406-L.
Item:
10100 FORMS WITH COMPACTION - PW
Requested Time:
11/8/2017 12:00:OOAM Requestor: WEBUSER
9493742941
Entered By:
WEBUSER
Comments:
ANY -
Assigned to:
77777777777�
Inspector:
Date: / Time: AM PM
Comments:
Old
or
Logecl
CIA
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
11/9/2017 City of Newport Beach Page 12 of 13
6:34:55AM INSP160 - Daily Inspection Request Report1.
Requested Inspection Date: 11/09/2017
Inspection Type : ENCROACH
Inspection Area: PW
Site Address : 2036 SANTIAGO DR
Activity : N2017-0449
SubType : NEW
Status : APPROVED
OWNER: FAHY TIM Phone:
APPLICANT: KISLING DONOVAN M Phone:
Description : INSTALL SEWER CLEAN OUT PER STD 406-L.
Item: 10100 FORMS WITH COMPACTION - PW
Requested Time: 11/9/2017 12:00:OOAM Requester: WEBUSER
9493742941
Entered By: WEBUSER
Comments: ANY -
Assigned to: 77777777777`
Date: �� Time: AM PM Inspector:
Comments:
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
11/13/2017 City of Newport Beach Page 9 of 12
6:34:16AM• INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/13/2017
Inspection Type : ENCROACH
Inspection Area: PW
Site Address: 2036 SANTIAGO DR
Activity : N2017-0449
SubType : NEW
Status : APPROVED
OWNER: FAHY TIM
APPLICANT: KISLING DONOVAN M
Description: INSTALL SEWER CLEAN OUT PER STD 406-L.
Item: 10100 FORMS WITH COMPACTION - PW
Requested Time: 11/13/2017 12:00:OOAM Requestor:
Entered By: WEBUSER
Comments: AM -
Assigned to: 77777777777`
Inspector:
Date:
Comments: 4f2l!l �� U �
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspWorSheet.doc
Phone:
Phone:
WEBUSER
9493742941
Time: AM PM
J5Y:.-.
Z.
1'1/1412017 City of Newport Beach Page 19 of 20
6:34:29AM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/14/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 2036 SANTIAGO DR
Y _ Y
Activity : N2017-0449
SubType : NEW
Status : APPROVED
OWNER: FAHY TIM Phone :
APPLICANT: KISLING DONOVAN M Phone :
Description : INSTALL SEWER CLEAN OUT PER STD 406-L.
Item: 10100 FORMS WITH COMPACTION - PW
Requested Time: 11/14/2017 12:00:OOAM Requestor: WEBUSER
9493742941
Entered By: WEBUSER
Comments: ANY -
Assigned to: 77777777777*
Inspector: y Date: < < 1 `1 /% Time: AM PM
Comments:
F:\UsersWBW\Shared\ENCROACHWASTERS\FORMS\InspectorSheet.doc