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N Permit Counter Phone (949)644-3311
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Job Address: 2242 CHANNEL RD NB
Description : Replace approx 50 LF of sidewalk per City Std.
Parcel # :
Legal Desc :
Owner:
Phone :
Address
0482-930-4 -
518 LOT 14 BLK P NWLY 25 FT & SELY 25 FT & POR LOT M LYING
MCFARLAND WILLIAM
506 MYSTIC WAY COMPLETED
LAGUNA BEACH CA 92651
Applicant: MANUEL CRUZ ARMENTA
Phone : 714-974-2716
Address : 5308 E WESTRIDGE RD
ANAHEIM HILLS CA 92807
Special Cond.: Pre -construction meeting required
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 :
$495.00
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:
Thomas:Guide:
Permit No: N1017-00561
Project No: 0811-2015 SCANN5D
Inspection Requests Phone (949)644-3255
919D2
Contractor : MANUEL CRUZ ARMENTA
Phone : 714-974-2716
Address : 5308 E WESTRIDGE RD
ANAHEIM HILLS CA 92807
Contractor State Lic: 970891
License Expire: 03 31. 2018
Business License: BT00021846
Business Expire:
05 31, 2017
Workers' Compensation Insurance - -
Carrier :
STATE COMP
Policy No:
9139943
W. C. Expire:
03 01, 2017
Total Fee $736.00
Paid : $736.00
Balance: $0.00
Receipt No:
Date:
_/_/
Other Department: Date:
Date:
Date :
_/ /
_/ /
Permit Denied -Date:
Issued Permit : Date :c2/
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Date:
/ /
DETAILED DESCRIPTION OF PROPOSED WORK:
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Phone: / —
APPLICANT: v .
Email Address:
Mailing Address:
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Public Works Department 949.644-3311
100 Civic Center Drive, Newport Beach, CA 92660
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
permit and construction plan shall be kept at the job site at all times. Work, which has been done prior to issuaPays
a permit, is subject to rejection/fine. City reserves the right to void permit if work does not commence within 30
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 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
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 bac kfilling, or applicant may be required to excavate site. Separate inspections by
the Municipal Operations Department 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 feet of any City utilities, unless approved by the Public Works Department. Locate and pothole
existing City -owned utilities (is: water, sewer, or street lighting conduits) to verity locations. Maintain a one -foot
clearance over or under existing City -owned utilities. Sewer cleanouts 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 obstructigps. A
signs, flags, lights and other warning and safety devices shall conform to the requirements of the current "MEIRMISO
Warning Signs, Sights and Other Devices for the Use in Performance of Work Upon Highways`, issued by Ind
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 FNday), unless approved by
the Public Works Department. Any work affecting the State Highway's traffic or within the State Highway right-of-way
will require a Cattrans 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. All USA marks
shall be removed prior to Final Public Works Inspection.
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 949-644-3088
for the collection schedule so service is not interrupted. To place a dumpster or materials in the public righ f- ay a
Temporary Street Closure Permit must be obtained from the Public Works Department.
WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code)
I certify that 1 have a Certificate of consent to self -insure, Certificate of Worker's
Compensation Insurance, or a Certified Copy thereof.
Date: 2n
— /- 7 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. 1 shall Indemnify
and hold the City harmless for any liability associated with the minor
encroachments.
Date: Signature:
INITIALS:
15. All above ground facilities shall comply with the Municipal Code, including but not limited
to Chapter 13.20.
W. Homeowner, contractors, and subcontractors 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 Solis Compaction Certificate or
Evidence of a Slurried Badkfill 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, or relocated
without approval from the Municipal Operations Department, Parks and Street Trees
Division.
19. All work in the public right-of-way must meet the approval of the Public Works 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 feesi`
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
$241.00
$275.00
$817.00
$192.00
$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" $65.00 Sewer Connection Fee
24" x 36" $143.00 4TT Box & Cover
Additional
• THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE
I
REVENUE DIVISION PRIOR TO PAYMENT OF FEES
TBD
TBD
$108.00 0
$$64..00
64
-----------
Revenue Division
(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/V' 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
12" Meter
$425.00
12" Turbine Meter
$845.00
For Traffic & Alley Areas (Box + Cover = Cost)
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
Meter
$7.190.00 .
Qty.
Budget Number
Certificate of Compliance Fee (+100% of My 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 hrly over 4 hrs)
$1,022.00
5200-5031
Street Tree Fee ($700 Planting Fee)
---•---- --.
TBD
030-2284
.....
..--
Engineering Tech:
Total Amount
For Finance Use Only
/Due:
Permit Saacialist
Receipt No.
L/usersfpbwlshanmUencroadVmasterslep front and back masters/
Rev. 1/5/20171
opfeeshestAs-reWsed 1012112016
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2Y1/2017 City of Newport Beach Page 3 of 5
4-2M:30PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 02/02/2017
Inspection Type : ENCROACH
Inspection Area : PW
Site Address- 1249, CHANNEL RD
A/P/D Information:
Activity : N2017-0056
SubType : NEW
Status : APPROVED
OWNER: MCFARLAND WILLIAM
APPLICANT: MANUEL CRUZ ARMENTA
Description : Replace approx 50 LF of sidewalk per City Std.
Requested Inspection(s)
Item: 10110 CONCRETE PUBLIC WORKS
Requested Time: 2/2/2017 12:00:OOAM Requestor:
S Y Wi-04Z
Entered By: NBIVR
Comments: AM 8 • 3 ��/
Assigned to:
Inspector: J\/ Date: :+
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Comments: kg9 f5o,er-i S 4f �r/zaK.
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Phone :
Phone : 714-974-2716
NBIVR
7143497188
Time: 18 = 3a PM
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F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131
Run Id: 4018
1/10/2022 City of Newport Beach Page 10 of 20
6:30:45AM INSP150 - Daily Inspection Request Report
Requested Inspection Date:
01/10/2022
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address :
2242 CHANNEL RD
Activity
2017-0056
SubType
Status :
APPROVED
OWNER:
MCFARLAND WILLIAM
APPLICANT:
MANUEL CRUZ ARMENTA
Description :
Replace approx 50 LF of sidewalk per City Std.
Item: 10250 FINAL - PW
Requested Time: 1/10/2022 12:00:OOAM Requestor:
Entered By: WEBUSER ��
Comments: 'ANY-'
Assigned to: 77777777777*
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Id
Phone :
Phone : 714-974-2716
WEBUSER
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