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HomeMy WebLinkAboutN2017-0535City of Newport Beach IJ11JIIIIIII����11111111111111111111�111111111111IIill Permit No: N2I 01i�7' -�0�535 ; 10�Center Drive, Newport Beach CA 92660 �1 Permit Counter Phone (949)644-3311 Project No : ¢ :N ,j EL) Online Inspection Request - www newportbeachca gov / Online Services Inspection Requests Phone (949)644-3255 Job Address : 100 W COAST HWY NB Thomas:Guide: Description : Remove 2 existing palm tree from State right of way. Request approval of revised Exhibit A of agreement between Caltrans and City; City and Owner. Parcel # . Legal Desc : Owner: VBAS PROPERTIES, INC. Phone: Address : 1775 NEWPORT BOULEVARD SUITE B COSTA MESA, CA 92627 COMPLETF Applicant: TOD RIDGEWAY Phone: [ Address : 2804 LAYFAYETTE AVENUE NEWPORT BEACH, CA Special Cond. : 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 . $0.00 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 Contractor : PARKVIEW LANDSCAPE Phone: Address : 1630 E FRANCIS STREET UNIT F ONTARIO CA Contractor State Lic: 869619 License Expire : 12 31, 2017 Business License: BT30061207 Business Expire: 11 30, 2018 Workers' Compensation Insurance - - Carrier : ATLANTIC SPECIALTY INS CO Policy No: 406043521 W. C. Expire: 11 05, 2018 Total Fee $241.00 Paid : $241.00 Balance : $0.00 Receipt No: Date: _/_/ Other Department . Date: Date. _/_/ Permit Denied Date /_/ / Date / / Issued Permit Date : G / Date _/_/ WO RKSHEET FOR ENCROACHMENT PERMIT CITY OF NEWPORT BEACH PUBLIC WORKS DEPARTMENI COMPILLTE THE BELOW 1PROJECT ADDRESS:C, C, DETAILED DESCRIPTION OF PROPOSED WORK: E:Lx -Ae _r1j, IN d/ -j e APPLICANT: IP e: Email Address: Mailing Address: CA;P i4e E�te!Z 1 p: OWNER: \j Phk Email Address: Mailing Address: n City/sktqe/Zip: ALL CONTRACTOR INFOFMATIOR IS REQUIRED -PLEASE COMPLETE CONTRACTOR: Office Phone: 79=0� __ 3 Company (if different): Jobsite Phone: Other Phone: q C'i S 3 --/r 7C Email Address: Mailing Address: City/S to/Zip: State License Number & Class: Expires: City Business License Number: Expires: WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code) Company: Policy No: Expires: REFUNDABLE DEPOSIT INFORMATION (if Applicable, ):.. Refund Pa able To, Mail Refund To: FOR OFFICE USE ONLY Special Conditions of Permit: ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS Utilities: General Services: Traffic: 0 Fire: Other: Engineering Technician: Pub (Wks Specialist: Date: Permit No. f fusers/pbwtshareci/encroachtmasters/opvorksheet x1s Public Works Department 949-644-3311 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 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 copy of the permit and construction plan shall be kept at the job site at all times 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 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 State 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 State Contractor License Class C-34 is required For construction or connection to sewer Imes a valid State Contractor License Class C-42 is required 6 All trenching and/or resurfacing shall conform to City Standard 105-L for parkwav/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 feel 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 (ie 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 4TT box 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 Highways", 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 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 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 from December 19 to January 1, unless approved by the Public Works Department 11 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 Friday), 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 Caltrans 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 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 949-644-3066 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 Code) I certify that I have a Certificate of consent to self -insure, ertificate of Worker's Compensa on In 7urance, or a Certified Copy thereof. Bate: 1 I / IJi / 1-7_, �Inature:'_ "c ♦_IA1`..7+�' - y V 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. I shall indemnify and hold the City harmless for any liability associated with the minor encroachments. Date: Signature: 24-hour notice for Encroachment Permit Inspection is re 'red by calling Public Works at 949-644-3311. G 15 Any above ground utility facilities will require documented approval from t e a agent affected property owner(s) 16 Homeowner contractors, and subcontracotrs 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 $25000 and/or up to three years in Stale 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 Certificate or Evidence of a Slurried Backfill 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 cr relocated without approval from the General Services Department 19 All work in the public right-of-way must meet the approval of the Public Work. Department or corrections will be required (i e removals, exposing connecboos. 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 fees No work related to this encroachment permit shall be performed until the Public Works Department has issued this permit. Applicant hereby af kn ledges he/she has read and undiKstands th 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 issuances - 41 Permit fees are nonrefundable. � Date: I J nature: CITY OF NEWPORT BEACH FINANCE DEPARTMENT 100 Civic Center Drive, Newport Beach, CA 92660 P.O. BOX 1768, Newport Beach, CA 92658-8915 Permit Number N2017-0535 Today's Date : Oct 24, 2017 CASH RECEIPT Plan Check Number: Receipt Number : R000082185 Job Address: 100 W COAST HWY NB Description: Remove 2 existing palm tree from State right of way Owner: VBAS PROPERTIES, INC. Applicant : TOD RIDGEWAY Date Paid . Oct,24,2017 03 06 PM Total Paid - $241.00 Notation - Initial: DK Description Payment Type Check Number Card Type Payment Check 1644 FOR PLAN CHECKS ONLY: TARGET DATE: Tendered $241.00 For status, please log on to www.newportbeachca.nov/building, and select PLAN CHECK STATUS or call (949) 644-3255 NOTICE: PLAN CHECK EXPIRES 180 DAYS FROM DATE OF SUBMITTAL 1 w � ♦ Yr r L. •�_ ..Mg • � Ndlonsrcn 11 i l•t:rrtucrn 1 tntwl• 2�e 7Pe IJ4.51"! � I ��Ji�+ JaY�ltl./ 1fZ� ��st� �• 'EXHIBIT',N d SPLCGIC MAINTENANCE AREAS 1 WEST COAST HW&MAY a DOVER WEST to PROPERTY, UK AS PART OF THE. MARINA'S POINT DEVELOPMENT 1 . CITY OF NEWPORT BEACH PCH PK 8&446 � NOTE: LAUDSCAPE MAINTENANCE KCOVERED UNDER A SEPERAI I ANOSCAPE MAINTENLNCIi AGREEMENT. i l .I I� Mod lemall wl+l r:o Aft 11 NV •+ W-C Re•Ant;;,1¢c� �- OK• LEGEND 5 • D�GI SYMBOL DESCRIPTION PRECAST CONCRETE PAVERS WITHIN STAIF RICH I OF WAY TO BF OWNEO & MNMTAINEO BY TI IE CITY OF NEWPORT RFACII CONrRFTE "IEWALK WRMN STATE RIGHT of WAY TO BE )!`//•t�7��`fIJ ►UMFAWEOBYINS STAIE COLORED CONCRETE VA MM SIA TE RIGHT Of WAY IO BE MAINTAINED BY 114E Cl rY OF NtWPORT BEACH f3usiness License Receipt : Quest https:/(apps.newportbeachca.gov/quest'bus_license/receipt?receipt—1 1... Logoff (../logoff.aspx) Business License Application - Receipt 11/13/2017 Thank you Richard! Your Business License Application has been submitted and your payment has been received. Your application will be reviewed by a staff member and then approved accordingly. Please wait 10 business days to receive your Business License Certificate via Postal Service. You may login to Quest at any time to view the status of your request (../main_view). Are you interested in joining your local chamber? Explore the links below to learn more. http://www.newportbeach.com (http:/Jw.vw.newportbeach.com) http:/Iwww.cdmchamber.com (http://www,cdmchamber.com) Receipt No: 1180724349 Business License #: BT30061207 Total Amount: $214.00 Please print this receipt for your records: Print Receipt Having technical issues? Send us an email (ma iIto: avery@newportbeachca.gov?subject=Quest Issues) © 2017 - City of Newport Beach ACOR�� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 11/1/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Victoria Mitchell NAME -Landscape Contractors (Lic$0755906) AlcrNo Ex (559)650-3555 AIC, No)(559)650-3558 Insurance Services, Inc. E-MAIL vmitchell@lcisanc.com ADDRESS 1835 N. Fine Avenue INSURER(S) AFFORDING COVERAGE NAIC • INSURERA Atlantic Specialty Insurance 27154 Fresno CA 93727 INSURED INSURER B INSURER Parkview Landscape 9265 56th Street INSURER INSURER E INSURER Riverside CA 92509 COVERAGES CERTIFICATE NUMBER-17/18 Pkcr & Auto & WC REVISION NUMRER- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELObV HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR' TYPE OF INSURANCE ADDL SUER! POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDDIYYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY - - - - - -- 1,000,000 A I = -le a-CE X 100,000 — j618-00-10-48-0002 11/1/2017 11/1/2018 X $500 Pd Ded G= _ - 1,000,000 2,000,000 X `iF-T _ 2,000,000 AUTOMOBILE LIABILITY=-iIE'IE_ £ 1,000,000 E,3 J-t A X -- _--- 618-00-10-48-0002 11/1/2017 11/1/2018 =-_ -_= r - :--r ',LL J HII-LL '>' X j -1 — - f UMBRELLA LIAR - - - - - - - - - --- -- - - f ^~ —~ EXCESS LIAR _ LL_ - f WORKERS COMPENSATION X =FF -'H- -F AND EMPLOYERS' LIABILITY Y / N � n_ FIE-_ -F' E- E E=_'I E — ,'I E - - -- 1,000.000 F _EF�•,1Er'EEF E �_ ______ NIA I'(MandatoryinNH) A u 406-04-35-21-0002 11/5/2017 11/5/2018 = _E,_E-E-E'er =' E - - - -- - 1,000,000 £ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101 Additional Remarks Schedule maybe attached if more space is required) RE: All landscape operations performed by or on behalf of the named insured_ *************Proof of Insurance Only*************** CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ********Proof Of Insurance* * * * * * * * * * * * THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 - i heck A License - License Detail Page 1 of Contractor's License Detail for License # 869619 )ISCLAIMER: A license status check provides information taken from the CSLB license database. Before relying on this nformation, you should be aware of the following limitations. CSLB complaint disclosure is restricted by law (B&P 7124 6) If this entity is subject to public complaint disclosure, a link for complaint disclosure will appear below Click on the link or button to obtain complaint and/or legal action information Per B&P 7071 17 , only construction related awl judgments reported to the CSLB are disclosed Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration Due to workload, there may be relevant information that has not yet been entered onto the Board's license database This license is current and active. All information below should be reviewed. C27 - LANDSCAPING Business Information PARKVIEW LANDSCAPE 9265 56TH STREET RIVERSIDE, CA 92509 Business Phone Number:(909) 923-5750 Entity Partnership Issue Date 12/17/2005 Expire Date 12/31 /2017 1 icanca Static Classifications Bondinq Information Contractor's Bond This license filed a Contractor's Bond with AMERICAN CONTRACTORS INDEMNITY COMPANY. 'Bond Number: SCR6343968 Bond Amount: $15,000 Effective Date: 01 /01 /2016 Contractor's Bond History Workers' Compensation This license has workers compensation Insurance with the ATLANTIC SPECIALTY INSURANCE COMPANY Policy Number:406043521 Effective Date: 11 /05/2015 Expire Date: 11/05/2017 Workers' Compensation Hlstory Other Personnel listed on this license (current or disassociated) are listed on other licenses tps://ww"?.cslb.ca.gov/OnlineSerk'ices/CheckLicenseII/LicenseDetaii.asps?LicNum=869619 I I / 13/201 STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION STANDARD ENCROACHMENT PERMIT APPLICATION TR-0100 (REV.03/2015) This application is not complete until all requirements have been approved. Permission is requested to encroach on the State Highway right-of-way as follows: Page 1 of 3 )/RT M I.COUNTY 2. ROUTE 3. POSTMILE Orange 1 N/A 4. ADDRESS OR STREET NAME 5. CITY 100 W. Coast Highway Newport Beach 6. CROSS STREET (Distance and direction from project site) T. PORTION OF RIGHT-OF-WAY DATE OF SIMPLEX STAMP Dover N. side of highway and west of Dover B. WORK TO BE PERFORMED BY 9. ESTIMATED START DATE 10. ESTIMATED COMPLETION DATE ❑ OWN FORCES ❑ CONTRACTOR October 24, 2017 October 25, 2017 11. MAX. DEPTH AVG. WIDTH LENGTH SURFACE TYPE EXCAVATION 1 n/a JAVG.DEPTH n/a n/a n/a n/a 12. ESTIMATED COST WITHIN STATE HIGHWAY RIGHT-OF-WAY FUNDING SOURCE(S) $ 1 ,000.00 0 FEDERAL ❑ STATE 0 LOCAL PRIVATE 13. PRODUCT TYPE DIAMETER VOLTAGE / PSIG 14, CALTRANS' PROJECT CODE (ID) PIPES n/a I n/a n/a I none 15. ❑ Double Permit Parent Permit Number Applicant's Reference Number / Utility Work Order Number n/a 16. Have your plans been reviewed by another Caltrans branch? ❑✓ NO YES (If "YES") Who? 17. Completely describe work to be done within STATE Highway right-of-way: Attach 6 complete sets of plans (folded to 8.5" x 11") and any applicable specifications, calculations, maps, etc. This is a request to remove one palm tree on the east side and move one plam tree on the east side. The tree to be moved will be moved to the west side of the project site and be on private property. This permit will aloow the vendor to cut one tree down and move the other. 18. Is a City, County or other public agency involved in the approval of this project? (] YES (If "YES", check type of project AM attach environmental documentation and conditions of approval) El COMMERCIAL DEVELOPMENT ❑ BUILDING ❑ GRADING ❑ OTHER B CATEGORICALLY EXEMPT ❑ NEGATIVE DECLARATION ❑ ENVIRONMENTAL IMPACT REPORT ❑ OTHER ❑ NO (If "NO", please check the category below which best describes the project AKQ answer questions A - K on page 2) ❑ DRIVEWAY OR ROAD APPROACH, RECONSTRUCTION, MAINTENANCE OR RESURFACING ❑ FENCE ❑ PUBLIC UTILITY MODIFICATIONS, EXTENSIONS, HOOKUPS ❑ MAILBOX ❑ FLAGS, SIGNS, BANNERS, DECORATIONS, PARADES AND CELEBRATIONS ❑ EROSION CONTROL ❑ OTHER ❑ LANDSCAPING ADA NOTICE: For mdrviduals with sensory disabilities, this document is available in alternate formats. For information, call (916) 445-1233. TTY 711, or wnte to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814 STATE OF CALIFORNIA " DEPARTMENT OF TRANSPORTATION STANDARD ENCROACHMENT PERMIT APPLICATION TR-0100 (REV.03/2015) PERMIT NO. z The following questions must be completed when a City, County or other public agency IS NOT involved in the approval of this project Page 2 of 3 Your answers to these questions will assist Departmental staff in identifying any physical, biological, social or economic resources that may be affected by your proposed project within State Highway right-of-way and to determine which type of environmental studies may be required to approve your application for an encroachment permit. It is the applicant's responsibility for the production of all required environmental documentation and supporting studies and in some cases this may be costly and time consuming. If possible, attach photographs of the location of the proposed project. Please answer these questions to the best of your ability. Provide a description of any "YES" answers (type, name, number, etc.) A. Will any existing vegetation and/or landscaping within State Highway right-of-way be disturbed? Slightly. New vegitation will replace where the 2 trees are being rmoved/moved from. B. Are there waterways (e.g. river, creek, pond, natural pool or dry streambed) adjacent to or within the limits of the project or State Highway right-of-way? no C. Is the proposed project located within five miles of the coast line? no 0. Will the proposed project generate construction noise levels greater than 86 dBA (e.g. jack -hammering, pile dnving)? no E. Will the proposed project incorporate land from a public park, recreation area or wildlife refuge open to the public? no F. Are there any recreational trads or paths within the limits of the proposed project or State Highway nght-of--way? no G. Will the proposed project impact any structures, buildings, rail lines or bridges within State Highway nghtof-way? no H. Will the proposed project impact access to any businesses or residences? no I. Will the proposed project impact any existing public utilities or public seances? no _ /J J. Will the proposed project impact existing pedestrian facilities, such as sidewalks, crosswalks or overcrossingsv t j Temporarily during the removal and moving of the 2 trees. K. Will new lighting be constructed within or adjacent to State Highway nght-of-way? no 19. Will this project cause a substantial change in the significance of a historical resource (45 years or older), or cultural resource? YES ✓ NO (If "YES", provide a description) 20. Is this project on an existing State Highway or street where the activity involves removal of a scenic resource including a significant tree or stand of trees, a rock outcropping or a historic building? AYES ✓QNO (if "YES", provide a description) 21. Is work being done on the applicant's property YES [] NO (If "YES", attach 6 complete sets of site and grading plans.) 22. Will the proposed project require the disturbance of soil? n YES n NO If "YES", estimate the area within State Highway nght-of-way in square feet AND acres: estimate the area outside of State Highway nght-of-way in square feet AND acres 23. Will the proposed project require dewatenng? If "YES", estimate total gallons AND galons/month. YES �✓ NO (gallons) AND (W) AND (acres) (ftz) AND (acres) (gaflons/month) SOURCE []STORM WATER NON -STORM WATER ('See Caltrans SWMP for definitions of non -storm water discharge: http://www.dot.ca.gov/hq/env/Stormwaterfndex.htm ) 24. How will any storm water or ground water be disposed of from within or near the limits of the proposed project? Storm Dram System Combined Sewer I Storm System Storm Water Retention Basin Other (explain): n/a STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION STANDARD ENCROACHMENT PERMIT APPLICATION TR-0100 (REV.03/2015) Page 3 of 3 PLEASE READ THE FOLLOWING CLAUSES PRIOR TO SIGNING THIS ENCROACHMENT PERMIT APPLICATION — The applicant, understands and herein agrees that an encroachment permit can be denied, and/or a bond required for non-payment of prior or present encroachment permit fees. Encroachment Permit fees may still be due when an application is withdrawn or denied, and that a denial may be appealed, in accordance with the California Streets and Highways Code, Section 671.5. All work shall be done in accordance with the California Department of Transportation's (Department) rules and regulations subject to inspection and approval. The applicant, understands and herein agrees to the general provisions, special provisions and conditions of the encroachment permit, and to indemnify and hold harmless the State, its officers, directors, agents, employees and each of them (Indemnitees) from and against any and all claims, demands, causes of action, damages, costs, expenses, actual attorneys' fees, judgments, losses and liabilities of every kind and nature whatsoever (Claims) arising out of or in connection with the issuance and/or use of this encroachment permit and the placement and subse- quent operation and maintenance of said encroachment for: 1) bodily injury and/or death to persons including but not limited to the Applicant, the State and its officers, directors, agents and employees, the Indemnities, and the public; and 2) damage to property of anyone. Except as provided by law, the indemnification provisions stated above shall apply regardless of the existence or degree of fault of Indemnities. The Ap- plicant, however, shall not be obligated to indemnify Indemnities for Claims arising from the sole negligence and willful misconduct of State, its officers, directors, agents or employees. An encroachment permit is not a property right and does not transfer with the property to a new owner. COMPLIANCE WITH THE AMERICANS WITH DISABILITIES ACT (ADA) OF 1990: All work within State Highway right-of-way shall be conducted in compliance with all applicable Federal, State and Local Access laws, regulations and guidelines including but not limited to the Americans with Disabilities Act Accessibility Guidelines (ADAAG), the Public Rights -of -Way Guidelines (PROWG), the Department's current Design Information Bulletin 82, "Pedestrian Accessibility Guidelines for Highway Projects", the Department's Encroachment Permits Manual and encroachment permit. V1JVr7n'1t[l J yr J1tJr�tl�_Yrx� ctCb7'ru nliPt J 1i,KM rYr�a Gi[: All riorn w&Lnut JitAin nlgnwdV nu(u-Ot-wnV bnalt utl G0llQUcit*G al VOIIiuilalice witls all applicable requirements of the National Pollutant Discharge Elimination System (NPDES) permit issued to the Department, to govern the discharge of storm water and non -storm water from its properties. Work shall also be in compliance with all other applicable Federal, State and Local laws and regulations, and with the Department's Encroachment Permits Manual and encroachment permit. Compliance with the Depart- ment's NPDES permit requires amongst other things, the preparation and submission of a Storm Water Pollution Protection Plan (SWPPP), or a Water Pollution Control Program (WPCP), and the approval of same by the appropriate reviewing authority prior to the start of any work. Information on the requirements may also be reviewed on the Department's Construction Website at: i h M1 ) . _ . _ - - _- 25. NAME OF APPLICANT OR ORGANIZATION VBAS Properties, Inc. ADDRESS OF APPLICANT OR ORGANIZATION WHERE PERMIT IS TO BE MAILED (Include City and Zip Code) 100 W. Coast lighway, Newport Beach, CA 92660 E-MAIL ADDRESS PHONE NUMBER FAX NUMBER tridgeway@sbcglobal.net 949-723-5854 949-723-5204 26. NAME OF AUTHORIZED AGENT / ENGINEER (A "Letter of authorization" is required if different from 825) IS A LETTER OF AUTHORIZATION ATTACHED? ❑ YES ❑ NO ADDRESS OF AUTHORIZED AGENT / ENGINEER (Include City and Zip Code) E-MAILADDRESS I PHONE NUMBER I FAX NUMBER 27. NAME OF BILLING CONTACT (Same as #25 Same as #26 ) Tod Ridgeway BILLING ADDRESS WHERE INVOICE(S) IS/ARE TO BE MAILED (Include City and Zip Code) 2804 Lafayette Ave, Nepwot Beach, CA 92663 E-MAIL ADDRESS PHONE NUMBER FAX NUMBER tridgewa c net 949-723-5854 949=723-5204 2E. SIGW TOR ORIZED AGENT 129. PRINT OR TYPE AM I30.TITLE 31. DATE 1z12 / e Pres. VBAS Prop. STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION ENCROACHMENT PERMIT FEE CALCULATION SHEET TR-0406 (NEW 06/2015) THIS PAGE IS FOR CALTRANS USE ONLY [] DEFERRED BILLING (Utility) ❑ EXEMPT ❑ PROJECT CODE (ID): FEES ORDER/REFERENCE NUMBER: 1. REVIEW................................................................................................. hours @ $ 82.00 / hour = $ INSPECTION.................................................................................... hours @ $ 82.00 / hour = $ FIELD WORK....................................... ............................................... hours @ $ 82.00 / hour = $ EQUIPMENTAND MATERIALS............................................................................................................................................... $ CALCULATED BY: DATE: AMOUNT: $ 2 REVIEW................ ............................................ ........ .............................. hours @ $ 82.00 / hour = $ INSPECTION............................................................................................. hours @ $ 82.00 / hour = $ FIELD WORK........................................................................................ hours @ $ 82.00 / hour = $ EQUIPMENT AND MATERIALS.............................................................................................................................................. $ CALCULATED BY: DATE: AMOUNT: $ 3. REVIEW.................................................... •............................................. hours @ $ 82.00 / hour = $ INSPECTION............................................................................................. hours @ $ 82.00 / hour = $ FIELD WORK........................................................................... .. hours @ $ 82.00 / hour = $ EQUIPMENT AND MATERIALS........... .....................��...�..3.. tj j�'../. L.,<......................................................... / ! + $ - I.WLCUi-AI ED Ry' "'+� 1!J AMOUNT: $ 4. REVIEW.........................................................................................a v hours @ $ 82.00 / hour = $ INSPECTION............................................................................................. hours @ $ 82.00 / hour = $ FIELD WORK.......................................................................................... hours @ $ 82.00 / hour = $ EQUIPMENT AND MATERIALS........................................................................................................................ ................. $ CALCULATED BY: DATE: AMOUNT: $ DEPOSITS 1. ❑ CHECK NUMBER: jr NAME ON CARD/CHECK: N^ ? f �/�%% ��� "/ ❑ CREDIT CARD PHONE NUMBER: ❑ CASH CASHIER'S INITIALS: j DATE: AMOUNT: $ 2. ❑ CHECK NUMBER: NAME ON CARD/CHECK: ❑ CREDIT CARD PHONE NUMBER: ❑ CASH CASHIER'S INITIALS: DATE: AMOUNT: $ 3. ❑ CHECK NUMBER: NAME ON CARD/CHECK: ❑ CREDIT CARD PHONE NUMBER: ❑ CASH CASHIER'S INITIALS: DATE- AMOUNT: $ 4. ❑ CHECK NUMBER: NAME ON CARD/CHECK: ❑ CREDIT CARD PHONE NUMBER: ❑ CASH CASHIER'S INITIALS: DATE: AMOUNT: $ TOTAL DEPOSITS: $ CASH DEPOSIT IN LIEU OF BOND DATE: AMOUNT: PERFORMANCE BOND ❑ DATE: AMOUNT: PAYMENT BOND ❑ DATE: AMOUNT: IS LIABILITY INSURANCE REQUIRED? ❑ YES ❑ NO AMOUNT: $ ADA Notice For Individuals with sensory disabilities, this document Is available in alternate formats. For alternate format information, contact the Forms Management Unit at (916) 445-1233, 17Y 711. or write to Records and Forme Mannnamont i inn m -zt—+ %AQ on v N- � _ ..... -_-�---.-----------------�----- Bank of America -- 1 642 A('i I HA 111,rn) 1')8 r, w i " 3 VBAS PROPERTIES, INC. 1!' NFWPOHI HtVU`'•I1 h s ) )s 1 A Nit SA c A 10/17/2017 Y R s R'820.00 f f )l Cal Trans #�1r�i�tf�Ytrtl,w*VR/'�'R�t4/r♦ft�FR/���tM•M/,t*#/Y};RR1�'RR1r.fw#Rf iYM11t'RRf�MYrf •A�i�hYi♦At;��lrfi#i*it►f '� Eight Hundred Twenty and 00/100 ucx i a"' '.l Cal Trans lie OU 164 2110 t: 1 2 1000 1 SFit: 3 2 50 2'� 199 LEa ill' EXHIBIT'A' SPECIFIC MAINTENANCE AREAS WEST COAST HIGHWAY u DOVER WEST to PROPERTY LIMIT AS PART OF THE MARINERS POINT OEVELOPMENT CITY OF NEWPORT BEACH PCH PM: 18.446 LEGEND SYMBOL DESCRIPTION PRECAST CONCRETE PAVERS WITHIN STATE RIGHT OF WAY TO BE OWNED A MAINTAINED BY THE CITY OF NEWPORT BEACH CONCRETE SIDEWALK WITHIN STATE RIGHT OF WAY TO BE MAINTAINED BY THE STATE CONCRETE WITHIN STATE RIGHT OF WAY TO BE mlCOLORED I MAINTAINED BY THE CITY OF NEWPORT BEACH NOTE: LANDSCAPE MAINTENANCE IS COVERED UNDER A SEPERATE LANDSCAPE MAINTENENCE AGREEMENT. Nam EXHIBIT'N SPECIFIC MAINTENANCE AREAS WEST COAST HIGHWAY at DOVER WEST to PROPERTY LIMIT AS PART OF THE MARINERS POINT DEVELOPMENT CITY OF NEWPORT BEACH PCH PM: 18.446 NOTE: LANDSCAPE MAINTENANCE IS COVERED UNDER A SEPERATE LANDSCAPE MAINTENENCE AGREEMENT. LEGEND SYMBOL DESCRIPTION PRECAST CONCRETE PAVERS WITHIN STATE RIGHT OF WAY TO BE OWNED A MAINTAINED BY THE CITY OF NEWPORT BEACH MUMMM CONCRETE SIDEWALK WITHIN STATE RIGHT OF WAY TO BE MOM MAINTAINED BY THE STATE COLORED CONCRETE WITHIN STATE RIGHT OF WAY TO BE MAINTAINED BY THE CITY OF NEWPORT BEACH 1/19/2022 City of Newport Beach Page 11 of 34 6:30:37AM INSP150 - Daily Inspection Request Report Requested Inspection Date : 01/19/2022 Inspection Type: ENCROACH Inspection Area : PW Site Address : 100 COAST HWY W A/P/D Information: Activity : N2017-0535 SubType : Status : APPROVED OWNER: VBAS PROPERTIES, INC Phone: APPLICANT: TOD RIDGEWAY Phone: Description : Remove 2 existing palm tree from State right of way. Request approval of revised Exhibit A of agreement between Caltrans and City-, City and Owner. Requested Inspection(s) Item: 10250 FINAL - PW Requested Time: 1/19/2022 12:00:OOAM Requestor: WEBUSER 11 Entered By: WEBUSER Comments: 'ANY-' Assigned to : z K , 1