HomeMy WebLinkAboutN2017-0268„V.�,�,,iT City of Newport Beach IIIIIIIIIII IIIIII IIIII II I III I I III Permit No: N2017-02E8 A�
100 Civic Center Drive, Newport Beach, CA 92660 N 2 0 1 7 0 2 6 8
Permit Counter Phone (949)644-3311 Project No : ;ti ^ ��
�. Online Inspection Request - www newportbeachca gov / Online E V;_„1
= ' Services
'°'} ”" Inspection Requests Phone (949)644-3255
Job Address : 1534 ANTIGUA WAY NB Thomas:Guide: 889C5
Description : Install 41 LF of 4-inch conduit, install (1) fiber barrel, install (1) above -ground pedestal, install (1) 3-electrode ground bed and remove (2)
existing above ground pedestals in parkway on Mariners Drive. Concrete restoration per City Standards. (AOOJV73)
Parcel # : 1176-640-1 -
Legal Desc : N TR 4224 LOT 271
Owner: SCHLUTZ MICHAEL J
Phone: 0
Address : 1534 ANTIGUA WAY
NEWPORT BEACH, CA
Applicant: AT&T CALIFORNIA
Phone : 714-618-9132 [
Address : 3939 E CORONADO ST, 2ND FLOOR
ANAHEIM, CA 92807
Special Cond.: Pre -job inspection required
Traffic control per WATCH
�IPIfTEd
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 :
$825 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 : H C I INC
Phone: 951-520-4200
Address : P O BOX 638
NORCO CA
Contractor State Lic: 378587
License Expire : 07 31, 2019
Business License : BT97021542
Business Expire:
06 30, 2017
Workers' Compensation Insurance - -
Carrier :
STARR INDEMNITY & LIABILITY CO
Policy No:
1000001397
W. C. Expire:
06 15, 2017
Total Fee $1,066.00
Paid : $1,066.00
Balance : $0.00
Receipt No:
Date : _/_/ Other Department : Date —/—/
Date : / / Permit Denied Date
Date : / / Issued Permit : t 7 _ Date /
Ij
Date : / /
A
LE(19) AOOJV73 "Gigapower'
WORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
COMPLETE THE BELOW INFORMATION
PROJECT ADDRESS: NEAR 1534 Antigua Way, Newport Beach, CA 92660 XST MARINERS D
DETAILED DESCRIPTION OF PROPOSED WORK:
EXCAVATE 54 SO FT IN DIRT TO PLACE 31' OF 1-4" CONDUIT. (1) FIBER BARREL
(10') OF 2-4" CONDUIT, (1) 576-PFP CABINET, (1) 3-ELECTRODE GROUND BED.
All Traffic Control shall be in accordance with the latest WATCH Manual and CA MUTCD.
Remove 2 Qwis4;n9 peaesibtS .
APPLICANT: AT&T CALIFORNIA It A
jPhone: (714) 618-9132
oe I
Email Address: vk3921 @att coin /' Valentina Gipson, AT&T Liaison
Mailing Address: City/State/Zip:
3939E CORONADO ST, 2ND FLOOR ANAHEIM CA 92807
OWNER:
Phone:
Email Address:
Mailing Address:
CityiState/Zip:
ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE COMPLETE
CONTRACTOR:
Office Phone:
Company (if different):
Jobsite Phone:
Other Phone:
Email Address:
Mailing Address:
CitylState/Zip:
State License Number & Class:
Expires:
City Business License Number:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: Policy No: Expires:
REFUNDABLE DEPOSIT INFORMATION (if Applicable):
Refund Payable To:
Mail Refund To:
FOR OFFICE USE ONLY
Special Conditions of Permit: �nS ¢cW" r v;red .
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
General Services:
Traffic: Fire:
Other:
Engineering Technician:
Public Works Specialist:
r2011:
Date:
-�; -23 —)
Permit No.
N20 i-1 ^ 02(O$
Vim; _r S•G0.+ahared er Re �hJiT.15'rrVCpnirkSPee' a.
Public Works Department 949-644-3311
FEE_ WORKSHEET FQR E 1CROACHMENT PER K ;
=...
PUBM
All Fees Are Non -Refundable Unless Otherwise Stated
PROJECT ADDRESS:
PERMIT N2017- 02b45
1634 AW4, guo Way
NUMBER:
APPLICANT:
F0 BE COMPLETED BY PUBM WORMS DEPARTFAMM-
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
Q Inspection Fee:
$241.00 I Public Works Field Inspection
$275.00 Utilities Field Inspection
General Services Inspection
Water Quality/Artificial Turf Inspection
$817.00
$1.2.00 Refundable Deposit:
$502-00 Improvements
/ .Q .
$165.0 5
$121 0
$165.00
$108 00
TBD
TBD
Street/Alley/Walk Closure: $65.00Newspaper 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 & Cover $64.00
Additional
THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Ige7erue7Division 1
REVENUE DIVISION PRIOR TO PAYMENT OF FEES Approval:
1
Qty.
. Qty,
IWater Meter:
Installation Charge $528-00
13/4" Meter
$50 25
Water Meter Boxes:
11" Meter
$121 50
For Parkway & Sidewalk Area (Box + Cover = Cost) 1
11 1/2" Meter
$285.00
1" Meter: 13.00 + 37 00 $50 00� 1
11 1/2" Turbine Meter
$700.00
2: Meter: 27.00 + 61.25 $88.25
12" Meter
$425.00
1
12" Turbine Meter
$845.00
For Traffic & Alley Areas (Box + Cover = Cost) 1
13" Meter
14"
$3,310.00
1" Meter: 13.00 + 38 00 $51 00 1
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 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 ony
rioaa ;
* t , Oka to -�--'
Permit Specialist
Receipt No.
' \ "
�C.O tL
f /users/obw/shared/encroachimasters/ep frort and back masters/
Rev 1/5/2017
iepfeestlet As -revised 1021/2016
CONSTRUCTION NOTES
EXCAVATION DATA
I MINIMUM LOVER FOR STRUCTURE 36• BELOW EXISTING
Ow EH ASPIUL! CONCRETE DTUNNEL
ME
IRT rU EL C t G GRADE OR 30' LON GUTTER FLOw1lNE
LITY Of Je XI -Je 50R 1 ALL SUBSTRUCTURE INFORMATION SHOWN WAS TAKEN
VNLAB
NEWPOHI BFALH - - - (FITTER BARRf L) -- FROM RECOROS ALE APPROXIMATE
IS APPROIE
_� ARIFY, LOGTE AND PROTECT AS REQUIRED
° 0 BEFORE EXCAVATING CALL
3 U G SERVICE ALERT 811
4 ALL —TO CONTROL 10 BE IN ACCORDANCE AT1H
00 THE C.I U T C M WORN AREA PROTECTION AND
00 TRAFFIC CONTROL MANUAL
00 L I I ♦• .111 PL 24 1-4 DUCT 5 THIS PROJECT REWIRES EXGVATION CONSrRUCDON
O IF
_ __ O WILL UIWZE AND IMPLEMENT ALL BEST MMYGEAIENT
TYPE _ - - -- NYE -CAST DO-- PRACTICES (BMP. AS REQUIRED 10 ENSURE COMPILNCE
4C( -�PM 4C C�PM 10-0000 C/L MARINERS OR STA of 140J WITH SBC POLICY LETTER ISSUES FEBRUARY 21 2003
190 FIBER BARREL TO MH 6J4 ARIFY 15J' FIBER BARREL TO MH 796, ARIFY TO"000 C/L GALAXY DR BY ENVIRONMENTAL MANAGEMENT CONCERNING
STORM WATER PERMITTING AND STORM WATER
O 1 L 1IBER HARREL V r POLL GDON PREANTION PLANS (SWEEP.) AND IN
OL tp iR Fl 6 GROUND WIRE C
IN5— 3 COPPER GROUND RODS 09 i MARINERS DR ACCORDANCE WITH THE CLEAN WA'ER ACT ... AND
_ _ _ _ EPA fcuuTlaNs PueLIsnLD 990 As MownEo
SO DIAMETER, a' MINIMUM LENGTH C/l-- - - �- - - --- - -- -- '- - BY THE PHASE II RULE IN 1999
OPL 10' 2 {- DUCTS NO PM - PROTECTION PRECAUTION I -
IYPf - - - - _
4CC _D PM I 5 I IIFCOROS INTE TIES XT FIS 10 %AN! PIORTI IIBIEON
GROUND BED !0 BE PLACED IN THE RGRN l .1LOlLL EXT KOXI FgRx9 WRMG DT—
I
U' FIBER BMtREL TO YFV 516. ARIFY SAME TRENCH WITH PROPOSED {• Ou TO MH eJ4 I 1-1• UU CORECI KRY.MEM RECDEJS
CURB I ---_-- - - - - --- i0 MM 796
Oj 11 I-57e PIP CABINET O1 REMOVE EXISTING ILDE514 k PAD
R/W
OREMOA EXISTING PEDESTAL Y PAD OV III \
e
971- _ _ 1_ LAZ
Q
T
GROUNDBEU SYMBOL ISJ4 ANDGW WA] :(
I
1)[ JAlt A � ' o� a i--z��j _ az a"
AWGRE °° (
pp m
�' cRouwo Roo -- 'III AmrovcD Jy`pQ/w{�� wrf -Gsr Du °� N u
5/R• DIAMETER CONNECTOIE (J) • srA aaa3 )5
CORPFR CLAD STEEL i • o - - -
CURVE _ DATA >.wrn ETHER eAHHfL
- o 0 125 325136 TIT" �
125J�-09� Bp1'7
2) 4 6) 25 - ill 2p 42 501
PFP-576 CABINET
H . ` }
SCALE 1•- 20'
MINIMUM DEPIH 2 INCHES
--� -- - - - COMMENCEO_2— RECONCILFI+
E FUJIMORI (J14) 669 -2241 SCALE 1'- 20' NEWPORT BEACH EXCHANGE
1�1tJ REV - REMOVE V2 ENISi1NC PEDESTALS D GLVERY (J11 61p-9131 AMESA c
C/� ) iGM ee9-CS NDUIT CONSTRULR'TION
DIAL TDIL FREE - - -- ----- DRAWING TO SCALE C GSTANEOA (]I4) 669-2226 MAP / PREPARED ) II St
ett _ -------- DO NOT REDUCE at&t "" FcCHC --- -- 2-42-LE19A'..
"ro DAYS — — --- -- DURING REPRODUCTION Consulting, LLC MM
BEFORE TW DIG - - ---- g..009 - Su11. J0U MPROAD
- - - - -- ---- Californiam�5 w wo. - LEI 19/ AOOJV73
lJ y. cA 9216e
uxwAvwxo Mxna Nsx1 M' MMm[Rx cAurumx - _ - ----- - (9499 250-ODO4 /FAX (949) 25U 0006 1A/ J DWG L- I
t tsa w.m.�.w y
Uri M-
u,
4PP
Ira. �m.gny
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 Stale 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 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
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,
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
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 he 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 S10 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
1 1 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 times 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 Slate 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 (S tion 3800 Labor Code) .
I certify that I have a Certificate of consent to sel r ure, Certificate of Worker's
Ympenssation¢Insurance, or a Ce fied Copy there
dte: (�� � > 7 \ Zonature:
CERTIFICATE OF EXEMPTION (Section 3800 Labor Code)
I certify that in the performance of the work under this permit, 1 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 Per Inspection is required by calling
Public Works at 949-644-3311 7
15 Any above ground utility facilitie wiU-4 umented approval from the adjacent
affected property owner(s)
16 Homeowner contractors, and subcontracolrs 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 Writer
Quality Laws are punishable by fines up to $25,000 and/or up to three year,; 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 Soils Compac tram
Certificate or Evidence of a Slurried Backfill and request a final inspection from thF,
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 General Services Department
19 All work in the public right-of-way must meet the approval of the Public V%/ork,
Department or corrections will be required (i e removals exposing connecb(�ns
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 acknowledges he/she has re a nd understands the terms and I
conditions of this permit and he/she agrees to abide by them. Permit is void if work is not commenced within 30 days after issu c _ 19//
Permit fees are nonrefundable. Date:l�j— �� �S'- nature
6/13/2017 City of Newport Beach Page 13 of 13
4:30:12PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 06/14/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 1534 ANTIGUA WAY
Activity : N2017-0268
SubType :
Status : APPROVED
OWNER: SCHLUTZ MICHAEL J Phone: o
APPLICANT : AT&T CALIFORNIA Phone : 714-618-9132
Description : Install 41 LF of 4-inch conduit, install (1) fiber barrel, install (1) above -ground pedestal,
install (1) 3-electrode ground bed and remove (2) existing above ground pedestals in
parkwa on Mariners Drive. Concrete restoration er Ci Standards. AOOJV73)
OWN —
It 10200 PRE JOB - PW
Requested Ti Requestor: WEBUSER
909-997-3639
Entered By: WEBUSER
Comments: AM -corner of galaxy dr and mariners dr
As i ned to : z 7z 777777 z* ` J
Inspec o�: JV Date: Time: ��3� AM M
Comments: l/41!, T wZ Wg'VU 70 ice/ 5 e-1-t5 'I,- <Z4 777"'
Logged
Refile
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
REPT131 Run Id: 4018
' 1/3/2017 City of Newport Beach Page 6 of 6
6:34;22AM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 07/03/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 1534 ANTIGUA WAY
AAM iiiian- 08 n r.
Activity: N2017-0268
SubType :
Status : APPROVED
OWNER: SCHLUTZ MICHAEL J Phone : 0
APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132
Description : Install 41 LF of 4-inch conduit, install (1) fiber barrel, install (1) above -ground pedestal,
install (1) 3-electrode ground bed and remove (2) existing above ground pedestals in
parkway on Mariners Drive. Concrete restoration per City Standards. (AOOJV73)
Item: 10000 EXCAVATION & PIPE INSTALL-UTIL
Requested Time: 7/3/2017 12:00:OOAM Requestor:
Entered By: WEBUSER � d
Comments: AM-
WEBUSER
909-997-3639 V�L._
Assigned to: /
Inspector: ��zzzzz Date: /C'7Time: 10.25 AM M
Comments:
t�y4� - /�L_ I,-%- O 'cL--
Iaaaed
Refile
F.\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet doc
i/5/2017 City of Newport Beach Page 9 of 9
6:34:47AM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 07/05/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 1534 ANTIGUA WAY
AM Wm inadiion:
Activity : N2017-0268
SubType :
Status : APPROVED
OWNER: SCHLUTZ MICHAEL J Phone : 0
APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132
Description : Install 41 LF of 4-inch conduit, install (1) fiber barrel, install (1) above -ground pedestal,
install (1) 3-electrode ground bed and remove (2) existing above ground pedestals in
parkway on Mariners Drive. Concrete restoration per City Standards. (AOOJV73)
Requeate 12 pection(s)
Item: 10000 EXCAVATION & PIPE INSTALL-UTIL
Requested Time: 7/5/2017 12:00:OOAM Requestor: WEBUSER
909-997-3618
Entered By: WEBUSER
Comments: ANY -
Assigned to: ZzZ:"�ZZ*
Inspector: - _. �,� Date: 1r7 Time: e - j� PM
Comments: Z..4 d � U-U A ti ti LO A,29 9 1 'f +-C-I> �� )
pC� G . A T-!> LAI1 r!6�� /511 -r-r, Pis r-
'�'��. PA-D .
Logged
Refile
F \Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet.doc
.� 7/5/2017 City of Newport Beach Page 5 of 5
4:31:11PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 07/06/2017
Inspection Type: ENCROACH
Inspection Area: PW
yrv�+y{ Site Address : 1534 ANTIGUA WAY
,,,,}j:4K'iJ9�Y•b. \' ��}" V Y•N". ♦ �' ..H 1 3. Y I � iY^S1'. a' iy i Sys"' 4- w t�i �..}��.y, _N ;
k'dSh�. =i�.rn.�<l��"�« �i'�br�iS�riiFiY����s:�!����•e'Rs�i"�«}�?f'�����t"sS'��£F��;•.,.'��ftiiJ� e�.�'�; :'`"�±�'_�."..._`., .t '
Activity : N2017-0268
SubType :
Status : APPROVED
OWNER: SCHLUTZ MICHAEL J Phone : 0
APPLICANT: AT&T CALIFORNIA Phone e 714-618-9132
Description : Install 41 LF of 4-inch conduit, install (1) fiber barrel, install (1) above -ground pedestal,
install (1) 3-electrode ground bed and remove (2) existing above ground pedestals in
parkwa on Mariners Drive. Concrete restoration per City Standards.AOOJV73)
, �3 t 'iCi.leg ' k 7
l'vi`-?,� .:.�v�: r t t�':�
nli .na+' .:i:,\`i t;.. c$:w'da'.. vF-r+flizis c� -
Item: 10210 PUBLIC WORKS
Requested Time: 7/6/2017 12:00:OOAM Requestor: WEBUSER
9099973818
Entered By: WEBUSER r�1 26- C-14 -t 6 /V r4 "
Comments: AM- 1/
Assigned to: zzz-zzz zz
Inspector: Date: Time: �SZ-d A PM
Comments: Qyf')e' CON(. T kQ
IL(,D 13E_ C-OAIV u I T P�, n!Ct� r15-0 _1_0 a C
Q -1n u CI LJL 66 P L-A-T' ti (
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
REPT131 Run Id: 4018
• '-*712017 City of Newport Beach Page 6 of 7
• 6:34:32AM INSP150 - Daily Inspection Request Report
Requested Inspection Date:
07/07/2017
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address :
-alia
1534 ANTIGUA WAY
Activity:
A M kdon
N2017-0268
r.
SubType :
Status:
APPROVED
OWNER: SCHLUTZ MICHAEL J Phone : 0
APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132
Description : Install 41 LF of 4-inch conduit, install (1) fiber barrel, install (1) above -ground pedestal,
install (1) 3-electrode ground bed and remove (2) existing above ground pedestals in
parkway on Mariners Drive. Concrete restoration per City Standards. (AOOJV73)
R�equesled sperein n($)
Item: 10210 PUBLIC WORKS
Requested Time: 7/7/2017 12:00:OOAM Requestor: WEBUSER
909-997-3618
Entered By: WEBUSER
Comments: AM- l
Assigned to: 77777777777* !
Inspector: 4I Date: -1 7 /17 Time: �� � AM M
Comments: P215— — CiD 14 / T JO
r:� 5 7_S . T_L rt��; - P I-) c% —,, A-Tz 4-,
�
t�C`Ino�•l
Refile
F.\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet doc
i
or
7/13/2017 City of Newport Beach Page 5 of 14
4:31:01PM INSP150 - Daily Inspection Request Report
Activity :
SubType :
Status :
Requested Inspection Date: 07/14/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 1534 ANTIGUA WAY
N2017-0268
APPROVED
OWNER: SCHLUTZ MICHAEL J Phone : 0
APPLICANT: AT&T CALIFORNIA Phone: 714-618-9132
Description : Install 41 LF of 4-inch conduit, install (1) fiber barrel, install (1) above -ground pedestal,
install (1) 3-electrode ground bed and remove (2) existing above ground pedestals in
parkwav on Mariners Drive. Concrete restoration per Citv Standards. (AOOJV73)
Item: 10210 PUBLIC WORKS
Requested Time: 7/14/2017 12:00:OOAM Requestor: WEBUSER
909-997-2738
Entered By: WEBUSER
Comments: AM -traffic control for fiber placing
Assigned to : zzzzzzzzzzz"
Inspector: �� V Date: /�Ld17 Time: �- SSAM PM
Comments: 56---T` 12ED S I0 U L L C7
1 nnaed
Refile
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet doc
REPT131 Run Id: 4018
td8/g017 City of Newport Beach Page 7 of 8
4:31:01PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 08/09/2017
Inspection Type : ENCROACH
Inspection Area: PW
Site Address : 1534 ANTIGUA WAY
Activity : N2017-0268
SubType :
Status : APPROVED
OWNER: SCHLUTZ MICHAEL J Phone : p
APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132
Description : Install 41 LF of 4-inch conduit, install (1) fiber barrel, install (1) above -ground pedestal,
install (1) 3-electrode ground bed and remove (2) existing above ground pedestals in
Darkwav on Mariners Drive. Concrete restoration per City Standards. (AOOJV73)
Item: 10210 PUBLIC WORKS
Requested Time: 8/9/2017 12:00:OOAM Requestor: WEBUSER
9515204200
Entered By: WEBUSER
Comments: AM -traffic control for rope placing
Assigned to: 77777777777*
Inspector:_j V Date: `/ / ? Time: �> M
Comments: c>,?/-4C>7-02 A 0,0 4 rT
L4 % k ov-y - 5 / 7';E!:- or-�a.U. 9'yam — % .
Logged
Refile
F:\Users\P B W\Shared\ENCROACH\MASTERS\FORMS\I nspectorSheet.doc
REPT131 Run Id: 4018
1/10/2022 City of Newport Beach Page 5 of 17
4:30:34PM INSP150 - Daily Inspection Request Report
Requested Inspection Date:
01/11/2022
Inspection Type:
ENCROACH
Inspection Area :
PW
Site Address :
1534 ANTIGUA WAY
A/P/D Information:
Activity :
N2017-0268
SubType :
Status :
APPROVED
OWNER: SCHLUTZ MICHAEL J Phone: 0
APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132
Description : Install 41 LF of 4-inch conduit, install (1) fiber barrel, install (1) above -ground pedestal,
install (1) 3-electrode ground bed and remove (2) existing above ground pedestals in
parkway on Mariners Drive. Concrete restoration per City Standards. (AOOJV73)
Requested Inspection(s)
Item: 10250 FINAL - PW
Requested Time: 1/11/2022 12:00:OOAM Requestor:
Entered By: WEBUSER
Comments: 'ANY-'
Assigned to : zzzzzzzzzzz`
r10_;A .410C4
WEBUSER