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HomeMy WebLinkAboutN2017-04181, of NeWCenterDpOrt Bea C� I II I II21111111111111111111111111111111 mi �11� Permit No: N2017-a41, 8 CivicNewportBhach, CA 92660 Permit Counter Phone (949)644-3311 I II 1II I Project No : SCANNED- " n Online Inspection Request - www newportbeachca gov / Online Z �- Services Inspection Requests Phone (949)644-3255 Job Address : 1435 MARINERS DR NB Thomas:Guide: 889C5 Description : Pothole to repair duct blockage on Dorothy Lane adjacent to the address. Pavement restoration per City Standards. Parcel # : 1174-240-1 - Legal Desc : N TR 3004 LOT 37 OHOURY ANTOINE F Contract: 9-9` 3 Phone: COMPLETED 9-1 1 0STROEET Address : PO BOX 7563 Addressor NEWPORT BEACH, CA UPLAND CA Contractor State Lic: 765716 Applicant: AT&T CALIFORNIA License Expire : 03 31, 2018 Phone: 714-618-9132 [ Address : 3939 E CORONADO ST, 2ND FLOOR ANAHEIM, CA 92807 Business License : BT30060084 Business Expire : 08 31, 2018 Special Cond.: Pre -job inspection required. Workers' Compensation Insurance - - Traffic control per WATCH. Carrier : LM INSURANCE CORP Policy No : WA563DO4260037 W. C. Expire: 07 31, 2017 Permit Processing Fee $241.00 Sewer Connection $0 00 Total Fee $1,066.00 Agreement Fee - $0.00 4TT Box Cover: $0 00 Paid : $1,066.00 Traffic control Plan Check $0.00 Total Water Meters : $0.00 Balance : $0.00 Inspection Fee : $825.00 Water Meter Connection : $0 00 Receipt No Refundable Deposit $0.00 Total Water Meter Box $0 00 Street Tree Fee $0.00 Adjustment : $0.00 Processed By: Date . _/_/ Other Department : Date Utilities Approval Date : _/_/ Permit Denied Date Date cr Issued Permit Date Traffic Approval : : _/_! General Services Approval Date COMPLETE THE BELOW INFORMATION PROJECT ADDRESS: DETAILED DESCRIPTION OF PROPOSED WORK: APPLICANT: Phone: U 910 Email Address: flckav Giol Mailing Address: City/State ip: V& J el OWNER: Phone: Email Address: Mailing Address: City/State2ip: CONTRACTOR: vC�7— Office Phone: Company (if different): Jobsite Phone: Other Phone: Email Address: Mailing Address: City/State/Zip: 9 1,7 to State License Number & Class: Expires: City Business License Number: 76157k. Expires: WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code) Company: Policy No: Expires: Municipal Orations: 949-644-3055 Utilities: 949-644-3011 Urban Forestry: 949-644-3083 Special Conditions of Permit: � t Utilities: Municipal Operations Traffic: Other: Fire: Engineering Technician: Pe Specialist Da Permit No. N2017- P/users/pbw/shared/encroach/masters/epwarksheetAs �--� Public Works Department 949-6"-3311 100 Civic Center Drive, Newport Beach, CA 92660 FEE WORKSHEET FOR ENCROACHMENT PERMIT CITY OF NEWPORT BEACH PUBLIC WORKS DEPARTMENT All Fees Are Non -Refundable Unless Otherwise Stated PROJECT ADDRESS: 1y35 Nlor;ntr5 ►7r;ve PERMIT N2017- N ►q NUMBER: r7 APPLICANT: Permit Processing Fee: Q Public Works Only $241 00 t Other Department $275.00 Agreement Fee: Preparation of Report/Agreement $817 00 Document Recordation Fee $192.00 Monitoring Wells $502.00 Inspection Fee: Public Works Field Inspection Utilities Field Inspection General Services Inspection Water Quality/Artificial Turf Inspection Refundable Deposit: Improvements Qty. $165.00 $121 00 $165 00 $108.00 TBD F] TBD Street/Alley[Walk Closure: $65 00= Newspaper Rack Inspection $108 00 Traffic Control Plan Check 8-1/2" x 11" $65 00 Sewer Connection Fee $250.00 F=� 24" x 36" $143 00 4TT Box 8r. Cover $64.00 Additional - — — — — — — — — — — — — — — — — — ------- -- — — — — THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division 1 1 REVENUE DIVISION PRIOR TO PAYMENT OF FEES ]Approval: t. Y 11 1 Q1 1Water 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 1 I2" Turbine Meter 13" Meter $845.00 $3,310.00 For Traffic & Alley Areas (Box + Cover = Cost) 1" Meter: 13.00 + 38.00 $51.00 14" Meter $4,730 00 1 2" Meter 27.00 + 162.00 $189.00 1 16" Meter $7,190.00 Qty. Budget Number 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 hrly 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 r2oa; 161, Db(v. Permit Specialist Receipt No. f /users/pbw/shared/encroach/masters/ep front and back masters/ Rev 1/5/2017 epfeesheet ids -revised 10/21/2016 ALL UNDERGROUND WORK SHALL BE PERFORMED BY A LICENSED CONTRACTOR Contact "Underground Service Alert" At Least 48-Hours in Advance of Any Excavation at 800422-4133 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, C tificate of Worker's contractor must provide a Letter of Authorization' to allow another party to pull a permit An approved copy of the Co eoation Insurance, or a Certified Cop thereof. permit and construction plan shall be kept at the job site at all times Work, which has been done prior to issuance of ' e a permit, is subject to rejection/fine City reserves the right to void permit if work does not commence within 30 days „L,=� Da O % Signature: after date of issuance CERTIFICATE OF EXEMPTION (S ction 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, I 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 State 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 personally 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 I 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 (ie water, sewer, or street lighting conduits) to verify locations Maintain a one -fool clearance over or under existing City -owned utilities Sewer cleanouts require VCP or PVC SDR35 be used with a Date: Signature: 4TT box over the riser 24-hour notice for Encroach ent ermit I pection r uired 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 949-644-3311. California Department of Transportation If needed, barricades can be obtained from the City at a charge of $10 00 15 Any above ground utility facilities will requ documented approval from the 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 er 16 Homeowner, contractors, and subcontracolrs may each be liable for violations 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 t 1 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 Ines up to $25,000 and/or up to three years in State 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 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 Backfill 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 Callrans 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 adds ial fees. No work related to this encroachment permit ;hall be performed until the Public Works Department has issued this permit. Applicant hereby acknowledges he/s has read and and rids t rms 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 Issuance. D '2 ? �7_Signature: Permit fees are nonrefundable. e: **DRAWING NOT TO SCALE** EXCAVATION DATA OWNER ASPHI CONCRE IF DIRT TUNNEL C & G CITY OF NEwPOAT BEACH T6 X4 -64 SOFT 4 %4 - 16 SOFT 6'XI'- 24 SO H 2'%4' - A SO FT -PUE 1X4'= 2B 1011 OEXCAVATE JS X4' PII TO REPMR DUCT BLIXX"GE 4M 10400 W CIL MARINERS DR _\ 10,OD00 CIL DOROTHY LN M'ERS� 1435 MARINERS DR CONSTRUCTION NOTES I MINIMUM COY£R FOR STRUCTURE 36' KLOW EXISTING GRAOE OR 30' BELOW GUTTER FLOWLINE 2 ALL SUBSTRUCTURE INFORIMTION SHOWN WAS TAKEN FROM RECORDS—ILABLE AND IS APPROMWIE VERIFY, LOCATE MID PROTECT AS REWIRED J BEFORE EXCAVATING CALL U G SERVICE ALERT EII . - rRAFTIC CONTROL TO K IN ACCONDWCE WITH THE C J U T C M WORK AREA PROTECTION AND TRAFRC CONrROL MANUAL 5 MIS PROTECT REQUIRES EXMVARON CONSTRUCTION WILL UTILIZE AND IMPLEMENT ALL BEST MANAGEMENT PRACTICES (BMP'! AS REWIRED TO ENSURE COMFTMCE W M AT&T POLICY LEITER ISSUES FEBRIT,Vi'Y 21 2003 BY ENNRONMENTM MANI-MENT CONCERNING STORM WATER KRMITIING AND STORM WATER —UTION PREVENTION PLANS (SWPPP.) AND IN ACCORDMICE WITH THE CLEW WATER ACT (1965) AND EPA RECUURONS PUBLISHED IN 1990 AS NOTIFIED BY THE FIHASE II ROLE IN 1999 .C—MITE TRS m EX6T91G AUWT 51IOWM HEW. MRHECT ACTWL CO.— I— W&NG FIE— C.OlIIFCT 0fAW E. KC m \ \ \ u1J ♦L REPMP BW,,, _ j - _ �' \ C1 I 65 1DO 51 MH 1' \ 1'%2 5%.7' _ - - UCH \ \ g SI UGHI HMIt \ \ \ 1l24 ESTELLE LN, 1100 ESTELLE b \ m SCALE 1'= 20' m COMMENCED- _— COMPLETED— 20_ RELONCIL£0-- -_.- - E 1U1IM011 (714) 669-2241 SCALE 1, 20' NEWPORT BEACH EXCHAI C O (114) 616-9111 TGM 669-85 CONDUIT CONSTRUCTIC --EOM (111) 669-2226 MAP PREPARED O) JI " SHAM DIAL TOLL FREE — ---- DRAWING TO SCALE - - -- -- ���� ��,.. �� -crow'-.-9_._ ROUTE2 SHTIB-LE(19) CHECXED _ anDO NOT REDUCE 1 Consultln LLC —T TWO DAn — -- -- --- - — DURING REPRODUCTION Ie45 w a.�9•WO.B Av.. s,D. nooE°ORE YDJ DIG California ayy. CA 92/6/ LE(I 9) AOOSGM (949) 250-D004 /FAX (949) 250-0006 pxA 2 DWG L I N2o►-1 -Oy«A **DRAWING NOT TO SCALE** - TABLE 6C-2 1014 CALIFORNIA MUTCD- STOPPING SIGHT DISTANCE AS A [UNCTION OF SPEED- - TABLE bC-3 2014 CALIFORNIA MUTCD- - TAPER LENGTH CRITERIA FOR TEMPORARY TRAFFIC CONTROL ZONE - TYPE OF TAPER TAPER LENGTH (L)- M.ging Tap•__ at L•a.t L SPEED' DISTANCE Sh Ru,9 Taper at L.a.t 0 5 L (MPH) (FT) Shout .r Too•. - a1 L•w1 033 L On• ion•, T.p-.py tr fR< taper 30 m (100R) M.. H. - D.r V.am Tap. 30 m (1000t) p. Ia 20 25 155 - TABLE 5C-4 2014 CALIFORNIA MUTCD- 30 200 FORMULAS FOR DETERMINING TAPER LENGTH- 35 250 - 40 - -- 305 SPEED OMIT (S) -A IERLTH (L FEET 4U mph a I.. L- V .6 3W - _ 50 125 55 495 60 51. Where L= taper length in meters (feet) _- 65 - 645 - W= width of offset in meters (fret) )0 )3U 820 S= pasted speed limit, or off-peak 25 -85th-pere,en 85th-percentile speed prior To work starting. or the lile • Posted speed, off -peck speed pr wr to work start ing anticipated operating speed In km/h (mph) or the anticipated operating speed LEGEND - TABLE 6C-1 2014 CALIFORNIA MUTCD- '� PORTABLE FLASHING BEACON (P F B ) - SUGGESTED MINIMUM ADVANCE WARNING SIGN SPACING- TYPE III BARRICADE W/SIGN TYPE P BARRICADE W/SIGN DISTANCE BETWEEN SIGNS •• • CHANNELIZING DEVICE ROAD TYPE -- -- - -- T TRAFFIC CONE WITH CLIP ON SIGN A B 7 SIGN URBAN (LOW SPEEG)'25 MPH OR LESS - ----- -- - - — - - - - - 10. FEET -- -- 100 FEET - -- 100 FEET -- O SIGNALIZED INTERSECTION URBAN HIGH (SPEEO)•MORE THAN 25 MPH TO 4a MPH 25U FEET 250 FEET 250 FEET ARROW PANEL (FLASHING ARROW) (WHERE REQUIRED) URBAN HIGH (SPEED) -MORE 40 MPH 350 FEET 350 FEET 15. FEET t HIGH LEVEL WARNING DEVICE (FLAGTREE) (OPTIONAL) RURAL 5W FEET 500 FEET 500 FEET • FLAGGER - -- - ---- - - --- -- - TANS TOW AWAY NO STOPPING __- TO -__ (SHOW HOURS) EXPRESSWAI/FREEWAY --- - ----- -� - IOW FEET - -- IWO FEET - _--- 10W FEEL - - TANSAT TOW AWAY NO STOPPING ANY TIME '%� WORK ZONE (ACTIVITY AREA) LIMITS •• the cai m heading A, S, and Coe the dimensions DIRECTION OF TRAFFIC (NOT PAVEMENT MARKING) Shawn in Figures bH -1 through bH-46 The A dlmenslon Is the distance from the transition o /� ROADWAY DESIGNATION (A THROUGH D) point olriction to the first sign The 8 dimension Is the distance between the first and second signs The C dimension is the distance between the second and third sign (,the thrld sign Is the First une in the three -sign series encountered by a driver approachlny a TTC cane) - - E [UJIMORI (1T4) 669-2241 SCALE NONE n/E IN T GEA I— NGE -- C .1. -A C G ARIA 611-1111 TGM 889-85 1F1c CGNTHG! v FAL TOLL FREE _- -- ���� - rvINA�ruN �ruu C CASTANEa4 _--(714) 619_2216 D 210etA Ilia - -_ _ 'w MEIMEO I Il G 9dN 81iECREO wo uwys - 40) Consulting, LL C.1 LEAST AIrR o E YW La -- California 1145 W Draa9..ao. 1.1. ,DD y. a s2.6• LE(7 9) AOOSGMP uMX:.aaro St.Ma A1tWI a sauTvux cu4aWi.- - ---- - -- (9499 250-0004 /FAX (949) 250-0006 DWG COVER SHEE I —DRAWING NOTTO SCALE- 175 I DOROTHY LN EXCAVATION PIT WORK AREA R ESTELLE LN z's MARINERS DR I LUHUInI IV' 1, 1 1 1 IE Ir \ LEGEND Q PORTABLE FLASHING BEACON (P E B ) TYPE III BARRIVDE W/SIGN - TYPE II BARRICADE W/SIGN • CHANNEUZING DEVICE TRAFFIC CONE N11. CLIP ON SIGN SIGN $O SIGNALIZED INTERSECTION ® ARROW PANEL (FLASHING MROW) (WHERE REQUIRED) y HIGH LEVEL WARNING DEVICE (FLACTREE) (OPTIONAL) •* FLAGGER TANS TOW AWAY NO STOPPING TO - - (SHOW HOURS) rANSAT TOW AWAY NO STOPPING MY TIME WORK ZONE (ACDWTY AREA) LIMITS .� DIRECTION OF TRAFFIC (NOT PAVEMENT MARKING) O ROADWAY DESIGNATION (A THROUGH D) Air • a lW I _ --- _ _ �Q z© DOROTHY LN (jam 1 � \ M[ a• _ OE NNK uUSEO 1 1 OIL TOH �^ (W y 1 1 � 91 ucrtALE .+Nr.WI I 1 k1`VLI ` �� ► �r DC ROTHY LN 1 ESCORT PEDESTRIANS THROUGH WORK AREA. Ir Arc [_] UN a.Tn SIDES 0= WORA AREA \I zs ESTELLE LN CONTACT PROPERTY OWNER(S) 72 1=11 � HOURS PRIOR TO START OF WORK MARINERS DR OMMENCED2U COMVLETEO-__ 10_ RECONULEO___ E FUJIMORI (714) 669-2241 SCALE 1-- 40' 11..... OCACH CXGFIANL;c LOSTA NICSA C O A C MIN (714) 61E 9111 TGIA BBR-65 TH.AFFIC CO 1- I+LAN U.IAL TOLL FREE _ - -- - - ' - -_ C CASIMEpA ()14) 619_2226 DAlI 21DELA PKPMEO at&tLIKCNEO EE As8lrwo oe rs --- — - - I, 1 Lr�Iv,LIUN ~L 120 Consulting, LLC A�av o AtI UNL YOU OI4 --- _ - -- California ID4S W O 9....a A- Suit..10D G a... CA 9z66� LE! 19J AOSGMP (949� 3SO-0004 /FAX (9411) 250-00011 DWG TC- I DF TC- I 8/25/2017 City of Newport Beach Page 2 of 9 6:34:29AM INSP150 - Daily Inspection Request Report Requested Inspection Date: 08/25/2017 Inspection Type : ENCROACH Inspection Area: PW Site Address : 1435 MARINERS DR ..,� �,�a- .:x•�.�:'t"4P� �,-�.�:�. N�.�-�x�ca„��;�!4x��: •..�','�''" ��� � •{.:�� .. * y� a.; ,'sya��.,,��.���� � ; � ,a: Activity: N2017-0418 SubType : NEW Status : APPROVED OWNER: KHOURY ANTOINE F Phone : p APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Pothole to repair duct blockage on Dorothy Lane adjacent to the address. Pavement restoration per City Standards. � '•zon. , Item: 10215 ROUGH UTIL �I C, l Requested Time: 8/25/2017 12:00:OOAM Requestor: NBIVR Entered By: NBIVR Comments: AM Assigned to: Inspector: Date: g �� �% Time: Comments:t�T�� Lt T-Y w o uv�' '' 4 P I-o v c) r )ea-AZ!5 . me -col 0" F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc 4 8/28/2017 City of Newport Beach Page 2 of 10 6:34:32AM INSP150 - Daily Inspection Request Report Requested Inspection Date: 08/28/2017 Inspection Type: ENCROACH Inspection Area: PW Site Address : 1435 MARINERS DR AlI)! ' I Activity : N2017-0418 SubType : NEW Status : APPROVED OWNER: KHOURY ANTOINE F Phone : 0 APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Pothole to repair duct blockage on Dorothy Lane adjacent to the address. Pavement restoration per City Standards. -1Jul'K0 Item: 10215 ROUGH UTIL Requested Time: 8/28/2017 12:00:OOAM Requestor: NBIVR Entered By: NBIVR Comments: AM Assigned to: Inspector: ),J Date: / = /7 Time: 8 - 3 !!eIQ PM Comments: 45500-114L fl 40 'PV 0> u 1 r ,rz� Ae o,t, soK r� e Sl�� o i pow a rt-�y mot/. l/L I i"P reWeZ_ Domfollp F:\Users\PBV4\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc 1/13/2022 City of Newport Beach Page 6 of 15 4:30:54PM INSP150 - Daily Inspection Request Report Requested Inspection Date : 01/14/2022 Inspection Type: ENCROACH Inspection Area: PW Site Address : 1435 MARINERS DR A/P/D Information: Activity : N2017-0418 SubType : NEW Status : APPROVED OWNER: KHOURY ANTOINE F Phone: 0 APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Pothole to repair duct blockage on Dorothy Lane adjacent to the address. Pavement restoration per City Standards. Requested Inspection(s) Item: 10250 FINAL - PW Requested Time: 1/14/2022 12:00:OOAM Entered By: WEBUSER Comments: 'ANY-' Assigned to : TZ LZMZ Z - /. 0,,-, ; 4 -f le", d , Requestor: WEBUSER 1.