HomeMy WebLinkAboutN2017-0366`4 �gwr nF d 00 Civic Center Drive N Newport Beach, CA 92660 II IIII III IIIII IIIII IIIII IIII IIIIIII IIII I IIIII III II
F Permit Counter Phone (949)644-3311
u y Online Inspection Request - www.newportbeachca.gov / Online
Services
Job Address : 222 LUGONIA ST NB
Description: INSTALL SEWER CLEAN OUT PER STD 406-L.
Parcel # : 0450-642-6 -
Legal Desc : TR 772 LOT 24 BLK 5 ALL (EX NELY 21 FT) AND NELY 25 FT LOT
25 BLK 5
Owner: SCOTTPHELPS
Phone: 949-677-0322
Address : 222 LUGONIA ST
NEWPORT BEACH, CA
Applicant: MASSARO ANTHONY P
Phone: 714-556-8299 [
Address : 2533 GREENBRIAR LN
COSTA MESA CA 92626
Special Cond.: PRE -CONSTRUCTION MEETING REQUIRED
COMPLETED
Permit Processing Fee :
$241.00
Sewer Connection :
$0.00
Agreement Fee :
$0.00
4TT Box Cover:
$64.00
Traffic control Plan Check :
$0.00
Total Water Meters :
$0.00
Inspection Fee:
$330.00
Water Meter Connection :
$0.00
Refundable Deposit:
$0.00
Total Water Meter Box :
$0.00
Street Tree Fee :
$0.00
Adjustment :
$0.00
Processed By:
Date:
Utilities Approval :
Date:
Traffic Approval :
Date:
General Services Approval :
Date :
U 'I.1� • l�
Permit No: N2017-0366
Project No : 1913-2016
Inspection Requests Phone (949)644-3255
Thomas:Guide: 888E5
SCANNED
Contractor : LANE COMPANY THE
Phone: 714-775-6905
Address : 14629 PLACID DR
WHITTIER CA 90604
Contractor State Lic: 542050
License Expire : 09 30, 2018
Business License:
BT30029596
Business Expire :
12 31, 2017
Workers' Compensation
Insurance - -
Carrier:
STATE FUND
Policy No:
1860194
W. C. Expire: 10 11, 2017
Total Fee $635.00
Paid : $635.00
Balance : $0.00
Receipt No:
Other Department : Date
Permit Denied : Date
Issued Permit : — A�9_ -Date : _L/_a/i2_
ORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
C0MPLETE5.THr= 85LOWINFORFATION
PROJECT ADDRESS: 2 22 �iUGti O ! P
DETAILED DESCRIPTION OF PROPOSED WORK:
G t
APPLICANT: ��
Phone: 63
Email Address:
Mailing Address:
2-I
City/State/Zip:
w__j t j 1, Gv G 2 G Zv
OWNER: Phone:
Email Address:
Mailing Address:
City/State/Zip:
ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE COMPLETE
CONTRACTOR: -T-k ,4
Office Phone: -1 ( "-1` 1S • D
Company (if different):
Jobsite Phone:
Other Phone:
Email Address:
Mailing Address:
�L A- C_ I 1> 1> ►L ,
City/State/Zip:
b i i� l TT 1
State License Number & Class:
Z2 4- A Expires: 3o fg
City Business License Number:
PjT3 d0 Z�( Sq Ex Tres:I
I
WORKERS COMPENSATION INSURANCE. Certificate of Insurance (Section 3800 Labor Code)
Company: Policy No: Expires:
REFUNDABLE DEPOSIT INFORMATION (1fAppiicabla):.
Refund Pa able To; . t
Mail Refund To:
FOR OFFICE USE ONLY
Special Conditions of Permit: • )" V. I' --`I " ^, �_ , _ • " �
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
General Services:
Traffic: Fire:
Other:
Engineering Technician:
Public o Specialist:
Dato:
, I�
�� ►
Pernlit No.
LL kz,
f /userslpbwlshared/eruroaWMastersfepworksheetxis
Public Works Department 949-644-3311
FEE WORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
All Fees Are Non -Refundable Unless Otherwise Stated
PROJECT ADDRESS:
222 L-u GtiLI6l
PERMIT !,/ -
NUMBER: N2017- �i��L� �'
APPLICANT: _5
Permit Processing Fee: Q
Public Works Only $241.00 l '
Other Department $275.00
Agreement Fee:
Preparation of Report/Agreement $817.00
Document Recordation Fee $192.00
Monitoring Wells $502.00
Inspection Fee: Q .
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: TBD
Improvements TBD
Street/Alley/Walk Closure: $65.000 Newspaper Rack Inspection $108.00 0
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 j
Additional
___ THEFOLLOWING ITEMS REQUIRE APPROVALFROM THE venue Division
REVENUE DIVISION PRIOR TO PAYMENT OF FEES ]iTe*
Approval: 1
Qty
(Water Meter:
Installation Charge $528.00r 1
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� 1
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) 1
13" Meter
$3,310.00
1" Meter: 13.00 + 38.00 $51.00
[�
14" Meter
$4,730.00
2" Meter: 27.00 + 162.00 $189.00 1
16" Meter
$7,190.00
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 My over 4 hrs)
$1,022.00
5200-5031
Street Tree Fee ($700 Planting Fee)
TBD
030-2284
Engineering Tech:
Total Due:
For Finance Use Only
]'Amount
Permit Spe . list
Receipt No.
f /users/pbw/sharedlencroach/masters/ep front and back masters/
Rev. 1/5/2017
_ /
epfeesheetxls-revisedl0/21/2016
Q___2
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 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
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 lie 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
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 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, Certificate of Worker's
Compensation Insurance, or a Certified Copy thereof. ,
Date: "i Z 2 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. 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 required by calling
(Public Works at 949-644-3311. '
15 Any above ground utility facilities will require documented approval from the adjacent
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 Wnior
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 Soils Compactir-1
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, 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 Mork'
Department or corrections will be required (i e removals exposing connecti(,ns,
etc ) Additional inspection fees may be required
20 Permit is for standard materials in the public right-of-way only, unless previorrsl\,
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 read and understands the 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 issuance.
Permit fees are nonrefundable. —' _ Date: ; �, Signature: „
A SITE PLAN
13
— (E) DRIVEWAY
V
-- - - --ALL Y- _ (98.63') SITE
1 PROVIDE H
- FLOWLINE OF ALLEY STREET.
34' PL 2 WATER, GA
�,� M
(98 75,) LINES AND
(E) DRIVEWAY
3. EXISTING S
in INSTALLED
_ _ _ _ _ _ _ _ _ _ _y - CITY STANC
GATE (99.33') - - .8F EXCEEDS 5
J I SLOPE SANDBAGS 4. EXISTING S
p I INSTALLED
I- I 2 �0 FOR EROSION FOLLOWING
TRASH CANS L J I CONTROL A.
I i ( LTERA
DONE
} i } B. ADDITIO
f I INCREASER
C. WHEN IT
1,164 SF h. SEWER IS IN
36 SF (E) GARAGE LINE OF UNSANITAR'
SECOND D IF THE A
1,233 SF W I
SLOPE J- FLOOR ABOVE PLUS ADDIT
2,433 SF N i 2% I EXISTING AF
.5 POOLS, SPA
414 SF (99.5') FREESTAND
400 SF (98.75') PERMITS
6 REMOVAL OI
I \ I GENERAL SE
(286) SF LINE OF ROOF
GAS METER ( I OVERHANG-1 7 SOILS EN GIG
HOUR RATED i FOOTING
I
ri. ALL GRAC
1,953 S.F. w LV
,. ti 8 DISTANCE FF
REA: 3,906 S.F.
a J N / - II TO BE ZONI(\
2,847 S F. 000 4i 9. A CAL -OSHA
�II THAN 5' 0" FE
d o 1 1 10. CONTRACTO
pLai A > j CERTIFIED M
� - WORK
WATER SERVICE INTO
I COVERED I HOUSE - PROTECT IN 11. CONSTRUCT
IN ADDITION
ENTRY 1 PLACE C
� — — ADDITION PL
�l I (99 52,) PROPOSED c 84" HIGH
U 12 AN APPROVI
rR 2�_ •� ��= � _SLOPE _ -�rACTIVITIES 1
TO 2%
- --- 1 13 A PUBLIC WO
{ 111 INSPECTION I
a 1
FINAI
EXISTING TWO STORY �� PERMIT MEW
p � DEPARTMEN-i
u SINGLE FAMILY RESIDENCE -� CONCRETES
S
CONCRETE S
F.F. EL. 100.00' PAVEMENT W
INFRASTRUC
ECT LINE OF ROOF 3'- WATER SERV
IISION OVERHANG-1 CLEANOUT W
HOUR RATED ` COST SHALL I
CODES 14.24.1
I �+ SLOPE EXTENT OF TI
l OF THE PUBLI
2%
----- --- - - - - -- -- (98.83') 14 AN ENCROACI
NOT-STANDAF
CD SANDBAGS FOR EROSION WAY ALL NOI
o WITH CITY CO
CONTROL
- Y-1- - y--ry - Y- - Y--1- - y-- - y--1- - y--� - Y _' y--r - y---Y--�-
0
34' PL
(98.42')
� SIDEWALK /
.I F. CURB
WATER METER - PROTECT IN PLACE
� ' I'- o
r € in INSTALL NEW SEWER CLEANOUT ON THE EXISTING
SEWER LATERAL PER CITY STANDARD STD-406-L - "C-i
OR "A" LICENSED CONTRACTOR
EXISTING SEWER LATERAL
c, arr r rvr nor ENr ATAR i rm Nr L U O N I A S T
f
7/13/2017 City of Newport Beach Page 10 of 14
4:31:01PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 07/14/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 222 LUGONIA ST
Activity : N2017-0366
SubType : NEW
Status : APPROVED
OWNER: SCOTT PHELPS Phone : 949-677-0322
APPLICANT: MASSARO ANTHONY P Phone : 714-556-8299
tony@marshillstudio.com
Description : INSTALL SEWER CLEAN OUT PER STD 406-L.
Item: 10200 PRE JOB - PW
Requested Time: 7/14/2017 12:00:OOAM
Entered By: WEBUSER
Comments: AM -
Assigned to : zzzzzzzuu*
Inspector: �,-) V Date
Comments:
Requestor: WEBUSER
949-677-0322 ' t�
�C,G OfT-
l'--111% Time: 19 . �' A PM
1y16 9 Scro 77- Tv
ogge
11(e] lie
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsaectorSheet.doc
w
jo.
REPT131 Run Id: 4018
7/17/2017 City of Newport Beach Page 8 of 9
6:34:54AM INSP150 - Daily Inspection Request Report
Requested Inspection Date : 07/17/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 222 LUGONIA ST
"ID iflFOfllub 0f1:
Activity : N2017-0366
SubType : NEW
Status : APPROVED
OWNER: SCOTT PHELPS Phone : 949-677-0322
APPLICANT: MASSARO ANTHONY P Phone : 714-556-8299
tony@marshilistudio.com
Description: INSTALL SEWER CLEAN OUT PER STD 406-L.
Requested ems)
Item: 10250 FINAL - PW
g 3
Requested Time: 7/17/2017 12:00:OOAM Requestor: WEBUSER
Entered By: WEBUSER
Comments: ANY -
Assigned to: 77777777777*
Inspector:
�,-ogged
Reflle
Date: II 1 1 -7
949-677-0322
Time: 0 sU PM
Comments: G4\L n5 Gpr�V�P l` I PAL- S
WV-- �2-n - I LU L
LOAJ& PLA-I—CD & S 1,(v
F- \Users\PBW\Sha red\ENCROACH \MASTERS\FORMS\I n soectorSheet.doc