HomeMy WebLinkAboutN2017-0570City of Newport Beach
CA 9266o II I II2IIIIIII,IIIII II IIII I II II II Permit No: N2017-0570 .
0Civic Drive, 1�1
Permit Counter Phone (949)644-3311 Project No .
Online Inspection Request - www.newportbeachca.gov / Online
e c tt uµ�• Services
Inspection Requests Phone (949)644-3255
Job Address:
1431 BONNIE DOONE TER NB
Thomas:Guide:
889D7
Description :
Install sewer cleanout on existing sewer lateral per City Standard #406-L. Concrete restoration per City Standards.
Parcel # :
0502-842-0 -
SCANNED
Legal Desc :
N TR 1701 LOT 1
Owner:
BOGARD JOHN A
Contractor :
CHASE GENERAL ENGINEERING CONTRACTOR INC
Phone:
0
Phone:
714-914-6345
Address :
1431 BONNIE DOONE TER
Address :
15332 NEWCASTLE LANE
CORONA DEL MAR, CA
HUNTINGTON BEACH CA
Applicant: CHASE INC
Phone : 714-914-6346 [
Address : 16835 ALGONQUIN ST #329
HUNTINGTON BEACH, CA 92649
Special Cond.: PRE -JOB INSPECTION REQUIRED
CoMpLETES
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:
Utilities Approval
Traffic Approval :
General Services Approval
Date :
Date
Date:
Date:
Contractor State Lic: 906147
License Expire : 11 30, 2017
Business License : BT30054273
Business Expire :
08 07, 2018
Workers' Compensation
Insurance - -
Carrier :
STATE COMP INSURANCE
Policy No :
9047185-16
W. C. Expire:
03 01, 2018
Total Fee $635.00
Paid : $635.00
Balance : $0.00
Receipt No
Other Department ' -Date:
Permit Denied Date:
Issued Permit: �� ' �� Date :
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
WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code)
1
Encroachment Permits may be taken out by the owner of benefited properly or a licensed contractor A licensed
I certify that I have a Certificate of consent to self -insure, Certificate of Worker's
contractor must provide a Letter of Authorization" to allow another party to pull a permit An approved copy of the
Compensatiop Insurance, or a Certified Copy th
permit and construction plan shall be kept at the fob 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
Date: Signature:
after date of issuance
CERTIFICATE OF EXEMPTION (Section 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 Slate 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 tie 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
Date: Signature:
4TT bor over the riser
24-hour notice for Encroachment Permit Inspection is required 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 require 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
16 Homeowner, contractors, and subcontracotrs 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
1 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 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
emergency vehicles must be maintained at all times Traffic Control must be per Work Area Traffic Control
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 Slate Highway right-of-way
Public Works Department. Monies may be held for six months after final inspection
will require a Caltrans 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 additional fees
No work related to this encroachment permit $hall be performed until the Public Works Department has issued this permit. Applicant hereby acknowledges he/she has read a terms and
conditions
�unrstand
of this permit and he/she agrees to abide by them. Permit is void if work is not commenced within 30 days after is ce.
,
Permit fees are nonrefundable.
DateK//— Signature:
:...
PROJECT ADDRESS:
DETAILED DESCRIPTION OF PROPOSED WORK:
APPLICANT: Phone: 7
Email Address: f
Mailing Address:
City/State/Zip:
OWNER: Phone:
Email Address:
Mailing Address: City/State/Zip:
F..;.� tL _CONTRACTOR INFORMATION IS-REQUIRED-=PLWE CF3MFF L-'PTg,-
Yi f•
CONTRACTOR: ->
Office Phone:
Company (if different):
Jobsite Phone:
Other Phone:
Email Address:
Mailing Address:
City/,State/Zip:
State License NttMber & Class:
D Ex Tres: � /
City Business License Number:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: Policy No: Expires:
. ... .... ..... ... . ................ .... .
REFUNUA¢ t-O�POSIT INFORMAtION ((iA4p' pli�a6le :::::. :, :.:: >. :. , :. , :: .."::.... ::::.> . :
:. :..... ..:... ..-:- ..... :..... . ..
Fletund E'a able...:::.::: . .:::..:::...... .
FOR OFFICE USE ONLY
Special Conditions of Permit: ?re y.,, ;nspevh'" Y,&jiire46
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
General Services:
Traffic: Fire:
Other:
1Engineering Technician:
,;26dy
Public Works Specialist:
1 7.o6�
Date:
Il-B'1�
Permit No.
WZD11 -0y?(
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Public Works Department 949-644-3311
Permit Processing Fee:
Q
Inspection Fee:
Q .
Public Works Only
$241.00
t
Public Works Field Inspection
$165.00 2
Other Department
$275.00
Utilities Field Inspection
$121.00
General Services Inspection
$165.00
Agreement Fee:
Water Quality/Artificial Turf Inspection
$108.00
Preparation of Report/Agreement
$817.00
Document Recordation Fee
$192.00
Refundable Deposit:
TBD
Monitoring Wells
$502.00
Improvements
TBD
Street/AlleylWalk Closure: $65.000 Newspaper 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
I THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division
[ REVENUE DIVISION PRIOR TO PAYMENT OF FEES ]Approval:
I
Qty
Water Meter:
Installation Charge $528.00
13/4" Meter
$50.25
11" Meter
$121.50
Water Meter Boxes: 1
11 1/2" Meter
$285.00
1" DFW Meter Box $96.66
11 1/2" Turbine Meter
$700.00
2" DFW Meter Box $203.24
12" Meter
$425.00
12" Turbine Meter
$845.00
13" Meter
$3,310.00
t4" Meter
$4,730.00
16" Meter
$7,190.00
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 EasementNacation 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
204 ► } (v35
Permit Specialist Receipt No.
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11r20/2017 City of Newport Beach Page 6 of 16
`4:30:51PMI INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/21/2017
Inspection Type: ENCROACH
Inspection Area: PW
�,,{1 y Site Address : 1431 BONNIE DOONE TER
Activity : N2017-0570
SubType :
Status : APPROVED
OWNER: BOGARD JOHN A Phone: 0
APPLICANT: CHASE INC Phone : 714-914-6346
Description : Install sewer cleanout on existing sewer lateral per City Standard #406-L. Concrete
restoration per Ci Standards.
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Item: 10040 SEWER LATERAL
Requested Time: 11/21/2017 12:00:OOAM Requestor: WEBUSER
714 914-6346
Entered By: WEBUSER
Comments: ANY -
Assigned to: zzzzzzzzzzz"
Inspector: II Date: �� 1 Z l Time: t� PM
Comments: _ SJ 79'! Tr,f7 QX(AVAT n/ o Al �vv U4� ,I
LA-r I - / G4,0 p //U 5 I°i 5;t,-'r 'At . C*"'IFJVr- J 0 i A/"
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REPT131 Run Id: 4018
11/28/2017 City of Newport Beach Page 7 of 11
6:34:36AM INSP150 - Daily Inspection Request Report
Requested Inspection Date : 11/28/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 1431 BONNIE DOONE TER
AM 1k -On C
Activity: N2017-0570
SubType :
Status : APPROVED
OWNER: BOGARD JOHN A Phone: 0
APPLICANT: CHASE INC Phone: 714-914-6346
Description : Install sewer cleanout on existing sewer lateral per City Standard #406-L. Concrete
restoration per City Standards.
-Ao*nNstlsdinelp In" on11" -
Item: 1'' C�vt'Z
Requested Time: 11/28/2017 12:00:OOAM Requestor: WEBUSER
714 914-6346�-fJ
Entered By: WEBUSER
Comments: ANY -
Assigned to: 77777777777*
Inspector: k t /-Z� Ill Date: Time: AM PM
Comments: L cea
s
F.\Users\PBW\Shared\ENCROACH\MASTE RS\FORMS\InsoectorSheet.doc
11/29/2017 City of Newport Beach Page 12 of 12
6:34:18AM INSP150 - Daily Inspection Request Report
Requested Inspection Date:
11/29/2017
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address :
-fin
1431 BONNIE DOONE TER
Activity :
MAIDIIr'iIf,
N2017-0570
C
SubType :
Status :
APPROVED
OWNER: BOGARD JOHN A Phone : O
APPLICANT: CHASE INC Phone : 714-914-6346
Description : Install sewer cleanout on existing sewer lateral per City Standard #406-L. Concrete
restoration per City Standards.
Rn 4k@ nsied irrsp>rtiion(s)
Item: 10020 PERMANENT PAVING- PW
Requested Time: 11/29/2017 12:00:OOAM Requestor:
Entered By: WEBUSER
Comments: AM -
Assigned to:
Inspector:
Comments:
77777777777*
\�V,
Date: It 4'Lt , 7
s /s
WEBUSER
714 914-6346
Time: AM PM
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11/30/2017 City of Newport Beach Page 9 of 10
6,34:26AM INSPI60 - Daily Inspection Request Report
Requested Inspection Date: 11/30/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 1431 BONNIE DOONE TER
+�iIOfC
Activity : N2017-0570
SubType :
Status : APPROVED
OWNER: BOGARD JOHN A Phone : O
APPLICANT: CHASE INC Phone : 714-914-6346
Description : Install sewer cleanout on existing sewer lateral per City Standard #406-L. Concrete
restoration per City Standards.
Item: 10110 CONCRETE PUBLIC WORKS
Requested Time: 11/30/2017 12:00:OOAM Requestor: WEBUSER
714 914-6346
Entered By: WEBUSER
Comments: AM -
Assigned to: 77777777777*
Inspector: \ Date: 36 ! 7 Time: AM PM
Comments:
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
Nyo1-7- 05-70
lq3l 80�441E DOVAIE reR
P&PJA 0 PAV \14
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llq -9lq4w 6344
Inspector: Date: Z & Time: A PM
Comments: G%1/1/� r C�'�'�' /� :57r/,) —%
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