HomeMy WebLinkAboutN2017-048617, Wj.r,4r City of Newport Beach _t� +100 Civic Center Drive, Newport Beach, CA 92660 111111111111111111111111111111111111111111111111111111
N 2 0 1 7 0 4 8 6
Permit Counter Phone (949)644-3311
Online Inspection Request - www.newportbeachca.gov / Online
Services
Permit No: N2017-0486
Project No : 1432-2017
Inspection Requests Phone (949)644-3255
Job Address:
2415 FRANCISCO DR NB
Thomas:Guide: 889B3
Description :
PLUG EXISTING DRIVE APPROACH PER STD 165-L AND CONSTRUCT NEW APPROACH PER STD 162-L
Parcel # :
4260-211-4 -
LegalD
12
Owner:
SUN DONA DT
COMPLETED Contractor: KISLING DONOVAN M
Phone:
714-335-5200
Phone:
Address :
2415 FRANCISCO DR
Address : 25571 VESUVIA AVE
NEWPORT BEACH CA 92660
MISSION VIEJO CA
Contractor State Lic: 873678
Applicant:
KISLING DONOVAN M
License Expire: 03 31, 2018
Phone :
[
Address :
25571 VESUVIA AVE
MISSION VIEJO CA
Business License: BT30056485
Business Expire : 09 30, 2017
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation Insurance - -
Carrier : STATE FUND
Policy No: 91747727
W. C. Expire: 12 19, 2017
Permit Processing Fee :
$241.00
Sewer Connection :
$0.00
Total Fee
Agreement Fee :
$0.00
4TT Box Cover:
$0.00
Paid :
Traffic control Plan Check:
$0.00
Total Water Meters:
$0.00
Balance
Inspection Fee :
$330.00
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 :
Utilities Approval :
Traffic Approval :
General Services Approval
Date: / !
Date: / 1
Date : _/ /
Date : / /
$571.00
$0.00
$571.00
Other Department: Date
Permit Denied _ Date
Date
Issued Permit :
WORKSHEET
FOR ENCROACHMENT
-CITY OF: NEWPORT•BEACH -
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EXTITTAII-BEL:I o
PROJECT ADDRESS:
DETAILED ESCR PTIO OF PROPOSED O :
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APPLICANT:
Phone:
Email Address:
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City/St tealp:
OWNER:
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Email Address:
Mailing Adr � � �
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ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE COMPLETE
CONTRACTOR:7LraeOff
Ice P h o n &IWIA —
Company (if different):
Jobsite Phone:
Other Phone:
Email Address:
Malling d�ir f
WMj
City/State0p:
Sta a License : nse Number Clas
.g__ Expires:
City u Ines License Num r:
Expires:
ORKERS COMP N ATIO SU NCE - Certificate of insurance (Section 3800 Labor Code)
Company: Policy No: Expires:
`. ........ .............. ...... ....
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ROM:
FOR OFFICE USE ONLY
Special Condition Permit:
AA
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities: Traffic: Fire: C�
General Services: Other:
Engineering Technician:
PubSpecialist:
i s
Date:
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}� Public Works Department 949-644-33 1
Permit Processing Fee:
Public Works Only
Other Department
Agreement fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
$241.00M
$275.00
$817.00
$192.00
$502.00
Inspection Fee:
Public Works Field Inspection
Utilities Field Inspection
General Services Inspection
Water Quality/Artificial Turf Inspection
Refundable Deposit:
Improvements
Street/Alley/Walk Closure: $65.00r-----1 Newspaper Rack Inspection
Traffic Control Plan Check
8-1/2" x 11" $65.00 Sewer Connection Fee
24" x 36' $143.00 4TT Box & Cover
Additional
_ _ _
I
THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE R
I REVENUE DIVISION PRIOR TO PAYMENT OF FEES A.
Qty.
$165.00
$121.00
$165.00
$108.00
TBD eTBD
$108.00
$64.00 $64.00
------------
venue Division 1
(Water Meter:
134' Meter $50.25
11" Meter $121.50
11 1 /2" Meter $285.00
11 1/2" Turbine Meter $700.00
12" Meter $425.00
12" Turbine Meter $845.00
13" Meter $3,310.00
�4" Meter $4,730.00
16" Meter $7.190.00
Installation Charge $528.001i
Water Meter Boxes:
For Parkway & Sidewalk Area (Box + Cover = Cost
1" Meter: 13.00 + 37.00 $50.00
2: Meter. 27.00 + 61.25 $88.25
For Traffic & Alley Areas (Box + Cover = Cost)
1" Meter: 13.00 + 38.00 $51.00
2" Meter: 27.00 + 162.00 $189,00�
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 EasementlVacation 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
Permit S list Receipt No.
P1usenVpbwrstwad1encroedYma9arakp front and back masters/
Rev. 1/5/20171 1Waht..ft-remsdi iomnois
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 field 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 I icense Class A can perform any work in the public right-of-way For
construction or connection to water Imes 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 backfdling, 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 (w 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 It 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 roust be obtained from the Public Works Department
WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code)
I certify t t I have a Certificate of consent to self -insure, Certificate of Worker's
CoinVendo Insurance, or a Certified Copy h eof.
Date_ l�ignature:
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, 1 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 949-644-3311r / _ � r /C _
15 Any above ground utility facilitie�wll require documented approval from t Z. adja .nt
affected property owners)
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 $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 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, 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 Works
Department or corrections will be required (i.e. removals, exposing connections.
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;hail, be performed until the Public Works Department has issued this permit.-Applleant hereby.acknowledges he/she has r�ea d understands the terms and
conditions of this permit and he/she agrees to ablde by them. Permit is void if work Is not commenced within 30 days -after Issuance; : • � � vi �l Permit fees are nonrefundable. Dat Signature: �_ _. ^__ _ .-_ _T___
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CITY OF NEWPORT BEACH CASH RECEIPT
FINANCE DEPARTMENT
100 Civic Center Drive, Newport Beach, CA 92660
P.O. BOX 1768, Newport Beach, CA 92658-8915
Permit Number: N2017-0486 Plan Check Number: 1432-2017
Today's Date : Sep 25, 2017 Receipt Number: R000081409
Job Address: 2415 FRANCISCO DR NB
Description: PLUG EXISTING DRIVE APPROACH PER STD 165-L AND CONSTRUCT
Owner: SUN DONALD
Applicant : KISLING DONOVAN M
Date Paid : Sep,25,2017 02:49 PM Total Paid : $571 00
Notation: KISLING CONST
Initial: DE
Description Payment Type Check Number
Payment Credit Crd
FOR PLAN CHECKS ONLY:
TARGET DATE:
Card Type
VISA
Tendered
$571.00
For status, please log on to www.newportbeachca.-gov/building, and select PLAN CHECK STATUS or
call (949) 644-3255
NOTICE: PLAN CHECK EXPIRES 180 DAYS FROM DATE OF SUBMITTAL
4/20/2022 City of Newport Beach Page 10 of 10
6:30:18AM INSP15O - Daily Inspection Request Report
Requested Inspection Date : 04/20/2022
Inspection Type: ENCROACH
Inspection Area : PW
Site Address : 2415 FRANCISCO DR
AM/D Information:
Activity : N2017-0486
SubType : NEW
Status : APPROVED
OWNER: SUN DONALD Phone : 714-335-5200
APPLICANT: KISLING DONOVAN M Phone:
Description : PLUG EXISTING DRIVE APPROACH PER STD 165-L AND CONSTRUCT NEW
APPROACH PER STD 162-L
Requested Inspection(s)
Item: 10250 FINAL - PW
Requested Time: 4/20/2022 12-00:OOAM Requestor: WEBUSER
'9493742941'
Entered By: WEBUSER
Comments: 'ANY-'
Assigned to : MW
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