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Home My WebLink AboutN2018-0438qP City of Newport Beach I �IIII�II�IIIIII�IIIII�II��IIII�I�I �I�� 100 Civic Center Drive,Newport Beach, CA 92660 N 2 0 1 8 0 4 3 8Permit No:N2018-0438 Permit Counter Phone (949)644-3311 Project NoOnline Inspection Request - www newportbeachca gov / Online Services .`CANNED Inspection Requests Phone (949)644-3255 Job Address : 870 W 16TH ST NB Thomas:Guide: 888G5 Description : REPLACE GAS LINE FROM VAULT IN RIGHT OF WAY TO PROPERTY LINE AT 870 AND 872 WEST 16TH STREET 00 Parcel # - 4241-110-6 - Legal Desc : NEWPORT MESA TR LOT 912 POR OF LOT *�/ Owner: TRICO RENTS Contractor : KNOX BROTHERS CONSTRUCTIOIA - Phone : 0 Phone: 714-925 3770 Address : 3100-A PULLMAN ST Address : P O BOX 11312 COSTA MESA, CA COSTA MESA CA 92626 Applicant: TRICO RENTS Phone: [ Address Special Cond.: PRE -CONSTRUCTION MEETING REQ 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 : $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 Contractor State Lic: 580452 License Expire: 02 28, 2019 Business License : BT30064127 Business Expire: 08 31, 2019 Workers' Compensation Insurance - - Carrier : W/C EXEMPT Policy No : W. C. Expire: Total Fee $571.00 Paid : $571.00 Balance : $0.00 Receipt No. Date: _/_/ Other Department : Date : _/ / Date. _/_/ Permit Denied Date : _/_/ Date : / / Issued Permit : Date: // 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 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 Slate 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 feel of any City utilities, unless approved by the Public Works Department Locate and pothole existing City -owned utilities (ie 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 11 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 limes 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 Stale Highway's traffic or within the Slate 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: 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 949-644-331tl-� 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 Waier 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 Compac tics 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 inspect!un before a refund will be processed 18 No trees in the public right-of-way shall be planted, removed, trimmed, cr relocated without approval from the General Services Department 19 All work in the public right-of-way must meet the approval of the P;;blic Mork, Department or corrections will be required (I e removals, exposing connectloos, 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 rea a erstands he 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 Issuanc p p Permit fees are nonrefundable. 7,Datc: COMPLETE THE BELOW INFORMATION PROJECT ADDRESS: — DETAILED DESCRIPTION OF PROPOSED WORK: (5 U r .'I-t-t 'C r fir, e �r ,I 2 C"'s 6" -;�b' ��s elet �n n e c g.a ! •'? -11, ,�,� 2 -1{r J C rk- G� r C�� L) �. APPLICANT: �� ,' (� Phone: Email Address: Mailing Address- 3 /oc — A Po 1 I (► oA Ciyy/State/Zip: �- /"C-f C- OWNER:— (, � c o RJC W vr'(" t Phone: %/V — %S/ Email Address: ran , c, ( C ,, M Mailing Address: 3/ av -A S 4- - Ci�Y/State/Zip: Cis M F1 �� 2 At CONTRACTOR INFORMATION IS REQL tED-PLEASE COMPLETE - CONTRACTOR: rt, C C"n Office Phone: / - 77 / — /<J Company (if different): Jobsite Phone: Other Phone: Email Address: L,_�4Cje L/ cZp (, � M ling Address: � % c, r o /e ( e. � /State/Zip: C CMr �� (t 4— (f ln I ( '7>•-j> -',- State License Number & Class: Expires: CiMr usi icense Number: C? �6 q / 2 Expires: U 3( WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code) Company: Policy No: Expires: MunicipalOperations: 949-644-3055 Utilities: 949-644-3011 Urban Forestry: 949-644-3083 - FOR OFFICE USE ONLY Special Conditions of Permit: ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS Utilities: Municipal Operations Traffic: 0 Fire: 0 Other: Engineering Technician: Permit Specialist Date: Permit No. N2018- bz� 3 S' f /users/pbw/shared/encroach/masters/epworksheet xls Public Works Department 949-644-3311 100 Civic Center Drive, Newport Beach, CA 92660 AW Gas Line Replacement 1.) Dig up existing gas line that is marked in RED 2.) Install 2 New 111 Gas Mains for Gas Vault to Building 3.) Connect building to meters in Gas Vaults SMORNAL NO 1 _ v' Y YNOMP11Y. •W. MwIMY "Avow* dWL W R6UUM0 •'71W MAR 1N Alli 4MMM . �Y+L OtN�1A0 Rii*IML M 4W 1UYM g _ ALL WOO/0"W* w Ow" O AVIV. "A& 10 cll�t� 7 _ MMMIO AM /MO11 dWW, M. MA WW MAMA ASV 4I0Mf "WYWYL 1W a#"* M/.�C♦ '�T 'PIi��•%i 4 /11�iI,�MK vY{,�IAV40 pa HMtL AN AMMO • tWR WYMMb6faw"fin mom UMO) AWD RtaotdM. (MIMCMMIMA} • MM. r1AMVM MNk i IMM Of ON" AT 0AW My - i1 _ Ail OW66 OF IOW Off.W O W" Mt ALA" W M #K*V W TOWA6 WW d~ . AIL MkI/TM* WOUtAftOW M 11M tWOR&M of QW Offten v 0 10 M>♦1104MI IkAL11 A O MMIMAW K W& O 7 _ " wl"& IIHtN WMiYM• 1D 106Atlk MIIAAl K 06UH 0 AIR M/MWP Of A" RK1~ MaM/MKR4 AID AT ARI.r W M" AWA#A WT MIIMR,iMNMY WtY W of" lIIOaMO _ k4MT ALL MrIM f" AMD ~ W4^L1.4 ^Mr. M>,Pt —.— FE- 0 —.� . 10/1!2018 City of Newport Beach 6:34:48AM INSP150 - Daily Inspection Request Report Requested Inspection Date : 10/01/2018 Inspection Type: ENCROACH Inspection Area : PW Site Address : 870 16TH ST W A/P/D Information: Activity : N2018-0438 SubType : Status : APPROVED OWNER: TRICO RENTS Phone: 0 Page 1 of 5 Description : REPLACE GAS LINE FROM VAULT IN RIGHT OF WAY TO PROPERTY LINE AT 870 AN 872 WEST 16TH STREET Requested Inspection(s) Item: 10200 PRE JOB - PW Requested Time: 10/1/2018 12:00:OOAM Requestor: NBIVR 7144542701 Entered By: NBIVR rT- Comments: AM Assigned to : 1002018 City of Newport Beach Page 4 of 11 6:34:55AM INSP150 - Daily Inspection Request Report Requested Inspection Date : 10/02/2018 Inspection Type: ENCROACH Inspection Area : PW Site Address : 870 16TH ST W AMID Infonfnation: Activity : N2018-0438 SubType: Status: APPROVED OWNER: TRICO RENTS Phone: 0 Description : REPLACE GAS LINE FROM VAULT IN RIGHT OF WAY TO PROPERTY LINE AT 870 AN 872 WEST 16TH STREET Requested Inspection(s) Item: 10210 PUBLIC WORKS Requested Time: 10/2/2018 12:00:OOAM Requestor: NBIVR Entered By: NBIVR Comments: AM Assigned to: J \1 (0j Z' it, 7144542701 C"/.0 Tr— , ,i r ?1C I 020ts W. 043b f6�0 W. 14rg pN/ PttvJAI, Inspector: Date: 3 Time: AM PM Comments: U ZWr o zz LZ C z zy .2. F \Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet doc