HomeMy WebLinkAboutN2018-0462r.w,„4 City of Newport Beach *N2018-0462*
Z � - 100 Civic Center Drive, Newport Beach, CA 92660
n Permit Counter Phone (949)644-3311
Online Inspection Request - www newportbeachca.gov / Online
c• Services
Job Address :
1521 KINGS RD NB
Description .
Pothole to repair damaged CAN conduit Pavement restoration per City Standards.
Parcel # :
0492-221-7 -
Legal Desc :
N TR 1219 BILK E LOT 42
Owner:
SENICK JOHN
Phone:
0
Address :
888 W CROWTHER AVE
PLACENTIA, CA
Applicant: CHARTER COMMUNICATIONS
Phone: 714-709-3388 [
Address : 7142 CHAPMAN AVENUE
GARDEN GROVE. CA 92841
Special Cond. :
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
$165 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
Permit No: N2018-0462'
Project No
Inspection Requests Phone (949)644-3255
Thomas:Guide: 88y��
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i'
Contractor : VIDEO VOICE DATA COMMUNICATIONS
Phone : 714-897-6300
Address : 12681 PALA DRIVE
GARDEN GROVE, CA 92841
Contractor State Lic: 821598
License Expire : 07 31, 2019
Business License:
BT30048732
Business Expire :
10 31, 2018
Workers' Compensation Insurance - -
Carrier :
HDI GERLING - AMERICA INSURANC
Policy No:
EWGCC000224716
W. C. Expire:
11 14, 2018
Total Fee
$406.00
Paid :
$406.00
Balance :
$0.00
Receipt No:
Q
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
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 fie 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 I 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 Stale 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 sel in rtificate of Worker's
Comply that
'on have
a Certificate
or a Certified Copy t
Date: 1 Z� Signatur
CERTIFICATE OF EXEMPTION (Se cin 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 Insp cti W.
Public Works at 949-644-3311.
15 Any above ground utility facilities will require docume e approval from the adjacent
affected property owner(s)
16 Homeowner, contractors, and subcontracolrs 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 Weer
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. er relocated
without approval from the General Services Department.
19 All work in the public right-of-way must meet the approval of the Public \Nork;
Department or corrections will be required (i e removals, exposing connectic,,is,
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 §hall be performed until the Public Works Department has issued this permit. Applicant hereby a 51nowlIedges he/she has read a nit stands 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. q�
,tly
Permit fees are nonrefundable. �,,,,.r V." , Date: _[ l iignaturet
�p-
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All Fees
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>°� �. w�Y.Al:1:�;ah�fi:.£<'��:t-W�i�.r�• (__as's�.�;'.:,�_��.�.�.3�-.�c�:z:�'<i:�:•�iwir����i'.�'�s+:�'�:,'. •�
Are • • • Otherwise Stated
PROJECTADDRESS:
•
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Permit Processing Fee: Q
Public Works Only $241.00 I
Other Department $275.00
Agreement Fee:
Preparation of Report/Agreement $817.00
Document Recordation Fee $192.00
Monitoring Wells $502.00
Inspection Fee: Qty.
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/AlleyfWalk 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
Additional
I THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE ]Z;erurDivision I
i REVENUE DIVISION PRIOR TO PAYMENT OF FEES Approval: 1
[Water Meter:
Installation Charge
-$52e-lzi [
13/4" Meter
$50.25
t wp3, pp
11" Meter
$121.50
Water Meter Boxes:
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
14" Meter
$4,730.00
0" Meter
$7,190.00
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 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
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Receipt No.
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;,'8/2018 City of Newport Beach Page 1 of 8
' 6:34:18AM INSP150 - Daily Inspection Request Report
Requested Inspection Date : 09/28/2018
Inspection Type : ENCROACH
Inspection Area : PW
Site Address : 1521 KINGS RD
A/P/D Information:
Activity : N2018-0462
SubType :
Status : APPROVED
OWNER: SENICK JOHN Phone: 0
APPLICANT: CHARTER COMMUNICATIONS Phone : 714-709-3388
Description : Pothole to repair damaged CATV conduit. Pavement restoration per City Standards.
Requested Inspection(s)
Item: 10050 EXCAVATION- PW
Requested Time: 9/28/2018 12:00:OOAM Requestor: NBIVR
5622127697 - c kA121-I
Entered By: NBIVR
Comments: AM
Assigned to
W
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Reffle
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1501( lZin6ezo Rt�
P JoJ P INA4o,-
Inspector: Date: 1*130 Time:
Comments:
AM PM
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