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HomeMy WebLinkAboutN2018-0353. 10.19-3 City of Newport Beach III I III II IIIIIIIII I I II II w 100 Civic Center Drive, Newport Beach, CA 92660 II� N 2 0 1 8 0 3 5 3 Permit Counter Phone (949)644-3311 'x Online Inspection Request - www.newportbeachca.gov / Online Services Job Address: 1 PUBLIC ROW NB Thomas:Guide: Description : Install (2) 3'5" handholes and 189 LF of 4-inch duct (x2) on 15th Street east of Irvine Avenue. Parcel # : Legal Desc Owner: CITY OF NEWPORT BEACH Phone: Address Applicant: AT&T CALIFORNIA Phone: 714-618-9132 i Address : 3939 E. CORONADO ST, 2ND FLOOR ANAHEIM, CA 92807 Special Cond.: Pre -job inspection required 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 : $1.650.00 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 Phone: Address Permit No: N2018-0353 Project No : Inspection Requests Phone (949)644-3255 SCANNED `om , VCI CONS440 909-949-1350 1921 W 11TH STREET UPLAND CA Contractor State Lic: 765716 License Expire : 03 31, 2020 Business License: BT30060084 Business Expire : 08 31, 2018 Workers' Compensation Insurance - - Carrier : LM INSURANCE CORP Policy No: WA563DO42600 W. C. Expire: 01 31, 2019 Total Fee Paid : Balance: Receipt No $1,891.00 $1,891.00 $0.00 12.4 pro L>4 Other Department : -Date: _/_/ Permit Denied -Date: _/_/ 2s, tY Issued Permit: Date : _!_/ I 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 cut 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 Specidl 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 backfillmg, 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 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 VCR 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 S35 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: %- Z. - t i& Signature: CERTIFICATE OF EXEMPTION (Section kDO 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. n 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 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 Compa(tion 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 Work, 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 shall be performed until the Public Works Department has issued this permit. Applicant hereby acknowledges he/she has read an nderstands 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_Isuance. ? 23{ Permit fees are nonrefundable. Date: _"-_____d_ Signature: LE(19) A01A55F "BAU - Fiber" WORKSHEET FOR ENCROACHMENT PERMIT CITY OF NEWPORT BEACH PUBLIC WORKS DEPARTMENT COMPLETE E BELOW INFORUTION PROJECT ADDRESS: NEAR 1801 E 15th St, Newport Beach, CA 92663 DETAILED DESCRIPTION OF PROPOSED WORK: EXCAVATE 410 SQ FT IN DIRT TO PLACE 2 3X5 HANDHOLES & 189' OF 2-4e DUCT. APPLICANT: AT&T CALIFORNIA j Phone: (714) 618-9132 Email Address: vk3921@att.com -✓Valentina Gipson, AT&T Liaison Mailing Address: 3939 E. CORONADO ST, 2ND FLOOR ICity/SVate/Zip: ANAHEIM CA 92807 OWNER: Phone: Email Address: Mailing Address: City/State/Zip: ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE COMPLETE CONTRACTOR: Office Phone: Company (if different): Jobsite Phone: Other Phone: Email Address: Mailing Address: City/StatelZip: State License Number & Class: Expires: City Business License Number: Expires: WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code) Company: Policy No: Expires: REFUNDABLE, DEPOSIT INFORMATION (if Applicable): Refund Payable To: Mail Refund To: FOR OFFICE USE ONLY Special Conditions of Permit: ?-c-,uo ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS Utilities: General Services: Traffic: Fire: Other: Engineering Technician: Public Works Specialist: Date: t� Permit No. f/users,'pAnlsharedler oaWmrasterslep�vorksheet ds 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: PERMIT N2018- I Pvbtl c. Rom NUMBER: APPLICANT: A-r -T t;,ol,6v'0,0- 10 Est COMPLETED BY PUBLIC WORKS DEPARTMEN I Permit Processing Fee: Public Works Only Other Department Agreement Fee: Preparation of Report/Agreement Document Recordation Fee Monitoring Wells Q Inspection Fee: $241.00 Public Works Field Inspection $275.00 Utilities Field Inspection General Services Inspection Water Quality/Artificial Turf Inspection $817.00 fJ $192.00 Refundable Deposit: $502.00 Improvements Street/Alley/Walk Closure: $65.00F1 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 THE FOLLOWIN( ITEMS REQUIRE APPROVAL FROM THE R t REVENUE DIVISION PRIOR TO PAYMENT OF FEES AI Q $165.00 O $121.00 $165.00 $108.00 TBD TBD $108.00 0 $.00" $64 $64.00 venue Division QtY• - Qry (Water Meter: Installation Charge $528.00 1 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 1 11 1/2" Turbine Meter $700.00 2" DFW Meter Box $203.24 1 B 12" Meter $425.00 1 12" Turbine Meter $845.00 1 13" Meter $3,310.00 1 4" Meter $4,730.00 16" Meter $7,190.00 Certificate of Compliance Fee (+100% of hriy 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/VacationFee (+100%of Myover 4hrs) $1,022.00 5200-5031 Street Tree Fee ($700 Planting Fee) TBD 030-2284 Engineering Tech: Total Amount Due: For Finance use only 1►0 ' tg Pe7rmit Specialist Receipt No. Fo d1 f.tuserWpbw/sharetllenaoaWm teNeP front and back r Sters/ Rev. 12/18/2017 epfeesheec,as{ Ww tvem CONSTRUCTION N07£5 ' CITY OF NEWPORT BEACH Excavation Derail I... IlA TV 10R SrRVCIIJK 36' BELOL EnsTgo 189' x V x 2'= 378 sq. Itin dirVgrass GMOE OR JO' BELO GUTTER EL NF ' 3x5' Ur0LL TRENCH �'RRD:MIAmB� ER"FN OMnECORDS 15APWTOc q dirt/grass I�� PRO KRry0GR ANECT AS R[WRO O COnCeiE J BEFORE EXCAVATING CALL: O a. Teo' 2-4. DUCTS 0 asphalt 611"D LINE U.G. SERVICE ALERT Oil IVPL A. ALL TRAFFC CONTROL TO BE IN ACCOAL KE MRN 4C 1ELEnYJNE THE CJV.TC.u. ITOW AREA PROTECTION AHO '89' F9ER VAVLi TO P/L VERRY a OI TT4FTK CdTROt wNWL -ryA`RBIIR OS WR SECCfIPWY 5 TH5 PROECT RfWIRFS EXCAVATION. CONSTRUCTION O PL J'NS' INNg10LE T �1 pAq pRIWpE ll M, UI:L NC ANO MLE"EM AU BEST uAwGC"f.' pRAC1FE5 BNP'A AS RCOWREC TO EHSIJK CIO PLUNCF AC H 6 - N AT&T LIO LETTER ISSUES TEBRVAT 21 2003 MPO BY CMMONN[NT4 W.WGENENI CGNCCPNING O S MNNTNN A MINIMUM OF 12' FROM SiORU wATOT PERUITTNG AMO 510RU wATP, 1RENCX W/ ONER ALL OTHER TRENCH DCCI1PAWS T LVTI PREKNTXM' PIAN5 (SWFPq) ANO M B A SEE G D 128 ACCORrw+CE W K THE CLEAN WATER ACT i,965) AHV GIASWOT IM AS S1 L RUBUSTE 9EATHr PASE R N1 A G a wR M, a EXmw Rw s1GRs [I.- AEN[CT r m xnT AO .. CT. mK[[l,,.4rRT "ZaCS f V_LL,T,ER�g= NOO \, i R/L pF- 't—���� Y 2537 51' I i ( wig g W � 1807 E 75TH 57 E. I STH ST. 12 N O x �2 0 _ R/w _ + 387 3756' 146.3' Y 25 I 1601 E 15TH 57 _A � 1401 E iSTH 57 101 C0.00 C/L EST . mRMt p �O SCALE 1'- 20' AL Tq1 ERCE en LEABTDURING rAOvw w , OATC ANE I.'ONC DRAWING TO SCALE DO NOT REDUCE REPRODUCTION V / at&t California U.O. OLwION LAN" NCCM: L FWIUpP (I-) 6 Y-Z].T -VITANOC CNWINECR: 5 B,,MI,TTE (I1A) 618-9118 SCALE - 10 1. fi.M. B69-AS CO STI NEId L.O. REA INe PECT ANQ ACQI/INE RVa., INeceCTCR: C CASTENVA (714) WO-2226 uV W0201C OA 91OfOI ooNfRAOFoe r 1 CHCCONSUL7ING-ORF 16As W ae.p.Poe A»., wn" Jxa aP 9 . c. 916R (W9) i50-0WA /FAX (S49) 150-00� A,P6wsn �MrDj6 " LEf i 91 AO I A55F- OING. L- 1 — — " � . A OPL. 3'X5' HANDHOLE 4C OPL. 189' 2-4" DUCTS TYPE 4C= PM 189' FIBER VAULT TO P/L VERIFY OPL. 3'X5' HANDHOLE 4C 14 F. I 0 a 2' V-CUTTER R/w Excavation Detail 189' x 1' x 2'= 378 sq. ft. in dirt/grass 4' x 4' x 2= 32 sq. ft. in dirt/grass D concrete CURVE DATA tq R L A 25 4T 42 0 21.25 e n r 4�1{E - - � w 2.5' 37.57' y� I Y RY, AYE cI W i SF II e 1801 E 15TH ST + 9 TRENCH DETAIL TYPICAL GROUND LINE OT TELEPHONE QS PWR. SECONDARY © PWR. PRIMARY NOTE: , d � © S MAINTAIN A MINIMUM OF 12" FROM INDICATES-MNT ALL OTHER TRENCH OCCUPANTS. TRENCH W/ POWER SEE G.O. 128 E. 1 5TH ST. 12 — - I -- T- rll 103.87' U m aF o n m 1601 E 15TH S7 / O I 4 f i � 37.56' 2.5' &' I W J T a o = a6 t1 2' V-GUTTER R/IW 148.5' 1407 E 15TH ST CONSTRUCTION NOTES 1. MINIMUM COVER FOR STRUCTURE 36" BELOW EXISTING GRADE OR 30" BELOW GLITTER FLOWLINE 2. ALL SUBSTRUCTURE INFORMATION SHOWN WAS TAKEN FROM RECORDS AVAILABLE AND IS APPROXIMATE. VERIFY, LOCATE AND PROTECT AS REQUIRED. 3. BEFORE EXCAVATING CALL: U.G. SERVICE ALERT 811 4. ALL TRAFFIC CONTROL TO BE IN ACCORDANCE WITH THE C.J. U.T.C.M. WORK AREA PROTECTION AND TRAFFIC CONTROL MANUAL. 5. THIS PROJECT REQUIRES EXCAVATION. CONSTRUCTION WILL UTILIZE AND IMPLEMENT ALL BEST MANAGEMENT PRACTICES (BMP's AS REQUIRED TO ENSURE COMPLIANCE WITH AT&T POLICY LETTER ISSUES FEBRUARY 21. 2003 BY ENVIRONMENTAL MANAGEMENT CONCERNING STORM WATER PERMITTING AND STORM WATER POLLUTION PREVENTION PLANS (SWPPPS) AND IN ACCORDANCE WITH THE CLEAN WATER ACT (1965) AND EPA REGULATIONS PUBLISHED IN 1990 AS MODIFIED BY THE PHASE II RULE IN 1999. RECORDS NOTE TIES OF EXISTING PLANT SHOWN HEREON REFLECT ACTUAL CONDITIONS FOUND WRING FIELDING. CORRECT PERMANENT RECORDS. 10+00.00 C/L ST. ANDREW RD. F0+00 E.E 15TH ST. lO Q O SCALE 1": 20' COMMENCED 20— COMPLETED_2Q— RECONCILED DATE REVISIONS U.G. DESIGN ENGINEER: E. FUIIMORI (714) 669-2241 SCALE : 1 "- 20' NEWPORT BEACH EXCHANGE EXCHANGE ENGINEER: S. BESNEATTE (714) 618-9116 COSTA MESA C.O. AREA T.G.M. 889-A6 INSPECT AND ACQUIRE r%AT AL TOLL FREE DRAWING TO SCALE SUBWAY INSPECTOR: C. CASTENEDE (714) 669-2226 MAP / : FIELD PREPARED OS 15/18 W. IRRN sv DO NOT REDUCE at&t CONTRACTOR: pp CM0207C CHECKED 61 M.IMRCUELO LEAST TWO DAYS li� CHC CONSULTING AEFORE YOU DIG DURING REPRODUCTION 16 California 1845 W. C 92868od Ave., Suite 300 LEY 91 AO iASSF UNDERGROUND SEANCE ALFIiI CF SOUTHERN CALIFDNWA (949OrZ3e. CA 92868 (949) 250-0004 /FA% (949) 250-0006 DAA` 31D704 DWG. L-7 N20121 - 0353 7/24/2018 City of Newport Beach Page 1 of 14 4:30:30PM INSP150 - Daily Inspection Request Report Requested Inspection Date: 07/25/2018 Inspection Type: ENCROACH Inspection Area: PW Site Address: 1 PUBLIC ROW Activity : N2018-0353 SubType : Status : APPROVED OWNER: CITY OF NEWPORT BEACH Phone: APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Install (2) 3'5" handholes and 189 LF of 4-inch duct (x2) on 15th Street east of Irvine Avenue. Item: 10050 EXCAVATION- PW Requested Time: 7/25/2018 12:00:OOAM Requestor: NBIVR Entered By: NBIVR Comments: AM Assigned to: IZS / &V Date: Z � Time: A A Y PM Inspector: A-- n /J i i // _ / - - _ Comments: e F:\Users\PB\MShared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc REPT131 Run Id: 4018 i/27�201s City of Newport Beach Page 4 of 15 6:34:40AM INSP150 - Daily Inspection Request Report Requested Inspection Date : 07/27/2018 Inspection Type: ENCROACH Inspection Area : PW Site Address : 1 PUBLIC ROW "10 Information: Activity : N2018-0353 SubType : Status : APPROVED OWNER: CITY OF NEWPORT BEACH Phone: APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Install (2) TY handholes and 189 LF of 4-inch duct (x2) on 15th Street east of Irvine Avenue. Requested Inspections) Item: 10010 BACKFILL / COMPACTION- PW Requested Time: 7/27/2018 12:00:OOAM Requestor: NBIVR Entered By: NBIVR Comments: AM Assigned to J 84/2018 City of Newport Beach Page 3 of 24 6:34:04AM INSP150 - Daily Inspection Request Report Requested Inspection Date : 08/08/2018 Inspection Type: ENCROACH Inspection Area : PW Site Address: 1 PUBLIC ROW AM/D Information: Activity : N2018-0353 SubType : Status : APPROVED OWNER: CITY OF NEWPORT BEACH Phone: APPLICANT: AT&T CALIFORNIA Phone : 714-618-9132 Description : Install (2) 3'5" handholes and 189 LF of 4-inch duct (x2) on 15th Street east of Irvine Avenue. Requested Inspection(s) Item: 10060 PIPE INSTALLATION - UTIL Requested Time: 8/8/2018 12:00:OOAM Requestor: NBIVR Entered By: NBIVR Comments: AM Assigned to "^ 0 6 ' � � C ' Inspector: Comments: C) W 6 �-v�- Date: /- / 0 ' 2 3 Time: AM PM F \Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet doc