HomeMy WebLinkAboutN2018-0125�.lo.2V
"wk�lv� ,City of Ne 100 Civic pport Beach rive, NewportBeach, CA 92660 II I IIIII IIIIIIII I III III,IhII I II Permit No: N2018-0125
in Permit Counter Phone (949)644-3311 Project No
Online Inspection Request - www.newportbeachca.gov / Online
ry �k4 4;, Services
Inspection Requests Phone (949)644-3255
Job Address : 1228 RUTLAND RD NB
Thomas:Guide: 889B5 ^�
Description : replace gas service from meter to property line.
Parcel # : 9341-803-4
Legal Desc : TR 8638 LOT 1 UNIT 34 OF PROJECT LOCATED ON AP 425-081-07
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TOGETHER
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ANNED
SCANNED
Owner: KINKEL ESTELLE H
Contractor : BUTIN'S PLUMBING
Phone : 0
Phone : 714-670-1900
Address :
Address : 15762 HARSHAW PL
LA MIRADA CA 90638
Contractor State Lic: 841262
Applicant: BUTLIN'S PLUMBING
License Expire : 06 30, 2018
Phone : 714-620-1900 [
Address : 15762 HARSHAW PL
LA MIRADA, CA 90638
Business License : BT30062504
Business Expire : 03 31, 2019
Special Cond.:
Workers' Compensation Insurance - -
Carrier : OHIO SECURITY
Policy No: XWS57764765
W. C. Expire: 02 28, 2019
Permit Processing Fee :
$241.00
Sewer Connection :
$0.00
Total Fee
$406.00
Agreement Fee :
$0.00
4TT Box Cover:
$0.00
Paid :
$406.00
Traffic control Plan Check :
$0.00
Total Water Meters :
$0.00
Balance :
$0.00
Inspection Fee :
$165.00
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:
Date . _/_/
Other Department :
Date:
Utilities Approval :
Date . _/_/
Permit Denied
Date
Traffic Approval :
Date . _/_/
Issued Permit :- `i 3
Date
General Services Approval :
Date: _/_/
ALL UNDERGROUND WORK SHALL BE PERFORMED BY A LICENSED CONTRACTOR I
Contact "Underground Service Alert" At Least 48-Hours in Advance of Any Excavation at 800-422-4133 "'1-
TERMS AND CONDITIONS OF ENCROACHMENT PERMIT
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
1 he Permitlee 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
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
Perrnittee 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
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 Imes a valid State Contractor License Class C-34 is required For construction or
connection to sewer Imes a valid State Contractor License Class C-42 is required
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
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 backtilling, 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.
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 VCP or PVC SDR35 be used with a
41-T box over the riser
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
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
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
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
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
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
fernporary Street Closure Pernul must be obtained from the Public Works Department
WORKER'S COMPENSATION INSURANCE (Se Vabode)
I certify that I have a Certificate of consent to se s f rker's
Compensation Insurance, or a Certified Copy th o
Date: c J�l511t/ 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 requir calling
Public Works at 949-644-3311.
15, Any above ground utility facilities will require documented ap roval 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 $25,000 and/or up to three years in State
prison plus the full cost to clean up an illegal discharge or spill
17, If a refundable deposit was paid, applicant must submit a Soils Compaction
Certificate or Evidence of a Slurried Backfill and request a final inspection from the
Public Works Department. Monies may be held for six months after final inspection
before a refund will be processed.
18, No trees in the public right-of-way shall be planted, removed, trimmed, or relocated
without approval from the General Services Department.
19. All work in the public right-of-way must meet the approval of the Public Works
Department or corrections will be required (i.e. removals, exposing connections,
etc ). Additional inspection fees may be required.
20, Permit is for standard materials in the public right-of-way only, unless previously
approved by Public Works and an Encroachment Agreement has been processe .
21 Permit is valid for "description" of work noted on front only____AddAionXVVork
performed may require issuance of a separate per or addi}or
No work related to this encroachment permit shall be performed until the Public Works Department has issued this permit. Applicant hereby acknowledges he/she has read
conditions of this permit and he/she agrees to abide by them. Permit is void if work is not commenced within 30 days after Issu ce.
Permit fees are nonrefundable. � ►Dated, /4elle_ SlgnatureL- ,,
and
..
PROJECT ADDRESS:
DE A}}�ED DESCRIPTION OF_PROPOSED WORD:
05 10,41 X,/ 4�xl
APPLICANT: Phone:
Email Address: �,� S ��,, 4 , Cli/✓l
Mail"? ?� k
Ci /State/Zip: O f 7
!O J
OWNER Phone:
Email Address:
Mailing Address:
City/State/Zip:
WCONTRAQ_ TORAIN O tM T[Q �S'REQUIREQ P ;E k$E C�`O
CONTRACTOR:
4-14JS
Office Phone:
Company (if different):
Jobsite Phone:
Other Phone: ----
Email Address: / N ak"z a,i•-L
Mailing Address:
City/State/Zip /1
State License Number & Class:
Ex fires 0�
City Business License Number:
Expires:
WORKERS COMPENSATIJJN INSSUU"NCE - Certificate of Insurance (Section 3800 Labor Code)
Company: /itQ , C �' Policy No: Expires:
. .. . ........... ... ....... . . . .. ..... . . . . - .
REF(I14$}AB1.E:DEPOS1T INE:ORMA*TIQN.([F-.AO011Cabk •::::.- ::, .:.',:::.::: ,. _ . .
.
......... . .... . .. ..
IVtail.Refund; l o:..=: :. =.: - ::•::.::..:...:. :•... . . ..:• :.::...:.:...:• ::.....:.. -. .:.::: :::::::::.::.:. :::.:: •.
FOR OFFICE USE ONLY
Special Conditions of Permit:
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
General Services:
Traffic: Fire: 0
Other:
Engineering Technician:
loch
Public Works Specialist:
R.cd�
Date:
3-13-1$
Permit No. _
N?vi1-8�27
P/userspbw/shared/encroactVmasWs/epwoftheeLAS
Public Works Department 949-644-3311
Permit Processing Fee:
Public Works Only
Q
$241.00 !
Inspection Fee:
Public Works Field Inspection
Q .
$165.00
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:
TBDB
Monitoring Wells
$502.00
Improvements
TBD
Street/Alley/Walk Closure:
$65.00
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 Revenue Division 1
]Approval:
REVENUE DIVISION PRIOR TO PAYMENT OF FEES
1
1
Qhf-
QtY•, 1
(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
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
Qty.
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 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
mod;
0 H0lv.—
Permit Specialist
Receipt No.
f /users/pbw/shared/encroach/masters/ep front and back masters/
Rev 1 2/18/2017
epfeesheet xis -revised 11/8/17
1 /10/23, 6 05 AM
iPW-000714-2023-Manage Inspection
f►t,3k-
iPW-000714-2023 (1228 RUTLAND RD) Permit Number: N2018-0125
Details
No Title
`e Location
Added By
Additional
Julio Velasco • 01 /09/2023 13 I AM
Info
Note
OLD PERMIT INSPECTION
11 Inspectors (1)
Previous O,G -TV ttj ASS„ h LL P— V—
Inspections ��,�,P �t+�,ei (20,r f4Lr ^^
Checklist
Contacts (1)
Fees
( Time Tracker
IIf Files
Print
https films newportbeachca gov/energov_prod/manageinspection/#hnspection/b5ef9aed-55d8-4099-acde-051090c6855chnternal_notes
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