HomeMy WebLinkAboutN2018-0178City of Newport Beach I II I III II IIII III I IIIIII
100 Civic Center Drive, Newport Beach, CA 92660 II N 2 0 1 8 0 1 7 8
Permit Counter Phone (949)644-3311
1 n Online Inspection Request - www newportbeachca gov / Online
Services
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Permit No: N2018-0178
Project No -. SCANNED
Inspection Requests Phone (949)644-3255
Job Address :
4880 CAMPUS DR NB
Thomas:Guide: 859F6
Description
Remove and replace fire hydrant valve.
Pavement restoration per City Standards.
Parcel # .
4451-211-1 -
Legal Desc :
P BK 76 PG 45 PAR 4
Owner:
CARL KARCHER ENTERPRISES
Contractor : IRVINE RANCH WATER DISTRICT
Phone:
0
Phone: 949-453-5671
Address :
PO BOX 4349
Address : 3512 MICHELSON DRIVE
ANAHEIM, CA
IRVINE, CA 92612
Contractor State Lic:
Applicant:
IRVINE RANCH WATER DISTRICT
License Expire
Phone:
949-453-5671 [
Address :
3512 MICHELSON DR
IRVINE, CA 92612
Business License
Business Expire:
Special Cond.:
Workers' Compensation Insurance - -
Carrier :
Policy No:
W. C. Expire:
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
$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 :
Utilities Approval .
Traffic Approval
General Services Approval .
$406.00
$406.00
$0.00
Date _/_/ Other Department . Date : _/_/
Date. _/_/ Permit Denied Date:
Date, / / Issued Permit
Date: / /
FEE WORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
All Fees Are Non -Refundable Unless Otherwise Stated
PROJECT ADDRESS:
PERMIT
N2018- O+`)
1411U i,3mpJs +)r,vE,
NUMBER:
APPLICANT:
10 BE COMPLETED BY PU9[IC WORKS DEPARTMENT
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
Q Inspection Fee:
$241.00 1 Public Works Field Inspection
$275.00 Utilities Field Inspection
General Services Inspection
Water Quality/Artificial Turf Inspection
$817 00
$192001 Refundable Deposit:
$502.00 Improvements
Qty.
$165.00 1
$121.00
$165.00
$108.00
TBD"TBD
Street/Alley/Walk Closure: $65.00Newspaper 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
F=1
Additional
THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE
REVENUE DIVISION PRIOR TO PAYMENT OF FEES lre7erurDivisionApproval:
I
Qty.
Q
(Water Meter:
Installation Charge $528.00"
13/4" Meter
$50.25
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
13"
$845.00
Meter
14" Meter
$3,310.00
$4,730.00
16" Meter
$7,190.00
uty.
tsuaget Numoer
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 EasementNacation 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
��yi
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Permit Specialist
Receipt No.
f /users/pbw/shareo/encroach/masters/ep front and oack masters/
Rev 12/18/2017
epfeesheet xis-revised'1/8/17
Almendralo, Rodi
From:
Omar Escobar <Escobar@irwd.com>
Sent:
Tuesday, April 03, 2018 8:41 AM
To:
Almendralo, Rodi
Cc:
Dave Crowe; David Perez
Subject:
Permit for 4880 Campus Dr.
Attachments:
UNIRPSENTI_(NEW) D40Construct - B_W Canon iR-ADV 4235 PCL_2686_001_1.pdf
Good Morning Rodi,
I would like to request an encroachment permit for work being done in front of 4880 Campus Drive. Our crew will be
replacing a fire hydrant isolation valve. I've attached maps of the area site of where the work is being done. We will be
using California Barricade for our traffic control. Please let me know if you have any questions.
Thank You,
Omar Escobar
Water Maintenance Tech III
Irvine Ranch Water District
3512 Michelson Drive
Irvine, CA 92612
Office 949-453-5671
Cell 714-905-4291
Fax 888-507-8955
escobar@irwd.com
I 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
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 Imes a valid State Contractor License Class C-42 is required
5 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
9 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 he 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 boy 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 1 Any wort: 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 AgNinsure, Certificate of Worker's
Compensation, lnsyrancg,pr a Certified Copy t eo . _
Date
Sign
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 P it Inspection is required by calling
Public Works at 949-644-33v / l l� i ,, " 7,
15 Any above ground utility facilities wM—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 Compaction
Certificate or Evidence of a Slurried Backfill and request a tinal 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 1PJork-,
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 ra7d
erstan 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. �y I li q n� �( /_Permit fees are nonrefundable. , . Datf U"u Slanaturi l/
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