HomeMy WebLinkAboutN2018-0024„w►►,.„�� City of Newport Beach I II I III IIIIIII II II II I IIII
100 Civic Center Drive, Newport Beach, CA 92660 II N 2 0 1 8 0 0 2 4
Permit Counter Phone (949)644-3311
Online Inspection Request - www newportbeachca.gov / Online
Services
Job Address : 2240 UNIVERSITY DR NB Thomas:Guide
Description . NEW 6” UG FIRE LINE FROM EXISTING 8" ON SITE WATER MAIN TO NEW 4" SPRINKLER RISER.
Parcel # : 4394-010-2 -
Legal Desc : P M 176-42 PAR 3 POR OF PAR
Owner: JDG ENTERPRISES LLC
Phone: 0
Address : 2240 UNIVERSITY DR #200
NEWPORT BEACH, CA
Applicant: PACIFIC FIRE SUPPRESSION INC
Phone: 714-502-0211 [
Address : 1010 N BATAVIA #318
ORANGE CA 92867
Special Cond.: PRE -CONSTRUCTION MEETING 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 :
$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
Date
Date
Date
Date:
Permit No: N2018-0024
Project No : 2828-2017
Inspection Requests Phone (949)644-3255
889D2
Contractor : PACIFIC FIRE SUPPRESSION INC
Phone: 714-502-0211
Address : 1010 N BATAVIA #318
ORANGE CA 92867
Contractor State Lic: 423418
License Expire : 11 30, 2019
Business License :
BT03042109
Business Expire :
03 31, 2018
Workers' Compensation Insurance - -
Carrier :
EVEREST NATIONAL
Policy No:
5300001686
W. C. Expire:
09 17, 2018
Total Fee $571.00
Paid : $571.00
Balance : $0.00
Receipt No .
Other Department : Date
Permit Denied Date
Issued Permit : Date
.a
1y'r g,
COMPLETE THE BELOW INFORMATION
PROJECT ADDRESS:
DETAILED DESCRIPTION OF PROPOSED WO
W U11
APPLICANT: (`
Phone: 2 dZ
Email Address:
A,;) 14crg
Mailing Address: i
2 Sty e
J.CilState/Zip:
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OWNER: TLUMIMVIVAPhone:
Email Address:
Mailing Address:
City/State/Zip:
>. .i: CO[rFTR�k,CTOR� W ;0FUMT lit IS E COMPLETE
CONTRACTOR:'
7wy&I
Office Phone:
Company (if different):
Jobsite Phone:
Other Phone:
Email Address:
Mailin Address:
un
City/State/Zip:
-
State License Number & Class: ,/�
Expires 3o f I
City Busi s License Number:
Expires:
WORKERS COMPENSATION RAIJCE - Certificate of Insurance (Section 3800 Labor Code)
Compan kQ WbortalPolic No:
Municipal Oerations: 949-644-3055
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
FOR OFFICE USE ONLY
Special Conditions of Permit:
ADOMONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
Municipal Operations
Traffic: Fire:
Other:
Engineerin echnician:
VA-t
Perm i ialist
Date-
IN2018-
Permit No.
CCC�4
3
f /users/pbw/shared/encroach/masters/epworksheet As �
Public Works Department 949-644-3311
100 Civic Center Drive, Newport Beach, CA 92660
Ati Fees Are
2.24o Vwa ve,*%�}1 'Pr;ve
,PPLICANT:
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
Otherwise Stated
NUMBER: N2018- c
Inspection Fee:
$241. 1 Public Works Field Inspection $165.0 A
$275. 0 Utilities Field Inspection $121.00
General Services Inspection $165.00
Water Quality/Artificial Turf Inspection $108.00
$817.00
$192.00 Refundable Deposit: TBD
$502.00 Improvements TBD
Street/Alley/Walk Closure: $65.000 Newspaper Rack Inspection $108.00
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 _q
I TFOIN LLOWG ITEMS REQUIRE APP
HEROVAL FROM THE Revenue Division 1
I REVENUE DIVISION PRIOR TO PAYMENT OF FEES ]Approval: I
I
may-
, QtY-
1Water Meter:
Installation Charge $528.00 1
13/4" Meter
$50.25
1
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 B
12" Meter
$425.00
12" Turbine Meter
$845.00
13" Meter
$3,310.00
�4" Meter
$4,730.00
1
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 mount Due:
For Finance Use Only
Permit Sp c'
Receipt No.
f /users/pbw/shared/encroach/masters/ep front and back masters/
Rev 12/18/2017
epfeesheet xis -revised 11/8/17
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
I 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
? 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 Stdnddrd Drawinys
of the City of Newport Beach, and in compliance with all applicable State laws and City ordinances
1 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
3 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
3 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 0e 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
3 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 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 s If-*��tsur C rtific of Worker's
Compensation Insur�nl or a Certified Copy thpr �, ,J
Date`
Signature:
CERTIFICATE OF EXEMPTION (SeAtIon 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 949-644-3311, /
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 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 VVork-,
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 a o)odedges he/she has re er t s 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. j
Permit fees are nonrefundable. Datei, Ii_ _Signature: _^_._
7;5/2018 City of Newport Beach Page 3 of 11
6:34:40AM INSP150 - Daily Inspection Request Report
Requested Inspection Date :
07/05/2018
Inspection Type:
ENCROACH
Inspection Area :
PW
Site Address :
2240 UNIVERSITY DR
A/P/D Information:
Activity : N2018-0024
SubType : NEW
Status : APPROVED
OWNER: JDG ENTERPRISES LLC Phone: 0
APPLICANT: PACIFIC FIRE SUPPRESSION INC Phone : 714-502-0211
Description : NEW 6" UG FIRE LINE FROM EXISTING 8" ON SITE WATER MAIN TO NEW 4"
SPRINKLER RISER.
Requested Inspection(s)
Item: 10200 PRE JOB - PW
Requested Time: 7/5/2018 12-00:OOAM Requestor: WEBUSER
7147970763
Entered By: WEBUSER
Comments: AM -Contact: Hugo
Assigned to : zzzzzzzuu'` n C
7-0/1 `iv 4'r
1 7/12/2018 City of Newport Beach Page 6 of 17
6:34:29AM INSP150 - Daily Inspection Request Report
Requested Inspection Date :
07/12/2018
Inspection Type:
ENCROACH
Inspection Area :
PW
Site Address :
2240 UNIVERSITY DR
A/P/D Information:
Activity : N2018-0024
SubType : NEW
Status : APPROVED
OWNER: JDG ENTERPRISES LLC Phone: 0
APPLICANT: PACIFIC FIRE SUPPRESSION INC Phone : 714-502-0211
Description : NEW 6" UG FIRE LINE FROM EXISTING 8" ON SITE WATER MAIN TO NEW 4"
SPRINKLER RISER.
Requested Inspection(s)
Item: 10215 ROUGH UTIL
Requested Time: 7/12/2018 12:00:OOAM Requestor: WEBUSER
7147970763
Entered By: WEBUSER
Comments: AM -HYDRO INSP- FIRE DEPT ARR. 11/12PM
Assigned to: zzzz zzzzzz*
/ f
Inspector: Date: Ao 4w Time: AM PM
Aff
Comments:
F \Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet doc