HomeMy WebLinkAboutN2018-0121City of Newport Beach IIIIIIIIIIIII IIII III IIIIII IIIIIIII IIIIIIIIIII Permit No: N2018-0121
}+t 100 Civic Center Drive, Newport Beach, CA 92660 N 2 0 1 8 0 1 2 1
n Permit Counter Phone (949)644-3311 Project No
Online Inspection Request - www.newportbeachca.gov / Online
Services
r�`""1 Inspection Requests Phone (949)644-3255 .
Job Address:
1 PUBLIC ROW NB Thomas:Guide:
Description :
Install 3'x5' CAN vault in parkway, replace existing 17"x 30" CAN lowboy with a 2'x3' CATV lowboy and pull fiber through existing Cox conduit.
Parcel # :
Legal Desc :
Owner:
CITY OF NEWPORT BEACH Contractor :
SOURCE BROADBAND SERVICES
Phone:
Phone:
909-720-7533
Address :
Address :
13900 SYCAMORE WAY
CHINO, CA 91710
Applicant: COX COMMUNICATIONS
Phone : 310-265-5875 [
Address : 27121 TOWNE CENTER DR
FOOTHILL RANCH. CA 92610
Special Cond.: Traffic control per WATCH.
Contractor State Lic: 908128
License Expire : 12 31, 2019
Business License :
BT30060574
Business Expire :
09 30, 2018
Workers' Compensation Insurance - -
Carrier :
STARR INDEMNITY & LIABILITY CO
Policy No:
1000002267
W. C. Expire:
06 29, 2018
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 : 1"' f� .i
Date
General Services Approval :
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- Ji21
?vW.0 Ra�1
NUMBER:
APPLICANT:
Co>~ Carnw,�,ni to�kvtS
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
$192.00 Refundable Deposit:
$502 00 Improvements
StreeVAlley/Walk Closure: $65 00E---] Newspaper Rack Inspection
Traffic Control Plan Check
8-1/2" x 11" $65.00 Sewer Connection Fee
24" x 36" $143.001 1 4TT Box & Cover
Additional
I
THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE T
REVENUE DIVISION PRIOR TO PAYMENT OF FEES
Q.
$165 00
$121.00
$165.00
$108 00
TBD
F��
TBD
$108.00
$250.00 B
$64.00
---
venue Division I
Qty.
QhL• , 1
(Water Meter:
Installation Charge $528 00. 1
13/4" Meter
$50 25
1
11" Meter
$121.50
Water Meter Boxes: 1
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
$3,310.00
14" Meter
$4,730.00
6" Meter
$7,190.00
MISCELLANEOUS
FEES
Certificate of Compliance Fee (+100% of hrly over 3 hrs) $288 00
Development Services Fee (Plan check hourly) $155.00
Final Tract Map Checking Fee $2,488.00
Final Parcel Map Checking Fee - Moderate $2,488 00
Lot Line Adjustment Fee $1,079 00
Park Dedication Fee Zone TBD
Street Easement/Vacation Fee (+100% of hrly over 4 hrs) $1,022 00
Street Tree Fee ($700 Planting Fee) TBD
Qty.
Budget Number
5200-5029
5200-5015
5200-5026
5200-5027
5200-5028
405-470_
5200-5031
030-2284
Engineering Tech:
Total Amount Due:
For Finance use only
2.od-I
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Permit Specialist
Receipt No.
f usersipbwlsnared/encroaCWrrastersiep front and back Tasters/
Rev 12/18120171
lefeesheet As -revised 1'/8/17
( NZONB30 )
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
PROJECT ADDRESS: On Ridge Park Rd, southwest of Tesoro
DETAILED DESCRIPTION OF PROPOSED WORK:
Place 3'x5' vault in grade; R/R (1) 17"00" lowboy with a 2'x3' lowboy.
& Rope and pull fiber through existing Cox randidt
APPLICANT: Cox Communications Phone: 310-265-5875
Email Address: sin a.muckenfuss@cox.com
Mailing Address: 27121 Towne Centre Dr City/State/Zip: Foothill Ranch, CA 92610
OWNER: See above
Phone:
Email Address:
Mailing Address:
City/State/Zip:
ALL CONTRACTOR INFORMATION IS REQUIRED -PLEASE COMPLETE
CONTRACTOR:
Office Phone: (909) 720-7533
Company (if different):
Source Broadband
Jobsite Phone:
Other Phone:
Email Address:
Mailing Address:
13900 Sycamore Way
City/State/Zip:
Chino, CA 91710
State License Number & Class:
908128 A, C-7 Expires. 12/31/19
City Business License Number:
BT30060574 Expires: 9/30/18
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company:Starr Indemni & LiabilityCompany Policy No: 1000002267 Expires: 6/29/18
REFUNDABLE DEPOSIT INFORMATION (If Applicable): "-
Refund Payable To: Sirta MuckenfUSS, Cox Communications
Mail Refund To: 3415 Kashiwa St, Torrance, CA 90505
FOR OFFICE USE ONLY
Special Conditions of Permit: pe, - WazCH
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOWING DEPARTMENTS
Utilities: Traffic: Fire:
General Services: Other:
Engineering Technician: Public Works Specialist: Date: Permit No.
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Public Works Department 949-644-3311
Project# 41005180315NZONB30
12 Cavalleri (work located at Ridge Park Rd, southwest of Tesoro)
Cox Planner: LISA MARCAURELLE
LISA.MARCAURELLE CCOX.COM 619-906-2652
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Contractor to have partial lane closure (width 8' closure) in
immediate vicinity of work shown, as per WATCH manual or
MUTCD, latest edition.
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Project# 41005180315NZONB30
12 Cavalleri (work located at Ridge Park Rd, southwest of Tesoro)
Cox Planner: LISA MARCAURELLE
LISA. MARCAURELLE@COX.COM 619-906-2652
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WNW REMOVE EXISTING CATV
17"X30" LOWBOY; REPLACE
r W/ A CATV 2'X3' NODE
a v� LOWBOY
R/O/W at 5' back of SW
Place CATV 3'X5 VAULT
Contractor to have partial lane closure (width 8' closure) in
immediate vicinity of work shown, as per WATCH manual or
MUTCD, latest edition.
RIDGE PARK DR
I/-. .Zoig -o/a /
r '40 1
ORA
Inspector: Date: //# �� Time: AM PM
Comments:
F \Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet doc