HomeMy WebLinkAboutN2018-0495City of Newport Beach III�IIIIIIII IIII IIII IIIIINIIIIIIIIIIIIIIIIIIIII Permit No: N2018-0495
100 Civic Center Drive, Newport Beach, CA 92660
H % Permit Counter Phone (949)644-3311 Project No '
a Online Inspection Request - www.newportbeachca gov / Online
r Services
Inspection Requests Phone (949)644-3255
Job Address 1 PUBLIC ROW NB Thomas:Guide:
Description Install 52 LF of 4-inch duct on 15th Street and alley between Catalina Drive and Santa Ana Avenue. Alley restoration per City Standards
Parcel # : SCANNED
Legal Desc
Owner: CITY OF NEWPORT BEACH Contractor : RASIC W A CONSTRUCTION COMPANY INC
Phone: Phone:
Address : Address : 7314 SCOUT AVENUE
BELL GARDENS CA
Contractor State Lic: 368761
Applicant:
AT&T CALIFORNIA
�,,
License Expire : 01 31, 2019
Phone :
714-264-7103
Address :
3939 E CORONADO STREET, 2ND FLOOR
ANAHEIM, CA 92807 "`
Business License : BT30064733
Business Expire : 10 31, 2019
Special Cond.:
Pre -job inspection required
Workers' Compensation Insurance - -
Carrier : TRAVELERS
Policy No: UB7K5207851826G
W. C. Expire: 07 01, 2019
Permit Processing Fee :
$257.00
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 :
$880.00
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 :
Total Fee
Paid :
Balance:
Receipt No:
$1,137.00
$1,137.00
$0.00
Q—g11TD
Other Department Date
i
Permit Denied Date
►O g l g
Issued Permit : 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
TERMS AND CONDITIONS OF ENCROACHMENT PERMIT
WORKER'S COMPENSATION INSURANCE (Section 3800 Labor Code)
1
Encroachment Permits may be taken out by the owner of benefited property or a licensed contractor A licensed
I certify that I have a Certificate of consent to set -� sure, Certificate of Worker's
contractor must provide a "Letter of Authorization" to allow another party to pull a permit An approved copy of the
Com en ation Insurance, or a Certified Cop th of.
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
Date:^C3� Signature:
after date of issuance
CERTIFICATE OF EXEMPTION (Section 3800 Labor Code)
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
I certify that in the performance of the work under this permit, I shall not employ
or damage to persons or property occurring as a result of work undertaken under this permit
any person so as to become subject to California Worker's Compensation Laws. If,
3
All work shall be done in accordance with the approved plans, Standard Special Provisions ind Standard Didwings
after signing this certificate I become subject to the Worker's Compensation
of the City of Newport Beach, and in compliance with all applicable State laws and City ordinances
provisions of the State Labor Code, I must comply with the provisions of Section
4
Permittee guarantees all work performed under this permit to be free of hidden and latent defects Any failures shall
3700 or this permit shall be deemed revoked.
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
Date: Signature:
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
CONTRACTOR LICENSE EXEMPTION
5
connection to sewer lines 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,
As the Owner of the benefiting property, I certify I am personally performing all
in the alley, where a minimum half -alley width resurfacing shall be provided, unless otherwise directed by the Public
work in the Public Right -of -Way.
Works Dept Contractors shall obtain permits to perform excavation or trench work from the California Division of
Date: Signature:
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
HOLD HARMLESS STATEMENT
7
The Public Works Department Inspectors must inspect all work in the Public right-of-way Forms and subgrade must
I understand that I am locating minor encroachments within the City Right -of -
be inspected and approved before concrete is ordered/poured Sewer, pipelines, and subgrade construction must be
Way/Easement. As property owner it is my responsibility to maintain the
inspected and approved before backfilling, or applicant may be required to excavate site Separate Utilities
encroachments. I will be responsible for replacing the improvements if the City
Department or General Services Department inspections may be required depending on scope of work performed
removes them for maintenance of utilities or other public need. I shall indemnify
8
All trench restoration must be inspected by the Public Works Department No utility installation(s) shall be allowed
and hold the City harmless for any liability associated with the minor
over or within 5 feet of any City utilities, unless approved by the Public Works Department Locate and pothole
encroachments.
existing City -owned utilities lie 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
Date: Signature:
4 VT box over the riser
24-hour notice for Encroachm t Permit Inspection is required by calling
9 Properly lighted barricades must be provided and maintained around all trenches excavations and obstructions All
"Manual
signs flags lights and other warning and safety devices shall conform to the requirements of the current of
Public Works at 949-644-3 1
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
IF
15 Any above ground utility facdi will require documented approval from the adjacent
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
affected property owners)
10
Work within or near beach sensitive areas will not be allowed during, City holidays, spring break Memorial Day
er
16 Homeowner, contractors, and subconlracotrs may each be liable for violations of Water
weekend, summer between June 15 and September 15, and during the holiday season from December 19 to
Quality Laws Best Management Practices will be enforced It is against the law to
I 1
January 1 unless approved tr the Public Works Department
Any work that extends into traffic or parking lanes and impedes the normal flow traffic requires the applicant to
discharge construction debris into the gutter and storm drain Felony violations of Water
acquire a temporary Street Closure Permit from the Public Works Department Access for fire, police and
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
codeposit
emergency vehicles must be maintained at all times Traffic Control must be per Work Area Traffic Control
17 If a refundable was aid, applicant must submit a Sods Compaction
p pP p
Handbook (WATCH) No nighttime traffic lane closures, unless prior approval has been granted Any lane(s) closure
Certificate or Evidence of a Slurried Backfill and request a final inspection from the
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
Public Works Department Monies may be held for six months after final inspection
will require a Cartrans Permit All vehicles shall be lawfully parked
before a refund will be processed
12
this penult does not authorize the closure of sidewalks streets, or alleys for construction access, storage of
18 No trees in the public right-of-way shall be planted, removed, trimmed, or relocated
materials, or parking of construction vehicles unless detailed on an attached Temporary Street Closure
without approval from the General Services Department
13
Applicant must notify USA at 1-800-227-2600 2 days before starting any underground construction. Applicant
19 All work in the public right-of-way must meet the approval of the Public Work,
must notify all affected residents 24 hours in advance of restricted access and any inconveniences
Department or corrections will be required (I e removals, exposing connections,
14
Refuse or unused materials shall be removed within 24 hours after completion of the work If not removed, the City
etc ) Additional Inspection fees may be required
may remove and bill the applicant Coordinate alley closures with City's refuse pick-up days by calling 949-644-3066
20 Permit is for standard materials in the public right-of-way only, unless previously
for the cnllection schedule so service is not interrupted To place a dumpster or materials in the public right-of-way, a
approved by Public Works and an Encroachment Agreement has been processed
Temporary Street Closure Pernid must be obtained from the Public Works Department
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 nowledges he/she has r d and �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 issuance.
Permit fees are nonrefundable. Date: - 00-6 -.Signature: - -- --
FEE WORKSHEET FOR ENCROACHMENT PERMIT
CITY OF NEWPORT BEACH
PUBLIC WORKS DEPARTMENT
All Fees Are Non -Refundable Unless Otherwise Stated
PROJECT ADDRESS:
I P,<c Row
PERMIT
N2018- O�i9�'
NUMBER:
APPLICANT:
R't •• "C Ca1��►rNQ
Permit Processing Fee:
Public Works Only
Other Department
Agreement Fee:
Preparation of Report/Agreement
Document Recordation Fee
Monitoring Wells
firrN Inspection Fee:
$257.00 1 Public Works Field Inspection
$293.00 Utilities Field Inspection
Water Quality/Artificial Turf Inspection
$871.00
$204.00 Refundable Deposit:
$535.00 Improvements
$176.00 3"
$129.0
$115.00
TBD
TBD
Street/Alley/Walk Closure: $70.00= Newspaper Rack Inspection $115.00
Traffic Control Plan Check
8-1/2" x 11" $70.00 Sewer Connection Fee $250.00
F=�
24" x 36" $152 00= 4TT Box & Cover $64.00
Additional _ _
THE FOLLOWG IS REQU INTEMIRE APPROVAL FROM THE Revenue Division 1
1 REVENUE DIVISION PRIOR TO PAYMENT OF FEES ]Approval: 1
IWater Meter:
Installation Charge $563.00
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 F-7 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
13" Meter
$3,310 00
14" Meter
$4,730.00
16" Meter
$7,190.00
MISCELLANEOUS
FEES
Qty.
Budget Number
Development Services Fee (Plan check hourly)
$165.00
5200-5015
Final Tract Map Checking Fee
$2,653.00
5200-5026
Final Parcel Map Checking Fee - Moderate
$2,653 00
5200-5027
Lot Line Adjustment Fee
$1,151.00
5200-5028
Park Dedication Fee Zone _
TBD
405-470_
Street Easement/Vacation Fee (+100% of hrly over 4 hrs)
$1,089.00
5200-5031
Street Tree Fee ($700 Planting Fee)
TBD
030-2284
Engineering Tech:
Total Amount Due:
For Finance use only
R"
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Permit Specialist
Receipt No.
.
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Rev 9/13/2018
epfeesheet As -revised 9113/18
PROJECT ADDRESS: ti emu b1� a c'ZvW
DETAILED DESCRIPTION OF PROPOSED WORK:
APPLICANT: Phone:
Email Address:
Mailing Address:
City/State/Zip:
OWNER:
Phone:
Email Address:
Mailing Address:
City/State/Zip:
exfr f �i�+r�L �iPLETE_
CONTRACTOR: t
C
Office Phone
Company (if different):
Jobsite Phone.
Other Phone:
Email Address:
Mailing Address:
Ci n/State/Zip:
C
St ate License NLYmber & Class:
Expires: -
City Business License Number:
Expires: : -a i -
ORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Compan (,_;v. rj �S,AVn Policy No: 0)gx Tres:
Municipal Operations: 949-644-3055
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
//FFMUSE V
Special Conditions of Permit:
ADDTTIVNAL APPROVAL REQWIIRED FROM THE FOLLOWING DEPARTMENTS
Utilities:
Municipal Operations
Traffic: Fire:
Other:
Engineering Technician:
R`.4:
Permit Specialist
,2od.:
Date:
�O'$-��
Permit No.
N2018- (JgRS'
t/users/pbw/shared/encroach/masters/epworksheetAs
Public Works Department 949-W-3311
100 Civic Center Drive, Newport Beach, CA 92660
EXCAVATION DATA
OWNER
ASPHALT
CONCRETE
DIRT
TUNNEL CURB
CITY OF
NEWPORT BEACH
32'X1'= 32 SO FT
14'X7'= 14 SO F7
3 LN FT
OPL. 52' 7-4" DUCT
TYPE
4C PM
52' EXIST HH TO POLE J/ 643948H, VERIFY
10+00 00 CIL CATALINA DR
10+00 DO CIL E 15TH ST
BO� '9•pr yF
/ L F1 �v
POLE # 643948H
ry
FOC
PLACE 1-4" DUCT
CURVE DATA
R L
A 1250' 8741'77" 19.13'
B 3' 1 901 1 4 71'
i
1,p�1'cl, CLl
d
px
,
'�4
3
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CONSTRUCTION NOTES
1 MINIMUM COVER FOR STRUCTURE 36" BELOW EXISTING
GRADE OR 30" BELOW GUTTER 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 7990 AS MODIFIED
BY THE PHASE II RULE IN 7999
RECORDS NOTE TIES OF EXISTING PLANT SHOWN HEREON
REFLECT ACTUAL CONDITIONS FOUND DURING RELDING
CORRECT PERMANENT RECORDS
4
c/ V
a
SCALE 1"= 20'
COMMENCED_ 20_ COMPLETED- 20 RECONCILED
rQAT
DATE REVISIONS U G DESIGN ENGINEER E FUJIMORI (714) 669-2247 SCALE 1"= 20' NEWPORT BEACH EXCHANGE
09 25 18 REV1-REVISE PER CITY COMMENTS-CLH COSTA MESA C O AREA
EXCHANGE ENGINEER C AKIN (714) 618-9111 TGM 888-J5 CONDUIT CONSTRUCTION
���� suewAr INSPEcraR: C CASTANEDA (714) 619-2226 Mqp ROUTINE DATE ICIELD
AL TOLL FREE DRAWING TO SCALE yPREPARED 09 U6 18 B SHARMA
811 DO NOT REDUCE CONTRACTOR 'nun CHC CONSULTING 33A-1-LE79 CHECKED A-2-LE19 APPROVED09 06 18 B LlX)NG
LEAST TWO DAYS DURING REPRODUCTION 11 APPROVED
EFORE YOU DIG
UNDERGROUND SERVICE ALERT OF SOUTHERN CALIFORNIA California 7845 W Orangewood Ave, Suite 300
Orange, CA 92868 LE( 7 9 ) AD 1 9 5 TB
1 00 1 (949) 250-0004 /FAX (949) 250-0006 DA# 3/05LA DWG. L- I OF 1
N2,Ol$ — 04gs
10/9/2018 City of Newport Beach Page 15 of 15
6:34:26AM INSP15O - Daily Inspection Request Report
Requested Inspection Date : 10/09/2018
Inspection Type: ENCROACH
Inspection Area : PW
Site Address : 1 PUBLIC ROW
AMM Information:
Activity : N2018-0495
SubType : NEW
Status : APPROVED
OWNER: CITY OF NEWPORT BEACH Phone:
APPLICANT: AT&T CALIFORNIA Phone : 714-264-7103
Description : Install 52 LF of 4-inch duct on 15th Street and alley between Catalina Drive and Santa Ana
Avenue. Alley restoration per City Standards.
Requested kwgmw on(s)
Item: 10200 PRE JOB - PW
Requested Time: 10/9/2018 12:00:OOAM Requestor: WEBUSER
Entered By: WEBUSER 310-864-0210
Comments: PM-Contact-Chrs
Assigned to : zzzzzzzzzzz*
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31d - J 0 AJA4L FoAeeOOW(
Inspector: 11"1v Date: 10/1111f Time: AM PM
Comments:
I -6zn2 z j i n/ S P�ti7 �/l.l C> I! - L � $
C
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F. \Users\PBW\Shared\ENCROACH\MASTE RS\FORMS\I n soectorSheet.doc
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City of Newport Beach Page 8 of 14
4:30:17PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 10/12/2018
Inspection Type : ENCROACH
Inspection Area: PW
Site Address 1 PUBLIC ROW
wt
Activity N2018-0465"`�,-,
SubType: NEW
Status : APPROVED
OWNER: CITY OF NEVVPORT BEACH Phone:
APPLICANT: AT&T CALIFORNIA Phone : 714-264-7103
Description Install 52 LF of 4-inch duct on 15th Street and alley between Catalina Drive and Santa Ana
Avenue. Alley restoration per City Standards.
Item: 10000 EXCAVATION & PIPE INSTALL-UTIL
Requested Time: 10/12/2018 12:00:OOAM Requestor: WEBUSER
310-345-1766
Entered By: WEBUSER
Comments: ANY -
Assigned to: zzz7777777 J \Y/
511c- 11407-
r
•
10/15/2018 City of Newport Beach Page 11 of 19
6:34:48AM INSP150 - Daily Inspection Request Report
Requested Inspection Date : 10/15/2018
Inspection T-,•pe : ENCROACH
Inspection Area : PW
Site Address : 1 PUBLIC ROW
A/P/D Information:
Activity : N2018-0495
SubType : NEW
Status : APPROVED
OWNER: CITY OF NEWPORT BEACH Phone:
APPLICANT: AT&T CALIFORNIA Phone : 714-264-7103
Description : Install 52 LF of 4-inch duct on 15th Street and alley between Catalina Drive and Santa Ana
Avenue. Alley restoration per City Standards.
Requested Inspection(s)
Item: - LpA-IG - i°w
Requested Time: 10/15/2018 12:00:OOAM Requestor: WEBUSER
310-345-1766
Entered By: WEBUSER
Comments: ANY -
Assigned to zzzzzzzzzzz*
PG2 gDs i OT--L -� /it L4
V95'r-/ F�C-0 T"7 c-1,,—e ' .