HomeMy WebLinkAboutN2015-0124City of Newport Beach IIII I III II I III IIII III I II II Permit No:N2015-0124
at 100 Civic Center Drive, Newport Beach, CA 92660 N 2 0 1 5 0 1 2 4
ti Permit Counter Phone (949)644-3311 Project No: 3069-2(E)CANNEL)
v Online Inspection Request- www.newportbeachca.gov/Online
Services Inspection Requests Phone (949)644-3255
Job Address : 5308 SEASHORE DR NB Thomas:Guide: 888F6
Description : Install 2 -inch water service with a 1 -1/2 -inch water meter per City Standard #503-L on Seashore Drive and sewer lateral with cleanout per City
Standard #406-L on Neptune Avenue. Pavement and concrete restoration per City Standards.
Parcel #: 4245-060-3 -
Legal Desc : N TR 3813 LOT 98
Owner: CARLINI ANTHONY M
Contractor :
SALAZAR J A CONSTRUCTION AND SUPPLY
CORPORATION
Phone: 0
Phone:
562-691-3647
Address : PO BOX 12649
Address :
2025 RANCH HILL DRIVE
NEWPORT BEACH, CA
LA HABRA HEIGHTS CA
Contractor State
Lie: 743587
Applicant: J.A. SALAZAR CONSTRUCTION & SUPPLY CORP
License Expire:
05 31, 2016
Phone: 562-691-3647 [
Address : 613 N. HARBOR BLVD.
LA HABRA, CA 90631
Business License : BT30050408
Business Expire:
03 17, 2016
Special Cond.: Pre -job inspection required.
Workers' Compensation Insurance - -
Carrier :
STATE COMPENSATION INSURANCE
Policy No:
9066530
W. C. Expire:
08 15, 2015
Permit Processing Fee :
$242.00
Sewer Connection :
$0.00
Total Fee
$1,609.30
Agreement Fee:
$0.00
4TT Box Cover:
$54.72
Paid :
$1,609.30
Traffic control Plan Check:
$0.00
Total Water Meters:
$775.00
Balance :
60.00
Inspection Fee:
$462.00
Water Meter Connection :
$406.00
Receipt No
Refundable Deposit:
$0.00
Total Water Meter Box:
$75.58
Street Tree Fee :
$0.00
Adjustment:
$0.00
Processed By:
Date: _/ /
Other Department:
—Date:
Utilities Approval :
Date : _/ /
Permit Denied
Date:
Traffic Approval:
Date: —/—I—
Issued Permit:
Date:
General Services Approval :
Date: _/ /
a* City of Newport Beach *N2015-0124* Permit No:N2015-0124
o� 100 Civic Center Drive, Newport Beach, CA 92660 ���111
F Permit Counter Phone (949)644-3311 Project NO 'S & q - .20f 3
Online Inspection Request- www.newportbeachca.gov/Online
D�_ a SBNICeS
�boRT- Inspection Requests Phone (949)644J255
Job Address : 5308 SEASHORE DR NB Thomas:Guide: 888F6
Description : Install 2 -inch water service with a 1 -1/2 -inch water meter per City Standard #503-L on Seashore Drive and sewer lateral with cleanout per City
Standard #406-L on Neptune Avenue. Pavement and concrete restoration per City Standards.
Parcel #: 4245-060-3 -
Legal Desc : N TR 3813 LOT 98
Owner: CARLINI ANTHONY M
CORPORATION
Phone: 0
Address : PO BOX 12649
NEWPORT BEACH. CA
Applicant: J.A. SALAZAR CONSTRUCTION & SUPPLY CORP
Phone: 562-691-3647 [
Address : 613 N. HARBOR BLVD.
LA HABRA, CA 90631
Special Cond.: Pre -job inspection required.
SCANNED
Contractor : SALAZAR J A CONSTRUCTION AND SUPPLY
Phone: 562-691-3647
Address : 2025 RANCH HILL DRIVE
LA HABRA HEIGHTS CA
Contractor State Lie: 743587
License Expire : 05 31, 2016
Business License:
BT30050408
Business Expire :
03 17, 2016
Workers' Compensation
Insurance - -
Carrier:
STATE COMPENSATION INSURANCE
Policy No:
9066530
W. C. Expire: 08 15, 2015
Permit Processing Fee :
$242.00
Sewer Connection :
$0.00
Total Fee
$1,609.30
Agreement Fee:
$0.00
4TT Box Cover:
$54.72
Paid :
$1,6,j9.30
Traffic control Plan Check :
$0.00
Total Water Meters :
$775.00
Balance :
$0.00
Inspection Fee :
$462.00
Water Meter Connection :
$406.00
Receipt No :
R D0005(ooz I
Refundable Deposit:
$0.00
Total Water Meter Box:
$75.58
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:
Date
General Services Approval :
Date
ALL UNDERGROUND WORK SHALL BE PERFORMED BY A LICENSED CONTRACTOR
Contact "Underground Service Alert" At Least 48 -Hours in Advance of Any Excavation at 1-800-227-2600 or 811
TERMS AND CONDITIONS OF ENCROACHMENT PERMIT
WORKER'S COMPENSATION INSURANCE\(Sec'o 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 s ff. r Certificate of Worker's
contractor must provide a "Letter of Authorization' to allow another party to pull a permit. An approved copy of the
Compensation I surance, or a Certified Copy there f.
permit and construction plan shall be kept at the job site at all times. Work, which has been done prior to issu
a permit, is subject to rejection/fine. City reserves the right to void permit if work does not commence within 30 days
Date: l Signature:
after date of issuance.
CERTIFICATE OF EXEMPTION (Section ib�p La o, 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 and Standard Drawings
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
37o0 or this shall be deemed revoked.
be corrected within two weeks after notification to the satisfaction of the Public Works Director.
permit
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
connection to sewer lines a valid State Contractor License Class C-42 is required.
CONTRACTOR LICENSE EXEMPTION
6.
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
1 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 inspections by
encroachments. I will be responsible for replacing the improvements if the City
the Municipal Operations Department 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 (ie: 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:
4TT box over the riser.
Inspections should be requested by calling th0, Pukk Works Inspection
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
Waring Signs, Sights and Other Devices for the Use in Performance of Work Upon Highways", issued by the
Request Line at: 949-644-3255. INITIALS: Y- r
California Department of Transportation. If needed, barricades can be obtained from the City at a charge of $10.00
15. All above ground facilities shall comply with the Municipal Code, including but not limited
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.
to Chapter 13.20.
10.
Work within or near beach sensitive areas will not be allowed during, City holidays, spring break, Memorial Day
16. Homeowner, contractors, and subcontractors 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
11.
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
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
emergency vehicles must be maintained at all times. Traffic Control must be per Work Area Traffic Control
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
Handbook (WATCH). No nighttime traffic lane closures, unless prior approval has been granted. Any lane(s) closure
Evidence of a Slurried Backfill and request a final inspection from the Public Works
on a major street will only be allowed between 9:00 a.m. and 3:00 p.m. (Monday thru Friday), unless approved by
Department. Monies may be held for six months after final inspection before a refund will
the Public Works Department. Any work affecting the State Highway's traffic or within the State Highway right-of-way
be processed.
will require a Caltrans Permit. All vehicles shall be lawfully parked.
18. No trees in the public right-of-way shall be planted, removed, trimmed, or relocated
12.
This permit does not authorize the closure of sidewalks, streets, or alleys for construction access, storage of
without approval from the Municipal Operations Department, Parks and Street Trees
materials, or parking of construction vehicles unless detailed on an attached Temporary Street Closure.
Division.
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 Works Department
must notify all affected residents 24 hours in advance of restricted access and any inconveniences. All USA marks
or corrections will be required (i.e. removals, exposing connections, etc.). Additional
shall be removed prior to Final Public Works Inspection.
inspection fees may be required.
14.
Refuse or unused materials shall be removed within 24 hours after completion of the work. If not removed, the City
.
20Permit is for standard materials in the public right-of-way only, unless previously approved
may remove and bill the applicant. Coordinate alley closures with City's refuse pick-up days by calling 949-644-3066
by Public Works and an Encroachment Agreement has been processed.
for the collection schedule so service is not Interrupted. To place a dumpster or materials in the public right-of-way, a
21 Permit is valid for "description" of work otad on front only. Additional work performed
Temporary Street Closure Permit must be obtained from the Public Works Department.
may require issuance of a separate pe it and/or additional Tees.
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 and understands 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 issuan e, ss otherwise approved by the Public Works Department
Permit fees are nonrefundable. Please note: Pr�aration of EncroaehmeJ1t14greenLtfee is non -ref able.
Date: ^ 5 Signature:
T : mserslpowrsnareo/encroach/masterslepworksheet.xls
Public Works Department 949-644-3311
100 Civic Center Drive, Newport Beach, CA 92660
Permit Processing Fee: Qty. Inspection Fee: Qty.
Public Works Only $242.008 Public Works Field Inspection $154.00
Other Department $319.00 Utilities Field Inspection $198.00
General Services Inspection $154.00
Agreement Fee:
TBD
Preparation of Report/Agreement
$900.00
Document Recordation Fee
$209.00
Monitoring Wells
$495.00
Street/Alley/Walk Closure:
$55.00
Traffic Control Plan Check
$1,089.00
8-1/2" x 11"
$55.00
24" x 36"
$139.00
Additional
TBD
Refundable Deposit:
Improvements
Sewer Connection Fee
4TT Box & Cover
Certificate of Compliance Fee (+10010 of hriy over 3 hrs) $288.00
Development Services Fee
TBD
Final Tract Map Checking Fee
$3,489.00
Final Parcel Map Checking Fee - Simple
$374.00
Final Parcel Map Checking Fee - Moderate
$2,297.00
Final Parcel Map Checking Fee - Complex
$3,489.00
Lot Line Adjustment Fee
$1,089.00
Park Dedication Fee Zone _
TBD
Street Easemt/Vacation Fee (+100°1 of hriy over4 hrs)
$983.00
Street Tree Fee ($700 Planting Fee)
TBD
TBD=
$250.008
$54.72 I
5200-5029
5200-5015
5200-5026
5200-5027
5200-5027
5200-5027
5200-5028
405-470_
5200-5031
030-2284
Engineering Tech:
Total Amount Due:
For Finance Use only
r?od(
$ 11(009. 30
�t411�
9—($._ t.�
Public Works Specialist:
Receipt No.
Rsa1
0000 �oLt
Rev. 12-22-2014
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w- r0 -/u 10 Inspection Request ReportingPae 2
5:26 pm NElllrppRT BEACH_ CA _ CI 9
Requested Inspect Date:
Thursday, March 19, 2015
Assigned To:
zzzzzzzzzzz*
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address:
5308 SEASHORE DR NB
A/P/D Information
Activity: N2015-0124 Type: ENCROACH Sub Type: Status: APPROVED
Const Type: Occupancy: Use: Insp Area: PW
Owner: CARLINI ANTHONY M Phone: 0
Applicant: CORP LAZAR CONSTRUCTION & SUPPLY Phone: 562-691-3647
Description: Install 2 -inch water service with a 1 -1/2 -inch water meter per City Standard #503-L on Seashore Drive and
sewer lateral with cleanout per City Standard #406-L on Neptune Avenue. Pavement and concrete
restoration per City Standards.
Requestedlnsoectionfs
Item:
Requester:
10200 PRE JOB - PW
WEBUSER
Requested Time: 12:00 AM
Comments:
AM -Jose
Phone: 714-493-1042
Assigned To:
Action:
zzzzzzzzzzz*
Time Exp:
Entered By: WEBUSER WB
Inspector: Date: 7// jam— Time: AM PM
Comments: �4a1 - - l /,' : /Y...'% . /:. 1'k.
- - Aaq
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoectorSheet doc
REPT131 Run Id: 6535
REPT131 Run Id: 4018
03-20-2015 Inspection Request Reporting Page 2
3:27 pm NE PART BEACH CA - CITY
Requested Inspect Date:
Monday, March 23, 2015
Assigned To:
zzzzzzzzzzz*
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address:
5308 SEASHORE DR NEI
A/P/D Information
Activity:
N2015-0124 Type: ENCROACH
Const Type:
Occupancy:
Owner:
CARLINI ANTHONY M
Applicant:
J.A, SALAZAR CONSTRUCTION & SUPPLY
CORP
Description:
Install
2 -inch water service with a 1 -1/2 -inch watt
sewer lateral with cleanout per City Standard #41
restoration per City Standards. 3-20-2015 Scope
ROW per conditions of parcel map.
Reouestedlnspection(s
Item: 10050 EXCAVATION- PW
Requester: WEBUSER
Comments: AM-8:OOAM Preferred
Assigned To: zzzzzzzzzzz*
Action: Time Exp:
Sub Type: Status: APPROVED
Use: Insp Area: PW
Phone: 0
Phone: 562-691-3647
�r per City Standard #503-1 on Seashore Drive and
i Neptune Avenue. Pavement and concrete
k expanded to include final inspection of the Public
Requested Time: 12:00 AM
Phone: 714-865-2314
Entered By: WEBUSER WB
Inspector: Date: '�l' r 'i Time: AM PM
Comments:
-A : z;_':
Logge®R
Refile
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InsoeclorSheet doc
__----
REPT131
Run -Id:_ 6537
Run Id: 4018
Inspector:
crib=
Date:
rY- Time: AM PM
Comments:
V6i-
Oggea,,
Reffle
F:\Users\PBW\Shared\ENCROACH\MASTERSIFORMS\Insl)ectorSheet.doc
REPT131 Run Id: 4018