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Permit No: N2018-012.0 .c -
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Center Oport
Newporth
Beach, CA 92660
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Permit Counter Phone (949)644-3311
Project No: 2131-2016
Online Inspection Request - www.newportbeachca.gov / Online
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Services
Inspection Requests Phone (949)644-3255
Job Address:
1515 SANTANELLA TER NB
Thomas:Guide: 919D1
Description :
Cosntruct new drive approach (W=16% X=3') per std 162-I., repair of curb/gutter/sidewalk
(extent of repair TBD by PW inspector), removal of
decorative stone walkway and brick ribbon in right-of-way, reuse of existing curb drain and installation
of one new curb drain per std 184-I.
Parcel # :
0502-831-4 -
Legal Desc :
N TR 1701 LOT 24
Owner:
GSR COASTAL LLC
Contractor : F D H CUSTOM HOMES
Phone:
949-910-3047
Phone: 949-910-3047
Address :
2505 W COAST HWY #202
Address : 2429 W COAST HWY #210
NEWPORT BEACH CA 92663
NEWPORT BEACH CA 92663
Contractor State Lic: 1008969
Applicant:
F D H CUSTOM HOMES
License Expire: 11 30, 2019
Phone:
949-910-3047 [
Address :
2429 W COAST HWY #210
NEWPORT BEACH CA 92663
Business License: BT30054934
Business Expire: 04 30, 2018
Special Cond.:
PRE -CONSTRUCTION MEETING REQUIRED
Workers' Compensation Insurance - -
Carrier : WC EXEMPT
Policy No: (NO EMPLOYEES)
W. C. Expire:
Permit Processing Fee : $241.00 Sewer Connection:
$0.00
Total Fee $736.00
Agreement Fee:
$0.00 4TT Box Cover:
$0.00
Paid : $736.00
Traffic control Plan Check : $0.00 Total Water Meters :
$0.00
Balance : $0.00
Inspection Fee :
$495.00 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
Issued Permit: Date
Traffic Approval :
Date : _/_/
General Services
Approval : Date
COMPLETE THE BELOW INFORMATION
PROJECT ADDRESS: 15 ,, tC—+--v��
DETAILED DESCRIPTION OF PROPOSED WORK:
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APPLICANT:
Phone:
Email Address: - ��', _�� „� G u A � w..� '-�S
Mailing Ad ess:
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City/StatelZip:
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113hone•
ail Address:
Mailing Address:
City/State/Zip:
L CONTRAMOR **;DF MTM IS .. pOMPtEFE
ffONTRACTOR:
ice Phone:
fferent):
Jobsite Phone:
Other Phone:
Email Address:
Mailing Address:
City/State/Zip:
State License Number & Class: o o �ti 4
Expires:
City Business License Number:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: Policy No: Expires:
Municipal Orations: 949-644-3055
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
FOR CFFWE USE ONLY
Special Conditions of Permit:
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOMIIING DEPARTI NTS
Utilities:
Municipal Operations
Traffic: 0 Fire: 0
Other:
�
Engineering Technician:
Permit Spec st
Date:
3 La 1 g
Permit No./�
IN2018— t/ j c�— D
f /usersipbw/sharecrenaoaUvm a sters"mrksheet. xis
Public Works Department 949444-3311
100 Civic Center Drive, Newport Beach, CA 92660
Permit Processing Fee:
Public Works Only $241.00
Other Department $275.00
Agreement Fee:
Preparation of Report/Agreement $817.00
Document Recordation Fee $192.00
Monitoring Wells $502.00
Inspection Fee:
Public Works Field Inspection $165.0
g��
Utilities Field Inspection $121.0
General Services Inspection $165.00
Water Quality/Artificial Turf Inspection $108.00
Refundable Deposit: TBD
Improvements 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 8t Cover $64.00
Additional
I THE FOLLOWING ITEMS QU REIRE APPROVAL FROM THE
REVENUE DIVISION PRIOR TO PAYMENT OF FEES JFe;erue7&V7s1on
Approval: 1
I
otY•
1
(Water Meter:
Installation Charge $528.00 �
1314" 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 1
e
12" Meter
$425.00
12" Turbine Meter
$845.00
1
1
IT' Meter
14"
$3,310.00
Meter
$4,730.00
16" Meter
$7,190.00
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
405470
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 Amount Due:
For Finance Use Only
ik i 3C0.0
Per cialist
Receipt No.
flusers/pbw/shared/encroach/masterslep front and back masters/
Rev. 12/18/2017
epfeesheoOds-revised 1118/17
=:2c31—aolo
ALL UNDERGROUND WORK SHALL BE PERFORMED BY A LICENSED CONTRACTOR
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 lincroachnienl 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 self -insure, 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 Insurance, or a Certified Copy thereof.
permit and construction plan shall be kept at the job site at all times. Work, which has been done prior to issuance of
Date: Signature:
a permit, is subject to rejection/fine. City reserves the right to void permit if work does riot commence within 30 days
after date of issuance
CERTIFICATE OF EXEMPTION (Section 3800 Labor Code)
2 1 he Pernuttee 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 darnage 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 t he Worker's Compensation
of the City of Newport Beach, and in compliance with all applicable State laws and City ordinances
of the State Labor Code, I must comp w h the provisions of Section
provisions sor
4 Perrnittee guarantees all work performed under this permit to be free of hidden and latent defects. Any failures shall
3700 permit shall be deemed revoked.
be conected within two weeks after notification to the satisfaction of the Public Works Director.
5 A valid Stale 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 rig hhof-way. For
CONTRACTOR LICENSE EXEM TION
construction or connection to water limes 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.
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 personally performing all
in the alley, where a minirnurn 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
rneans. Trenches less than 5 feet in depth shall be guarded when hazardous ground movement may be expected.
HOLD HARMLESS STATEMENT
7 fate 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 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 (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:
41-T box over the riser.
24-hour notice for Encroachment Per t If
ispection is required by calling
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
Public Works at 949-644-3311.
Warning Signs, Sights and Other Devices for the Use in Performance of Work Upon Highways", issued by the
California Department of Transportation. II needed, barricades can be obtained from the City at a charge of $10.00
15 Any above ground utility facilitie will reqUife—C, umenled approval from the adjacent
per barricade per day, with a nunimum 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 limes.
affected property owner(s).
10 Work within or near beach sensitive areas will not be allowed during, City holidays, spring break, Memorial Day
16. Homeowner, contractors, and subcontracotrs m 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
January 1, unless approved by the Public Works Department.
I I 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 Wafer
Quality Laws are punishable by fines up to $25,000 and/or up to three years in Stale
acquire a Temporary Street Closure Permit from the Public Works Department. Access for fire, police and
prison plus the full cost to clean up an illegal discharge or spill.
emergency vehicles must be maintained at all times Traffic Control must be per Work Area Traffic Control
17 If a refundable deposit was paid, applicant must submit a Soils Compaction
Handbook 1WATCH). No nighttime traffic lane closures, unless prior approval has been granted. Any lane(s) closure
Certificate or Evidence of a Slurried Bacand request 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 Slate Highway right-of-way
Public Works Department. Monies may be held for six moo nths after final inspection
be
will require a C:altrans Permit. All vehicles shall be lawfully parked
Il This pennil does not authonze the closure of sidewalks, streets, or alleys for construction access, storage of
before a refund will be processed.
18. No trees in the public right-of-way shall be planted, removed, trimmed, or relocated
matenals, or parking of construction vehicles unless detailed on an attached l emporary 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 Works
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 collection 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 Permit must be obtained frorn 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 acknowledges he/she haIres d understands the terms and
conditions of this permit and he/she agrees toabide by them. Permit is void if work Is not commenced within 30 days after Issuance.
Date
,_-e-_�g_Signature:.
Permit fees are nonrefundable.
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ITF & ASSOCIATES, INC.
11278 LOS ALAMITOS BLVD., SUITE 354
LOS ALAMITOS, CA 90720
PHONE (800) 797-9483
FAX (888) 932-9482
CITY OF NEWPORT BE
PRECISE GRADING Pb
EROSION CONTROL PL
1515 SANTANELLA TER)
NEWPORT BEACH, C
' 3/6%2018
4:30:39PM
City of Newport Beach Page 9 of 12
INSP150 - Daily Inspection Request Report
Requested Inspection Date: 03/07/2018
Inspection Type : ENCROACH
Inspection Area : PW
Site 1515 SANTANELLA TER
J�Address:
Activity :
N2018-0120
SubType :
NEW
Status :
APPROVED
OWNER:
GSR COASTAL LLC Phone ' 949-910-3047
APPLICANT:
F D H CUSTOM HOMES Phone : 949-910-3047
jrobinson@fdhcutomhomes.c
Description :
Cosntruct new drive approach (W=16', X=3') per std 162-I., repair of curb/gutter/sidewalk
(extent of repair TBD by PW inspector), removal of decorative stone walkway and brick
ribbon in right-of-way, reuse of existing curb drain and installation of one new curb drain per
std 184-I.
w
:Y: a
Requested fnspectloh($)
Item:
10200 PRE JOB - PW
Requested Time:
3/7/2018 12:00:OOAM Requestor: WEBUSER
949-910-3047
Entered By:
WEBUSER tin
Comments:
InsPA"%hed to -
AM- Z'-4 C7
zzzz77ZZZZz' Date: 3 Time: z ' AM PM
Comments:
VOL wd rx tlr it $b
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\Inspectorsheet.doc
REPT131
Run Id: 4018
Si15/2018 City of Newport Beach Page 10 of 16
6:34:21AM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 03/15/2018
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 1515 SANTANELLA TER
AMID Information:
Activity : N2018-0120
SubType : NEW
Status : APPROVED
OWNER: GSR COASTAL LLC Phone : 949-910-3047
APPLICANT: F D H CUSTOM HOMES Phone : 949-910-3047
jrobinson@fdhcutomhomes.c
Description : Cosntruct new drive approach (W=16', X=3') per std 162-I., repair of curb/gutter/sidewalk
(extent of repair TBD by PW inspector), removal of decorative stone walkway and brick
ribbon in right-of-way, reuse of existing curb drain and installation of one new curb drain per
std 184-I.
Requested Inspections)
Item: 10100 FORMS WITH COMPACTION - PW
Requested Time: 3/15/2018 12:00:OOAM Requestor: WEBUSER
949-910-3047
Entered By: WEBUSER
Comments: PM-
Assigned to: zzzzzzzzzzz`
lO��GED
3/19/2018
4:30:46PM
City of Newport Beach Page 1 of 4
INSP150 - Daily Inspection Request Report
Requested Inspection Date: 03/20/2018
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 1515 SANTANELLA TER
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Activity :
N2018-0120
SubType :
NEW
Status :
APPROVED
OWNER:
GSR COASTAL LLC Phone: 949-910-3047
APPLICANT:
F D H CUSTOM HOMES Phone • 949-910-3047
jrobinson@fdhcutomhomes.c
Description :
Cosntruct new drive approach (W=16', X=3') per std 162-I., repair of curb/gutter/sidewalk
(extent of repair TBD by PW inspector), removal of decorative stone walkway and brick
ribbon in right-of-way, reuse of existing curb drain and installation of one new curb drain per
std 184-I.
Item:
10100 FORMS WITH COMPACTION - PW
Requested Time:
3/20/2018 12:00:OOAM Requestor: WEBUSER
949-910-3047
Entered By: WEBUSER
Comments: AM -later mominq
IrApsigoed to
Comments: _
77777777777*
0
Date: 3 z/If
4'� r..j"
to P9.-'- Gf
F:\Users\PB W\Shared\ENCROACH\MASTERS\FORMS\Insoectorsheet.doc
Time: A PM
so
a -.et sVj & I&
REPT131 Run Id: 4018
4/19/2018 City of Newport Beach Page 4 of 9
4:30:35PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 04/20/2018
Inspection Type: ENCROACH
Inspection Area: PW
Site Address : 1515 SANTANELLA TER
Activity : N2018-0120
SubType : NEW
Status : APPROVED
OWNER: GSR COASTAL LLC Phone : 949-910-3047
APPLICANT: F D H CUSTOM HOMES Phone : 949-910-3047
jrobinson@fdhcutomhomes.c
Description : Cosntruct new drive approach (W=16', X=3') per std 162-I., repair of curb/gutter/sidewalk
(extent of repair TBD by PW inspector), removal of decorative stone walkway and brick
ribbon in right-of-way, reuse of existing curb drain and installation of one new curb drain per
std 184-1.
a s.
Item: 10250 FINAL - PW
Requested Time: 4/20/2018 12:00:OOAM Requestor: WEBUSER
949-910-3047
Entered By: WEBUSER
Comments: AM-
Ins{~ed to: ' zzz»7777ZZ* Date: Ld �� Time: /36 AM6
Comments: Ok V(cmo4
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMSUnsoectorSheet.doc
REPT131 Run Id: 4018