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Permit No: N2017-0233-
cNewenter oport
Beach, CA 92660
Newporth
'
Permit Counter Phone (949)644-3311
Project No: ' •
Online Inspection Request - www.newportbeachca.gov
/ Online
-
Services
Inspection Requests Phone (949)644-3255
Job Address:
121 MILFORD DR NB
Thomas:Guide: 919F4
Description :
Install new driveway approach, abandon existing driveway approach, and remove and replace any damaged curb, gutter, and sidewalk per City Standards.
Update 12-4-17: Install additional curb drain and install street tree (Purple Orchid tree).
Parcel # :
4750-111-1 -
Legal Desc :
N TR 3357 LOT 161
Owner:
VERLEUR CAROLYN CARTER
Contractor : SUNPEAK CONSTRUCTION
Phone:
0
Phone: 949-475-0501
Address :
121 MILFORD DR
�?
Address : 1401 QUAIL ST, STE 105
CORONA DEL MAR, CA
rJ
NEWPORT BEACH CA 92660
Contractor State Lic: 553434
Applicant:
VERLEUR CAROLYN CARTER
License Expire: 01 31, 2019
Phone:
[
Address
Business License: BT01083001
Business Expire: 07 31, 2018
Special Cond.:
PRE -JOB INSPECTION REQUIRED
Workers' Compensation Insurance - -
Carrier : EMPLOYEE SVC GRP
Policy No: WC475840202
W. C. Expire: 12 31, 2017
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:
Traffic Approval :
Date: _/_/
Issued Permit : — y Date: 12 / 4 / ► 7
General Services
Approval :
Date: _/_/
N ' 4�:.. of yiVo cNewenter Dport Beacrive, Newporth
Beach, CA 92660 IIIIPIIIIIIIIIIIIIIIIII�III°IIIIIIIIIIIIIIIIIIIIIIIIIIIII Permit No: N2017-0233
�� Permit Counter Phone (949)644-3311 Project No : r-
t
s Online Inspection Request - www.newportbeachca.gov / Online
Services Inspection Requests Phone (949)644-3255
Job Address: 121 MILFORD DR NB Thomas:Guide: 919F4
Description : Install new driveway approach, abandon existing driveway approach, and remove and replace any damaged curb, gutter, and sidewalk per City Standards.
Parcel # :
4750-111-1 -
Legal Desc :
N TR 3357 LOT 161
Owner:
VERLEUR CAROLYN CARTER
Phone:
0
Address :
121 MILFORD DR
CORONA DEL MAR, CA
Applicant: VERLEUR CAROLYN CARTER
Phone: [
Address
Special Cond.: PRE -JOB INSPECTION 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 :
$495.00
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
Contractor : SUNPEAK CONSTRUCTION
Phone : 949-475-0501
Address : 1401 QUAIL ST, STE 105
NEWPORT BEACH CA 92660
Contractor State Lic: 553434
License Expire: 01 31, 2019
Business License: BT01083001
Business Expire :
07 31, 2017
Workers' Compensation Insurance - -
Carrier :
EMPLOYEE SVC GRP
Policy No:
WC475840202
W. C. Expire:
12 31, 2017
Total Fee $736.00
Paid : $736.00
Balance : $0.00
Receipt No:
Date : _/_/ Other Department: Date:
Date: _/_/ Permit Denied Date
Date: / / Issued Permit: Date 5-/10/ 7
Date: / /
COMPLETE T E BELOW INFORMATION
PROJECT ADDRESS:
DETAILED DESCRIPTION OF PROPOSEDWORK:
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PPLICANT: /
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Email Addres
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Maili=dr
OWNER: I M, CPhone:
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Email Address: /1 O
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Mailing Add 0 o
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1CIty1S7/T-7-2- L4� -0
ONTRACTOR: e�
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sOffice
Phone:ompany
(if different):
Jobsite Phone. 3 8
Other Phone:
Email Address: l�f� ? R f
-S e • Go ,
Mailin Address: S,
City/Stet 7.) �
State Licens um er & Class: / .3 / GY
3 Ex i (
City Business License Numb`er-- 7 3/
3 / Expi
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WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor
Company: S"� �n Q PolicyNo: x ires:
Municipal Orations: 949444-3055
Uti I ities: 949-644-3011
Urban Forestry: 9494"-3083
Special Conditions of Permit: 'PCa-'100 ',nfptc�%s % r V;rt-
Utilities:
Municipal Operations
Traffic: Fire: 0
Other:
Engineering Technician:
1Zoa
Permi
alist
Date:
5-S-I -1
Permit No.
N2017- 02.33
flusers/ptndshared/enuoad*nasters/epworksheet.As '*__
94�
En
Public Works Department 949-644-3311
100 Civic Center Drive, Newport Beach, CA 92660
I Zl M:1 Ord VC.
i 2t (A. I;otrd C'p M . l-LC
Permit Processing Fee:
Public Works Only $241.0 l .
Other Department $275.0
Agreement Fee:
Preparation of Report/Agreement $817.00
Document Recordation Fee $192.00
Monitoring Wells $502.00
NUMBER: N2017- 0293
Inspection Fee: I OWN
Public Works Field Inspection $165.00
Utilities Field Inspection $121.00
General Services Inspection $165.00
Water Duality/Artificial Turf Inspection $108.00
Refundable Deposit:
Improvements
Street/Alley/Walk Closure: $65.000 Newspaper Rack Inspection
Traffic Control Plan Check
8-1/2" x 11" $65.00 Sewer Connection Fee
24" x 36" $143.00F:::] 4TT Box & Cover
Additional
1
THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE
REVENUE DIVISION PRIOR TO PAYMENT OF FEES
TBDeTBD
$108.00
$250.00
64 $64B
.00
----------
Revenue Division 1
(Water Meter:
13/4" Meter $50.25
11" Meter $121.50
11 1/2" Meter $285.00
11 1 /2" Turbine Meter $700.00
12" Meter $425.00
12" Turbine Meter $845.00
13" Meter $3,310.00
14" Meter $4,730.00
16" Meter $7,190.00
Installation Charge $528.001�J
Water Meter Boxes:
For Parkway & Sidewalk Area (Box + Cover = Cost
1" Meter: 13.00 + 37.00 $50.00
2: Meter: 27.00 + 61.25 $88.25
For Traffic & Alley Areas (Box + Cover = Cost)
1" Meter: 13.00 + 38.00 $51.00
2" Meter: 27.00 + 162.00 $189.00
Certificate of Compliance Fee (+100% of My 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 hry 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
Idi
iRe6elpt
Permit srreaist
No.
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f:luserslpbwlshare&wicroachlmestwWop front and back master
Rev. 1/5/2017
epfeesheet As -revised 10121n016
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
1 Encroachment Permits may be taken out by the owner of benefited properly or a licensed contractor A licensed
contractor must provide a I etter 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 al all times Work. which has been done prior to issuance of
a permit. is subject to rejection/fine Cfly reserves the right to void permit if work does not commence within 30 days
after date of Issuance
2 The Permittee agrees to defend. indenmifv and hold the (ity. 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 sha!! be done in accordance with the approved plans. Standard Special Provisions aril Slawlard Drawing.~
of the City of Newport Beach. and in compliance with all applicable State laws and City ordinances.
4. 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 Slate Contractor License Class A can perform any work in the public right-of-way For
construction or connection to water lines a valid Stale 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 parkwayiroadway 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 frorn 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.
8 All trench restoration must be inspected by the Public Works Department. No utility installation(s) shall be allowed
over or within 5 feel of any City utilities, unless approved by the Public Works Department. Locale and pothole
existing City -owned utilities fie water sewer. or street lightinq conduits) to verify locations Maintain a one -foot
clearance over or under existing City -owned uhfities Sewer cleanouts require VCP or PVC: SDR35 be. used with a
4TT box over the riser
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
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 S10.00
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 Depnrtnnenl
1 I Any work that extends into traffic or parking lanes and impedes the normal flow of traffic requires the applicant to
acquire a 1 emporary Streel Closure Permit from the Public Works Department Access for fire, police and
emergency vehicles must be maintained at all limes traffic Control must be per Work Area Traffic Control
Handbook MATCH) No nighttime traffic lane closures unless prior approval has been granted Any lane(s) closure
on a major slreel 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 Highways traffic or within the Slate Highway right-of-way
will require a Caltrans Permit All vehicles shall be lawfully parked
12 This permit does not authonze 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 dumpsler or materials in the public right-of-way, a
Temporary Street Closure Permit must he obtained from the Public Works Department
WORKER'S COMPENSATION INSURANCE (Section 3800- Labor Codu) -
certify that I have a Certificate of consent to self -insure, Certificate of 1Norkei's
CompensatioVinsyrance, or a Certified Copy there o . - i T
Date: -5 ! : Signature: Q ✓'��
CtRTIFICATE OF EXEMPTION (Section 38001-abor Code)
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 Ition is required by calling
Public Works at 949-644-3311.
15 Any above ground utility facilities will require documented approval from the adlacenl
affected property owners)
16 Homeowner contractors. and subcontracolrs may each be haldf- for viol�rtions of *,iler
Ouality Laws Best Management Practices will be enforced It Is against the law to
discharge construction debris into the gutter and storm drain I elony violations of VVa!^r
Ouality Laws are punishable by fines up to S25.000 and/or ;ip to three ve.;w; n Slab
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 Con!pacGc•n
Certificate or Evidence of a Slurried Backfill and request a final inspection from thc:
Public Works Department. Monies may be held for six months after final insimclion
before a refund will be processed.
18. No trees in the public right-of-way shall be planted. reproved. trimmed. c:r mlocattx!
without approval from the General Services Department
19. All work in the public right-of-way roust meet the approval of the P!:blic Mork%
Department or corrections will be required (i.e. removals. exposing ccrnrn:(,t,oi1s
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 harl4,4cknowIedges he/she h/reandderstands 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 i ance. �/
Permit fees are nonrefundable. �' Dd �l2 Signatur
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PLAN CHECK
SUBMITTAL 2
Issue Oaw �Y}.'6
Title
f'NtCI_t G4TVIM1l�
„✓=G LEVtI
C-1.2
121 MILFORD DR.
NEWPORT BEACH, CA
PROJECT NO.: 1355
NA & Associates, Inc.
16 TECHNOLOGY DR., SUITE 115 IRVINE. CA 92618
PHONE (949) 753-0600 FAX: (949) 753-0660
.1'IN12017 City of Newport Beach Page 1 of 13
6:34:55AM INSP150 - Daily Inspection Request Report
' Requested Inspection Date: 11/07/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 121 MILFORD DR Giew� S�
Activity : N2017-0233
SubType : NEW
Status : APPROVED
OWNER: VERLEUR CAROLYN CARTER
Phone : 0
OWNER: 121 MILFORD CDM, LLC Phone : 949-220-9387
Description : Install new driveway approach, abandon existing driveway approach, and remove and
Requested Time:
Entered By: NBIVR
Comments: AM
Assigned to:
Inspector:
`r
Requestor:
L099eci
Refile
Date: K I -7 /17
9496298263
Time: `l' ZJ CA�M)01%11
Comments: k4 E f' .,.�� /iy(� G 1f L co�c,�. o,�•+-s,�ti
"� AsIG -our G s��' .Fay�� S /�✓ /2 le- c.
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11/29/2017 City of Newport Beach Page 2 of 12
6:U:18AM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/29/2017
Inspection Type : ENCROACH
Inspection Area: PW
Site Address: 121 MILFORD DR
A MD IiC
Activity : N2017-0233
SubType : NEW
Status : APPROVED
OWNER: VERLEUR CAROLYN CARTER Phone : 0
OWNER: 121 MILFORD CDM, LLC Phone : 949-220-9387
Description : Install new driveway approach, abandon existing driveway approach, and remove and
replace any damaged curb, gutter, and sidewalk per City Standards.
Rquo sfN d 4rpscd m (8)
Item: 10100 FORMS WITH COMPACTION - PW
Requested Time: 11/29/2017 12:00:OOAM Requestor: NBIVR
9496298263
Entered By: NBIVR
Comments: AM
Assigned to:
Inspector: J�! Date: \ 1 zq 7 Time: AM PM
c G 40 S
Comments: � Q:I Z7�/l�S � —f�N � GO P-tr'OAVUil AAIJ
Dohs tioT KIT %Y It
'V d/sri�o�..-,•moo-L,
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F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
11/3012017 City of Newport Beach Page 5 of 10
6:34:26AM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 11/30/2017
Inspection Type : ENCROACH
Inspection Area : PW
Site Address: 121 MILFORD DR
Activity : N2017-0233
SubType :
NEW
Status :
APPROVED
OWNER:
VERLEUR CAROLYN CARTER
Phone: 0
OWNER:
121 MILFORD CDM, LLC
Phone : 949-220-9387
Description :
Install new driveway approach, abandon existing driveway approach, and remove and
replace any damaged curb, gutter, and sidewalk per City Standards.
... . RI M
Item:
10100 FORMS WITH COMPACTION - PW
0
4
Requested Time:
11/30/2017 12:00:OOAM Requestor:
9496298263
Entered By:
NBIVR
Comments:
AM
Assigned to:
Inspector:
J V Date: /1'7
Time: 10 ' 30 *PM
Comments: n
1GA-1 /`v ecA-4 6- <rz;ep—
G— 3z-I
G<
i
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
12/4/2017 City of Newport Beach Page 2 of 13
4:30:53PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 12/05/2017
Inspection Type : ENCROACH
Inspection Area : PW
Site Address : 121 MILFORD DR
Activity : N2017-0233
SubType : NEW
Status : APPROVED
OWNER: VERLEUR CAROLYN CARTER Phone: 0
OWNER: 121 MILFORD CDM, LLC Phone : 949-220-9387
Description : Install new driveway approach, abandon existing driveway approach, and remove and
replace anv damaged curb, cutter, and sidewalk per City Standards.
Item: 10250 FINAL - PW
Requested Time: 12/5/2017 12:00:OOAM
Entered By: NBIVR
Comments: AM
Assigned to :
Inspector:
Comments:
Requester:
Date: 2 a5- 1?
77)
NBIVR
9496298263
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ogge
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InSDectorSheet.doc
REPT131 Run Id: 4018
12/13/2017 City of Newport Beach Page 3 of 7
6:34:27AM INSP150 - Daily Inspection Request Report
Requested Inspection Date : 12/13/2017
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 121 MILFORD DR
AIP/D Information:
Activity : N2017-0233
SubType : NEW
Status : APPROVED
OWNER: VERLEUR CAROLYN CARTER Phone : p
OWNER: 121 MILFORD CDM, LLC Phone : 949-220-9387
Description : Install new driveway approach, abandon existing driveway approach, and remove and
replace any damaged curb, gutter, and sidewalk per City Standards. Update 12-4-17:
Install additional curb drain and install street tree (Purple Orchid tree).
Requested Inspection(s)
Item: 10250 FINAL - PW
Requested Time: 12/13/2017 12:00:OOAM Requestor: NBIVR
Entered By: NBIVR 9496298263
Comments: PM
Assigned to: Time: \�\
>> y PM
Inspector: / Date: - /
Comments:
(� Z- `� t I rr CN/ ,4 ( T Gti 1ti i L e i�'
F:\Users\PBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc