HomeMy WebLinkAboutN2018-04041A , 1. 1, " City ofNewport Beach
111111111111111111111111111111111111111111111IIIII 0'VcDacn, CA 92660
Permit Counter Phone (949)644-3311
4. Online Inspection Request - www.newportbeachca.gov / Online
Services
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Job Address : 206 29TH ST NB
Description : CONDITIONS OF APPROVAL INSPECTION FOR CONDO CONVERSION
Parcel # : 0471-010-7 -
Legal Desc : LAKE TR BILK 128 LOT 4
Owner: SHIRLEY/WINDMULLER
Phone : r` `
Address : 206 29TH STREET
NEWPORT BEACH CA 92663
Applicant: SHIRLEY/WINDMULLER
Phone : [
Address : 206 29TH STREET
NEWPORT BEACH CA 92663
Special Cond. :
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:
$165.00
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
Permit No: N2018-0404
Project No : 0459-20SC A i V N E- s
Inspection Requests Phone (949)644-3255
Thomas:Guide: 888G7
Contractor
Phone :
Address
Contractor State Lic:
License Expire :
Business License:
Business Expire :
Workers' Compensation Insurance - -
Carrier :
Policy No:
W. C. Expire:
Total Fee $406.00
Paid : $406.00
Balance : $0.00
Receipt No:
Date : —/—/ Other Department : Date:
Date : / / Permit Denied Date: —/—/
Date : —/—/ Issued Permit: ', I�. Date : =/` ,' // _,
Date: / /
'9.
COMPLETE THE BELOW INFORMATION
PROJECT ADDRESS: CA Q (O 1-;)- ej
DETAILED DESCRIPTION OF PROPOSED WORK:
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APPLICANT: VXqAtJ ZVa Phone: 3 31
Email Address: QV4—W&,Avu►U
Mailing Address: City/State/Zip:
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OWNER: —
Phone:
Email Address:
Mailing Address:
City/State/Zip:
-CONTRl4=0 iNF Ai'K�!!t 0 REt EE-PLEASE GOINIL:EFE
` ti ".,ALL
CONTRACTOR:
11
Office Phone:
Company (if different):
Jobsite Phone:
Other Phone:
Email Address:
Mailing Address:
City/State0p:
State License Number & Class:
Expires:
City Business License Number:
Expires:
WORKERS COMPENSATION INSURANCE - Certificate of Insurance (Section 3800 Labor Code)
Company: Policy No: Expires:
Municipal Oerations: 949-644-3055
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
FOR OFFICE E18E ONLY
Special Conditions of Permit:
.- S
J I.
ADDITIONAL APPROVAL REQUIRED FROM THE FOLLOW NG OtB'ARTrENTS
Utilities:
Municipal Operations
Traffic: 0 Fire:
Other:
Engineering Technician:
Permit ialist
V
Data]
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Permit No.
IN2018- c
//users/pbw/shareWencroach/masters/epworkshest.xls
Public Works Department 949444-3311
100 Civic Center Drive, Newport Beach, CA 92660
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
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 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
a permit is subject to rejection/fine. City reserves the right to void permit if work does not commence within 30 days
Date: Signature:
after date of issuance
CERTIFICATE OF EXEMPTION (Section 3800 Labor Code)
2. The Permitlee 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 Slate laws and City ordinances.
provisions
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 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 ce I 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 a Pu is Ri ht-of-Way.
Works Dept. Contractors shall obtain permits to perform excavation or trench work from the California Division of
Date: e. 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 STATEM T
7.
The Public Works Department Inspectors must inspect all work in the Public right-of-way. Forms and subgrade must
I understand that 1 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 feel of any City utilities, unless approved by the Public Works Department. Locate and pothole
encroachments.
existing City -owned utilities tiewater, 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.
24-hour notice for Encroachme t Permit I pection 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 safely devices shall conform to the requirements of the current of
Warning Signs. Sights and Other Devices for the Use in Performance of Work Upon Highways", issued by the
Public Works at 949-644-331 .
California Department of Transportation If needed barricades can be obtained from the City at a charge of $10.00
15. Any above ground utility facilities will require documented approval from the adjacent
per barricade per day, with a minimum charge of S35.00 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 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 may each be liable for violations of Water
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
Handbook (WATCH) No nighttime traffic lane closures, unless prior approval has been granted. Any lane(s) closure
on a major street will only be allowed between 9:00 a.m. and 3:00 p.m. (Monday thru Friday).. unless approved by
Certificate or Evidence of a Slurried Backfill and request a final inspection from the
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 Caltrans Permit All vehicles shall be lawfully parked
before a refund will be processed.
12
This permit 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 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 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;hall be performed until the Public Works Department has issued this permit. Applicant hereby acknowledges he/she has re nd unders nds 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: gnature: ,.,
1�
Permit Processing Fee:
Inspection Fee:
Public Works Only
$241.00
Public Works Field Inspection
$165.00
Other Department
$275.00
Utilities Field Inspection
$121.00
General Services Inspection
$165.00
Agreement Fee:
Water Quality/Artificial Turf Inspection
$108.00
Preparation of Report/Agreement
$817.00
Document Recordation Fee
$192.001
Refundable Deposit:
TBDB
Monitoring Wells
$502.001
Improvements
TBD
Street/Alley/Walk Closure: $65.000 Newspaper 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 & Cover $64.00
Additional
I THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division I
I REVENUE DIVISION PRIOR TO PAYMENT OF FEES ]Approval: I
1Water Meter:
Installation Charge $528.00
13/4" 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
13" Meter
$3,310.00
�4" Meter
$4,730.00
1
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 My 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
4 � I c, C,
Pe cialist
Receipt No.
f/users/pbwishared/encroach/masters/ep front and hack masters/
Rev. 12/18/2017
epfeesheet.xls-revised 1118/17
8/13/2018 City of Newport Beach Page 8 of 19
6:34:29AM INSPI60 - Daily Inspection Request Report
Requested Inspection Date:
08/13/2018
Inspection Type:
ENCROACH
Inspection Area:
PW
Site Address :
206 29TH ST
A/PM Information:
Activity :
N2018-0404
SubType :
NEW
Status :
APPROVED
OWNER:
SHIRLEYNVINDMULLER
Phone:
APPLICANT:
SHIRLEYNVINDMULLER
Phone:
Description :
CONDITIONS OF APPROVAL INSPECTION FOR CONDO CONVERSION
Requested Inspection(s)
Item:
10210 PUBLIC WORKS
Requested Time:
8/13/2018 12:00:OOAM Requestor:
WEBUSER
'g- ( ),- (
Z%�- ("I
804-334-3737
Entered By:
WEBUSER
Comments:
ANY -Contact: June
Assigned to : zzzzzzzzzzz`
L OGGED
8/13/2018 City of Newport Beach Page 8 of 9
4:30:33PM INSP150 - Daily Inspection Request Report
Requested Inspection Date: 08/14/2018
Inspection Type: ENCROACH
Inspection Area: PW
Site Address: 206 29TH ST
Activity : N2018-0404
SubType : NEW
Status : APPROVED
OWNER: SHIRLEY/WINDMULLER Phone
APPLICANT: SHIRLEY/WINDMULLER Phone
Description : CONDITIONS OF APPROVAL INSPECTION FOR CONDO CONVERSION
Item: 10250 FINAL - PW
Requested Time: 8/14/2018 12:00:OOAM Requestor: WEBUSER
Entered By: WEBUSER
Comments: ANY -
Assigned to: 77777777777*
Inspector: 74L, (I
Comments: DEC to �-�t
Date: 4�01,^ 14 —1% Time: AM PM
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F:\UserskPBW\Shared\ENCROACH\MASTERS\FORMS\InspectorSheet.doc
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