HomeMy WebLinkAboutN2018-0370�` " ` ootyi of
�Newenter cport Beach ortach, CA s2sso 1111111111111111111111111111111111111111111111111Jill
Permit Counter Phone (949)644-3311
K.. Online Inspection Request - www.newportbeachca.gov / Online
Services
III Y'`
Permit No: N2018-0370
Project No : 1907-2015
Inspection Requests Phone (949)644-3255
Job Address: 1108 W BAY AVE NB Thomas:Guide: 919A1
Description : Encroachment agreement for existing brick driveway within West Bay Avenue right-of-way.
Parcel # : 0472-610-9 -
Legal Desc : N TR 626 BLK 4 LOT 9
Owner: COFFIN III GEORGE H Contractor
Phone: 0 Phone:
Address : 1108 BAY AVE W ? Address
NEWPORT BEACH, CA �>
Contractor State Lic:
Applicant: CARLEY PENNINGTON
License Expire
Phone : 909-921-4112 [
Address : 1108 W BAY AVE
NEWPORT BEACH, CA 92661
Business License:
Business Expire:
Special Cond.: EA REQUIRED
Workers' Compensation Insurance - -
Carrier :
Policy No:
W. C. Expire:
Permit Processing Fee :
$0.00
Sewer Connection :
$0.00
Total Fee $817.00
Agreement Fee:
$817.00
4TT Box Cover:
$0.00
Paid : $817.00
Traffic control Plan Check :
$0.00
Total Water Meters :
$0.00
Balance : $0.00
Inspection Fee :
$0.00
Water Meter Connection :
$0.00
Receipt No:
Refundable Deposit:
$0.00
Total Water Meter Box:
$0.00
Street Tree Fee :
$0.00
Adjustment :
$0.00
Processed By:
Utilities Approval :
Traffic Approval :
General Services Approval:
Date : _/_/ Other Department: Date
Date : _/ / Permit Denied Date
Date: / / Issued Permit: Date :Irn / t1/ %$
Date : _/_/
L
9
COMPLETE THE BELOW INFORMATION
PROJECT ADDRESS: G V-C.
DETAILED DESCRIPTION OF PROPOSED WORK:
1oY �L
APPLICANT-
Phone: r y 112
Email Address: Ls�tty)\,)(L1 r ('Vm
Mailing Address:
1 Nit
City/State/Zip:
1 -cc4-(;
OWNER: O ., L L L Phone: 9 Z\ Z.
Email Address:
Mailing Address:
�O CG► rtv L .
City/State/Z p:
Nr- t.. u vfi eA' cc_H 'L L') u
:ALL C )NTR . : _ T-4M E
ONTRACTOR:
[company
Office Phone:
(if different):
Jobsite Phone:
Other Phone:
Email Address:
Mailing Address:
City/State/Zip:
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 Orations: 949-644-3055
Utilities: 949-644-3011
Urban Forestry: 949-644-3083
Y.
Special Conditions of Permit: F_a ;Z"a ,
ADDITIONAL APPROVAL REQtl1lRED FR M THE FOLLOM111116 D�ARTMENfS
Utilities:
ipal Operations
Traffic: 0 Fire: 0
Other:
�
tgineering Technician:
Permit Specialist
i�o -,
Date:
-1�- 1$'
Permit No.
1142018- 0�1c7
f /users/pbw/shared/encmach/masters/epwarksheetxls
Public Works Department 949-644-3311
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 properly 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 'I etter 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 relectionitine. 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 Permrttee 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 Spec./a/ 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 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
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 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 i yements if the City
Department or General Services Department inspections may be required depending on scope of work performed.
removes them for maintenance of utilities pu rc need. I shall i demnify
8.
All trench restoration must be inspected by the Public Works Department. No utility installation(s) shall be allowed
City by Public Works Department. Locate
Iother
and hold the City harmless for any liability,' associated ith t rrlir nor
over or within 5 feet of any utilities. unless approved the and pothole
encroachments.
existing City -owned utilities lie water. sewer, or street lighting conduits) to verify locations. Maintain a one -foot
1
clearance over or under existing City -owned utilities. Sewer cleanouts require VCP or PVC SDR35 be used with a
Date: Signatu
4TT box over the riser
24-hour notice for Encroachment 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 949-644-3311.
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
15. Any above ground utility facilities 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 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
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
1 1
January 1 unless approved by the Public Works Department.
Any wort: 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 S25,000 and/or up to three years in State
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 (WATCH). No nighttime traffic lane closures, unless prior approval has been granted Any lane(s) closure
on a malor 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 thc-
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, er 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 �^dork
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 ermit and fees.[
No work related to this encroachment permit shall be performed until the Public Works Department has issued this permit. Applicant hereby acknowledges he/sheLaslead find understa the s 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.
:Dates�Signatur,
Permit Processing Fee:
Public Works Only $241.00
Other Department $275.00
[n
Agreement Fee:
Preparation of Report/Agreement $817.00 i
Document Recordation Fee $192.00
Monitoring Wells $502.00
Inspection Fee:
Public Works Field Inspection $165.00
Utilities Field Inspection $121.00
General Services Inspection $165.00
Water Quality/Artificial Turf Inspection $108.00
Refundable Deposit: TBD
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 S Cover $64.00
Additional
THE FOLLOWING ITEMS REQUIRE APPROVAL FROM THE Revenue Division
I REVENUE DIVISION PRIOR TO PAYMENT OF FEES Approval:
(
may
[Water Meter:
Installation Charge $528.00 l-1
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 B
12" Meter
$425.00
12" Turbine Meter
$845.00
13" Meter
$3,310.00
�4" Meter
$4,730.00
6' Meter
$7,190.00
FEES
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
405-470
Street Easement/Vacation Fee (+100% of hrly over 4 hrs)
$1,022.00
5200-5031
Street Tree Fee ($700 Planting Fee)
TBO
030-2284
Engineering Tech:
Total Amount Due:
For Finance Use Only
4&�
V-61Z.._..
NA
-1 —1 $ " 146
Permit Specialist
Receipt No.
�2,6,
Q 21-6
— $ 1
f'/users/pbw/shar"encroach/masterstep front and back masters/
Rev. 12/18/2017
epfeesheet.xls-revised 11/8117
LEGEND
a = TREE
Exhibit "A"
Sheet 1 of 1
� = POWER POLE
0 =SEWER CLEANOUT !!
Q = WATER METER BOX I
%- v 11-U CX % J V 1 1 J-1"
following items must be accurately on the drawing:
1. Property lines
2. Distance from property line to all encroachments
in the PROW
3. Dimensions of proposed improvements
4. Any excavation requires underground utilities be
shown on Inn (i a sewer as water)
ADDRESS
P ,5
5. Street names Permit No.
August 6, 2018
Rodi Almendralo, P.E.
City of Newport Beach
Public Works Department
100 Civic Center Drive
Newport Beach, CA 92660
Dear Rodi:
Please accept this letter as authorization for Carley Pennington to sign on my behalf for any
business or matters in association with 1108 West Bay, LLC and our property at 1108 West Bay,
Newport Beach. CA 92661. /
nccre l}
Chris A Pennington
Cell: 909.921.4111
Chris and Debra Pennington
10611 Acacia Street, 2nd Floor. Rancho Cucamonga, CA 91730
H: 909094400550
J•KN{eup Copy
!V H ITNFSS WHEREOF (tic Mctnhers and :he Cotnmrmv ha%c cwcut"I this drxumew
is oI ttc J.,tc first arm-c yrtucn
ME COMPANY:
11418 WEST BAY,LLC
Bs: Chris . ennM nd De a Pennington. Trustees of the Chris A. and
Qebrr Pimninglion My T
dated March 4. 19%.
Chn. % Pennington. Tafstec
hr Pennington. Trustee
Carley Pennington is able to act on Chris
A. nnmgton behatl on matters for t t GO West Bay. LLC
B.% The David C. Felich Family Trust established August 9. MI.
Member
By ----�k
BY _ (jCa� al 1
D.rs,d 71:Itotd Feltch. Y. jstce
KAren E:VJmeth Feltch. Trustee
FIVE AIENIBERS:
Chris ♦. Pennington and Debra ftiR Rgton. Trustees of the Chris A. and Dehra
Pennington Family T.ruSt-Itated f%larchl, l'W6..
Chcs A Pcnntngion. 'Trustee Dchn Pennington. Crusts:
1
The David C. Felich Famih Trust established Aug" 9. 1"1,
[ .:d (-1W. w i cL h. Truster K.rrer EW.;hctn rt, h. Tga.:ec