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HomeMy WebLinkAboutLD24-1860Permit Number: LD24-1860 LD - Utilities/ Excavation - Parallel Issued: 07/10/2024 Expired: 02/18/2025 Job Address: 32769 Tulley Ranch Rd Legal Description: City of Temecula - Land Development Division 41000 Main Street - Temecula, CA 92590 Mailing Address: P.O. Box 9033 Temecula, CA 92589-9033 Phone: (951) 308-6395 Fax: (951) 694-6475 Spectrum/ Charter Communications 7337 Central Ave Riverside, CA 92504 (951) 406-1689 Applicant: Hhs Construction, Llc 2042 S Grove Avenue Ontario, CA 91761 (909) 393-3322 Contractor: Utility Work Order Number: N/A Description: Charter PID 5325679 WORK HOURS SHALL BE MONDAY – FRIDAY, NO HOLIDAYS, 8:30am - 3:30pm Location: Tulley Ranch Rd W/O Pascual Cir Proposed work: Bore 122' to place PVC (SCH-40) conduit for fiber optic cable. Tie into (1) existing vault. Place (1) new PVC conduit stub out. Place (3) bore/receiving pit in street. All facilities shall be installed in accordance with City Standard Drawing 117. Traffic Control shall be in accordance with approved Traffic Control Plan LD24-1860 Permittee shall comply with all applicable Traffic Control General Notes. Safe pedestrian/bicycle traffic and driveway access shall be maintained at all times. Concrete repair shall be in accordance with City Standards and the Greenbook. Trench repair shall be in accordance with City Standard Drawing 407. Final compaction test results shall be provided by a soils engineer. Concrete curbs, walks, gutters, cross gutters and driveway approaches damaged during construction shall be removed from joint to joint and reconstructed in accordance with City Standards and the Greenbook. All disturbed landscaping and other improvements shall be removed/repaired and replaced to the satisfaction of Public Works Inspector. Permittee shall contact LDInspections@temeculaca.gov a minimum of two (2) business days prior to any work. Page 1 of 3*****See Page 2 of this Permit for Permittee Responsibilities***** Permit Number: LD24-1860 LD - Utilities/ Excavation - Parallel Permittee must also request a final inspection, via LDInspections@temeculaca.gov, to verify completion of project. Permittee Responsibilities This Permittee agrees to indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. Trench repair shall be pursuant to City of Temecula Standard Drawing No. 407. 3.Traffic control devices shall be utilized to protect and control pedestrian and vehicular traffic in the construction area in accordance with the latest revision of the “Manual of Uniform Traffic Control Devices for Streets and Highways” (MUTCD). The contractor shall submit a specific traffic control plan for review and approval by the City in accordance with City “Traffic Control Plan Guidelines” for all work within Major Circulation Element streets. 2.BEFORE YOU DIG - CALL (TOLL FREE) 800-422-4133 A pre-construction meeting is required two (2) business days prior to any scheduled work. Permittee shall contact LDInspections@TemeculaCA.gov to schedule a meeting. 1. 4. Water Quality: Contractor shall remain in compliance with the City Water Pollution Control Ordinance. Contractor is required to provide protection of the City storm drain system. 5. Work hours shall be limited between 7:30 AM and 4:30 PM, Monday through Friday, unless otherwise noted. No work shall be allowed during City-recognized holidays." 6. THIS PERMIT IS ISSUED AND ACCEPTED SUBJECT TO THE FOLLOWING CONDITIONS AND ANY ATTACHED PROVISIONS: All U.S.A. mark outs shall be removed prior to completion of project.7. 8.All contractors and subcontractors shall have a valid City of Temecula business license and valid Certificate of Liability prior to start of work. 9.Should there be any claim against the City and the property owner with the encroachment being the proximate cause, the property owner shall be notified in writing to remove the encroachment within 30 days or the City will remove and bill the owner. 10.Permission is hereby requested to encroach into public right of way to perform work as set forth above. It is understood that this permit is limited to the work described herein and that all work is to be done in compliance with the provisions attached to this permit and with all other applicable rules. Permittee shall be responsible for said compliance, for acceptability of the work, for repair or replacement thereof if defective, and for repair or replacement of any existing improvement damaged by the doing of the work I hereby certify and agree on behalf of the Permittee that all laws, regulations and ordinances of the City of Temecula and the State of California and the terms and conditions of the Permit shall be complied with whether herein stated or not. 11. 12.I hereby warrant and represent to the City that I am authorized to execute this Permit Application on behalf of the Permittee and bind the Permittee to the agreements contained herein and any conditions of the Permit. ******Contractor and all subcontractors shall be present at the pre-construction meeting; otherwise, the meeting will be rescheduled to a later date****** Any work commencing within the City right-of-way before permit issuance or a pre-construction meeting shall be subject to a 72-Hour suspension of said work and an assessment of double permit fees.13. Permitee Date Page 2 of 3 Permit Number: LD24-1860 LD - Utilities/ Excavation - Parallel City Engineer or Authorized Representative Date 07/10/2024 Page 3 of 3 INLAND ENGINEERING SERVICES, INC. 1373 OLD TEMESCAL RD CORONA, CA 92881 TEL: 951.277.0800 FAX: 951.277.5300 DESIGNER OWNERTRAFFIC CONTROL PLANCOMPASS SHEET 01 OF 02 PROJECT: PID# 5325679 CITY OF TEMECULA WORK LOCATION: TULLEY RANCH RD W/O PASCUAL CIR TARGET/SERVICE ADDRESS: 32769 TULLEY RANCH RD, TEMECULA, CA 92592 DESIGNED BY:INLAND ENGINEERING SERVICES DRAFTED BY:INLAND ENGINEERING SERVICES TEL. NUMBER:(951) 277-0800 EXT 257 PERMIT COORDINATOR: EMAIL: REVISION DATE: 6/11/2024 TOTAL WORK DURATION: 02 DAYS agrim@inland-engineering.com AMBER GRIM N.T.SSCALE: TEMECULA MODIFIED 2014 CATTCH MANUAL LD24-1860 20 ' 20 ' 20 ' 20 ' 100'100'100' 100'100'100'63' 63'TULLEY RANCH RD (25 MPH NOT POSTED) PLEASE REFER TO EXC PLAN FOR ROUTE DETAILS PHASE 01 INLAND ENGINEERING SERVICES, INC. 1373 OLD TEMESCAL RD CORONA, CA 92881 TEL: 951.277.0800 FAX: 951.277.5300 DESIGNER OWNERTRAFFIC CONTROL PLANCOMPASS SHEET 02 OF 02 PROJECT: PID# 5325679 CITY OF TEMECULA WORK LOCATION: TULLEY RANCH RD W/O PASCUAL CIR TARGET/SERVICE ADDRESS: 32769 TULLEY RANCH RD, TEMECULA, CA 92592 DESIGNED BY:INLAND ENGINEERING SERVICES DRAFTED BY:INLAND ENGINEERING SERVICES PERMIT COORDINATOR: EMAIL: REVISION DATE: 6/11/2024 TOTAL WORK DURATION: 02 DAYS agrim@inland-engineering.com AMBER GRIM N.T.SSCALE: 100'100'42' PLEASE REFER TO EXC PLAN FOR ROUTE DETAILS PHASE 02 LD24-1860 20 ' 20 ' 100' TULLEY RANCH RD (25 MPH NOT POSTED) 20 ' 20 ' TEMECULA MODIFIED 2014 CATTCH MANUALTEL. NUMBER:(951) 277-0800 EXT 257 V SHEET 01 OF 02 PROJECT: PID# 5325679 CITY OF TEMECULA WORK LOCATION: TULLEY RANCH RD & PASCUAL CIRINLAND ENGINEERING SERVICES, INC. TARGET/SERVICE ADDRESS: 32769 TULLEY RANCH RD, TEMECULA, CA 925921373 OLD TEMESCAL RD, CORONA, CA 92881 TEL: 951.277.0800 FAX: 951.277.5300 DESIGNER OWNER 1-800-422-4133 AT LEAST TWO DAYS BEFORE YOU DIG UNDERGROUND SERVICE ALERT OF SOUTHERN CALIFORNIA TICKET# DIGALERT COMPASS EXCAVATION PLAN DESIGNED BY:INLAND ENGINEERING SERVICES DRAFTED BY:INLAND ENGINEERING SERVICES TEL. NUMBER:(951) 277-0800 PERMIT COORDINATOR: EMAIL: REVISION DATE: 06/11/2024 CONDUIT DATA BLOCK VICINITY MAP N.T.S. NORTH TOTAL WORK DURATION: 2 DAYS CONSTRUCTION NOTES: 1.BORE UNDER ALL CURBS & GUTTERS. 2.EXISTING TV VAULTS ARE TO REMAIN IN PLACE. 3.USE 1 SACK SLURRY IN STREETS. USE NATIVE SOIL IN PKWY. 4.ALL CONDUITS SHALL BE SCH-40 UNLESS OTHERWISE SPECIFIED, ALL SWEEPS TO POLES SHALL BE SCH-80. 5.CONTRACTOR TO POT HOLE FOR EXISTING DEPTH OF UTILITIES CONDUIT PRIOR TO START OF CONSTRUCTION. 6.CONTRACTOR TO REMOVE & REPLACE DAMAGED CONCRETE MATCH EXISTING LANDSCAPE TO THE SATISFACTION OF THE SATISFACTION OF THE CITY RESIDENT ENGINEER. PRIVATE ENGINEER'S NOTICE TO CONTRACTORS: THE EXISTENCE AND LOCATION OF ANY UNDERGROUND UTILITIES OR STRUCTURES SHOWN ON THESE PLANS ARE OBTAINED BY A SEARCH OF AVAILABLE RECORDS DONE BY THE CONTRACTOR ON USA, AND TO THE BEST OF OUR KNOWLEDGE. THERE ARE NO EXISTING UTILITIES EXCEPT THOSE SHOWN ON THESE PLANS. THE CONTRACTOR IS REQUIRED TO TAKE ALL PRECAUTIONARY MEASURES TO PROTECT THE UTILITIES SHOWN AND ANY OTHER LINES OR STRUCTURES NOT SHOWN ON THESE PLANS. THE CONTRACTOR IS REQUIRED TO POT HOLE THE EXISTING UTILITIES AND VISUALLY LOCATE THE LINE OR STRUCTURE WHILE PERFORMING THE JACK AND BORE OPERATION AND IS RESPONSIBLE FOR THE PROTECTION AND ANY DAMAGED TO THE THESE LINES OR STRUCTURES. CONSTRUCTION CONTRACTOR AGREES THAT IN ACCORDANCE WITH GENERALLY ACCEPTED CONSTRUCTION PRACTICES, CONSTRUCTION CONTRACTOR WILL BE REQUIRED TO ASSUME SOLE AND COMPLETE RESPONSIBILITY FOR THE JOB SITE CONDITION DURING THE COURSE OF CONSTRUCTION OF THE PROJECT, INCLUDING SAFETY OF ALL PERSONS AND PROPERTY; THAT THIS REQUIREMENT SHALL BE MADE TO APPLY CONTINUOUSLY AND NOT BE LIMITED TO NORMAL WORK HOURS, AND CONSTRUCTION CONTRACTOR FURTHER AGREES TO DEFEND, INDEMNIFY, AND HOLD HARMLESS THE PRIVATE ENGINEER FORM ANY AND ALL LIABILITY, REAL OR ALLEGED, IN CONNECTION WITH THE PERFORMANCE OF WORK ON THIS PROJECT. THE CONTRACTOR SHALL BE RESPONSIBLE TO REPORT DISCREPANCIES IN PLANS AND/OR FIELD CONDITIONS IMMEDIATELY TO THE DESIGN ENGINEER FOR RESOLUTION PRIOR TO CONSTRUCTION, AND SHALL BE RESPONSIBLE FOR DISCREPANCIES NOT SO REPORTED AND RESOLVED GENERAL NOTES: 1.ALL WORK SHALL CONFORM TO LATEST EDITION OF THE "STANDARD SPECIFICATION FOR PUBLIC WORKS CONSTRUCTION, ADOPTED BY THE CITY AS MODIFIED BY STANDARD PLANS. 2.THE EXISTENCE AND LOCATION OF UTILITY LINES SHOWN HEREON ARE OBTAINED BY SEARCH OF AVAILABLE RECORDS. OTHER UTILITY LINES MAY EXIST; CONTRACTOR SHALL VERIFY PRIOR TO START OF CONSTRUCTION AND SHALL USE EXTREME CARE AND PROTECTIVE MEASURES TO PREVENT DAMAGE TO THE SAME. HE IS RESPONSIBLE FOR THE PROTECTION OF ALL UTILITY LINES, VALVES, METERS, TRAFFIC SIGNAL CONDUIT,& DETECTOR LOOPS, ETC.; WITHIN LIMITS OF WORK WHETHER THEY ARE SHOWN OR NOT. 3.AT LEAST TWO WORKING DAY PRIOR TO STARTING WORK NOTIFY UNDERGROUND SERVICE ALERT (1-800-422-4133). 4.INDEMNIFICATION CLAUSE-CONTRACTOR AGREES THAT HE SHALL ASSUME SOLE AND COMPLETE RESPONSIBILITY FOR JOB SITE CONDITIONS DURING THE COURSE OF CONSTRUCTION OF THE PROJECT, INCLUDING SAFETY OF ALL PERSONS AND PROPERTY, THAT THIS REQUIREMENT SHALL APPLY CONTINUOUSLY AND NOT BE LIMITED TO NORMAL WORKING HOURS; AND THAT THE CONTRACTOR SHALL DEFEND, INDEMNIFY AND HOLD THE OWNER AND THE ENGINEER HARMLESS FROM ANY AND ALL LIABILITY, REAL OR ALLEGED, IN CONNECTION WITH THE PERFORMANCE OF WORK ON THIS PROJECT EXCEPTING FOR LIABILITY ARISING FROM THE SOLE NEGLIGENCE OF THE OWNER OR THE ENGINEER. 5.ALL WORK AREA AND STREET TRAFFIC CONTROL SHALL BE PER LATEST EDITION CA MUTCD: (CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES) UNLESS OTHERWISE SPECIFIED. 6.ALL PAVEMENTS, CURBS , GUTTERS, SIDEWALKS, DRIVEWAYS AND OTHER EXISTING IMPROVEMENTS TO BE RECONSTRUCTED SHALL BE RECONSTRUCTED PER CITY IMPROVEMENT STANDARDS. 7.PRIOR TO THE BEGINNING OF ANY EXCAVATION AND THROUGHOUT THE COURSE OF CONSTRUCTION WORK THE CONTRACTOR SHALL COMPLY WITH THE CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH OF 1973 INCLUDING ALL REVISIONS AND AMENDMENTS THERETO. 8.THE CONTRACTOR SHALL HAVE COPIES OF THE PLANS ON THE PROJECT SITE AND BE FAMILIAR WITH ALL APPLICABLE STANDARDS. 9.THE CONTRACTOR SHALL BE RESPONSIBLE FOR DAMAGE TO EXISTING ABOVE OR BELOW GROUND IMPROVEMENT, AS A RESULT OF HIS REPLACEMENT OF SAME TO THE SATISFACTION OF THE CITY. 10.ALL BACKHOE EXCAVATION SHALL BE SAW CUT TO FACILITATE REMOVAL BY THE USE OF A POWER DRIVEN SAW. THE CUT SHALL BE STRAIGHT, CLEAN, AND TO THE FULL DEPTH OF THE SECTION OF MATERIAL TO BE REMOVED. 11.EXISTING PORTLAND CEMENT CONCRETE SHALL BE SAW CUT TO FACILITATE REMOVAL BY THE USE OF A POWER DRIVEN SAW. THE DEPTH OF THE CUT SHALL BE DEEP ENOUGH TO PRODUCE A CLEAN, STRAIGHT BREAK WITHOUT CRACKING, CHIPPING LOOSENING ADJOINING PCC. THE EXISTING PCC SHALL BE CUT BEYOND THE CONFIGURATION OF THE TRENCH OR EXCAVATION AREA AS MAY BE REQUIRED BY THE PUBLIC WORKS INSPECTOR TO ELIMINATE SMALL "FLOATING" PIECES OF CONCRETE. CONCRETE PANELS SHALL BE REMOVED OR REPLACED FROM SCORE LINE TO SCORE LINE(ENTIRE PANEL) WHERE PCC IS DAMAGED OR CRACKED. THE SAW CUT LIMITS SHALL BE LOCATED NO CLOSER THAN 3 FEET FROM A SCORE LINE OR COLD JOINT. MIN. PCC REMOVAL IS 25 SQUARE FEET, SCORE LINE TO SCORE LINE. 12.UNLESS OTHERWISE NOTED: 3" CONDUIT BENDS SHALL HAVE A RADIUS OF 3'. 2" CONDUIT BENDS SHALL HAVE A RADIUS OF 2'. PLACE 1 SACK SLURRY MIX AROUND ALL CONDUIT BENDS HAVING A RADIUS OF LESS THAN 50'. 13.ALL CONDUIT SHALL BE SCH-40 UNLESS OTHERWISE SPECIFIED. ALL SWEEPS TO POLES SHALL BE SCH-80. 14.REMOVE AND REPLACE CURB AND GUTTER ABOVE SWEEPS TO VAULTS IN THE SIDEWALK, OR BORE UNDER CURB AND GUTTER. JETTING IS NOT ALLOWED. 15.THE CONTRACTOR SHALL NOTIFY THE APPLICABLE DEPARTMENTS OF THE CITY AT LEAST TWO DAYS BEFORE START OF THE WORK. DURING THE COURSE OF WORK. THE CONTRACTOR SHALL CALL FOR INSPECTION OF ALL APPLICABLE WORK. 16.ALL SHRUBS, PLANTS, OR TREES THAT HAVE BEEN DAMAGED OR DISTURBED DURING THE COURSE OF THE WORK SHALL BE REPLANTED OR REPLACED PER CITY ENGINEER'S DIRECTION. 17.DURING THE COURSE OF THE WORK, PEDESTRIANS AND VEHICULAR ACCESS MUST BE MAINTAINED AT ALL TIMES. 18.NON-SKID CALTRANS APPROVED STEEL PLATES SHALL BE RECESSED IN TRENCH CROSSING MAJOR STREETS (AREA DESIGNATED BY THE CITY ENGINEER) AND INSTALLED PER CALTRANS SPECS. PAVEMENT SHALL BE COLD PLANED TO A DEPTH EQUAL TO THE THICKNESS OF THE PLATE AND TO THE WIDTH AND LENGTH EQUAL TO THE DIMENSIONS OF THE PLATES. 19.STEEL PLATES USED FOR BRIDGING MUST EXTEND A MINIMUM OF 12" BEYOND EDGES OF TRENCH. 20.TEMPORARY PAVING WITH COLD MIX SHALL BE USED TO FEATHER THE EDGES OF THE PLATES TO MINIMIZE WHEEL IMPACT. CONTRACTOR MAY BE REQUIRED TO WELD PLATES TOGETHER TO MINIMIZE RATTLING. CONTRACTOR MAY BE REQUIRED TO SWEEP UP LOOSE GRAVEL SEVERAL TIMES PER DAY AS DEEMED NECESSARY BY CITY ENGINEER. 21.BRIDGING SHALL BE SECURED AGAINST DISPLACEMENT USING ADJUSTABLE CLEATS, SHIMS OR OTHER DEVICES. 22.RESTORE ALL LANDSCAPING, INCLUDING IRRIGATION SYSTEM AROUND VAULTS. 23.INSTALL VAULTS NEXT TO CURB WHERE POSSIBLE. 24.NEW PAVEMENT SHALL BE PER CITY STANDARD 25.TACK COAT SHALL BE APPLIED OVER ROADWAY SURFACE PRIOR TO PAVEMENT INSTALLATION. TACK COAT SHALL BE PG 64-10 PAVING ASPHALT OR SS-1H EMULSIFIED ASPHALT PER "GREEN BOOK" REQUIREMENTS. 26.ONE SACK SLURRY MIX SHALL BE USED FOR BACKFILL. ALL SLURRY BACKFILLS WILL REQUIRE 72 HOURS OF CURE TIME. ALL EXCAVATION. TRAFFIC CONTROL NOTE: CONTRACTOR SHALL SET UP TEMPORARY TRAFFIC CONTROL SHOWN ON ACCOMPANYING TRAFFIC CONTROL PLAN LD24-1860. SCALE:1"=20' P 1 SACK SLURRY TULLEY RANCH RD S LD24-1860 EXCAVATION LEGEND - GENERAL PROP. VAULTV PROP. BORE PROP. TRENCH PROP. PEDESTALP PROP. BORE PIT PROP. POTHOLE CONCRETE TO BE REMOVE & REPLACE EX. HANDHOLE / SCE VENT EX. UTILITY HOLE EX. LIGHT POLE EX. TREE EX. VAULT / PEDESTAL / CABINET EX. TELEPHONE POLE EX. FIRE HYDRANT C/L CENTER LINE C&G CURB & GUTTER R/W RIGHT OF WAY CITY BOUNDARY EX. VAULTV EX. ANCHOR EX. PEDESTAL 6" VARIES 36 " MI N C O V E R 6" VARIES 3" MIN 3" MIN *REMOVE AND REPLACE EXISTING A.C IF REMNANT IS 2' OR LESS AND REPLACE CURB & GUTTER CONTRACTOR TO VERIFY DEPTH OF ALL UTILITY CROSSINGS AND KEEP A MIN OF 12" CLEARANCE SAWCUT EDGES 12 " MI N . *NOTE: WHERE CUT IS 24” OR LESS FROM THE EDGE OF AN EXISTING PATCH, CURB & GUTTER, CONCRETE PAVEMENT, CONCRETE CROSSWALKS AND/OR DECORATIVE PAVERS, REMOVE THE EXISTING A.C. BETWEEN THE CUT AND THIS EDGE AND REPLACE. EXISTING ASPHALT AT A MIN. MATCH EXISTING ASPHALT THICKNESS 12" A.B. @ 95% COMPACTION PROPOSED PVC CONDUIT BORE PIT / POTHOLE - ASPHALT - DETAIL N.T.S CONSTRUCTION NOTES: 1.BORE TO PLACE PVC (SCH-40) CONDUIT. COUNT AND SIZE PER CONDUIT DATA BLOCK ................................ 122 L.F. 2.TIE INTO EXISTING VAULT ...................................................................... 1 EA. 3.PLACE 3'x5' BORE/RECEIVING PIT ......................................................... 3 EA. 4.PLACE PVC (SCH-40) CONDUIT STUB OUT. COUNT AND SIZE PER CONDUIT DATA BLOCK ................................... 1 EA. 5.PLACE 3'x5' POTHOLES TO LOCATE UTILITIES ................................... 1 EA. agrim@inland-engineering.com AMBER GRIM PA S C U A L C I R EX. SEWER EXCAVATION LEGEND - UTILITIES WHERE PLAN NOTES CONFLICT THE CITY OF TEMECULA NOTES SHALL GOVERN. SEE SHEET 02 FOR UTILITY PLAN GENERAL NOTES AND DETAILS. CLEARED BY CITY OF TEMECULA PUBLIC WORKS Tricia.ortega 07/08/2024 07/08/2024 07/08/2024 07/08/20 SHEET 02 OF 02 PROJECT: PID# 5325679 CITY OF TEMECULA WORK LOCATION: TULLEY RANCH RD & PASCUAL CIRINLAND ENGINEERING SERVICES, INC. TARGET/SERVICE ADDRESS: 32769 TULLEY RANCH RD, TEMECULA, CA 925921373 OLD TEMESCAL RD, CORONA, CA 92881 TEL: 951.277.0800 FAX: 951.277.5300 DESIGNER OWNER 1-800-422-4133 AT LEAST TWO DAYS BEFORE YOU DIG UNDERGROUND SERVICE ALERT OF SOUTHERN CALIFORNIA TICKET# DIGALERT EXCAVATION PLAN DESIGNED BY:INLAND ENGINEERING SERVICES DRAFTED BY:INLAND ENGINEERING SERVICES TEL. NUMBER:(951) 277-0800 PERMIT COORDINATOR: EMAIL: REVISION DATE: 06/11/2024 CONDUIT DATA BLOCK TOTAL WORK DURATION: 2 DAYS EXCAVATION LEGEND - GENERAL PROP. VAULTV PROP. BORE PROP. TRENCH PROP. PEDESTALP PROP. BORE PIT PROP. POTHOLE CONCRETE TO BE REMOVE & REPLACE EX. HANDHOLE / SCE VENT EX. UTILITY HOLE EX. LIGHT POLE EX. TREE EX. VAULT / PEDESTAL / CABINET EX. TELEPHONE POLE EX. FIRE HYDRANT C/L CENTER LINE C&G CURB & GUTTER R/W RIGHT OF WAY CITY BOUNDARY EX. VAULTV EX. ANCHOR EX. PEDESTALP agrim@inland-engineering.com AMBER GRIM LD24-1860 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD DATE (MM/DD/YYYY) PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGG $JECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE $ CLAIMS-MADE AGGREGATE $ DED RETENTION $$ PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 kcasu@lockton.com HHS CONSTRUCTION, LLC 2042 S. GROVE AVE. ONTARIO CA 91761 - Hartford Casualty Insurance Company 29424 Hartford Fire Insurance Company 19682 Twin City Fire Insurance Company 29459 X X 1,000,000 300,000 10,000 1,000,000 2,000,000 2,000,000 X X X X $1,000,000 XXXXXXX XXXXXXX XXXXXXX XXXXXXX X X X 10,000 10,000,000 10,000,000 XXXXXXX XXXXXXX XXXXXXX XXXXXXX C 37 UENOL5831 9/30/2023 9/30/2024 A 37 ECS0L5825 9/30/2023 9/30/2024 B 37XHUOL5832 9/30/2023 9/30/2024 NOT APPLICABLE 9/30/2024 1451971 N N N N N N 8/31/2023 16271358 16271358 XXXXXXX CITY OF TEMECULA 41000 MAIN STREET TEMECULA CA 92590 RE: ALL OPERATIONS PERFORMED BY THE NAMED INSURED DURING THE CURRENT POLICY PERIOD. EXCEPT 10 DAYS NOTICE OF CANCELLATION OF NON-PAYMENT OF PREMIUM; SHOULD THIS POLICY BE CANCELLED BEFORE THE EXPIRATION DATE, LOCKTON COMPANIES WILL MAIL 30 (THIRTY) DAYS WRITTEN NOTICE TO THOSE CERTIFICATE HOLDERS WHICH REQUIRE SUCH ACTION PER CONTRACT OR AGREEMENT. X X CERTIFICATE OF LIABILITY INSURANCE Acct#: 2795388 DATE (MM/DD/YYYY) 02/09/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LOCKTON COMPANIES, LLC 3657 BRIARPARK DR., SUITE 700 HOUSTON, TX 77042 CONTACT NAME: PHONE (A/C, No, Ext): 888-828-8365 FAX (A/C, No): E-MAIL ADDRESS: INSPERITYCERTS@LOCKTONAFFINITY.COM INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Indemnity Insurance Co. of North America 43575 INSURED HHS CONSTRUCTION, LLC 2042 S GROVE AVE ONTARIO, CA 91761-5617 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT T O ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS- MADE OCCUR OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ OWNED AUTOS ONLY HIRED AUTOS ONLY SCHEDULED AUTOS NON-OWNED AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS’ LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A X C55949013 10/01/2023 10/01/2024 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Waiver of Subrogation in favor of Certificate Holder when required by written contract RE: ALL OPERATIONS PERFORMED BY THE NAMED INSURED DURING THE CURRENT POLICY PERIOD. CERTIFICATE HOLDER CANCELLATION 2795388 CITY OF TEMECULA 41000 MAIN ST TEMECULA, CA 92590 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number HHS CONSTRUCTION, LLC 2042 S GROVE AVE ONTARIO, CA 91761-5617 Policy Number Symbol: WLR Number: C55949013 Policy Period 10/01/2023 TO 10/01/2024 Effective Date of Endorsement 10/01/2023 Issued By (Name of Insurance Company) Indemnity Insurance Co. of North America Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. ( X ) Specific Waiver Name of person or organization: CITY OF TEMECULA 41000 MAIN ST TEMECULA, CA92590 Waiver of Subrogation in favor of Certificate Holder when required by written contract ( ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: RE: ALL OPERATIONS PERFORMED BY THE NAMED INSURED DURING THE CURRENT POLICY PERIOD. 3. Premium: The premium charge for this endorsement shall be INCLUDED percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: INCLUDED Authorized Representative WC 90 03 75 (05/18) Land Development Encroachment Permit 41000 Main Street Temecula, Ca 92590 Phone: 951-694-6444 www.temeculaca.gov R:\LAND DEVELOPMENT DIVISION\Forms\Permit Applications\Word\Encroachment Permit App.docx Page 1 of 2 Revised: 06/16/2020 APPLICATION INFORMATION PERMIT NO.: Type of Encroachment:  Street/Storm Drain  Sewer/Water  Utility Trenching  Signing & Striping  Traffic Signal  Miscellaneous (SPECIFY BELOW) The undersigned hereby applies to excavate, construct and otherwise encroach on City street right-of-way, as follows: Name(s) of street(s) and/or street address: Utility Work Order #: Start Date: End Date: In consideration of granting this application, all applicants including utility companies hereby agree to: 1. If applicable, submit a set of Construction Drawings, Traffic Control Plans, proof of City Business License for all parties involved, proof of Contractor’s License along with this application at the time of submittal. See the Traffic Control Plan Checklist for details. 2. Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. (See below for specific liability insurance requirements.) 3. Remove/relocate any encroachment installed/maintained under this permit, upon written notice from the City Engineer. 4. Notify the Land Development Inspection Division via email at LDInspections@temeculaca.gov at least two (2) working days prior to commencing construction. Hold a pre-construction meeting prior to the start of construction. The developer/general contractor must be present for the timely request of inspections. 5. Comply with the Standard Specifications, most current Improvement Standard Drawings for Public Works Construction, City of Temecula Municipal Code Chapters 13.04 and 18.12, terms and conditions of the permit and all applicable rules and regulations for the City of Temecula and other public agencies having jurisdiction. LIABILITY INSURANCE REQUIREMENTS PROVIDE PROOF OF INSURANCE COVERAGE MEETING THE REQURIEMENTS STATED BELOW OR A CITY ATTORNEY APPROVED EQUIVALENT WITH THE CITY NAMED AS ADDITIONAL INSURED. IN THE EVENT THAT THE INSURANCE IS PROVIDED BY THE CONTRACTOR, THE CITY AND THE OWNER/DEVELOPER MUST BE NAMED AS ADDITIONAL INSURED. THIS REQUREMENT SHALL BE MET BY EITHER THE APPLICANT (DEVELOPER, OWNER, PUBLIC UTILITY AGENCY OR FRANCHISE) OR BY THE CONTRACTOR PERFORMING THE SUBJECT WORK, PRIOR TO BEGININNG ANY WORK PROPOSED UNDER THE SUBJECT ENCROACHMENT PERMIT. Bore to place 122' of PVC (SCH-40) conduit for fiber optic cable. Tie into (1) existing vault. Place (3) bore/receiving pits in the street. Place (1) new PVC conduit stub out. 32769 Tulley Ranch Rd (Rulley Ranch Rd & Pascual Cir) PID 5325679 06/04/2024 06/06/2024 LD24-1860 CLEARED BY CITY OF TEMECULA PUBLIC WORKS Tricia.ortega 06/06/2024 06/06/2024 06/06/2024 06/06/20 Land Development Encroachment Permit 41000 Main Street Temecula, Ca 92590 Phone: 951-694-6444 www.temeculaca.gov R:\LAND DEVELOPMENT DIVISION\Forms\Permit Applications\Word\Encroachment Permit App.docx Page 2 of 2 Revised: 06/16/2020 Proof of coverage shall be by certificate (Accord or equivalent) naming the City of Temecula as certificate holder and the minimum limits of insurance coverage shall be as follows: a. General Liability: One million dollars ($1,000,000) per occurrence for bodily injury, personal injury and property damage. If Commercial General Liability Insurance or other form with a general aggregate limit is used, either the general aggregate lim it shall apply separately to this project/location or the general aggregate limit shall be twice the required occurrence limit. b. Automobile Liability: One million dollars ($1,000,000) per accident for bodily injury and property damage. c. Worker’s Compensation as required by the State of California; Employer’s Liability: One million dollars ($1,000,000) per accident for bodily injury or disease. d. Course of Construction: Completed value of the project. There is a limited exception to this requirement. Owners of single family homes doing work on the home’s driveway approac h located in the public right-of-way, may use their homeowners insurance with public liability and property damage coverage in at least the following minimum limits and which will name the City of Temecula as an additional insured for the duration of the encroachment permit: BODILY INJURY $250,000.00 EACH PERSON $500,000.00 EACH OCCURANCE $500,000.00 AGGREGATE PRODUCTS AND COMPLETED OPERATIONS PROPERTY DAMAGE $100,000.00 EACH OCCURANCE $250,000.00 AGGREGATE PRODUCTS AND COMPLETED OPERATIONS A combined single limit homeowner’s policy with aggregate limits in the amount of $1,000,000.00 will be considered equivalent to the required minimum limits. Homeowners: a copy of the required homeowners insurance and a Certificate of Insurance showing the City named as an additional insured shall be attached to the application. The undersigned applicant and/or contractor states that they have read and agrees to meet all the conditions on this application, including provisions of required liability insurance or a City Attorney approved equivalent, and acknowledges that this application will be made a part of the encroachment permit. APPLICANT’S INFORMATION (THIS SECTION MUST BE COMPLETED) Company Name: Mailing Address: Contact: Phone #: E-mail: I hereby warrant and represent to the City that I am authorized to execute this permit application on behalf of the permittee and bind the permittee to the agreements contained herein and any conditions of the permit. Authorized Signature: Date Applied: CONTRACTOR’S INFORMATION Company Name: Mailing Address: Contact: Phone #: 24-HR Emergency #: State Contractor’s License #: Class: City Business License #: Charter Communications (Marcus/Owner) / Inland Engineering Services (Amber/Applicant) 7337 Central Ave, Riverside, CA 92504 / 1373 Old Temescal Rd, Corona, CA 9288 Amber Grim 951.277.0800 x257 agrim@inland-engineering.com 04/30/2024 H H S Construction 2042 S. Grove Ave., Ontario CA 91761 Michael Sisler (909) 393-3322 818906 A / C31 049178