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HomeMy WebLinkAboutLD24-2895Permit Number: LD24-2895 LD - Utilities/ Excavation - Parallel Issued: 09/17/2024 Expired: 03/16/2025 Job Address: 31195 Pauba 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 Sung Baik 7391 Lincoln Dr Garden Grove, CA 92841 (714) 909-3912 Applicant: Alexis Scanlan 2042 S Grove Ave Ave Ontario, CA 91761 (909) 393-3322 ext 228 Contractor: Utility Work Order Number: 5414443 Description: Charter PID 5440187 WORK HOURS SHALL BE MONDAY – FRIDAY, NO HOLIDAYS, 8:30am - 3:30pm Location: Pauba Rd S/S 425' W/O Margarita Rd Proposed work: Access one (1) handhole as shown on Charter "SITE PLAN 31195 PAUBA RD, LD24-2895" All facilities shall be installed in accordance with City Standard Drawing 117. Traffic Control shall be in accordance with approved Traffic Control Plan LD24-2895 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 the City Engineer or their designated assignee. Permittee shall contact LDInspections@temeculaca.gov a minimum of two (2) business days prior to any work. Permittee must also request a final inspection to verify completion of project. Page 1 of 2*****See Page 2 of this Permit for Permittee Responsibilities***** Permit Number: LD24-2895 LD - Utilities/ Excavation - Parallel 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 City Engineer or Authorized Representative Date 09/17/2024 Page 2 of 2 CITY OF TEMECULA COVER PAGE 31195 PAUBA RD WORK AREA VICINITY MAP N.T.S. N WORK AREA SCOPE OF WORK: WORK HOURS: PERMIT NO. LD24- 2895 PUBLIC WORKS - TRAFFIC ENGINEERING DIVISION CITY OF TEMECULA 1 2 ENGINEER'S SEAL FOR TRAFFIC CONTROL PLANS TIE-IN TO EXIST. CHARTER VAULT 31195 PAUBA RD. CONTRACTOR: RECOMMENDED BY:DATE: ACCEPTED BY:DATE: R.T.E. NO. 1 PER CITY M.M.7/25/2024 JOHN GRIFFIN CONSTRUCTION INC 244 JASON COURT CORONA, CA 92879 Business Phone Number:(951) 278-2377 ERICK ESCOBEDO TRAFFIC ENGINEER 3002 TYPICAL CONSTRUCTION SIGNS SHARE THE ROAD END ROAD WORK 1.ALL TRAFFIC CONTROL DEVICES SHALL CONFORM TO THE LATEST EDITION OF THE CALIFORNIA MANUAL ON UNIFORM TRAFFIC CONTROL DEVICES (CALIFORNIA MUTCD) AND THE STANDARD SPECIFICATIONS FOR PUBLIC WORKS CONSTRUCTION. 2.THE CITY ENGINEER OR HIS REPRESENTATIVE HAS THE AUTHORITY TO INITIATE FIELD CHANGES TO ASSURE PUBLIC SAFETY. 3.ALL TRAFFIC CONTROL DEVICES SHALL BE REMOVED FROM VIEW WHEN NOT IN USE. 4.WORK HOURS SHALL BE RESTRICTED TO THE PERIOD BETWEEN 8:30 A.M. AND 3:30 P.M., MONDAY THROUGH FRIDAY, UNLESS APPROVED OTHERWISE. WHEN NIGHT WORK IS REQUIRED, WORK HOURS SHALL BE 9 P.M. TO 5 A.M., SUNDAY THROUGH THURSDAY. 5.TRENCHES MUST BE BACK FILLED OR PLATED DURING NON-WORKING HOURS. STEEL PLATES SHALL HAVE ASPHALTIC CONCRETE BERM ON ALL EDGES. ALL DIRT, DUST, AND DEBRIS SHALL BE REMOVED FROM STREET AT END OF EACH DAY AND AT THE END OF THE JOB. THE STREET SHALL BE IN DRIVABLE CONDITION AT ALL TIMES. 6.PEDESTRIAN CONTROLS SHALL BE PROVIDED AS SHOWN ON THE PLANS. 7.TEMPORARY "NO PARKING" SIGNS WILL BE POSTED 24 HOURS PRIOR TO COMMENCING WORK. 8.ACCESS TO DRIVEWAYS WILL BE MAINTAINED AT ALL TIMES UNLESS OTHER ARRANGEMENTS ARE MADE. 9.THE CONTRACTOR SHALL REPLACE WITHIN 72 HOURS, ALL TRAFFIC SIGNAL LOOP DETECTORS DAMAGED DURING CONSTRUCTION. 10.THE CONTRACTOR SHALL REPLACE WITHIN 24 HOURS, ALL STRIPING REMOVED OR DAMAGED BY CONSTRUCTION WORK. (STRIPING MAY BE REPLACED TEMPORARILY WITH TAPE.) 11.ALL WORKERS SHALL BE EQUIPPED WITH AN ORANGE VEST (OR A REFLECTIVE VEST AT NIGHT). ALL FLAGGERS SHALL ALSO BE EQUIPPED WITH A HARD HAT, C28 "STOP/SLOW" PADDLE AND SHALL BE TRAINED IN THE PROPER FUNDAMENTALS OF FLAGGING TRAFFIC. 12.ANY WORK THAT DISTURBS NORMAL TRAFFIC SIGNAL OPERATIONS SHALL BE COORDINATED WITH THE CITY OF TEMECULA'S TRAFFIC DIVISION, 48 HOURS PRIOR TO BEGINNING CONSTRUCTION. CONTACT THE CITY'S TRAFFIC DIVISION AT (951) 694 -6411. 13.THE CONTRACTOR SHALL MAINTAIN ALL TRAFFIC CONTROL DEVICES 24 HOURS PER DAY AND 7 DAYS PER WEEK. 14. A MINIMUM OF TWELVE (12) FOOT TRAVEL LANES MUST BE MAINTAINED UNLESS OTHERWISE APPROVED BY THE DEPARTMENT OF PUBLIC WORKS. 15. ALL NIGHT WORK WILL REQUIRE WRITTEN APPROVAL FROM THE DEPARTMENT OF PUBLIC WORKS. LANE CLOSURES, ROAD DETOURS, ROAD CLOSURES, AND TRAFFIC SIGNAL MODIFICATIONS ASSOCIATED WITH OVERNIGHT CONSTRUCTION ACTIVITIES WILL REQUIRE WARNING SIGNS BE PLACED AT LEAST ONE WEEK IN ADVANCE OF STARTING CONSTRUCTION. 16. A SOLAR POWERED FLASHING ARROW BOARD SHALL BE REQUIRED ON ALL ARTERIAL STREET LANE CLOSURES. 17. IF THE PERMIT APPLICANT DETERMINES THAT CONDUIT INSTALLATION WILL BE BY THE BORING MACHINE METHOD, THE TRENCH PATCH FOR THE UTILITY OBSERVATION EXCAVATION WILL BE THE SAME AS FOR OPEN TRENCH EXCAVATION METHOD. THIS WILL PROVIDE A SINGLE CONTINUOUS SURFACE RESTORATION ELIMINATING THE MULTIPLE PENETRATION INTO THE PUBLIC ROADWAY TO ALL REQUIREMENTS IN CITY STANDARD DRAWING # 407 (REFERENCE ALL SHEETS) FOR TRENCH PATCH. 18. ANY WORK THAT CREATES AN UNDUE SAFETY RISK OR CREATES SEVERE CONGESTION MAY BE SHUT DOWN BY CITY TRAFFIC ENGINEERS, CITY FIELD INSPECTION, OR THE POLICE DEPARTMENT. 19. CONES AND DELINEATORS SHALL HAVE REFLECTORIZED SLEEVES FOR NIGHT WORK. 20. IF PARKING IS ALLOWED IN ADVANCE WARNING AREA, ADVANCE WARNING SIGNS SHALL BE MOUNTED ON HIGH LEVEL DEVICES. APPLICANT IS RESPONSIBLE FOR FULL AND COMPLETE REPRESENTATION OF THE ACTUAL ROAD CONDITIONS SHOWN ON THIS PLAN INCLUDING, BUT NOT LIMITED TO EXISTING STRIPING, SIGNING, SIDEWALKS, AND BIKE LANES. PID# 5414443 FLASHING ARROW BOARD CLOSED LANE 2 PER CITY M.M.8/15/24 Signed Date 8/15/2024 R.C.E. NO. C95514 Exp. 012/31/2025 Firm Address 9 Albany Irvine, CA 29604 Telephone 714-862-3882 ENGINEER'S INFORMATION Name: Essam Dolah RCE No.: C95514 EXP.: DEC 31, 2025 FIRM: ADDRESS: 9 Albany Irvine CA 92604 08/15/2024 09/04/24 9/09/20 24 VT S PAUB A R D 45 MP H MA R G A R I T A R D 45 M P H SIDEWALK SIDE W A L K SIDE W A L K SID E W A L K DIRT S I D E W A L K D I R T SI D E W A L K SI D E W A L K G R A S S BIKE L A N E BIKE L A N E SIDE W A L K BIKE L A N E BIKE L A N E SIDE W A L K BIKE LANE BIKE L A N E SIDEW A L K G R A S S 100' BUFFE R 540' MERGING TA P E R 50' DOWN S T R E A M TAPE R 1 4 ' 350' MA R G A R I T A R D 45 M P H WORK AREA PAINTED ME D I A N 180' BIKE TAPER FLASHING ARROW BOARD PAINTED MEDIAN 1 2 ' S I G N A L S I G N A L A H E A D A H E A D B I K E L A N E SIDEWALK B I K E L A N E LAND S C A P E 350'350'350'350' SIDEWALK SIDEWALK PAUBA RD 45 MPH PAINTED MEDIAN PAINTED MEDIAN STOP SI D E W A L K SI D E W A L K 10 0 ' CA L L E C A M E L L I A 25 M P H CITY OF TEMECULA TRAFFIC PLANS 31195 PAUBA RD PHASE 1 OF 1 CONTACT PROPERTY OWNER(S) 72 HOURS PRIOR TO START OF WORK CONTRACTOR TO PROVIDE ACCESS TO DRIVEWAYS AT ALL TIMES AN INDIVIDUAL WILL BE ASSIGNED TO MAINTAIN THE CONES WHILE THE WORK ZONE IS IN PLACE 0 SCALE: 1"=40' 40'80' PUBLIC WORKS - TRAFFIC ENGINEERING DIVISION CITY OF TEMECULAENGINEER'S SEAL FOR TRAFFIC CONTROL PLANS TIE-IN TO EXIST. CHARTER VAULT 31195 PAUBA RD. PERMIT NO. LD24-2895 RECOMMENDED BY:DATE: ACCEPTED BY:DATE: R.T.E. NO. CONTRACTOR: JOHN GRIFFIN CONSTRUCTION INC 244 JASON COURT CORONA, CA 92879 Business Phone Number:(951) 278-2377 Charter CLIENT: WORK HOURS: 2 2 1 ERICK ESCOBEDO TRAFFIC ENGINEER 3002 M A T C H L I N E A - A MA T C H L I N E A - A PID# 5414443 FLAGGER TO ASSIST PEDESTRIANS THROUGH WORK AREA ENGINEER'S INFORMATION Name: Essam Dolah RCE No.: C95514 EXP.: DEC 31, 2025 FIRM: ADDRESS: 9 Albany Irvine CA 92604 08/15/2024 09/04/24 9/09/20 24 SS SS SS SS SS CL CL CL CL CL CL CL CL CL R/W R/W R/W R/W R/W R/W R/W R/W R/W P L P L P L 8 8 ' 4 4 ' 4 4 ' 1 2 ' 1 2 ' 31195 EX. HH 31217 43000 4+00 27' 6 ' 5+00 8 8 ' 4 4 ' 4 4 ' 1 2 ' 3 2 ' 3 2 ' 1 2 ' C L C L C L C L C L C L C L C L 3 2 ' 3 2 ' 0+00 0 + 0 0 M M M 1 C T V L CL CL CL CL CL CL CL C L C L C L C L C L C L C L 131' ROD & ROPE2 C&G 6' DIR T R/W 6' S/W R/W R/W R/W C&G C&G 6' DIR T 6' S/W 6' S/W 6' S/W C&G BIKE L A N E BIKE L A N E BIKE L A N E BIKE L A N E C L SITE PLAN REV#DATE DESCRIPTION INT 0 SCALE: 1"=20' 20'40' Charter SIDEWALKRAILROAD TREE R/R S/W FOC R/W EDGE OF PAVEMENT CURB FACE UNDERGROUND CENTER LINE CONCRETE RIGHT OF WAY FRONT OF CURB EXISTING FROM CURB FACE CL EOP CF U/G CONC EX FCFEOP C/L R/W FOC SYMBOL/LINETYPE DESCRIPTIONABBRV. TRAFFIC SIGNAL HAND HOLE FIRE HYDRANT STREET LIGHT MANHOLE VALVE PEDESTAL UTILITY POLE SYMBOL/LINETYPE DESCRIPTIONABBRV. HH F/H MH VLV PED SL TS W G SS SLC SD E T ELECTRIC TELEPHONE GAS STORM DRAIN SANITARY SEWER WATER OIL / PETROLEUMOIL STREET LIGHT CONDUIT SYMBOL/LINETYPE DESCRIPTION DESCRIPTIONABBRV. C&G CURB & GUTTERC&G VENT METERM DRIVEWAYD/W CURB FACE GUTTER LIP POLE MTR SIDEWALK DRAIN POLE ANCHOR FIBER OPTICFO CATVTV EXISTING STRUCTURES MISC. LE G E N D ADA RAMP BACKFLOW CONC.SIDEWALKCSW P PARKING METER STREET SIGN BEHIND CURB FACEBCF VERTICAL GROUND RODVGR OVERHEADO/H OF SHEET E-MAIL: DATE: SCALE: PROJECT: WORK LOCATION: SERVICE ADDRESS:THOMAS GUIDE: CITY OF TEMECULA5414443 31195 PAUBA RD. 31195 PAUBA RD. TEMECULA, CA 92592 1 1 07/01/2024 1" = 20' CRISTY.AGUSTIN@VVDCOMM.NET 959 - C7 REVISION: CLIENT: TICKET# UNDERGROUND SERVICE ALERT OF SOUTHERN CALIFORNIA AT LEAST TWO DAYS BEFORE YOU DIG CONTACT 811 ENGINEER: VIDEO VOICE DATA 7391 Lincoln Way Garden Grove, CA 92841 714-897-6300 KEY NOTES: 1 2 TIE-INTO EXIST. CHARTER HH IN DIRT STA 4+27 - 6' FOC ROD & ROPE NEW COAX CABLE 131' THRU EXIST. CATV CONDUIT TO BLDG. 31195 SITE PLAN TIE-INTO EXIST. CHARTER HH IN DIRT. ROD & ROPE NEW CAOX CABLE 131' THRUEXIST. CATV CONDUIT FROM EXIST. CHARTER HH TO BLDG. 31195. WORK ZONE VICINITY MAP N.T.S. N "NO EXCAVATION ALLOWED" APPLICANT SHALL COMPLY WITH ALL CITY OF TEMECULA UTILITY PLAN GENERAL NOTES LD24-2895 CLEARED BY CITY OF TEMECULA PUBLIC WORKS Tricia.ortega 07/23/2024 07/23/2024 07/23/2024 07/23/20 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 Land Development Encroachment Permit 41000 Main Street Temecula, Ca 92590 Phone: 951-694-6444 www.temeculaca.gov R:\LAND DEVELOPMENT DIVISION\FORMS\Permit Applications\Encroachment Permit App.docx Page 1 of 2 Revised: 06/03/2019 APPLICATION INFORMATION PA No.: 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 two (2) sets of Construction Drawings along with two (2) sets of the appropriate 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 dam age to persons or property happening or occurring as a proximate result of any work under taken 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 ENCROACH MENT PERMIT. Tie-in to existing Charter handhole in dirt; rod & rope new coax cable through existing CATV conduit from existing Charter handhole to building. 31195 Pauba Rd Temecula CA 92592 5414443 07/22/2024 07/26/2024 4 LD24-2895 CLEARED BY CITY OF TEMECULA PUBLIC WORKS Tricia.ortega 07/23/2024 07/23/2024 07/23/2024 07/23/20 Land Development Encroachment Permit 41000 Main Street Temecula, Ca 92590 Phone: 951-694-6444 www.temeculaca.gov R:\LAND DEVELOPMENT DIVISION\FORMS\Permit Applications\Encroachment Permit App.docx Page 2 of 2 Revised: 06/03/2019 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 approach 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 7337 Central Ave Riverside CA 92504 Emily Osborn 562-332-0499 emily.osborn@vvdcomm.net 07/02/2024 HHS Construction LLC 2042 S Grove Avenue Ontario CA 91761 Michael Sisler 657-207-4641 (657)207-4641 818906 A, C31, C10, B, C-7 049178