application for water service installation - Pasadena - City of Pasadena

application for water service installation - Pasadena - City of Pasadena

For PWP Use Only ___ / ___ / ___ City of Pasadena Department of Water and Power 1055 East Colorado Blvd, Suite 350 Pasadena, CA 91106-2383 Attention:...

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For PWP Use Only ___ / ___ / ___

City of Pasadena Department of Water and Power 1055 East Colorado Blvd, Suite 350 Pasadena, CA 91106-2383 Attention: Water Utility Services Planning Section Phone: (626) 744-4495

Date: _____________________

APPLICATION FOR WATER SERVICE INSTALLATION Owner Billing Information Assessor's Parcel Number Service Address (Use Assessor's Parcel Number if not available)

City

ZIP

Apt/Unit #

Additional Addresses:

City

ZIP

Apt/Unit #

Billing Name

Email Address

Billing Address (if different from service address) Contact Name

Phone Number

City

Zip

Email Address

Contact Company

Cell Phone Number

Phone Number

City

Apt/Unit # Cell Phone Number

Zip

Apt/Unit #

Project Engineer/Manager Company Name Address

Apt/Unit #

Contact Name

Email Address

City

Zip

Phone Number

Cell Phone Number

Plumbing Contractor Company Name Address

Apt/Unit #

Contact Name

Email Address

City

Zip

Phone Number

Cell Phone Number

Building Information Construction Start Date: New

Status of Building: Building Type:

Construction Completion Date:

Commercial

Exis9ng

Number of Stories _______

Mul9-Unit (______ units) Single Family Residen9al Requested Water Service 2" _______

Mixed Use

Domestic Lateral Units

1" _______

4" _______

6" _______

8" _______

Domestic Meter Units

1" _______ 1.5" _______ 2" _______3" _______ 4" _______

6" _______

8" _______

Fire Service Units

4" _______ 6" _______ 8" _______ Fire Hydrant Units Signature of Owner or Authorized Agent

_______

Signature of Owner or Authorized Agent ____________________________________________ Date _______________________

Thank you for giving Pasadena Water and Power (PWP) the opportunity to serve you. The following summarizes the work flow process and requirements for your water improvements. Please complete the attached application and submit with the applicable drawings, documents and deposit. Incomplete application will not be processed. Communications: PWP requires a single point of contact. All communications must be in writing. Payment: Payments are by check only payable to "City of Pasadena Water and Power". Construction Schedule: Submitting a construction schedule will allow PWP to plan accordingly to try to meet your schedule. Deposit: Deposit will be credited towards the formal estimate. Commercial: $5,000.00 Single Family: $2,000.00 Requirements: Composite Utility Drawing / Site Plan Please allow 6-8 weeks for the review and approval of the composite utility drawing. This six-week time includes meetings and correspondence with your Civil Engineer or designee for the public right of way water improvements and easement requirements. The owner is responsible for ensuring a clear and unobstructed pathway for the installation of all water services to the parcel. Upon completion and approval of the composite drawing, a formal estimate will be issued to the applicant. An AutoCAD format of the final drawing may be required. The estimate is valid for 90-days. Your Composite Utility Drawing shall reflect: • The assessor's address of the parcel • The north arrow (must not be pointing down) • The street name, street right-of-way, curb and gutter. • The building footprint, in whole or in part, showing the front of the structure. • The existing and proposed use and location of water services, measured in feet from the property line. For existing services, include existing backflow prevention assemblies at the meter: identify type, size, manufacture, model, and serial number. For new services, include proposed backflow devices: identify type, size, manufacture and model. All trees, driveway aprons, bus pad, ADA curb ramp, fire hydrants, sewer, storm drain, and other utilities (including laterals, • vaults, meter boxes, manholes, vents, poles, guy wires, traffic loops, etc.), within the frontage public right of way. Show minimum 5-foot separation from the adjacent proposed services.

• • • • • • • •

General Requirements: Water lines shall not cross lot lines to serve adjoining lots without a utility easement. Utility Service Planning (USP) shall approve all proposed easements. Provide a certified record from the County Assessor Office for subdivided lots. USP will evaluate all existing water services for reuse. All services not utilized will be disconnected from the water main at total cost to the property owner. PWP shall designate the distribution main for service, and install the service lateral and water meter. All city cross-connection control polices shall be adhered to. If more than one domestic water service is required to serve the parcel; the property owner is responsible for the installation of a USC approved backflow prevention assembly at each water service, subject to PWP approval of its type, manufacture and model. The assemblies shall be located on private property, within 10' of the water meter, 12" above grade and maintained in a readily accessible location for test and maintenance. Upon installation, the owner is responsible for testing and certifying the assemblies by a person that possesses a current and valid tester license issued by the County of Los Angeles Department of Health Services. The owner shall submit the results of the test to the Utility Services Planning for approval. A $190 registration fee is due for each new assembly installed. The property owner is responsible for the annual test and certification.

Helpful Links: Water Regulation and Cross-Connection Policy: http://ww2.cityofpasadena.net/waterandpower/yourwater/WaterServiceRequirements.pdf Water Rate Ordinance: https://www.municode.com/library/ca/pasadena/codes/code_of_ordinances?nodeId=TIT13UTSE_CH13.20WASERA&searchText= Los Angeles County Parcel Maps: http://maps.assessor.lacounty.gov/GVH_2_2/Index.html?configBase=http://maps.assessor.lacounty.gov/Geocortex/Essentials/REST/sites/P AIS/viewers/PAIS_hv/virtualdirectory/Resources/Config/Default USC List of Approved Backflow Devices USC Foundation for Cross-Connection Control and Hydraulic Research: List of Approved Backflow Prevention Assemblies Department of Public Health List of Approved Backflow Testers LA County Department of Public Health - EH - Cross Connection and Water Pollution Control Program