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ENC2015-00097
�4, OF C F' G� OkCHAR9 CITY OF CAMPBELL .Public Works Department Andrew Nichols 1245 Lakeside Dr. Sunnyvale, CA 94085 SUBJECT: PERMIT NO. ENC 2015-00097 355 Carlyn Ave., Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Andrew: The City of Campbell has made the final one year maintenance inspection of the subject Public Works improvements and finds that no remedial work is required. Your warranty requirements and any surety, therefore, are hereby released. AND - The remaining 25% of your Faithful Performance Security deposit. in the amount of $500.00 is enclosed. Sincerely, Syed Wahidi Public works Inspector Cc: Permit # ENC 2015-00097 70 North First Street • Campbell, California 95008-1436 TEL 408.866.2150 • FAX 408.376.0958 • TDD 408.866.2790 CITY OF CAMPBELL VENDOR NO. 10015064 CHECK NO. 269227 *See Reverse Side For Easy pening Instructions* -. CITY OF CAMPBELL ' 70 NORTHIFIRST STREET CAMPBELL,ICALIFORNIA 95008 i ANDREW NICHOLS 1245 LAKESIDE DR SUNNYVALE CA 94085 I I I I I i I Refundable ; Deposit= Check.. Request: j To: Finance Director Check, Payable To Andrew Nicholes Address -'Line 1: 1245 Lakeside -Dr: Line 2; City.. 'Sunnyvale . State: CA Zip 94685 Description: " 355 Carlyn•Ave-.. Account'Number: .. 101.2203 ,. _ Amount:.. $500:00 Account Number: 101.2203 Amount: _ Account Number: 101.540.7448 - - . Amount:' {Finance Dept only) - In'terest Earned (FinanceDept.ogly)" Total -Payable: F - (Exact -Amount) _ Purpose: .356 Carlyn remaining 25% refund Permit #' .ENC2015-00097 . Receipt.#:. 258580• Date: 5115/20f 5 Receipt #:_ Date:.. Date; Requested.by: Title: , Inspector Syed Wahidt Approved by: Title: Sr. Engineer.. Date: _ Roger-Stori Finance'Dept Only: Verified by:. _ Title:. Accounting Clerkal• Date: Approved by: Title: Accountant Date:. 5pecial.•Instructions For Handling Check Mail Ails:- _ Mail 'in' Attached Envelope: Interim .Check: Needed By: Return To: JoAnna-Thomason Public. Works (Name):• (De,partment) .... Other: Please return check to:JoAnna CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR FINAL MAINTENANCE ACCEPTANCE LETTER Encroachment Permit # ENC2015-00097 Property Address 355d"Carlyn Ave. Andrew Nichols Date of Final Inspection: 7/19/18 On File: Bonds CD Cash Faithful Performance 0m, !1 000 . b°/n-vf r Labor and Material $ Construction Cash Deposit to be released: $ Other overdue deposits to be released (Description): Processed by: Reviewed by: Reviewed by: 71)4 ministrator -7/2`r /i 6 Insn cfor Land Development Enginedr 10 J:VoAnnaT\Deposit refunds\CHECKLISTS\Car1yn355 1 YR.doc (Rev. 10/11) ,f r Print Form . P 't N CITY OF CAMPBELL - ENCROACHMENT PERMIT ermi o DEPT. OF PUBLIC WORKS (for working within the public X-Ref. File 70 North First Street right-of-way) Application Date Campbell, CA 9SO08 Application Expiration Date r S r Ph. (408) 866-2150 Issued cot)/oAl APN O\ Fx. (409) 376-0958 Permit Expiration Date (� 1 APPLICATION - Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code, Section 11.04. (Application expires in six (6) months if the permit is not issued. Application Fee is non-refundable.) A. Work Address or Tract No.: Utility Trench Location: ........... ................_....._..... __................................. ... ........ ..... ... ....._.....__._.......... ........ ............. ........ ..... ....... .... ... ..... ...... ..: B. Nature of Work: � � �� Sir eY �)WY /a ,Pmo^e -t C. Attach four (4) copies of an engineered plan showing the location and extent of the work, and four (4) copies of the preliminary Engineer's Estimate of work. The plans shall show the relation of the proposed work to existing surface and underground improvements. When, approved by the City Engineer, said plan becomes a part of this permit. D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction; the General Permit Conditions listed on the reverse side; and the Special Provisions for this permit, listed below. Failure to abide by these conditions and provisions may result in job shutdown and/or forfeiture of Faithful Performance Sureties and cash deposits, (See General Permit Conditions, I and 2.) E. The Contractor must. have this permit and approved plans at the site and must notify the Public Works Department at least.two days before starting work. Notice must be given to Public Works at least 24 hours before restarting any work. Name of Applicant: '.........._.............._._.....-..._........._......... ...._..._:.....__... Telephone: �ZS Z� Address: 3 s E Mail Address: 24-HOUR EMERGENCY PHONE NUMBER: - CSdS 3Sy�Soo3. Is this work being done by th property owners at their ovM residence? YES NO The Applicant/Permittee hereby agrees by affixing.their signature to this permit to hold the City of Campbell, its officers, agents, and employees free, safe and harmless from any claim or demand for damages resulting from the work covered,by this permit. The Applicant/Permittee hereby acknowledges that they have read and understand both the front and back of this permit, and they wilt inform their contractor(s) of the infor ation. Applicant is advised that upon issuance of this permit, property owner, or property owner's successors, shall be responsible for any an I d mages arng out of thelition f any prate improvements in the public right-of-way. Accepted: (Applicant Permittee) (sign) (Contractor) (Print Name) Date SPECIAL PROVISIONS: 1. Street shall not be open cut for underground installations. Minimum cuts may be allowed for connections or exploration holes. Such cuts may be specifically approved by the Inspector oriorto cutting. 2. Pavement may be cut forunderground installations and must be restored in accordance with the Standard Details Trench Restoration Method "A", unless otherwise approved by the Engineer. 3. Work to be staked by a licensed Land Surveyor or Civil Engineer and two (2) copies of the cut sheets sent to the Public Works Department before starting work. 4. Per Section 4216 of the Government Code this permit is not valid for excavations until Underground Service Alert (USA) has been notified and the inquiry identification number has been entered hereon. USA Phone: 1-800-227-2600. USA TICKET NO. 5. Prior to any work, the property owner shall execute an Agreement for Private Improvements in the Public Right -of -Way, which shall be recorded. 6. Public Notification Requirements: 7 SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES AMOUNT PERMIT APPLICATION FEE $ 22,0 PLAN CHECK DEPOSIT $ SECURITY FOR FAITHFUL PERFORMANCE/LABOR & MATERIALS $ laC50 CONSTRUCTION CASH DEPOSIT $ PLAN CHECK & I NSPECTION FEE $ EMERGENCY PERMIT FEE IF < APPROVED FOR ISSUANCE RECEIPT NO. 'ln RS o k-yed 4- F�e *,Li Pei;v 4- A/) F-. t Si'!k&- I' VI GENERAL PERMIT CONDITIONS 1. A Construction Cash Deposit is required. Charges will be made against this deposit if there is an emergency call -out, overtimelrispection or when -City ordered barricading is required. Any such costs in excess of the deposit will be billed to the Permittee. 2. A one-year maintenance period and surety are required. Such period will begin on date of written acceptance.by the City. 3. Refund or the cash deposit balance and refund or cancellation of the Faithful Performance Surety will be initiated by the written acceptance of the work by the City. 4. Submit project schedule 10 (ten) days prior to proposed start of work. Special provisions maybe required for work within City facilities and downtown Campbell. S. The Permittee must request in writing a final inspection and acceptance of the work upon completion. Acceptance by the City will be made in writing to the Permittee. 6. Maintain safe pedestrian and vehicular crossings and free access to private driveways, bus stops, fire hydrants, and water valves. 7. A Construction Traffic Control Plan and a Construction Schedule are required for all lane closures, detours, and street closures. This plan must be reviewed and approved prior to any lane closures. 8. A Construction Traffic Control Plan shall conform to the Caltrans Manual of Traffic Controls for Construction and Maintenance Work Zones, dated 1990, available at Caltrans. Traffic control equipment shall include Type II flashing arrow signs if required. 9. Replace as directed by the City Engineer any damaged or.removed improvements in accordance with City Standards and Specifications at the sole expense of the Permittee. 10. Sawcut for all PCC or AC removals. All PCC removals shall be to the nearest scoremark and shall be doweled to existing improvements. 11. Prior approval of inspector is required for any work done after normal working hours, on weekends or holidays and may require reimbursement of inspection costs at the current overtime rate. 12. Adequate signing and barricading is required on the job site. Failure to provide such signing and barricading may result in the City's providing signing and barricades and charging the cost (including all labor and materials) against the cash deposit. 13. Compaction testingof subgrade, base rock, and asphalt concrete by Permittee is required unless otherwise stated by the City Engineer. 14. The Contractor or Permittee will have a supervisory representative available for contact on the project at all times during construction. Contractor or Permittee shall provide'a phone number at which they can be contacted outside the hours of 6:00 a.m. to 4:00 p.m. 15. No storage of materials or equipmentwiII be allowed near the edge of pavement, the traveled way, or within the shoulderline which would create a hazardous condition to the public. 16. This permit shall not be construed as authorization for excavation and grading on private property adjacent to the work or any other work for which a separate permit maybe required, nor does it relieve the Permittee of an), obligation to obtain any other permit required by law. 17. This permit does not release the Permittee from any liabilities contained in other agreements or contracts with the City and ar yother public agency. 18. This permit is' not transferable. Work must be performed by the Permittee or his designated agent or contractor as specified thereon. 19. Call back (call out). due to emeregencies regarding this permit shall beat the current overtime rate with a three (3) hour minimum charge per occurrence. 20. Pursuant to Chapter 14.02 of the Campbell Municipal Code, applicant shall not cause -to be discharged any material into the municipal storm drain system other than storm water. Applicant shall adhere to the BEST MANAGEMENT PRACTICES established by the Santa Clara Valley Urban Runoff. Pollution Prevention Program. 21. If the public interest requires a modification of, or a departure from the plans and specifications, the City shall have the authority to require or approve. any modification or departure and to specify the manner in which the same is to be made for City -owned or maintained facilities. 22. Permitttee must provide advance notification to all parties that may be affected by the permit activities. Notification shall be reviewed by the City prior to distribution and include dates of work and a contact name and phone number. Applicant shall be responsible for ensuring that all those providing services under the applicant are aware and understand all of the above conditions. Applicant e Contractor (Print Name) Date: Date: J:\FORMS\Templates\Encroachment Permits\Encroachment Permit STATIC form2.pdf Rev. 02/14 Encroachment Permit Final Sign Off Encroachment Permit Address: ���t2�(�cJi✓ Date of Final Inspection and Acceptance: Inspected by: 75 OK to release deposits: 100% d` Comments: CITY OF CAMPBELL VENDOR NO. 10014477 CHECK NO. 263624,' 10014477 ANDREW NICHOLES �llljll HE 14dol 6191,111:91111MIL, N1111413aille a ,'CHECK: DATE CHECK CHECk',,N0. CAMPBELL -14PBET" !9�90 ��ANK, N. STREET '--:E,2 —lo b 24 7-t,-,� 4 0 z" TH FIRST STREET sass FRANclsco cA salon CAMPBELL, CALIFORNIA 95008 Ty MbUNT",,, < 1:5 VOID"AFTER 11AVL i -,ONE��',,7H THOUSAND, HUNDRED. DOLLARS �ZERO CENTS D, FIVE FAY THE .�SUM�,OF-,, S UN m ry TO TxaANDREW ,"NICHOLES )ER,, 124'5 'L , AKESI'DE DR?' F UNNYVAL -408,5, E CA'9 V s S,41 M. I all,[:Loj,,c5l2liolKo].lDlel*:I� . . ...... .. .... .......................................... ................ . ... .. .............................. ... .................. . ......... . ......... . ... ....... ....................... ............ ................ ... .... ........................................ ........... ................... ......................... .......... ....... .......... ............. *See Reverse Side For Easy Opening instructions* CITY OF CAMPBELL 70 NORTH, FIRST STREET CAMPBELL,; CALIFORNIA.9,5008 ANDREW NICHOLES 1245 LAKESIDE DR. SUNNYVALE CA 94085 pF C4� � � r "ReMao) CITY OF CQAMPBELL Public Works Department July 13, 2017 Andrew Nichols 1245 Lakeside Dr. Sunnyvale, CA 94085 SUBJECT: PERMIT NO. ENC 2015-00097 355 Carlyn Ave., Campbell CA FINAL INSPECTION AND ACCEPTANCE Dear Andrew: The City of Campbell has made a final inspection of subject Public Works improvements and finds the work to be acceptable and in conformance with City standards. Accordingly, the City Engineer accepts the improvements. The one year maintenance period stated in the permit begins as of July 3, 2017. The permittee.is responsible for the repair and/or replacement of any defective work or failures that occur within one year. The City will inspect the improvements within one year and notify you, in writing, whether or not any repairs are required. 75% of your Faithful Security Deposit in the amount of $1,500.00 is enclosed. If you have any questions, please call me at (408) 866-2165. Sincerely, Syed Wahidi Public Works Inspector Cc: Inspector /Suspense Files Permit File ENC2015-00097 70 North First Street • Campbell, California 95008-1436 . TEL 408.866.2150 • Fax 408.376.0958 • TDD 408.866.2790 To: Finance Director Check Payable To: Address - Line 1: Line 2: City: Description: Account Number:. Account Number: Account Number: (Finance Dept only) Total Payable: Purpose: able Deposit Check Andrew Nicholes 1245 Lakeside Dr. Sunnyvale State: CA Zip 94085 355 Carlyn Ave. 101.2203 Amount: $1,500.00 101.2203 Amount: 101.540.7448 Amount: Interest Earned (Finance Dept only) 355 Carlyn 75% FPS refund (Exact Amount). Permit #: ENC2015-00097 Receipt#: 258580 Date: 5/15/2015 Receipt#: Date: Requested by: ' Title: Inspector Date: Syed Wahidi Approved by: Title: Sr. Engineer Date: .Roger Storz Finance Dept Only: Verified by: Title: Accounting Clerk II Date: Approved by: Title: Accountant Date: Mail As Is: Special Instructions For Handling Check Mail in Attached Envelope: Interim Check: Needed By: Return To: JoAnna Thomason (Name) Other: Please return check to JoAnna .Public. Works (Department)' CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR ONE YEAR MAINTENANCE ACCEPTANCE LETTER Encroachment Permit # ENC2015-00097 Property Address 355xCarlyn Ave. Andrew Nichols Date of Final Inspection: 7/3/17 On File: Bonds . CD Cash Faithful Performance $1,500.00 (75% of $2,000.) Labor and Material $ Construction Cash Deposit to be released: $ Other overdue deposits to be released (Description): Processed by: dml istrator Reviewed by: inspector -ffftf (� Reviewed by: � 1 S,an� 11Ld Development Engineer JAJoAnnaT\Deposit refunds\CHECKLISTS\Carlyn355..doe (Rev. 10/11) CITY OF CAMPB ELL Public Works Department July 13, 2017 Andrew Nichols 1245 Lakeside Dr. Sunnyvale, CA 94085 SUBJECT: PERMIT NO. ENC 2015-00097 355 Carlyn Ave., Campbell CA FINAL INSPECTION AND ACCEPTANCE Dear Andrew: The City of Campbell has made a final inspection of subject Public Works improvements and finds the work to be acceptable and in conformance with City standards. Accordingly, the City Engineer accepts the improvements. The one year maintenance period stated in the permit begins as of July 3, 2017. The permittee is responsible for the repair and/or replacement of any defective work or failures that occur within one year. The City will inspect the improvements within one year and notify you, in writing, whether or not any repairs are required. 75% of your Faithful Security Deposit in the -amount of $1,500.00 is enclosed. If you have any questions, please call me at (408) 866-2165. Sincerely, Syed Wahidi Public Works Inspector Cc: Inspector /Suspense Files Permit File ENC2015-00097 70 North First Street • Campbell, California 95008-1436 • TEL 408.866.2150 • FAX 408.376.0958 • TDD 408.866.2790 Encroachment Permit Final Sign Off Encroachment Permit # [' C 2�i�j aac.�j Address: Date of Final Inspection and Acceptance: 715 1-% inspected by: CJ� OK to release deposits: 100% 75% Comments: d o� ` SQC) 4 2 ncroac ment Permit Application t-ee Non-UtilityEncroachment Permit Major >_$10 000 $385.00 2217 Minor Encroachment Permit <$10,000 $220.00 Initial R-1 Permit NIC Subsequent R-1 Permits within Two Year Period $220.00 Inspection Fee Minimum Charge per Location $i385.00 Street Tree Planting/Removal 2203 $500 er Tree Plan tin De osit Re uired $500.00/tree. 2203T Plan Check Deposit 2% of Engineer's Estimate $500.00 min no deposit required_ Utility and R 1 Permits - 4722 Grading & Drainage Plan Review $270.00 Single Family Lot Site < 10,000 s.f. $810.00 Site >_ 10,000 s.f. < 0.5 Acre $1 081.00 Site >_ 0.5 Acre $1 621.00 4722 NPDES Review C3 Re uirements $156.00 For projects not required to submit numeric sizing For projects required to submit numeric sizin Im ervious Area 10,000 S . Ft to 1 Acre $676.00 Impervious Area 1 Acre or more $884.00 Consultant Cost +20% 4722 For projects sent to Consultant for review Plan Check & Inspection Fee(Non-Utility) 14°/D of Engineer's Estimate 4722 2203 En r. Est. < $250,000 En r. Est. ?$250,000 and <$500 000 $35 000 + 8°/D of Engineers Estimate 2203 En r. Est. >_$500 000 $55,000 + 7% of En ineers Estimate 4% of En r. Est° $500 min/$10 000 Max 2203 Emergency Cash Deposit 100°/D of ENGR. EST.' 2 6 �% 2203 Faithful Performance Securit FPS 100% of ENGR. EST." 2203 Labor and Materials Security R-1 $2 120.00 4721 Storm Drainage Area Fee Per Acre (Multi -Res $2 385.00) All Other $2,650.00 Parcel Ma 4 Lots or Less) $3 850.00 + $83/lot $4,681.00 +. $114/lot 4722 4722 Final Tract Ma 5 or More Lots 100% of Cit 's ivionumentation Estimate 2203 Monumentation Security 4920 Parkland Dedication Fee 75%/25% Due U on Cert. of Occu anc 4722 Lot Line Adjustment Includes Certificate of com liance $1 820.00 4722 - Vacation of Public Streets & Easements $2,434.00 4722 Certificate of Compliance $1 800.00 4722 Certificate of Correction $540.00 4722 Appeal Filing Fee $200.00 4722 Notary Fee(per si nature $10.00 4722 Assessment Segregation or Reapportionment First Split $860.00 Each Additional Lot $270.00 511 4424 Postage MISCEELAN Other (Please S eci 'Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $ 2 Q 5 NAME OF APPLICANT " N F- L-0 WCH oi' NAME OF PAYOR W E- PHONE ADDRESS t-��-UAK i'DE: JD ZIP FOR .:' RECEIVED BY4. CITY CLERK ONLY# Date �� Receipt .o?�J Da te( Initials MAT 10 ZU15 J:\FORM51TamoalaslAtlmlNSVatireV2ece,pl Farm LaM Development 1,1-15 ITY �'^' G^ , v a ® �� Syed Wahidi From: Roger Storz Sent: Wednesday, June 17, 2015 2:07 PM To: 'Floyd Masalta' Cc: Syed Wahidi Subject: Encroachment Permit (355 Carlyn Avenue) Hi Floyd, You will need to apply for an Encroachment Permit once PG&E has issued you.the approved drawings for gas and electricity. Please make sure your contractor has a City Business license and insurance on -file indemnifying the City of Campbell (specific insurance requirements are listed on theweb page below). You can find the application form and other supporting documents at the bottom of this page: http://www.ci.campbell.ca.us/187/Permit-Information Regards, Roger K. Storz, P.E. I Senior Civil Engineer City of Campbell I Public Works Department roeersCacit ofy campbell.com 408.866.2190 70 N. First Street, Campbell, CA 95008 1 Syed Wahidi ° From: Roger Storz - Sent: Thursday, May 07, 2015 3:08 PM To: 'Andy Nicholas'; Syed Wahidi Cc: 'Floyd Masalta'; 'Michele Nicholas' Subject: RE: BLD205-00209 - 355 Carlyn Hi Andy, We are good. Just make sure to get your encroachment permit from Syed to do the new driveway approach. Also, the new water meter needs to be behind the property line, similar to how your sewer cleanout is on your side of the property line, Good luck with the project and let me know if you need anything. Sincerely, Roger From: Andy Nicholas[mailto:andy.nicholas.mailCabgmail.com] Sent: Thursday, May 07, 2015 2:56 PM To: Roger Storz Cc: Floyd Masalta; Michele Nicholas Subject: BLD205-00209 - 355 Carlyn Hi Roger, Our team did the re -submit for 355 Carlyn Ave a few weeks ago. I wanted to make sure that you received everything necessary with this re -submit? . - I think Floyd Masalta was getting the ADA driveway issue squared away and finishing -up some other issues. Hopefully there was nothing obvious missing from our re -submit? If there's anything obviously missing we can jump right on each issue quickly. Thank you for your help reviewing our planset. Thank you, Andy Nicholas r. 1 7o P Qp\C��S S• p �O SIDEWALK 6 OI MECHANICAL F� SEPARATOR CONSTRUCTION JOINT SIDEWALK SEE NOTE 5 WEAKENED PLANE JOINT OR CUT JOINT SIDEWALK �p'I 1/8" WIDE, O 2' DEEP WEAKENED PLANE JOINT p OR CUT JOINT 1/8" WIDE, .2" DEEP �O v /O —y I 3/4„ .� 5 S=1 „ F-� PER FOOT 5/8" 1"R t• ' T — 1 /2" R R 10'-0" 4,-6„ 5,-6„ 2'-0„ +10% MAX 6" CONFORMSLOPE = 1/ 4" PER Fr. —6% MAX ..:o-:•'-40- b. 6" CLASS -A CONCRETE, TYP. :, ::':,. 6" 6" CLASS 2 AGGREGATE BASE, NOTES SECTION A —A DOWEL T 1. WHEN THE DRIVEWAY IS NOT POURED AT THE SAME TIME AS THE CURB AND GUTTER, 12" OF NO. 4 REBAR AT 4' INTERVALS SHALL BE INSTALLED AS SHOWN (REBARS TO BE BENT DOWN AND COVERED UNTIL USED). 2. SCORE MARKS SHALL NOT EXCEED 4'-0" O.C., AND USE MECHANICAL SEPARATOR AT .EVERY OTHER SCORE MARK. 3. DRIVEWAY APPROACHES -(EXCEPT SINGLE FAMILY) SHALL HAVE A 6"X6"X10/10 WELDED WIRE FABRIC 3" ABOVE BOTTOM OF CONCRETE. 4. DOWEL ALL NEW CONCRETE IMPROVEMENTS TO EXISTING CONCRETE IMPROVEMENTS. 5. AT LOCATIONS WHERE NEW SIDEWALK ENDS AND MEETS AN EXISTING SIDEWALK, THE NEW SIDEWALK SHALL TRANSITION TO MEET THE EXISTING SIDEWALK AS DETERMINED BY THE CITY ENGINEER. CA CITY OF CAMPBELL REV. DATE BY SCALE: a °� �jD� PUBLIC WORKS DEPARTMENT Residential N.T.S. �' redo a r DRAWN BY: DATE 02/04 Driveway Detail DETAIL • °'On�� CHECKED BY: DATE (Attached Sidewalk) NO. APPROVED BY: �RCHAR9 MICHE ENGINEER Y J:/DrawingS/Std D0ta11S/D15 D -15 0 2" A.C. — TYPE A 3O GRIND PAVEMENT KEY 3/4" MAXIMUM MEDIUM 9^-12a 2"-4" DEEP x 9"-12" WIDE 95% COMPACTION C-10" 2"_4.' / 4" MIN — 10" MAX A.C. — TYPE A (3" PLUS THICKNESS 3/4" MAX. MED. OF EXISTING AC SECTION) 95% COMPACTION —T /\�� TOP 30" OF BACk LL /� AT 95% RELATIVE APPROVED SELECT NATIVE COMPACTION OR STRUCTURAL BACKFILL r FILTER •FABRIC 6 REMAINING BACKFILL AT 9.0% RELATIVE COMPACTION 12" (TYPE A BEDDING) ' fro r•• ®• tl•�• CLASS 1 BEDDING, • • Y . • (CLEAN SAND AROUND ®• Y o GAS CONDUITS) r• • Y ' p • o • . ' O • �tl p ; • •tl • 0 1 /8 D (4" MIN) 'D' PLUS 6" MIN. 'D' PLUS 24" TRENCH WIDTH MAX CENTER PIPE IN TRENCH NOTES: 10 Place permanent pavement within thirty (30) days after backfilling. Install temporary AC to finish grade until 'permanent AC is placed. Backfill shall be compacted by mechanical tamping in 0.15' (max.) lifts. Trench backfill to be compacted to 90% R.C. with top 30" compacted to 95% R.C. O If ,existing AC section is less than 4", grind AC key to full depth of existing AC and replace full depth AC section (min. 2"). ® If outside traveled way, eliminate AC and replace surface improvements to match existing. O This detail does not apply to electrical conduit installation. © Recessed trench plates shall be used at the following locations: all arterial streets, all collector streets, at trench alignments not parallel with or perpendicular to the direction of traffic and locations determined by City Engineer to be necessary. The Contractor shall prepare for placement of plates over trench by grinding a relief 12" wide on each side of the trench -by .the thickness of the steel plate so that the surface of the steel plate is level with the adjacent pavement surface. TRENCH RESTORATION — METHOD B DATE. MAY 2012 Backfill and Surface Restoration APPROVEDCITY�cx�csED BY _ CITY OR CAMPBELL DETAIL 8 lO 2" A.C. TYPE A 3/4" MAXIMUM MEDIUM 95% COMPACTION " • 9"-12" O2 GRIND PAVEMENT KEY 2"-4" DEEP x 9"-12" WIDE 6"-10" 2"-4" Q. EXISTING AC SECTION 44 4 4 lO 2 SACK SAND/CEMENT SLURRY 4 4 d. 4 BACKFIII 9 d a a tl•• o O e y • tl Y y e • to. Y YY:O •,° a ••i • my y e • CLASS 1 BEDDING. • ® 12" (TYPE A BEDDING) (CLEAN SAND BEDDING • SHALL BE USED AROUND y GAS CONDUITS) 0 s ed e e tl , S • Oy O • 1/8 D (4" MIN) TRENCH WIDTH 1 'D' PLUS 6" MIN. 'D' PLUS 24" MAX CENTER PIPE IN TRENCH NOTES- 10 Place permanent paveinent within five (5) days after backfilling an excavation. (Steel plating required during curing period of 3 days min. — 5 days max.) O If existing AC section is less than 4", grind AC key to full depth of existing AC and replace full depth AC section (min. 2"). 3O This detail does not apply to electrical conduit installation. ® Recessed trench plates shall be used at the following locations: all arterial streets, all collector streets, at trench alignments not parallel with or perpendicular to the direction of traffic and locations determined by the Engineer to be necessary. O The Contractor shall prepare for placement of plates over trench by grinding a relief 12" wide on each side of the trench by the thickness of the steel plate so that the surface of the steel plate is level with the adjacent pavement surface. TRENCH[ RESTORATION — METHOD A REVISED DATE: MAY 2012 Backfill and Surface Restoration DRAWN PRO 7VED BY CHECKED .BY "PROVED CITY OF CAMPBELL DETAIL _._._ Policy Endorsement (Imumd Copy) Policy No-- FNG 056967601 (02) (Pay type: OTH-CC) January 19, 2016 Page 1 I--- a Provided by MCGRAW INSURANCE SERVICES P.O. BOX 40 ANAHEIM, CA 92815-0040 Namcd hmurcd ANDREW NICHOLAS NICHOLAS, MICHELE 1245 LAKESIDE DR APT 3019 SUNNYVALE, CA 94085 CALIFORNIA H®-3 Preferred Homeowners Insurance This is your Endorsements Page Policy No.: ENG 0569676-01 Policy Type: HO-3 PREFERRED PERSONAL HOMEOWNERS Policy Term: D—mbcr 15, 2015 to December 15, 2016 at 12d01am Standa+d Time at the address of Named hmwcd as stated herein This poky has bran cndmscd far the following reason and mdorsemrnt date is 01/192016. TT TAX AND TITLE INFORMATION REVIEWED Coverage sunnnuy Imurcd Location 355 CARLYN AVE CAMPBELL CA 95008 01/19M16 Pacific Specialty IN, IA: R ARC:S Cons PA\Y Undenwitum By PACIFIC SPECIALTY INSURANCE COMPANY FINANCIAL RATING: "A" (EXCELLENT) BY AM BEST STATUS: ADMITTED Imurame Producer PRODUCER: A74000, (408)-739-6950 GLORIAALVORD@ALLSTATE.COM GLORIA CATHERINE ALVORD 525 W. REMINGTON DR #110 SUNNYVALE, CA 94087 www.Paciflcspecially a Manage your account. Pay bills. For policy service/questions contact your producer at (408)-739-6950 or crs at 1.800-303.5000 1-800-962-1172 (For claims service) Please see next page for a full list of coverages, credits and Adjustments applied to your policy, as well as other available options. Covcragc L'mrit Dcductiblc * DED, UNLESS SPECIAL DED. BELOW $1,000.00 ................................................................................................................................................................ A DWELLING $465,000.00 ................................................................................................................................................................ Al 25% EXTENDED REPLACEMENT COST ................................................................................................................................................................ A2 ORDINANCE OR LAW COVERAGE ................................................................................................................................................................ B OTHER STRUCTURES $46,500.00 ................................................................................................................................................................ C PERSONAL PROPERTY $232,500.00 ................................................................................................................................................................ C1 REPLACE COST PERSONAL PROPERTY ................................................................................................................................................................ D LOSS OF USE $93,000.00 ................................................................................................................................................................ E PERSONAL LIABILITY $300,000.00 ................................................................................................................................................................ ElE ANIMAL LIABILITY EXCLUSION ................................................................................................................................................................ F ................................................................................................................................................................ MEDICAL PAYMENTS $1,000.00 b Policy Ful—ent(I—W Copy) Policy No_ ENG 056967601 (02) (Pay type: OTH-CC) Ianumy 19, 2DI6 Page 2 MPD MULTI POLICY DISCOUNT 1 - Tier ................................................................................................................................................................ P1 COPPER PLUMBING ENDORSEMENT 16 No. of years ................................................................................................................................................................ P18 TRAMPOLINE EXCLUSION ................................................................................................................................................................ P19 DIVING BOARD & SLIDE EXCLUSION ................................................................................................................................................................ RFR ROOF REPLACEMENT COST ................................................................................................................................................................ Policy Coverage P—ni= (excluding Pccs): 01/192016 You wed $60.00 by being a Pacific Specially poliyboldal --qWS IS NOT A BILL— Anypayment it formation will he requested separately (if applicable). Please read your policy carefully for coverage details. $1,245.00 Policy Enlonomeot (I®urcd Copy) Policy No_ ENG 05I§967641 (02) (Pay type: OTH-CC) January 19, 2016 Page 3 Outline of covemo Detail Coverage Limits Deductible Premium ................................................................................................................................................................ Dwelling A DWELLING $465,000.00 $1,208.00 ................................................................................................................................................................ Al 25% EXTENDED REPLACEMENT COST $72.00 ................................................................................................................................................................ B OTHER STRUCTURES $46,500.00 INC. ................................................................................................................................................................ RFR ROOF REPLACEMENT COST INC. ................................................................................................................................................................ Personal Pcopaty C PERSONAL PROPERTY $232,500.00 INC. ...............................................................................................................................................I................ C1 REPLACE COST PERSONAL PROPERTY INC. ................................................................................................................................................................ Liability E PERSONAL LIABILITY $300,000.00 $25.00 ................................................................................................................................................................ EIE ANIMAL LIABILITY EXCLUSION INC. ................................................................................................................................................................ F MEDICAL PAYMENTS $1,000.00 INC. ................................................................................................................................................................ P18 TRAMPOLINE EXCLUSION INC. ................................................................................................................................................................ P19 DIVING BOARD & SLIDE EXCLUSION INC. ................................................................................................................................................................ Otbor A2 ORDINANCE OR LAW COVERAGE INC. ................................................................................................................................................................ D LOSS OF USE $93,000.00 INC. ................................................................................................................................................................ P1 COPPER PLUMBING ENDORSEMENT 16 No. of years INC. ................................................................................................................................................................ Additional Credits MPD MULTI POLICY DISCOUNT 1 - Tier $60.00- ................................................................................................................................................................ Dcductbb * DED, UNLESS SPECIAL DED. BELOW $1,000.00 INC. ................................................................................................................................................................ Policy coverage premium: $1,245.00 ............................................................................................................................................................ POLICY FEE (Fully earned) $30.00 ......................................................................................................................................I..................... INSPECTION FEE (Fully earned) $40.00 ............................................................................................................................................................ Total Policy Premium after the change: $1,315.00 Total Policy Premium before the change: $1,315.00 Difference: $0.00 Total Prorated Premium Change: $0.00 You saved $6DDG by being a Pacific Speckltypol'cybolderl Poly and inspection f , if cbarged, are fully earned (retained). *-R TEUS IS NOT A BILL"a* Any payment in forination will be requested separately (If applicable). Please read your policy carefully for coverage details. THIS POLICY DOES NOT INCLUDE OPTIONAL EARTHQUAKE COVERAGE. 01/I9MI6 Policy Fidorsem d (htsmal Copy) Policy No_ FNG 056967601 (02) (Pay typo: OTH-CC) J--y 19, 2016 Page 4 limhokl r infommtion We send certain notices such as coverage summaries and cancellation notices to the following: 11=bolda FIRST TECHNOLOGY FEDERAL CU ITS SUCCESSORS AND/OR ASSIGNS P.O. 692414 SAN ANTONIO, TX 78269 Loan No.: 9323364043 Limholdu FIRST TECHNOLOGY FEDERAL CU ITS SUCCESSORS AND/OR ASSIGNS P.O.BOX 692414 SAN ANTONIO, TX 78269 Loan No.: 9323364076 hsumd Property Cb—cleristks L)—Bin6 Rouf Year of construction: 1951 Material: COMP Type: FRME Condition: Unknown Living Area Square Footage: 2,254 Stated Age: 16 Number of Units: 1 Roof Type: Unknown Dwelling Category: ABDV Garage: None Porches/Decks: None Fireplace(s): None Estimated Value: $354,000.00 Additional Adjustment: Insured Value: $465,000.00 Dwelling Valuation Method: MSB The dwelling coverage should be an amount sufficient to replace the home in the case of a total loss. Please reference the requirements of Insurance Regulation 2188.65 regarding estimating dwelling replacement cost. Please be aware that it is ultimately the insured's responsibility t0 obtain adequate insurance coverage. If you feel that the dwelling replacement cost estimated above is insufficient, you should increase the coverage to the appropriate amount. The following statement is required by California Insurance Code Section 10103: 'The limit of liability for this structure (Coverage A) is based on an estimate of the cost to rebuild your home, including an approximate cost forlabor and materials in your area, and specific information that you have provided about your home.' 01/192016 Policy Euda¢ =n (Insumd Copy) Policy No_ ENG 05¢9676-01 (02) (Pay rA=: OTH-CC) January 19, 2016 Page 5 Your policy does not contain the following coverage options: - AP PREMIER PACKAGE - A6 WATER BACKUP COVERAGE - C2 ENHANCEMENT -JEWELRY, GOLDWARE - C3 COMPUTER EQUIP.(SEE SUBLIMITS) - C3A PERSONAL COMPUTER SYSTEMS - C3B PERSONAL COMPUTER PROGRAMS - C3C DATA RE-CREATION - C4 HOME FREEZER CONTENTS COVERAGE - C5 SCHEDULED PERSONAL PROPERTY - C6 INCR.UNSCHED.PROP.IN BUSINESS - D1 SUPERIOR HOME PROT. PACKAGE - E1 ANIMAL LIABILITY - E2 PERSONAL INJURY LIABILITY - E3 PERS. LIA. EXTENDED TO OTHER - H EARTHQUAKE - I1 IDENTITY THEFT - I2 IDENTITY THEFT WITH ID ALERT Please contact your producer to learn about these coverage options. Your policy premium does not incude the following premium credits: - CRF TILE ROOF CREDIT - CRG GATED COMMUNITY CREDIT - CR1 BURGLARY PROTECTION CREDIT - CR2 FIRE PROTECTION CREDIT - GRC GATED RETIREMENT COMM. CREDIT - S NEWER HOME CREDIT Please contact your producer to see if you qualify for any additional premium credits. Important: If a payment plan is utilized, a fully earned service charge will be added for each installment payment made by the Insured. The maximum service Charge applied per installment payment is $10.00. Service charges are determined at the time a payment plan is selected. Service charges are not charged on down payments, on installments not tendered due to early payment of your premium balance, or on the entire premium payment. An installment invoice will be sent to the Insured detailing the required payment amount and payment due date. Payments must be received in our office prior to the due date or the policy will be cancelled for non-payment of premium. Fmud Stamm= For your protection California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. Any revisions, changes and/or corrections made on the printed application after the information has been submitted online are not reflected on this Declarations page and are not part of the application for insurance. If any information on the Declarations page is inaccurate, please notify us in writing via US Mail to: McGraw Insurance Service ATTN: Underwriting Dept. PO BOX 40 Anaheim, CA 92815-0040 01)192D16 PoliV Fndeas I (Imured Copy) PoGry No: ENG OU9676-01 (02) (Pay type: OTACC) January 19, 2016 Page 6 For claims reporting, please call: 1-800-962-1172. For policy service, please call: 1-800-303-5000. O1119rz016 Policy Endorsement (Insured Copy) Policy No_ ENG 0169676-01 (02) (Pay type: OTH-CC) January 19, 2016 Page 7 Important Information About Yoir Policy Based on the information you have provided, your policy has been issued subject to the following coverage forms and endorsements. Please note that some Of these endorsements may limit certain portions of your coverage. Others add optional coverages that you have selected. These are summary descriptions only. Please read the actual policy forms and endorsements to determine the exact level Of coverage your endorsed policy provides. We highly recommend reviewing your coverage with your insurance producer. HO-3 (Fd.72) HO-3 Homeowners Policy This is your basic coverage form and it is subject to the various endorsements noted below. CAM (Fd. 1) Registered Domestic Parmer Coverage This endorsement provides state -mandated coverage for a registered domestic partner. HO-90 (9-84) Workers' Compensation This endorsement provides state -mandated workers compensation coverage for residence employees. NM-CA-MF.PI. (04/021 Mold Fclwion This endorsement excludes coverage for losses stemming directly or indirectly from mold, fungi, mildew, spores, wet or dry rot, or similar organisms, regardless of cause. NM-CA-PO1 (I ItOl) Pathogcnic Organism Exclusion This endorsement excludes coverage for losses stemming directly or indirectly from bacteria, yeasts, mildew, virus, fungi, mold, or their spores, mycotoxins or other metabolic products. NM-CA-TW I (05,02) Terrorism and War Exclusion This endorsement further defines the terms "terrorism" and "war" and excludes loss due to either from your policy. NYMI Your Privacy and Tts Protection This endorsement memorializes the steps we will take to safeguard your personal information. NY07 Mortgage Clause This endorsement outlines the loss payable procedure when a mortgage company is listed in the Declarations. PM I-CA-HO (Ed. 2) California Amendatory Fndorscment for Hcmcmvncrs Policies This endorsement alters some of the cancellation and non -renewal provisions of your policy form to adhere to current California insurance laws and regulations. PM l 1 (Ed. 5) Increased lkductible for Ines m Damage Caused by Tenants This endorsement notes that, should a loss occur by deliberate act(s) by a present or past tenant of the property, the deductible will be increased to $2,500. This endorsement is not applicable if the policy deductible stated in the Declarations is $5,000. PM 17 (Ed. 2) Lrss Settlement Provision for California Residential Property Policim This endorsement amends the loss settlement provision of your policy to provide you with an option to make a claim under this policy for loss or damage to buildings on an actual cash value basis. PM I8 (Fd. 1) Trampoline Exclusion This endorsement excludes coverage for any loss stemming from the use or presence of a trampoline on the insured premises. PM 19 (Ell. l) Swimming Pool Diving Board and Slide Exchmion This endorsement excludes coverage for any loss stemming from the use or presence of a swimming pool slide, diving board, or similar structure on the insured premises. Ol 119MI6 Policy Endorsement (Insured Copy) Policy No-- F14G 05.69676-01 (02) (Pay type: OTH-CC) January 19, 2D16 Page 8 PM20 (Fd. 2) Inflation Guard This endorsement automatically increases your dwelling coverage limit 3% annually to help the amount of coverage provided by your policy to keep pace with inflation. However, it is important that you periodically review the coverage provided by your policy as the amount and type of insurance you purchased is ultimately your decision. This includes ensuring that you have adequate coverage in the event of a large or total loss. PM22 (Ed. S) Preferred Package Fidmsement This endorsement increases special limits of personal property. PM3 (Ed. 4) Occupancy Er don,ement (Primary Residence Only) This endorsement notes that, should your property become vacant or unoccupied, your policy will only provide Coverage for the perils of fire or lightning, windstorm or hail (unless otherwise excluded), smoke, or volcanic eruption. No other coverage will be afforded by your policy until the property is no longer vacant or unoccupied. PM34 (Ed. 1) SZ500 Sublimit for late Wildf=Claim Reporting This endorsement adds a special limit of coverage to your policy of $2,500 total property and dwelling coverage for wildfire smoke, soot and ash damage not reported to us within forty-five (45) days. PM4 (Fd. 1) Satellite Dish aclslon This endorsement excludes coverage for satellite dishes, antennas, their components and mounting hardware. PO53 (Ed. 1) Prof—d Thclt Coverago This endorsement enhances theft coverage in the policy form by including coverages such as losses caused by theft that occurs away from the residence premises. Form No. PO44 (Ed. 2) Fxterded Replaoemem Coat Coverage - 255 This endorsement provides additional dwelling coverage (Coverage A) of 25% above the limit specified on your Declarations in the event of a total loss of your insured dwelling. Form No. PO16 (Ed. 21 Ordinanee or law Coverage This endorsement amends the loss settlement provision of your policy to include coverage, subject to your policy limits, for upgrades in building construction that are required due to building codes, laws or ordinances. Form No. PO5-HO (Ed. 2) Pmonal Property Replammenl Cwt This coverage amends the loss settlement provisions of your policy form to provide coverage for personal property (Coverage C) on a replacement cost basis. If this endorsement is not applied, personal property is settled on an actual cash value basis, with the deduction of depreciation. Forth No. PM2 (Ed. 3) Animal liability Eccclwion This endorsement excludes liability and medical payments coverage for bodily injury or property damage caused by or originating from any animal. Form No. PM7 (Ed.3) Capper Plumbing Agreement When you applied for insurance, you indicated that 100% of the pressurized plumbing in your dwelling is constructed from copper plumbing. This endorsement excludes coverage for your plumbing and any loss stemming from your plumbing system if it is determined that 100% of the pressurized plumbing in your dwelling is not copper. Font, No. PN132 (Fd. 2) Rcplamment Cwt Coverage for Roofing and Roof Com This endorsement amends your policy form to automatically provide coverage for roofs (and roof components) on a replacement cost basis. Internal print codm: CA-H03(P)-POL (Fd. 3.2); CA-H03(P)-END (Ed. 11) 01/192016 Syed Wahidi From: Syed Wahidi Sent: Thursday, August 04, 2016 7:45 AM To: 'Andy Nicholas'; Roger Storz Subject: RE: PGE Status for 355 Carlyn Ave? EPM# 31146990 & GPM# 31200246 Hi, Andy, To date, there is only one permit issued for this address that allows to abandon gas. The following permits have been sitting on my desk for a long time. 2. ENC 201S-00234 (underground power line). Fee paid. Waiting for contractor's insurance. Syed Wahidi I Public Works Inspector Cit', o1 C"Ini1)b e I i PU1)1iC W o r k S 1)ePt. sVecIW6ii;citVofeanapbell.coin 70. N, V irst Street: C <aniph ii, CA 9-50 8 �Kww.CitvafQai I_ b e I ,co i From: Andy Nicholas [mailto:andy.nicholas.mail@gmail.com] Sent: Thursday, August 04, 2016 1:56 AM To: Roger Storz Cc: Syed Wahidi Subject: Re: PGE Status for 355 Carlyn Ave? EPM# 31146990 & GPM# 31200246 I will try to get PGE to clarify where they expect us to dig, more precisely so we are dealing with less hypothetical situations. On Aug 3, 2016, at 11:24 AM, Roger Storz <rorers((�cityofcampbell.com> wrote: Hi Andy, if the two areas of work are close to one another, than we will require one large patch that encompasses both areas. You may want to meet in the field with our Public Works Inspector to clarify the limits of work. Regards, Roger From: Andy Nicholas [mailto:andy.nicholas.mail@gmail.com] Sent: Wednesday, August 03, 2016 8:48 AM To: Roger Storz Subject: Fwd: PGE Status for 355 Carlyn Ave? EPM# 31146990 & GPM# 31200246 Hi Roger, If we need to dig a hole in one side of the street to connect the gas line and if we need to dig a 4x4 patch to re -run the water main, does Public Works require the entire road to be re -paved? Or only the 2 patches? From PGEs previous map, it appears that the gas line is on city property, just beside the sidewalk... However, Ryan from PGE seems to think otherwise (see below). I will try to get this clarified. Thank you, andy Begin forwarded message: From: "Shellito, Ryan" <RRSS a,pge.com> Date: August 3, 2016 at 8:33:36 AM PDT To: Andy Nicholas <andy.nicholas.mailLgmail.com> Subject: RE: PGE Status for 355 Carlyn Ave? EPM# 31146990 c& GPM# 31200246 The gas main is on your side of the street. You will not need to cross the street for the gas service. You will need a 6X4 tap for the gas. I'll begin the process to get a new contract issued for just the gas. You will be refunded the electric portion of the job, minus the Engineering Advance. There is a $75 fee you will be charged for the overhead service. Ryan Shellito Electric Estimator rrss@pge.com 408-725-2077 Available by appointment @ 10900 N. Blaney Ave. Cupertino, CA From: Andy Nicholas [mailto:andy.nicholas.mail@gmail.com] Sent: Monday, August 01, 2016 11:44 AM To: Shellito, Ryan; Sandhu, Jay Subject: Re: PGE Status for 355 Carlyn Ave? EPM# 31146990 & GPM# 31200246 This is an EXTERNAL EMAIL. Stop and think before clicking links or opening attachments. Ping. We could use a reply about the changed electrical plan here. Thank you. On Thu, Jul 28, 2016 at 5:18 PM, Andy Nicholas <ands.nicholas.mail,ggymail.com> wrote: E-Notification #:110025272 E-PM #: 31146990 Hi Ryan, We recently learned that Campbell City is no longer requiring us to underground the electrical service to our project. The municipal ordnance from Campbell City requiring underground utilities for single-family homes has been changed. From the previously enclosed drawings, it looks like digging a 4x4-foot square is still necessary to connect the gas line, but the connection does not require digging up the street. From your understanding of our gas -line connection, is this correct? No digging of the street is necessary? If so, we would like to figure out how to change our request from underground electrical to overhead electrical. We confirmed that our electrical panel supports overhead connections and our panel is situated on the north side of the building so that dropping electric wires would seem to be straight -forward. Thank you, andy LEGEND & NOTES TO #355 - D — INSTALL (1)4' DUCT BY APPLICANT = cn 4 L2] INSTALL 17" X 30" X 18" IVT SPLICE BOX BY APPLICANT CD N pn l` ° REMOVE EXISTING RISER BY PG&E. IN Cr) #355 INSTALL NEW RISER BY PG&E. ° 200 AMS JOINT TRENCH W/ E-G-PHONE-CATV w 120/240 3W 10 � O is O � _ 10.8 KVA DEM. APPLICANT TO PROVE CONDUIT WITH MANDREL IN O cn z O un � PRESENCE OF P.G.&E. INSPECTOR. � � � z ° APPLICANT TO EXPOSE EXISTING SERVICE FOR REROUTE AS PER P.G.&E. INSPECTORS DIRECTION. APPLICANT TO CL ° L _ o BACKFILL. I -1 � u MAXIMUM AMOUNT OF BENDS PER RUN: 315' E---a O UNDERGROUND SERVICE ALERT w 0'3 I TO AVOID CONTACT & LIABILITY WITH UNKNOWN UNDERGROUND U X UTILITIES, CONTACT U.S.A. @ (800) 227-2600, 48 HOURS IN a 3 0 < ADVANCE OF TRENCHING. WHEN TRENCHING WITHIN 5 FEET OF LU Q KNOWN ENERGIZED ELECTRIC FACILITIES, CONTACT P.G.& E w U U i U INSPECTOR 48 HOURS IN ADVANCE TO MAKE STANDBY j > Q LLJ ° ARRANGEMENTS. Lu Q U J TO #370 n W — w— w w— w I IMPORTANTRI DEVELOPER, GENERAL CONTRACTOR, r-D T- m o ELECTRICAL CONTRACTOR, PLEASE NOTE. a� jj BEFORE BEGINNING SUBSTRUCTURE WORK, PLEASE CONTACT Q Q z CARLYN AVE. I �� 9 N 57A� �a2utc- 3(p THE (408)7&-2202O E. UNDERGROUND 25-777 . WORR, 48K HOURSNOT z m U Q @ (408)725-2202 OR FAX (408) 725-7773. WORK NOT PROPERLY (f) INSPECTED WILL BE REJECTED. �, i3L��+tND Si DtuA-L-k - ±660' TO W. HAMILTON AVE. I v I IF THERE ARE ANY CONFLICTS BETWEEN SUBSTRUCTURE o Z3 INSTALLATION AND LANDSCAPING (SPLICE BOXES, TRANSFORMER I a PADS, MOUNDS, BERMS, TREES, BUSHES, ETC.) CONTACT INSPECTOR PRIOR TO INSTALLATION. _ o � LL VERIFY RISER QUADRANT APPLICANT IS RESPONSIBLE TO ENSURE TRENCHING AND 02 WIPGBE INSPECTOR SUBSTRUCTURE INSTALLATION MEET PG&E GREENBOOK STANDARDS. GREENBOOKS ARE AVAILABLE AT YOUR LOCAL PG&E Q HEADQUARTERS OR CAN BE FOUND ON THE INTERNET AT W W W. PGE. COM/GREENBOOK. X , r MAINTAIN A MINIMUM 3 FIF OF PARALLEL SEPARATION BETWEEN o UTILITIES AND 'WET' FACILITIES. ow RIM #354370 Underground Service Alert c I ALMS PUT WEIY ORST. I LOOK FOR AND ACT TO N p RESOLVE UNSAFE SfllfflONS. Call: TOLL FREE oR�Ta TO ACT WELY. 1-800-227-2000 un a u� J � c TWO WORKING DAYS BEFORE YOU DIG di Q (n K N Syed Wahidi From: JoAnna Thomason Sent: Friday, October 23, 2015 2:57 PM To: Floyd Masalta' Cc: Syed Wahidi Subject: RE: Insurance Requirements Hi Floyd, I was just following up on your insurance. I have not seen anything come through yet. This needs to be in place before the permit can be issued. JoAnna Thomason: Public Works Department Joan natru?cityofcamobell.com www.C'i1vol'Campbell.com From: Floyd Masalta[mailto:floydmasaltaCa7gmail.com] Sent:: Monday, October 19, 2015 9:24 PM To: JoAnna Thomason Cc: Roger Storz; Syed Wahidi Subject: Re: Insurance Requirements Thank you JoAnna! I do have one question that regarding special construction risk projects. Is the PGEtE project considered a construction risk project. I talked to Syed today and forgot to ask him about this section. Thank you, Kindest Regards, Floyd Floyd Masalta AIM NETWORK SYSTEMS, Inc. dba GIBRALTAR Construction License # 419310 1VIAILING PO Box 4691 Santa Clara, CA 95056 F. 800-838-2779 C. 408-709-6954 T. 805-354-8003 i Hi Floyd, attached are the City's coverage requirements and required wording. We require a Waiver of Subrogation for your Worker's Comp. Please make sure to have the location referenced in the'Description of Operations section along with the other required Also when referencing the insurance companies, please have your agent include their "NAIC" number. Please let me know if you have any questions. Thank you ]oAnna ]oAnnaThwnmason I Office Specialist Public Works Department From: Roger Stocz Sent: Monday October 1Q,2U153:Z3PM To: 'Floyd y4asalta'; Sv6d VVahidi; ]oAnnaThomason Subject: RE: Insurance Requirements Can you please help Floyd with our insurance requirements. Thank you, 2 Roger From: Floyd Masalta [mailto:floydmasalta@gmail.com] Sent: Monday, October 19, 2015 2:27 PM To: Roger Storz Subject: Insurance Requirements Hello Roger! We are ready to cut in the street crossing for the power undergrounding project located at 355 Carlyn Ave. I.woutd like to submit a request to my carrier but I want of make sure I have all the language listed as the City requires. Can you please let me know if the PGE trench is considered an "construction risk" project? Here is the language regarding construction risk projects; ; (d) The Contractor shall procure and maintain Course of Construction insurance for those projects with "Construction Risk" as defined by the City Engineer and as specifically required in the Special Provisions. Course of Construction policies, if required, shall name City as loss payee, and the insurer shall waive all rights of subrogation against the City. Also, is there a specific "subrogation clause" language the City wants stated on the insurance Accord form? appreciate your help! Thank you, Kindest Regards, Floyd Floyd Masalta AIM NETWORK SYSTEMS, Inc. dba GIBRALTAR Construction License # 419310 MAILING PO Box 4691 Santa Clara, CA 95056 F. 800-838-2779 C. 408-709-6954 T. 805-354-8003 Syed Wahidi From: Syed Wahidi Sent: Tuesday, October 20, 2015 8:03 AM To: 'Floyd Masalta'; JoAnna Thomason Cc: Roger Storz Subject: RE: Insurance Requirements Floyd, This work doesn't come under "Construction risk". Besides the insurance, - please submit an encroachment permit - pay permit fees of $815 - pay security deposit of $1000 Syed Wahidi I Public Works Inspector City of Campbell I Public Works Dept. syed«(a cityofcampbelLcom 468.866.2165 3 408.376-0958 70. N. first Street Campbell, CA 95008 w ww.Ci tvofCampbe.l l.coni From: Floyd Masalta [mailto:floydmasalta@gmail.com] Sent: Monday, October 19, 2015 9:24 PM To: JoAnna Thomason Cc: Roger Storz; Syed Wahidi Subject: Re: Insurance Requirements Thank you JoAnna! I do have one question that regarding special construction risk projects. Is the PGi:tE project considered a construction risk project. I talked to Syed today and forgot to ask him about this section. Thank you, Kindest Regards, Floyd Floyd Masalta AIM NETWORK SYSTEMS, Inc. dba GIBRALTAR Construction License # 419310 MAILING PO Box 4691 Santa Clara, CA 95056 F. 800-838-2779 C. 408-709-6954 Syed Wahidi From: Syed Wahidi Sent: Wednesday, July 29, 2015 7:56 AM To: 'Floyd Masalta' Cc: Roger Storz Subject: RE: Encroachment Permit (355 Carlyn Avenue) Hi Floyd, PG&E plans are good except that the new splice box shall be installed behind sidewalk and we will put a note on the plans. Please submit an encroachment permit for this work and pay the permit fee of $425(Permit) + $390 (Inspection). Security deposit of $1000 is required. Also, provide contractor's insurance and workers comp certificates for City's review and approval. The street improvements permit for this project is still on hold pending contractor's insurance that has not been submitted to us. Syed Wahidi I Public Works Inspector Cite of Campbell I Public Worl.s Dept. syedw(a'citvofca►npbell.com 408.866.2165 1, 408.376-0958 70. N. First Street i Campbell, CA 95008 www.CitvofCampbell.com From: Floyd Masalta[mailto:floydmasaitaCa)gmail.com] Sent: Tuesday, July 28, 2015 2:18 PM To: Syed Wahidi Subject: Re: Encroachment Permit (355 Carlyn Avenue) Thank you very much Syed!, Kindest Regards, Floyd Floyd Masalta AIM NETWORK SYSTEMS, Inc. dba GIBRALTAR Construction License # 419310 MAILING PO Box 4691 Santa Clara, CA 95056 F. 800-838-2779 C. 408-709-6954 T. 805-354-8003 On Tue, Jul 28, 2015 at 1:41 PM, Syed Wahidi <syedwncityofcampbell.com> wrote: Hi Floyd, I am reviewing the plans and will get back to you by tomorrow. Syed Wahidi I Public Works Inspector City of C:arnpbell I Public Works Crept. syedw(a eitvofcampbelLcom 408.866.2165 1 A 408.376-0958 70. N. First Street I Canpbell, CA 95008 www.CityofCarnpbeILcom From: Roger Storz Sent: Monday, July 27, 2015 4:13 PM To: Syed Wahidi Subject: FW: Encroachment Permit (355 Carlyn Avenue) Hi Syed, Can you please respond to Floyd with the details of what he needs to provide to get a Utility Encroachment permit to do the joint trench work shown on the attached PG&E drawings. Thank you, Roger From: Floyd Masalta[mailto:floydmasaltaCcbgmail.com] Sent: Monday, July 27, 2015 4:02 PM To: Roger Storz Subject: Re: Encroachment Permit (355 Carlyn Avenue) Hello Roger! I attached, the PGEtE drawing for construction. Will this suffice for submittal purposes or do you need more detail for placement of PGEtE facilities? Do I need the following for the PGEtE work; Emergency cash deposit and how much? CGL Insurance? W/Comp? Surety bond? Who develops the engineering estimate? If I sub -contract this do they need to supply all this as stated above? Thank you, Kindest Regards, Floyd 3 Floyd Masalta AIM NETWORK SYSTEMS, Inc. dba GIBRALTAR Construction License # 419310 MAILING PO Box 4691 Santa Clara, CA 95056 F. 800-838-2779 C. 408-709-6954 T. 805-354-8003 On Wed, Jun 17, 2015 at 2:06 PM, Roger Storz <rogers(a cityofcampbell.com> wrote: Hi Floyd, You will need to apply for an Encroachment Permit once PG&E has issued you the approved drawings for gas and electricity. Please make sure your contractor has a City Business license and insurance on -file indemnifying the City of Campbell (specific insurance requirements are listed on the web page below). You can find the application form and other supporting documents at the bottom of this page: http://www.ci.cainpbell.ca.us/I 87/Perinit-hifon-nation Regards, Roger K. Storz, P.E. I Senior Civil Engineer City of Campbell I Public Works Department 4 roQers@citvofcanipbell.com 408.866.2190 70 N. First Street, Campbell, CA 95008 Syed Wahidi From: Roger Storz Sent: Monday, July 27, 2015 4:13 PM To: Syed Wahidi Subject: FW: Encroachment Permit (355 Carlyn Avenue) Attachments: 31146990SubstructDWGB.pdf Hi Syed, Can you please respond to Floyd with the details of what he needs to provide to get a Utility Encroachment permit to do the joint trench work shown on the attached PG&E drawings. Thank you, Roger From: Floyd Masalta [mailto:floydmasalta@gmail.com] Sent: Monday, July 27, 2015 4:02 PM To: Roger Storz Subject: Re: Encroachment Permit (355 Carlyn Avenue) Hello Roger! I attached, the PGEtE drawing for construction. Will this suffice for submittal purposes or do you need more detail for placement of PGEtE facilities? Do I need the following for the PGEtE work; Emergency cash deposit and how much? ✓CGL Insurance? ✓ W/Comp? Surety bond? Who develops the engineering estimate? If I sub -contract this do they need to supply all this as stated above? Thank you, Kindest Regards, Floyd Floyd Masalta AIM NETWORK SYSTEMS, Inc. dba GIBRALTAR Construction License # 419310 MAILING PO Box 4691 i Santa Clara, CA 95056 F. 800-838-2779 C. 408-709-6954 On Wed, Jun 17, 2015 at 2:06 PM, Roger Storz <rogersncityofcampbell.com> wrote: Hi Floyd, You will need to apply for an Encroachment Permit once PG&E has issued you the approved drawings for gas and electricity. Please make sure your contractor has a City Business license and insurance on -file indemnifying the City of Campbell (specific insurance requirements are listed on the web page below). You can find the application form and other supporting documents at the bottom of this page: http://www.ci.campbell.ca.us/I 87/Peimit-Inforniation Regards, Roger K. Storz, P.E. I Senior Civil Engineer City of Campbell I Public Works Department roQersLikityofcampbell.com 408.866.2190 70 N. 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