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1017 Lucot Way (PLN2014-85)
PLEASE KEEP THIS SHEET ON TOP Project Fact Sheet 1. Project Address: 1(7\� �-�Ltd vJ���i ENC 2. APN: o - 3. Owner Name(s): ( a 1 .o ve-Z- 4. Owner Address: 617 L¼3( o} 5. Owner Phone: 6. File No. (Planning) O (LA 7. Project Planner: S'MecA 8. Cross Reference File(s) 9. Condition of Approval: Circle one: City Council Planning Commission Comm Dev. Director Resolution No. 10. Architect: 11. Architect Address: 12. Architect Phone: 13. Engineer Name: 14. Engineer Address: 15. Engineer Phone: 16. Surveyor Name: 17. Surveyor Address: 18. Surveyor Phone: 19. Monumentation Security Amount: C:\)ocuments and Settings\joannat\Desktop\My Forms\Templates\Project fact sheet.doc b PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2014 /��/4 TO: City Clerk PUBLIC WORKS FILE NO. A " . PROPERTY ADDRESS j I LUG"� Wt& Please collect&receipt for the following monies: U ACCT. I ITEM AMOUNT LAND DEVELOPMENT 4722 Encroachment Permit Application Fee Non-Utility Encroachment Permit Major≥$10,000 $385.00 Minor Encroachment Permit<$10,000 $220.00 Initial R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $220.00 Inspection Fee Minimum Charge per Location $385.00 Street Tree Planting/Removal N/C 2203 ($500 per Tree Planting Deposit Required) $500.00/tree 2203 Plan Check Deposit 2%of Engineer's Estimate $500.00 min Utility and R-1 Permits no deposit required 4722 Grading&Drainage Plan Review Single Family Lot $270.00 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 Requirements) For projects not required to submit numeric sizing $156.00 For projects required to submit numeric sizing Impervious Area 10,000 Sq. Ft to 1 Acre $676.00 Impervious Area 1 Acre or more $884.00 4722 For projects sent to Consultant for review Consultant Cost+20% Plan Check& Inspection Fee(Non-Utility) 4722 Engr. Est.<$250,000 14%of Engineer's Estimate 2203 Engr. Est.≥$250,000 and<$500,000 $35,000+8%of Engineers Estimate 2203 Engr. Est. ≥$500,000 $55,000+7%of Engineers Estimate 2203 Emergency Cash Deposit 4%of Enqr. Est.*($500 min/$10,000 Max) 2203 Faithful Performance Security(FPS) 100%of ENGR.EST.* 2203 Labor and Materials Security 100%of ENGR. EST.* 4721 Storm Drainage Area Fee Per Acre R-1 $2,120.00 7i45, 0 Q (Multi-Res$2,385.00) (All Other$2 650.00) 4722' Parcel Map(4 Lots or Less) $3,850.00+$83/lot 4722 Final Tract Map(5 or More Lots) $4,681.00+$114/lot 2203 Monumentation Security 100%of City's Monumentation Estimate 4920 Parkland Dedication Fee(75%/25% Due Upon Cert.of Occupancy) 4722 Lot Line Adjustment(Includes Certificate of Compliance) $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 signature) $10.00 4722 Assessment Segregation or Reapportionment First Split $860.00 Each Additional Lot $270.00 511.7424 Postage MISCELLANEOUS I Other(Please Specify) *Engineer's Estimate shall be as approved by(/the ^-City Engineer and shall include all items of work. TOTAL $ a' S. o L NAME OF APPLICANT ;lG� - ( tope' NAME OF PAYOR PHONE 6 2, ADDRESS JO ` )r `` ZIP FOR RECEIVED tt��J� 1;1Ula 3 CITY CLERK ONLY Date l 1 _t i Receipt# �' �� �fi, ¢4PAl"'L( zt a Date/ Initials J'.\FORMS\Templates\4dmin,strshve1Receipt Form Land Development 14-15 CIT.( OF G«&w REVD S: awls GgQEaL42 ey«sa«a 1110»14 REGISTER DATE: 11/0.S,14 g6: S:S Rww3Iq am« STORM BRIM FEES FN Q4«y OUST ID: QR mmT #Y TOTAL DUE: g3. TENDERED: !9%Q C%R: «; ; V • . . . . . 1017 1,0/0 weA Al' 406-0011- Oki JJGNATURES REQUIRED: IN-HOUSE Building Division: Signature Print name Date Planning Division: r i1/ j�/ 'lb Orbde, livis. la S (.. /...critriev.7 igna e 8 --. -k Print name �*C�€tte 1 J.1) Public Works Department: 1I/5//4 Signature Print name. Date i 'ef t aF t Pc7A - Redevelopment Agency: _ Signature Print name Date • I have read, understand and will comply with the conditions and responsibilities during all demolition work. � 0 6 . `� • van i 1 i / 3/i Owner's Signature I U Print name Date • Contractor's Name: O LA, .7,r / g , ' Su- Telephone#: (1Q ) ? -- q G$ Address: I 0 I .7 Lb,Co—r- LiA1 , ( /IPA P6 E • COST: permit issuance fee. Paid: Permit# Project Address: `4•°v•° itA City of Campbell 101 -7 L UC.o T WA Y • (a01Pbu1 ) cam► 4co,.,x 0 WASTE MANAGEMENT• Permit No. °R°.00' PLAN WMP REQUIRED BECAUSE PROJECT IS A SUBMIT TO: Demolition≥500 Sq. Ft. City of Campbell ❑ Construction/Remodel ≥$250,000 Public Works Dept. 70 N. First St. Construction/Remodel ≥2000 sq.ft. Campbell, CA 95008 Mon.— Fri. 8:00 am-5:00 pm INFORMATION AND SUPPORT: Public Works Dept.-408 866 2150 SECTION ONE: PERMIT APPLICATION This Waste Management Plan (WMP) must be completed and approved to obtain a building permit. Separate WMPs must be completed for demolition and construction at the same site unless the Building Department requires only one permit. Step 1: PROJECT INFORMATION - FILL OUT THE FOLLOWING INFORMATION Applicant's Name: David A Contact Phone Number: 0-I00 3-7 3._y(7$L' Fax Number: Check one: ❑ Owner ❑ Architect ❑ Builder gOwner/Builder ❑Other Contractor: A//,•6s- Contact Phone Number: Project Type: gNew ❑ Remodel ❑ Addition ❑ Demolition Project Square Footage: S1 D Project Description: . 1J-1.)-I e. ra 144 i /y Gl�' j Estimated Completion Date: _Cell cJ wz.o i Step 2: WASTE MANAGEMENT REQUIREMENTS REQUIREMENTS: You are required to recycle or re-use 50%of all construction and demolition debris. I understand that I am required by the City of Campbell Municipal Code Section 6.12 t salvage, reuse, or recycle a minimum of 50% of all construction and demolition debris (C&D). (Initial) understand that failure to meet the requirements of Municipal Code Section 6.12 shall constitute a misdemeanor, and shall be punishable by imprisonment in the county jail for up to 6 months, or by a fine of up t $1,000, or both. In addition, a stop order on the job or a delay of final approval may occur. (Initial) At the completion of this project, or more frequently if required, all receipts or other equivalent documentation from salvage,recycling and waste facilities will be provided to the City of Campbell Public Works Department and I understand that I may not be issued my final inspection unless all recets Qnd documentation are submitted to the City of Campbell Public Works Department. ��. (Initial) Step 3: RECYCLING CONSTRUCTION AND DEMOLITION DEBRIS-ANSWER THE QUESTIONS BELOW SALVAGE AND REUSE: 1 4X(e wd' i c. 2)ZXC9 co to Fl000 3)2)(4 S 'Aids . What materials will be salvaged?q W'vt Sow S ''ro w 4 6900 et Salvage Company (if applicable): / n What materials will be reused on site?ApOtve . cea v 51 °G.cX, How will this be documented? Pi c 4v Y-0 ax&C o te o N S e f t V/S! 1- • MATERIAL TRANSPORTATION: D i °61' -II u using a hauling company or hauling the material yourself? e) �" r e�t Valley Collection & Recycling Co. (WVCR)* XSelf Haul OVA? Permit Avpplicant is required to contact WVCR (408-283-9250) to reques c ion and demolition debris box service. All original receipts, weight tags and documentation for salvage,recycling, and disposal must be submitted: ill On Completion of project ❑ Other DPW Approval: Date: SECTION TWO: FINAL REPORT APPROVAL Please complete this section and have it approved by the Public Works Department no later than 30 days after completion of the demolition or construction project. This section must be completed and signed, and all original receipts or other supporting documentation must be attached in order to receive final project approval. ❑ All original receipts or equivalent documentation for salvage, recycling, and disposal are hereby attached. ❑ This project has recycled at least 50%of all construction and demolition debris generated. Applicant: Date: DPW Approval: Date: bL-8 L-E -31VOLNIad £L-Z.L-LL 31VO103fO2id VN :31VOA3N C731ONSV 71vo5 00 SO`N 1011 fl 21 IVIHL NIHIS9 .L � Q 80096 b'IN2iOdl7`dO`11 b'd8dWD hVM lO3f17 L406 5, U, H00000000 L2000� rc i11 w=w� O h a f jJ a¢`� c¢wi z aom o Z J " ° zz ®LLZ L1J cn m r r a <a _ Q s 'll N M wp Jw w JU Q® , X �a99 z W ZOC~.) a u. u.� W Q wo p°of 0 h_®JJ a D o as w - o d 10 1mm w W�I—Co W' (� QWI— z I•— <ala- ��--- )Oa 8 ) H - aoz 000ao �F-ZZJZ U W F W = o o 0 0 0 0 5 O W °w W F aw ad a°m S O(JU ® w w as Q;w <<O c9ZW�Z Ci mao m <¢<<<<¢a Z,D CJ LLl< W a <tt a e>'a c,^ = w m s .>cc ZW Cry 99 ° wo o <> o ° zoo LL°(�WJZ HO .. U pm p ¢ Q a ¢ a °oo � WC,J N OWN l- a o¢ a:QW z < 9 a z m a W W>-U 990 of wa ? om9 �ti� o o ¢z-aaz W® z <98O99 Z W U �zoa ° Q oow K ≥ OOa J0UjWH ®C/7d® _ W JQWLLI w W U) n �\ a tt s W °__u,� � I 0 o Y r ry a ₹ W dd 51 ICI a N o I UU H Q LLI w o o0 J J.. Q _ cap ~ 1"} p U " U Q _..i env o� n�Un fly Y w Q 4 d¢ U x, m c.,12 7+ JUN ,0 2014 . PLAN REVIEW ROUTERPublic works AdministratioCIT ' OF CAMP'BELL ew Submittal y ❑Resubmittal: (?"d,3rd , .0, S`t'Review) ❑Revision to Existing P ermit �CEIVED APN# APPL]CATION/PEP.MIT#'14i JOB ADDRESS /0/ 7 `- (/ JOB DESCRIPTION /v .�� r ,Otr.) O COMMERCIAL _SIDENTIAL SECWED Plans RECIEVED Structural Calcs. AL0 1 '6\4 _WVSD i _Soils Report �F School Fee.Form i Truss Calcs. o WG 0_Nks1°' —Health Department Approval 7 ^3UU.D 3T-?4 Calcs. 4 _Resppnse Letter . Gr.� Initia I " 5d ding n Checked By 'l f_ Date: c9\_5e..4- ) S ctural Plan Checker: i„15.1.41,,%,:)_________Date: DAPPROVED ❑NOT APPROVED tannin, Zone: lan Check d By: Date: IOAP PROVED DNOT APPROVED • Public Works v Han Chec ed By: i Date: • , L' PPROVED ONO'APPROVED L a)i ie d-- -e_to ) Fire an Checke By: Date: . ` � S ❑APPROVED ONOT APPROVED Application for Building Permit _ lrAApplicant:Fill in all applicable areas;Please print clearly. Application Number: 1---: Intake Person(office use onl Applicant is: /'\ Owner Contractor Architect/Designer Agent: ------ ---- - -- ----- Project Identiffication: APN: 4-1•0(O— 2 L �2 Lot#: 3r Suite or Space#: N(4 Job Address: (01-1 LL'GO I w'A Y City: (A '-IPI^»6-LL State: ( . Zip: q S0g ---- --- - ----- --- - Project Type (check appropriate item) Permit Type(s) (check appropriate items) Commercial X Residential K BLDG MECH PLUMB ELEC Sfrin of Work _ — - f..-,10 r(A L___--- ..- / , - - - 'v v .- Valuation: $ 2 ¶O /-9 9O Const.Type: V Occupancy./� F....Ps Is Bldg. Sprinklered? Yes No Existing Use: ,— I F= PS 1`C 1C Proposed Use —f 1`PSif tf C-e-. #of Stories: L #of Units: Comm.Sq.Ftg. Office: '..4(//./1-n r Retail: —7/,/#- Warehouse: N(,(4- Other:Res.Sq.Ftg. Total Sq. Ftg...', (-I� 3 Dwelling: ZV{0 J Gar: 51# � of cars 2 Patio: 4.1('A Porch: I 0:1) Deck: (--",-(4 AregYofiretnovmcr8-sfreettree? 77:T: -es 7. " re=Votri'.romilanVrwor ran. e-pubicliiiiht��waV� &: Yes;i�• . .:R-�^T�o` Owner's Name Address,Pone Name 1)QttA4 I.--D(>6 Z_.`"1- I'r��,F�{�•�(�Home Phone. 0�y -- dr Adess (OI - LUG_ © ) . Li Y Bus Phone LmaililQti ToP Z tr;;•f-�i;;(r City (:AkisKrL.f_. State (A Z!p.Goce ^ moo .-- i Contractor-s Name,Address,Phone'&.Contractor's Lic #' .`' Check'Here if"Owner/quilder,Permit r e<: ' Company Name, F' ' '*_- r nct- ' ?f Bus Phone ._';',127,',:,- 66ntact.N'One , ie i...i : i e ° .."47f1:- sF c _= Address ' 7�':"X .life��- � _ ‘„ - Small., : . . --, ,, ' � City 7 � �� _.. ., License#: M .:. ' Lise-Classii cationsls : `- t,'t ** ,• > •._..: Architect Designer_ Engineer (please check one) ` '30 -- G5fi- ( (I' C Name ( .11�� ��'�L'7 .l(e 4�Y,( , !1,1)f,, �, '6�C'.: Phone: , 1 ‘-1 r r Address i 5)G lr' -c'1"ltt k 4r"`F.-•\ Bus. Phone: `-t�', ' r{`'.: &11`f Email]t✓,1't(1V Q. .1 City C%'�t:CC U;,`. ``i''t-; , state �.L\- Zip Code c l t v\0-C ‘ Cu `d.k9.5t\ C.f:e-1-, 1 Desired contact Person: ` , Owner Contractor "•• rchitect/Designer Agent Applicant Signature I � Printed Name I) Date t MEMORANDUM CITY OF CAMPBELL TO: Bill Bruckart, Building Official DATE: 7/1/2014 FROM: Doris C. Quai Hoi, Project Engineer (408)866-215 f� SUBJECT: BUILDING PERMIT APPLICATION Site Address: 1017 Lucot Way For File No(s): PLN2014-85 Project Description: Site and Architectural Review Permit for demolition of the existing house and construction of a new house. Applicant: David Lopez PUBLIC WORKS DEPARTMENT CONDITIONS OF APPROVAL 1. Prior to issuance of any grading or building permits for the site, the applicant is required to complete the Conditions of Approval for the project approved by the Community Development Director on May 18, 2014 (PLN 2014-85). J:\LandDev\Conditions\Bldg\Lucot Way 1017.doc Page 1 of 1 7/1/2014 Fees Associated With 4:15:07PM ►CCEL Case#: BLD2014-00622 Fee Start End Trans Revenue Created Type Date Date Dept Description Code Account Number By Date Amount Due PRVW 7/1/2013 6/30/2014 Plan Review Fee 101.554.4211 KO 6/26/2014 2,263.46 0.00 SDA 7/1/2013 6/30/2014 Storm Drain Fee-R-1 209.715.4721 DQH 7/1/2014 745.00 745.00 Total Due: $745.00 Page 1 of 1 CaseFees..rpt Iowe ONNOd LON --- dd w 1WN)d 0009 fAAI cNrIOdiON i OO,ZS.BB N N r�.�---�-�- �--.—...—....- avaa dog-7-.._ ... So- . � 1 a ys w WN Hd OO p,,, OZ-H Av LL65 7 •OE;Zbel _."' 9O.9r Z9'LE'^'7 /y -ti_ one seven ,��,�.. .,m,,, I ww._ I � M I g p , owoo. IT rtrt.. h t p 2e 7 �1 IlVM IIWJ v� (C 1 7 ® 73A HJ I1C» { `p� 6VN1SIN3 mw...gy «-paiN ! OVd JNQJ. I "m. .?• �� ...m. I 1111TG i 006 ssve� / i . _ 2/4 3 OO 5.B9 N /1 / 25.99 N.. „� OOIdNON z. a<:��.�c+w-o-r a.- 9B LE 'Nb'N%d a� •� N9/N..___ Y' 3 aoom 5'Wl � o�la� z la1 aNno� 00 k NOV vD rn'p (7N/1Od O NOW vi y n oa �m n `1 N oV.c Project Address: ti t, City of Campbell ` o i '7 L Qc_,o T c� E r Col/vile-11 ) (A o.N a �.:,;:: ° N WASTE NT Permit No.c)l/f ` O//O j MAN AGEMENT Q °RCH"Rs)' PLAN WMP REQUIRED BECAUSE PROJECT IS A SUBMIT TO: y Demolition ≥500 Sq. Ft. City of Campbell u Construction/Remodel ≥$250,000 Public Works Dept. 70 N. First St. X Construction/Remodel ≥2000 sq.ft. Campbell, CA 95008 Mon.— Fri. 8:00 am-5:00 pm INFORMATION AND SUPPORT: Public Works Dept. -408 866 2150 SECTION ONE: PERMIT APPLICATION This Waste Management Plan (WMP) must be completed and approved to obtain a building permit. Separate WMPs must be completed for demolition and construction at the same site unless the Building Department requires only one permit. Step 1: PROJECT INFORMATION FILL OUT THE FOLLOWING INFORMATION Applicant's Name: David A Contact Phone Number: 0-1,0C,,) 3 7- —41(A ' Fax Number: Check one: ❑ Owner El Architect Cl Builder 14 Owner/Builder ❑Other Contractor: ,N/A- Contact Phone Number: Project Type: gNew ❑ Remodel ❑ Addition El Demolition Project Square Footage: 7 �d C Project Description: 5-lilt).- )e. 6 L+i/ /Y D Lk/ rJli vt_C Estimated Completion Date: c4 C ' understand that failure to meet the requirements of Municipal Code Section 6.12 shall constitute a misdemeanor, and shall be punishable by imprisonment in the county jail for up to 6 months, or by a fine of up t $1,000, or both. In addition, a stop order on the job or a delay of final approval may occur. (Initial) At the completion of this project, or more frequently if required, all receipts or other equivalent documentation from salvage, recycling and waste facilities will be provided to the City of Campbell , Public Works Department and I understand that I may not be issued my final inspection unless all receetsnd documentation are submitted to the City of Campbell Public Works Department. (Initial) • Step 3: RECYCLING CONSTRUCTION AND DEMOLITION DEBRIS -ANSWER THE QUESTIONS BELOW SALVAGE AND REUSE: 64,(46v'd'c-vc. z) XC- ‘...) 1. Elect,. 3)ZX4 S IvJs . What materials will be salvaged?q 'w OA So w s • $)-Ito(A-I Zoo✓` Salvage Company (if applicable): // What materials will be reused on site?AP0Ve . e -6 v 5-Li e.-c-e, How will this be documented? P c av1r-‘,S ax&C oe o vA S I t t Lind- MATERIAL TRANSPORTATION: �� °{14)4 'II u using a hauling company or hauling the material yourself? e) C.J ` e t Valley Collection & Recycling Co. (WVCR)* /' Self Haul 0�`�y Permit Kpplicant is required to contact WVCR (408-283-9250) to reques co ion and demolition debris box service. All original receipts, weight tags and documentation for salvage,recycling,and disposal must be submitted: X On Completion of pr . ct ❑ Other DPW Approval: Date: 1// 211 S SECTION TWO: FINAL REPORT APPROVAL Please complete this section and have it approved by the Public Works Department no later than 30 days after completion of the demolition or construction project. This section must be completed and signed, and all original receipts or other supporting documentation must be attached in order to receive final project approval. ❑ All original receipts or equivalent documentation for salvage, recycling, and disposal are hereby attached. ❑ This project has recycled at least 50% of all construction and demolition debris generated. Applicant: Date: DPW Approval: Date: • MP *. * * CASH DISBURSEMENT RECEIPT * * * IIl ' ; iH III"!II III 'ill 111I of MI II10l ii Receipt 4 3 9377 Receipt Date: 12/22/14 10:40am 11 SAN JOSE RC0704 PR0039 1800 MONTEREY HIGHWAY SAN JOSE. CA 95112-6116 408-494-4200 Purchased From: CP011N DAVID 0 LOPEZ (License/ID No: R0864697) 10'9 AUDREY AVE CAMPBELL. CA 95008 Veh # I.U. # R08646t'97 Ticket# Ship Dt Commodity Price UM Frt Ext Total Amt Zaofji 12/16/14 High Grade Wire 1.100d LB 0.00 60.20 Veh#: Weights: 362g 311t 51n Zaofji 12/16,-14 Aluminum Old Sheet ( 0.4500 LB 0.00 40.05 Veh#: Weights: 429g 340t 89n Supplier CPO11N Totals (Pounds): 791g 651t 140n TOTAL AMOUNT PAID 10 SUPPLIER (ATM): $100.25 Cashier Signature _, t'EvangeIina R iz) Customer Signature 1r- 44- liii 1111111111 Ticet # Zao ji , �� PURChA .r TICKET \�v\ Weighed At: SIMS Metal 1800 Monterey Hwy. San Jose. California (408) 494-4200 PR0 RC0704 PR0039 I (7 Control No:: 11 619072 Ticket # Zaofji Date: 12/16/14 Time: 10:20am Vehicle Tag No: 6Z00632 State: CA Purchased From: CP011N DAVID D LOPEZ License/ID No: R0864697 (CA) 1079 AUDREY AVE CAMPBELL, CA 95008 Pounds Itm Material Gross Tare Net Adj Pd Wt 1. High Grade Wire 362f 311m 51 0 51 2. Aluminum Old Sheet (T/T) 429f 340m 89 0 89 Totals 791 651 140 0 140 Material Summary Pd Wt(lb) Price $/Unit Extended Price $ High Grade Wire 51 1.1800/Pounds 60.18 Aluminum Old Sheet (T/T) 89 0.4500/Pounds 40.05 Total: $ 100.23 Deputy Weighmaster Signature (Jose C Customer Signature (All weights a-e reported in Pounds unless otherwise indicated) ("m" Represents a weight that was manually entered) WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described ccmmodity was weighed, measured, or counted by a weighmaster, Whose signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the California Business and Professions Code, administered by the Division of Measurement Standards of the California Department of Food and Agriculture. BILL OF SALE: I warrant that I am thc. er (or owner's representative) of the material descr hereon and have the right to sell same, that it contains no Ha: Materials as defined by any federal or state law and tl-et :ayment hereby received, I sell and convey title to Sims Meg HOLD HARMLESS AGREEMENT: Seller A indemnify and hold buyer harmless from damages, demands and liabilities, including reasonable attorney's fees, resulting from the breach of any warranty hereunder and driver agrees to be responsible for damage to vehicle during unloading. NOT REFUNDABLE MORE THAN 90 DAYS FROM DATE ABOVE Customer Copy i _ Y • * * CASH DISBURSEMENT RECEIPT * * * * * * * * * * * 1 $ * 4 * * * * * * 11111 liii 111111 Receipt # 3626 teceipt Cate: 11/25/14 2:52pm 11 SAN JOSE RC0704 PR0039 1800 MONTEREY HIGHWAY ;AN JOSE. CA 95112-6116 (08-494-4200 'urchasec From: CP011P ELAINE TORTE LOPEZ (License/ID No: NO354769) 1079 AUDREY AVE CAMPBELL, CA 95008 leh # TK TAWCSE I.D. # 6Z00632. 'icket# Ship Dt Commodity Price UM Frt Ext Total Amt TAWCSE 11/25/14 Bundling Mat'1/Tin 115.0000 NT 0.00 70.15 4eh#: TK TAWCSE Weights: 6940g 5720t 1220n supplier CP011P Totals (Pounds): 6940g 5720t 1220n 'OTAL AMOUNT PAID TO SUPPLIER (ATM): $70.15 :ashler Signature (Diana Lopez, :ustomer Signature • WEIGHMASTER CERTIFICATE a S111AS METAL TRUCK SCALE ' MANAGEMENT WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that He following descnbed commodity was weighed,measured,or counted by a weighmaster,whose Ticket #: TAWCSE signature is on One certificate,who a a recognized authority of accuracy,as prescribed by Chapter 7(commencing with Seceon 12700)of Division 5 of the California Business and Professions Code,administered by the Division of Measurement Standards of the California Department of Food and Agrculture. Purchased From: CP011P SHIP DATE: 11/25/14 Control No:: 11 524017 ELAINE MARIE LOPEZ WEIGHED AT: 11 SAN JOSE RC0704 PR0039 1079 AUDREY AVE 1800 MONTEREY HIGHWAY CAMPBELL, CA 95008 SAN JOSE, CA 95112-6116 Vehicle Tag No: 6Z00632 State: CA 408-494-4200 ID # 6Z00632 SHPMNT# COMMODITY GROSS TARE NET PRICE ADJ REASON RED C/W RD EXT ADJ AMT CBK FRT PRICE TOTAL AMT TAWCSE Bundling Mat'l/Tin 6940b 5720a 1220 0.0 0.00 0.00 0.00 115.0000NT 70.15 ALL WEIGHTS ARE REPORTED IN POUNDS UNLESS OTHERWISE INDICATED. ALL NON-POUND WEIGHTS ARE ASSUMED TO BE MANUAL WEIGHTS TOTALS 1220 0.0 0.00 0.00 70.15 Ticket Comment: 3 HATS + + GRS Date 11/25/14 (METRIC TON WEIGHMASTER SIGNATURE I GRS Time 14:32 I 0.5534 (Diana Lopez) I TRE Date 11/25/14 CUSTOMER SIGNATURE I TRE Time 14:52 a=SCALE 1 b=SCALE 2 c=SCALE 3 d=SCALE 4 m=MANUAL WEIGHT + + NOT REFUNDABLE M9AE JTAeN5 91IiAYS FROM ABOVE DATE Customer Copy In acordance with the Clean Air Act and other applicable laws,seller must sign the Scrap Acceptance Agreement form prvided at the scale at least one time every 3 years,which applies to any recyclables in the transaction which may contain or have contained refrigerants or other potential Hazardous Materials. FOR SALVAGE VEHICLE SALES:I hereby certify,under penalty of perjury that any vehicle sold has been cleared for dismantling with the Department of Motor Vehicles. HOLD HARMLESS AGREEMENT.Seller will indemnify and hold buyer harmless for damages,demands and liabilities,including reasonable attorney's fees,resulting from the breach of any warranty hereunder and driver agrees to be responsible for damage to vehicle during unloading. BILL OF SALE I warrant that)am the owner(or owner's representative)of the material described hereon and have the right to sell same,that it contains no Hazardous Material as defined in the Scrap Acceptance Agreement or otherwise by any federal or state law and that for payment hereby received,I sell and convey title to Sims Hugo Neu. Seller certifies that all refrigerant including but not limited to Chlorofluorocarbons and Hydrochlorofluorocarbons(collectively"CFC's")Refrigerants and their substitutes as defined in section 608 of the Clean Air Act that has not leaked previously have been recovered from appliance and motor vehicles prior to delivery. I understand it is unlawful to release Freon and CFC's into the atmosphere and that any CFC's must be properly removed before appliances or motor vehicle air conditioners can be recycled. I verify that either(check one): (1)all CFC's previously leaked from this container,or ❑ (2)all CFC's were properly recovered in accordance with 40 C.F.R.Section 82.156(g)and(h)by: El vendedor certifica que todos los refrigerantes incluyendo pero no limitado a CFC's y HCFC's Refrigerantes y sus substitutos como se define en la section 608 del Acta de Aire Limpio que no ha goteado previamente han sido recuperados de los electrodomesticos y automoviles antes de ser entregados. Yo entiendo que es contra la ley liberar Freon y otros clorofluorocarbonos y hydroclorofluorocarbonos(legalmente Ilamados CFCs)en el aire y que todos los CFC's tienen que estar removidos apropiadamente antes de que los aparatos o aire acondicionados de los carros puedan ser reciclados. Yo verifique que(cheque uno): Ei (1)todos los CFC's han sido previamente evacuados de este contenedor,o ▪ (2)todos los CFC's fueron recuperados en forma appropiada de acuerdo con 40 C.F.R.Seccibn 82.156(g)y(h)por: Name/Nombre: Address/Direction: Date/Fecha: Seller Signed/Seller Firma: Printed Name/Nombre: Date/Fecha: Seller's Warrant/Seller's Warrant:Seller warrants and represents to the Purchaser the material transferred,by the Seller to the Purchaser pursuant to this Agreement is not and does not contain a"hazardous substance"as said term is defined in the current applicable federal or state environmental laws,rules,or regulations. In the event Purchaser incurs any liability or obligation due to a breach of said warranty and representation,Seller agrees to indemnify and hold Purchaser harmless from all such liabilities and obligations. Notwithstanding the foregoing,nothing set forth herein shall constitute a waiver by Seller of any rights under the law pursuant to any written or oral agreements that it may have against any entity. EL VENDEDOR GARANTIZA.El vendedor garantiza y representa al Comprador que el material transferido,por el Vendedor al Comprador de acuerdo a este acuerdo no es y no contiene"substancias peligrosas"como se dijo en e termino como se define en las leyes,reglas,o regulaciones ambientales federales y estatales. En el evento que el Comprador incurra alguna responsabilidad u obligation por el rompimiento de dicha garantia y representacion. El Vendedor acuerda en indemnizar y no hacer responsable al Comprador de toda dicha responsabilidad y obligation. No obstante to precedente,nada dicho aqui constituira una renuncia por el Vendedor de cualquier derecho bajo la ley segun cualquier acuerdo escrito u oral que pueda tener en contra de cualquier entidad." •* * * CASH DISBURSEMENT RECEIPT * * * III I IIII II II Receipt 4731 Receipt Cate: 12/16/14 10:50am 11 SAN JOSE RC0704 PR0039 1800 MONTEREY HIGHWAY SAN JOSE, CA 95112-6116 408-494-4200 Purchasec From: CP011P DAVID D LOPEZ (License/ID No: R0864697) 1079 AUCREY AVE CAMPBELL, CA 95008 Veh # PECDTAWGDH I.D. # 6Z00632 Ticket# Ship Dt Commodity Price UM Frt Ext Total Amt TAWGDH 12/16/14 Bundling Mat'1/Tin 115.0000 NT 0.00 35.65 4eh#: PEDDTAWGDH Weights: 6500g 5880t 620n Supplier CP011P Totals (Pounds): 6500g 5880t 620n TOTAL AMOUNT PAID 10 SUPPIIER (AIM): $35.65 Cashier Signature (Steven Howard) Customer Signature WEIGHMASTER •CERTIFICATE a SIMS TRUCK SCALE 'VP ' METAL MANAGEMENT WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the foaoednp described commodity was weighed,measured,or counted by a weighmaster,whose Ticket #: TAWGDH signature is on this certificate,who is a recognized aullay of accuracy,as present:rad by Cheater 7(commencing with Section of the 12700)of Division 5 of the California Business end Professions Code,administered by the Division of Measurement Standards of the Cahfoncia Dep.onrrant of Food end ogrculture Purchased From: CP011P SHIP DATE: 12/16/14 Control No:: 11 526402 DAVID D LOPEZ WEIGHED AT: 11 SAN JOSE RC0704 PR0039 1079 AUDREY AVE 1800 MONTEREY HIGHWAY CAMPBELL, CA 95008 SAN JOSE, CA 95112-6116 Vehicle Tag No: 6Z00632 State: CA 408-494-4200 ID # 6Z00632 SHPMNT# COMMODITY GROSS TARE NET PRICE ADJ REASON RED C/W RD EXT ADJ AMT CBK FRT PRICE TOTAL AMT TAWGDH Bundling Mat'l/Tin 6500b 5880a 620 0.0 0.00 0.00 0.00 115.0000NT 35.65 ALL WEIGHTS ARE REPORTED IN POUNDS UNLESS OTHERWISE INDICATED. ALL NON-POUND WEIGHTS ARE ASSUMED TO BE MANUAL WEIGHTS TOTALS 620 0.0 0.00 0.00 35.65 Ticket Comment: 2 HATS + + I GRS Date 12/16/14 (METRIC TON WEIGHMASTER SIGNATURE I GRS Time 10:29 I 0.2812 (Steven Howard) I TRE Date 12/16/14 I CUSTOMER SIGNATURE I TRE Time 10:49 I a=SCALE 1 b=SCALE 2 c=SCALE 3 d=SCALE 4 m=MANUAL WEIGHT + + NOT REFUNDABLE M9AE JTMeNQL9R,AYS FROM ABOVE DATE Customer Copy In acordance with the Clean Air Act and other applicable laws,seller must sign the Scrap Acceptance Agreement form prvided at the scale at least one lime every 3 years,which applies to any recyclables In the transaction which may contain or have contained refrigerants or other potential Hazardous Materials. FOR SALVAGE VEHICLE SALES:I hereby certify,under penalty of penury that any vehicle sold has been cleared for dismantling with the Department of Motor Vehicles. HOLD HARMLESS AGREEMENT Seller will indemnify and hold buyer harmless for damages,demands and liabilities,including reasonable attorneys fees,resulting from the breach of any warranty hereunder and driver agrees to be responsible for damage to vehicle during unloading, BILL OF SALE:I warrant that I am the owner(or owner's representative)of the material described hereon and have the right to sell same,that it contains no Hazardous Material as defined in the Scrap Acceptance Agreement or otherwise by any federal or state law and that for payment hereby received,I sell and convey title to Sims Hugo Neu. Seller certifies that all refrigerant including but not limited to Chlorofluorocarbons and Hydrochlorofluorocarbons(collectively"CFCs")Refrigerants and their substitutes as defined in section 608 of the Clean Air Act that has not leaked previously have been recovered from appliance and motor vehicles prior to delivery. I understand it is unlawful to release Freon and CFC's into the atmosphere and that any CFC's must be properly removed before appliances or motor vehicle air conditioners can be recycled. I verify that either(check one): ▪ (1)all CFC's previously leaked from this container,or • (2)all CFCs were properly recovered in accordance with 40 C.F.R.Section 82.156(g)and(h)by: El vendedor certifica que todos los refrigerantes incluyendo pero no limitado a CFC's y HCFC's Refrigerantes y sus substitutos como se define en la seccidn 608 del Acta de Aire Limpio que no ha goteado previamente han sido recuperados de los electrodomdsticos y automoviles antes de ser entregados. Yo entiendo que es contra la ley liberar Freon y otros clorofluorocarbonos y hydroclorofluorocarbonos(legalmente Ilamados CFC's)en el aire y que todos los CFC's tienen que estar removidos apropiadamente antes de que los aparatos o aire acondicionados de los carros puedan ser reciclados. Yo verifique que(cheque uno): ▪ (1)todos los CFC's han sido previamente evacuados de este contenedor,o ▪ (2)todos los CFC's fueron recuperados en forma appropiada de acuerdo con 40 C.F.R.Seccidn 82.156(g)y(h)por: Name/Nombre: Address/Direccion: Date/Fecha: Seller Signed/Seller Firma: Printed Name/Nombre: Date/Fecha: Seller's Warrant/Seller's Warrant:Seller warrants and represents to the Purchaser the material transferred,by the Seller to the Purchaser pursuant to this Agreement is not and does not contain a"hazardous substance"as said term is defined in the current applicable federal or state environmental laws,rules,or regulations. In the event Purchaser incurs any liability or obligation due to a breach of said warranty and representation,Seller agrees to indemnify and hold Purchaser harmless from all such liabilities and obligations. Notwithstanding the foregoing,nothing set forth herein shall constitute a waiver by Seller of any rights under the law pursuant to any written or oral agreements that it may have against any entity. EL VENDEDOR GARANTIZA.El vendedor garantiza y representa al Comprador que el material transferido,por el Vendedor al Comprador de acuerdo a este acuerdo no es y no contiene"substancias peligrosas"como se dijo en e termino como se define en las leyes,reglas,o regulaciones ambientales federales y estatales. En el evento que el Comprador incurra alguna responsabilidad u obligaci6n por el rompimiento de dicha garantia y representaci0n. El Vendedor acuerda en indemnizar y no hacer responsable al Comprador de toda dicha responsabilidad y obligaci6n. No obstante to precedente,nada dicho aqui constituir5 una renuncia por el Vendedor de cualquier derecho bajo la ley segdn cualquier acuerdo escrito u oral que pueda tener en contra de cualquier entidad." 11111777 * * * CASH DISBURSEMENT RECEIPT * * * * * * * * * * * * * # * * # r 4 1111111111 1111Ill Receipt # 593585 Receipt Date: 11/25/14 11:43am 11 SAN JOSE RC0704 PR0039 1800 MONTEREY HIGHWAY 1,4)41 SAN JOSE, CA 95112-6116 408-494-4200 Purchased From: CP011P ELAINE MARIE LOPEZ (License/ID No: NO354769) 1079 AUDREY AVE CAMPBELL, CA 95008 Veh # TK TAWCOL I.D. # 6Z00632 Ticket# Ship Dt Commodity Price UM Frt Ext Total Amt TAWCOL 11/25/14 Bundling Mat'1/Tin 115.0000 NT 0.00 70.15 Veh#: TK TAWCOL Weights: 7140g 5920t 1220n Supplier CP011P Totals (Pounds): 7140g 5920t 1220n TOTAL AMOUNT PAID TO SUPPLIER (ATM): $70.15 Cashier Signature (Louann Macri) Customer Signature �__- • f WEIGHMASTER CLRTIFICATE N. sims METAL TRUCK SCALE MANALEMENT wEIOHNASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed.measured.or counted by a weighmaster,whose signature is on this cers&cate,who Is a recognized eutriywitho of accuracy,as prescribed by Cheater T(commencing w Section Ticket #: TAWCOL 127031 of Division 5 of the California Business and Professions Cade,administered by are Division of Measurement Standards of the California Department of Food end Agriculture. Purchased From: CP011P SHIP DATE: 11/25/14 Control No:: 11 523921 ELAINE MARIE LOPEZ WEIGHED AT: 11 SAN JOSE RC0704 PR0039 1079 AUDREY AVE 1800 MONTEREY HIGHWAY CAMPBELL, CA 95008 SAN JOSE, CA 95112-6116 Vehicle Tag No: 6Z00632 State: CA 408-494-4200 ID # 6Z00632 SHPMNT# COMMODITY GROSS TARE NET PRICE ADJ REASON RED C/W RD EXT ADJ AMT CBK FRT PRICE TOTAL AMT TAWCOL Bundling Mat'l/Tin 7140b 5920a 1220 0.0 0.00 0.00 0.00 115.0000NT 70.15 ALL WEIGHTS ARE REPORTED IN POUNDS UNLESS OTHERWISE INDICATED. ALL NON-POUND WEIGHTS ARE ASSUMED TO BE MANUAL WEIGHTS TOTALS 1220 0.0< 0.00 0.00 70"15 Ticket Comment: 1 HAT ** NEW CUSTOMER ** + + GRS Date 11/25/14 'METRIC TON WEIGHMASTER SIGNATURE I GRS Time 11:17 I 0.5534 (Diana Lopez) I TRE Date 11/25/14 CUSTOMER SIGNATURE I TRE Time 11:39 a=SCALE 1 b=SCALE 2 c=SCALE 3 d=SCALE 4 m=MANUAL WEIGHT + + NOT REFUNDABLE M9 E JTTeAtV9AAYS FROM ABOVE DATE Customer Copy In ecordance with the Clean Air Act and other applicable laws,seller must sign the Scrap Acceptance Agreement form prvided at the scale at least one time every 3 years,which applies to any recyctables in the transaction which may contain or have contained refrigerants or other potential Hazardous Materials, FOR SALVAGE VEHICLE SALES:I hereby certify,under penalty of perjury that any vehicle sold has been cleared for dismantling with the Department of Motor Vehicles. HOLD HARMLESS AGREEMENT:Seller will indemnify end hold buyer harmless for damages,demands and liabilities,including reasonable attorney's fees,resulting from the breach of any warranty hereunder end driver agrees to be responsible for damage to vehicle during unloading. BILL OF SALE:I warrant that 1 am the owner(or owner's representative)of the materiel described hereon and have the right to sell same,that it contains no Hazardous Material as defined in the Scrap Acceptance Agreement or otherwise by any federal or slate law end that for payment hereby received,I sell and convey title to Sims Hugo Neu. Seller certifies that all refrigerant including but not limited to Chlorofluorocarbons and Hydrochlorofluorocarbons(collectively"CFC's")Refrigerants and their substitutes as defined in section 608 of the Clean Air Act that has not leaked previously have been recovered from appliance and motor vehicles prior to delivery. I understand it is unlawful to release Freon and CFC's into the atmosphere and that any CFC's must be properly removed before appliances or motor vehicle air conditioners can be recycled. I verify that either(check one): ❑ (1)all CFC's previously leaked from this container,or ▪ (2)all CFC's were properly recovered in accordance with 40 C.F.R.Section 82.156(g)and(h)by: El vendedor certifica qua todos los refrigerantes incluyendo pero no limitado a CFC's y HCFC's Refrigerantes y sus substtutos como se define en la section 608 del Acta de Aire Limpio que no ha goteado previamente han sido recuperados de los electrodomesticos y automOviles antes de ser entregados. Yo entiendo que es contra la ley liberar Freon y otros clorofluorocarbonos y hydroclorofluorocarbonos(legalmente Ilamados CFC's)en el aire y que todos los CFC's tienen que estar removidos apropiadamente antes de que los aparatos o airs acondicionados de los carros puedan ser reciclados. Yo verifique que(cheque uno): • (1)todos los CFC's han sido previamente evacuados de este contenedor,o ▪ (2)todos los CFC's fueron recuperados en forma appropiada de acuerdo con 40 C.F.R.Section 82.156(g)y(h)por: Name/Nombre: Address/Direction: Date/Fecha: Seller Signed/Seller Firma: Printed Name/Nombre: Date/Fecha: Seller's Warrant/Seller's Warrant:Seller warrants and represents to the Purchaser the material transferred,by the Seller to the Purchaser pursuant to this Agreement is not and does not contain a"hazardous substance"as said term is defined in the current applicable federal or state environmental laws,rules,or regulations. In the event Purchaser incurs any liability or obligation due to a breach of said warranty and representation,Seller agrees to indemnify and hold Purchaser harmless from all such liabilities and obligations. Notwithstanding the foregoing,nothing set forth herein shall constitute a waiver by Seller of any rights under the law pursuant to any written or oral agreements that it may have against any entity. EL VENDEDOR GARANTIZA.El vendedor garantiza y representa al Comprador que el material transferido,por el Vendedor al Comprador de acuerdo a este acuerdo no es y no contiene"substancias peligrosas"como se dijo en e termino como se define en las leyes,reglas,o regulaciones ambientales federales y estatales. En el evento que el Comprador incurra alguna responsabilidad u obligacion por el rompimiento de dicha garantia y representation. El Vendedor acuerda en indemnizar y no hacer responsable al Comprador de toda dicha responsabilidad y obligacion. No obstante to precedents,nada dicho aqui constituire una renuncia por el Vendedor de cualquier derecho bajo la ley segtin cualquier acuerdo escrito u oral que pueda tener en contra de cualquier entidad." • IIIII I I I IIIIIIllTic etao z \II\ 0 1 cX fD� _Cy PURCHASE TICKET - Weighed At: SIMS Metal 1800 Monterey Hwy. _ Sic), fS ,P�Gr. Gt"ie ( San Jose, California O" (408) 494-4200 /' RC0704 PR0039 -- Co prV v w 1 h.,-`' Vtoiyk_ Control No:: 11 619881 Ticket # Zaogqz Date: 12/22/14 Z. V 6 < iolV 4 Vehicle Tag No: 6Z00632 State: CA Time: 10:38am Purchased From: CP011N DAVID D LOPEZ License/ID No: R0864697 (CA) 1079 AUDREY AVE CAMPBELL, CA 95008 Pounds Itm Material Gross Tare Net Adj Pd Wt 1. Mid Grade Wire 352f 348f 4 0 4 �' \\�\� 2. Brass-Yellow 348f 334f 14 0 14 3. #2 Copper Solids & Wire 334f 318m 16 0 16 4. #1 Copper Solids & Wire 312f 275m 37 0 37 Totals 1346 1275 71 0 71 Material Summary Pd Wt(lb) Price $/Unit Extended Price $ /VD-1 c : l-t 94 Mid Grade Wire 4 0.6200/Pounds 2.48 Brass-Yellow 14 1.5400/Pounds 21.56 #2 Copper Solids & Wire 16 2.2400/Pounds 35.84 6'0 / 6 C c #1 Copper Solids & Wire 37 2.4000/Pounds 88.80 `p �// I Total: $ 148.68 4v CA, S V`( Deputy Weighmaster Signature (Jos an es) I Customer Signature (All weights are reported in Pounds unless otherwise indicated) ("m' Represents a weight that was manually entered) �— \I I, t, WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed, measured, or counted by a weighmaster, whose signature is on this certificate, who is a recognized authority of accuracy, as prescribed by Chapter 7 (commencing with Section 12700) of Division 5 of the California Business and Professions Code, administered by the Division of Measurement Standards of the California Department of Food and Agriculture. BILL OF SALE: I warrant that I am the owner (or owner's representative) of the material described hereon and have the right to sell same, that it contains no Hazardous Materials as defined by any federal or state law and that for payment hereby received, I sell and convey title to Sims Metal. HOLD HARMLESS AGREEMENT: Seller will indemnify and hold buyer harmless from damages, demands and liabilities, including reasonable attorney's fees, resulting from the breach of any warranty hereunder and driver agrees to be responsible for damage to vehicle during unloading. NOT REFUNDABLE MORE THAN 90 DAYS FROM DATE ABOVE Customer Copy • Zanke-r te-r L.;t1 rc :4: s inct F ac::iiitpr TICKET:: :i: 991599 675 I...o E;arch.=. Rd DATE 12./1:3/2 014 95134 T.tt'Ett 9::t9 a� C: .Jf r"CItY&::F:: C t fl21C, ` C a rnpi. Cochl : on Co.. DIRECT Ini ,x.And 04:f+::' :`r: :I.3.Ciat ::rt"ot...1::::: Ho."k:i ►:>p:I:c :: C::tf„ptx:i:tl 1AEIE 7aT ` cx.r.tt TRUCK: the I...:t:1X11 :: ##: CA KE ...N.:P t N::.t ''',..:.3l 31.N. i::CJf''NyIC::IttT';, tut.xt Ct:lIYIVIt:?X):t:"i'( 1.14X i° (Try RATE 1(:f"i u... , DEBRI':3 TON 5.:€4.3 i} t..QX 1 / 7'1-424.I7S1 WED] x:<:h.�i::4_.,, i'� �; 7 28-c'--- DRIVER SIGNATURE By Acceptance of this Receipt,the customer certifies there are no Hazardous Materials contained within this load as defined by the California State Health Department. / Printed on recycled paper. Ca e 'jaded peio/oaJ uo poluPd luawuedea 4lleeH elelS - - eiwoJileO agl Aq peugop se peol sfgl u!glpnn peufeluoo sieualeW snopJezeH ou aae aaagl saiJilaao Jawolsno eql `ldlaoeH slyl to eoueideooy A / - 2-3Hn1VNOI4H3AIHo /� III r.'Z'S:�:9 cri•J•E:�yurrl.i >�(�I1.:=;kal,.+; fi.+_,,, // -/ 4 .... . ... • • , ..P;,.t.1),I.. ::?f.1..li:::1 !...1•) .1.II•I I 1J..;(1.fl7}INA„:);:) 1.'1:Z."i:: 41.1-IN :!:I13: .1:T tf t'... •ii 3:A,1: ...1.t + :if >t:ifP.:11. I)7a•x)..i :.':f"Itr3S ii.n"r.:. ":::6`.111. 1:1:c xa ci tur:.) ::N I 0 1:4) 1r.).iroll irllKx; I€ "'C 1' s Eg-:XC). l fx.a-rxluI ::t(:►11.0)31:I.O. :1-OOYI'f: ,./..1:0T =t?i:1 "c;';] !.I.cr r:V:) O-1.scu:):::) 1:cittf?") / 91:c�t() ";:131110.t.:11 I4..1 ter:::_'. W 1 r.'..4_de.'_ n:1 III ►I:lc.; ti:) ''c:r:sc:,,[.- t.tl:>S VTec t')'I/c,''L JI.l.tXi pd 3c:l.l.r:1. s_:l :i;o 1 Sw:.':) i:J.:49[ 66 T ::1.::f>I3:L.1. Xi.T 1t.:ai.:9 fiat. sst.3.:x:...J.,1 Tt=TrJ.0::1114 J.O;•P,1, .: _1‘ c) a DC 111 y�9z = GARY POLL. TRUCKING P.O. Box 620413 • Woodside, CA 94062 • (650) 851-9289 DELIVERY RECEIPT CA 114337 TRK LIC. NO. I CIRCLE ) MON. TUE. WED. THUR. FRI. - SAT. SUN. TRUCK NO. ,ED HS TF 1O LB BD FB DATE UNDERLYING /^ 7 C. BRIDGE CARRIER TOLLS RECEIVED FROM (CONSIGNOR) DELIVERED TO (CONSIGNEE) • ADDRESS ADDRESS CITY .....�. CITY BILL TO " JOB NO. �jL I POLLACK P.O. # PRE POINTCISE OF ORIGIN PRECISE POINT OF DESTINATION TAG NO. WEIGHT LOADING UNLOADING ARRIVE DEPART ARRIVE DEPART 1 2 3 4 5 6 7 8 9 10 11 NUMBER OVER 56 FEET BETWEEN OF FIRST AND LAST AXLE TOTAL TONS: AXLES COMMODITY / a TYPE OF LOADING TRANSPORTED - .j �,i6.4 AT ORIGIN POWER❑ HAND 0 OTHER❑ TIME DRIVER REPORTED ��1 TIME TRUCK FOR WORK / �- COMPLETED WORK DISPATCH TIME OVERALL TIME SIGN OUT TIME INITIAL DEDUCTIBLE TIME HERE FOR FOR MEALS OR FAILURE OF TRAVEL TIME NO LUNCH CARRIER EQUIPMENT DRIVER'S SIGNATURE TARE NET CHARGEABLE TIME CHARGES DEBTOR AGREES TO PAY ANY LEGAL FEES,COURT COSTS FOR COLLECTION APPLICABLE OF DELINQUENT ACCOUNTS.LEGAL RATE OF INTEREST WILL CHARGED FOR HOURLY RATE ALL PAST DUE ACCOUNTS. ATE X RATE IN CENTS PER TON CUSTOMER SIGNATURE ACCESSORIAL HELPERS OTHER CHARGES "These charges include taxes paid to California cities instead of TOTAL excise or business license taxes they could otherwise impose." Gary Pollack Trucking is NOT Responsible for ANY HAZARDOUS MATERIAL IFGARY POLL TRUCKING _ i ' i • P.O. Box 620413 • Woodside,CA 94062 • (650)851-9289 CA'114337 DELIVERY RECEIPT TRK • LIC. NO.2f&-VII-kilCIRCLE 1 MON. TUE: WED. THUR. FRI. SAT. SUN. TRUCK No. CO/ ED HS TF IO LB BD FB DATE'�r - ' UNDERLYING q BRIDGE CARRIER e"—AP-,NI ; .4O ST, TOLLS RECEIVED FROM (CONSIGNOR) ,/y.� DELIVERED TO (CONSIGNEE (P ?..._ .. NA ii fir;//75 �� I4 / A� l S 7/ "D V- 7 'A DpR E5 A ix1L i S .'#O :-r CITY CITY Al It.-/// BILL TO JOB NO. POLLACK P.O. # PRECISE rJ/f 7 j vol.?:w1 ` POINT OF i to I al./! ]4/Zy- {// ORIGIN 3 Ss// �j PRECISE _'� �f • POINT OF DESTINATION .A ' �"'� TAG NO. WEIGHT LOADING UNLOADING ARRIVE j.��qD�/fE-PPART" ARRIVE DEPART 1 0 `-...J ;+ I F ! yam'AF ,,11, ' 3 3 rr rc 4 . r'1"} 5 6 7 ,`S t:.-'t? 8 • 1 , o � 9 ( ---fit ) I/ f ,.�.. ° ; 1 1 NUMBER OVER 56 FEET BETWEEN OF FIRST AND LAST AXLE TOTAL TONS. AXLESCOMMODITY {aTY, E OF TRANSPORTED tii-.) j064/06'644/ AT P ORIGIN LOADING POWER HAND❑ OTHER TIME DRIVER REPORTED TIME TRUCK FOR WORK COMPLETED WORK DISPATCH TIME OVERALL TIME , / J�„J SIGN OUT TIME INITIAL DEDUCTIBLE TIME TRAVEL TIME HERE FOR FOR MEALS OR FAILURE OF '� ,0 NO LUNCH CARRIER EQUIPMENT DRIVER'S SIGNATURE TARE NET CHARGEABLE TIME ,JJ( ,y /7619 if / CHARGES DEBTOR AGREES TO PAY ANY LEGAL FEES COURT.OOSTS FOR COLLECTION APPLICABLE It I OF DELINQUENT ACCOUNTS.LEGA EJIF INTEREST WILL CHARGED FOR ROURLY ALL PAST DUE ACCOUNTS. w ;F. RATE RATE X IN CENTS PER TON CUSTOMER SIGNATURE ACCESSORIAL HELPERS OTHER CHARGES "These charges include taxes paid to California cities instead of TOTAL excise or business license taxes they could otherwise impose." Gary Pollack Trucking is NOT Responsible for ANY HAZARDOUS MATERIAL GARY POLL( TRUCKING II P.O. Box 620413 • Woodside, CA 94062 • (650) 851-9289 CA 114337TRK ‘-'f �^j uc. No. /6!r i./C. RC MON. TUE. WED. THUR. FRI. SAT. SUN. TRUCK NO. ED HS TF 1O LB BD FB DATE UNDERLYING /'j ( BRIDGE CARRIER - TOLLS RECEIVED FROM (CONSIGNOR) DELIVERED TO (CONSIGNEE) ADDRESS/ (,,,C. + ADDRESS CITY ^..... CITY .+. , / BILL TO f� C� JOB NO. / 7 POLLACK P.O. M PRECISE POINT OF ORIGIN PRECISE POINT OF DESTINATION TAG NO. WEIGHT LOADING UNLOADING ARRIVE DEPART ARRIVE DEPART 1 2 3 4 5 6 8 10 11 NUMBER OVER 56 FEET BETWEEN OF FIRST AND LAST AXLE TOTAL TONS: AXLES COMMODITY TYPE OF LOADING TRANSPORTED AT ORIGIN POWER HAND OTHER El TIME DRIVER REPORTED TIME TRUCK FOR WORK COMPLETED WORK -.._..,../. DISPATCH TIME OVERALL TIME ,,,,i.- ~�'�7.SIGN OUT TIME INITIAL DEDUCTIBLE TIME -�.•�s/w� HERE FOR FOR MEALS OR FAILURE OF :/J; TRAVEL TIME NO LUNCH CARRIER EQUIPMENT f+� DRIVER'S SIGNATURE TARE NET CHARGEABLE TIME -1--/ P.' CHARGES DEBTOR AGREES TO PAY ANY LEGAL FEES.COURT COSTS FOR COLLECTION APPLICABLE OF DELINQUENT ACCOUNTS.LEGAL RATE OF INTEREST WILL CHARGED FOR ROURLY ALL PAST DUE ACCOUNTS. RATE ATE X R RIN CENTS PER TON IIP CUSTOMER SIGNATURE ACCESSORIAL HELPERS OTHER CHARGES "These charges include taxes paid to California cities instead of TOTAL excise or business license taxes they could otherwise impose." Gary Pollack Trucking is NOT Responsible for ANY HAZARDOUS MATERIAL A IMMEMMIMMOMMEMMIMMEMEMMIli T144183(07/11) Campi INVOICE Development Co. License #930432 1089 Audrey Ave Campbell Ca 95008 INVOICE #100 650 245 9510 DATE: DECEMBER 21, 2014 TO: FOR: Dave Lopez House Demolition and Clean Up at 1017 Lucot Way Campbell Ca. 1017 Lucot Way Campbell CA 95008 DESCRIPTION AMOUNT Work Required to Demo existing house, partial footing to remain. Equipment Rent and operate cat 320 CU excavator includes all delivery and fuel charges included. Rent and operate Bobcat T250 track skid steer all delivery and fuel charges included. Debris Removal Removal of(2)40 yard mix debris loads Removal of(4) 20 yard clean concrete loads Removal of(2) 12 yard final debris clean up loads. Total to perform work above including all trucking fees, delivery fees, and dump fees. $8,400.00 Make all checks payable to CAMPI DEVELOPMENT CO. Total due in 15 days. Overdue accounts subject to a service charge of 1.5% per month. Thank you for your business! .y(• KII j j.` • a'fRv3�+li► -»'g-'. L. .'.s - ....,•..t 'y i •.ti;-.`t EP )ACHMENT PERMIT ISSUANCE CHE( IST City of Campbell Encroachment Permit No.ENC Department of Public Works Tract No. _ Mali( J Address: Ion' FULL- 1( s'U"'a' ( ITEMS REQUIRED FOR PERMIT APPLICATION: 1. Encroachment Permit Application complete,with applicant signature and date front and back) 2. Permit Application Fee paid$ -Receipt Number ate 3. Plan Check Deposit Paid(2%of Engineer's Estimate,$50 n)$ Receipt 4. Grading Plan Review Fee paid$ ecei t &Date 5. City Engineer's Estimate Completed and miffed (:)/P 1c) M 6. Four(4)Sets of Street Improve I �' J"� " t Plans , 7. Four(4)Sets of Gradin d Drainage Plans 8. Check Lists(Gr ' g and Drainage,Street Improvement) ITEMS REQUIRED PRIOR TO PUBLIC WORK CLEARANCE FOR BUILDING PERMITS 9. Plan Check&Inspection Fee:Engineer's Estimate(EE)=$ ;if EE is<$250,000,then fee is 14%of EE. If EE≥$250,000,fee is Actual Cost+20%. $35,000 minimum deposit. Amount$ Receipt No.&Date 10. Security for Faithful Performance and Labor and Materials, 100%each of Engineer's Estimate,supplied or paid. IKAmount$ Form Receipt No.&Date 11. Security for Monumentation Amount$ Receipt No.&Date 12. • Construction Emergency Cash Deposit: 4%of Engineer's Estimate.($500 minimum,$10,000 maximum) 01 Amount$ Receipt No.&Date `2 LI Storm Drainage Area Fee Amount$ Receipt No.&Date IS'1J -J it P5 Iq. 14. Street Improvement Agreement signed and notarized(proof of ownership submitted) 15. Right of Way Documents Completed and Fees Paid. 16. All other Public Works requirements listed in the Conditions of Approval of the development. 17. Other Fees,Payments,Deposits Amount$ Receipt No.&Date 18. SWPPP+NOI 19. C3 Certification 20. Covenant Agreement 21. Geotech Letter 22. Storm Water Management Plan O ITE S REQUIRED PRIOR TO ISSUANCE OF ENCROACHMENT PERMIT: 23. Contractor's signature added to the permit application(front and back) 24. Contractor's City of Campbell Business License# 25. Worker's Compensation Insurance Information Sheet received from Contractor. \ 26. Certificate of Insurance with Additional Insured's Endorsement received from Applicant or Contractor. r stamped 27. One mylar set and six(6)or less sets of off-site plans signed by engineer, APPROVED FOR CONSTRUCTION. _Contractor, _Inspector _PW Superintendent(Service Center) _EP File _LD File _Signals&Lighting Supervisor(Service Center) 28. NiPermit signed by City Engineer. 29. INITIATE CHECK REQUEST FOR PLAN CHECK DEPOSIT REFUND WHEN ALL OF THE ABOVE ITEMS ARE COMPLETE,PERMIT MAY BE ISSUED. Issuer:Initial and date and file with permit i OF (244/4 J r ORCHARD" CITY OF CAMPBELL Community Development Department May 8, 2014 Daniel Lopez 1017 Lucot Way Campbell, CA. 95008 Re: File No: PLN2014-85 Address: 1017 Lucot Way t49 Application: Administrative Site&Architectural Review Permit Decision: Approved Dear Mr. Lopez, The Community Development Director has approved your Administrative Site & Architectural Review Permit application for construction of a new single-family residence on property located at the above referenced address, subject to the enclosed Conditions of Approval. This action is effective in ten calendar days, unless appealed in writing to the Community Development Department by 5:00 p.m. on May 18, 2014. If an appeal is received, you will be immediately notified of its receipt. If you should have any questions regarding this approval, I may be contacted at (408) 866- 2142 or by email at ricks@cityofcampbell.com. Sincer Richard Smeaton Planner Encl: Conditions of Approval—PLN2013-85 cc: Aki Snelling,Planning Manager Doris Quai Hoi,Assistant Engineer 70 North First Street • Campbell, California 95008-1436 • TEL 408.866.2140 • FAX 408.871.5140• TDD 408.866.2790 o l00%RECYCLED PAPER CONDITIONS OF APPROVAL-PLN2014-85 - 1017 LUCOT WAY Pg. 1 CONDITIONS OF APPROVAL FOR FILE NO. PLN2014-85 SITE ADDRESS: 1017 Lucot Way. APPLICANT: David Lopez PROPERTY OWNER: David Lopez DATE: May 6, 2014 The applicant is hereby notified, as part of this application, that (s)he is required to meet the following conditions in accordance with the ordinances of the City of Campbell and the State of California. The lead department with which the applicant will work is identified on each condition where necessary. Where approval by the Director of Community Development, City Engineer, Public Works Director, City Attorney, or Fire Department is required, that review shall be for compliance with all applicable conditions of approval, adopted policies and guidelines, ordinances, laws and regulations, and accepted engineering practices, for the items under review. Additionally, the applicant is hereby notified that(s)he is required to comply with all applicable Codes or Ordinances of the City of Campbell and the State of California that pertain to this development and are not herein specified: COMMUNITY DEVELOPMENT DEPARTMENT Planning Division: 1. Approved Project: Approval is granted for an Administrative Site and Architectural Review Permit (PLN2014-85) for a 3,144 square-foot new house on property located at 1017 Lucot Way The project shall substantially conform to the Revised Project Plans dated as received by the Community Development Department on April 15, 2014, except as may be modified by the Conditions of Approval herein. 2. Permit Approval Expiration: The Administrative Site and Architectural Review Permit approval shall be valid for one (1) year from the date of final approval. Within this one-year period, a building permit must be obtained. Failure to meet this deadline will result in the Administrative Site and Architectural Review Permit being void. 3. Driveway/Access: Due to the scope of work for this project, the existing gravel driveway on the east side of the property will need to be paved and brought up to City development standards. Paving standards are set forth in the Campbell Municipal Code Section 21.28.080(I) and call for asphalt, concrete, or other all-weather surface. This shall be submitted for review at the time of building permit application. 4. Attic Space: No attic, loft, or second floor space is allowed to be occupied or converted into living space. 5. Fences/Walls: Any newly proposed fencing and/or walls shall comply with Section 21.18.060 of the Campbell Municipal Code and shall be submitted for review and approval by the Community Development Department. 70 North First Street•Campbell,CA 95008-1423•TEL(408)866-2140•FAX(408)866-5140•E-MAIL planning@cityofcampbell.com CONDITIONS OF APPROVAL-PLN2014-85 - 1017 LUCOT WAY Pg. 2 6. Contractor Contact Information Posting: The project site shall be posted with the name and contact number of the lead contractor in a location visible from the public street prior to the issuance of building permits. 7. On-Site Lighting: On-site lighting shall be shielded away from adjacent properties and directed on site. The design and type of lighting fixtures and lighting intensity of any proposed exterior lighting for the project shall be reviewed and approved by the Community Development Director prior to installation of the lighting for compliance with all applicable Conditions of Approval, ordinances, laws and regulations. Lighting fixtures shall be of a decorative design to be compatible with the residential development and shall incorporate energy saving features. 8. Construction Activities: The applicant shall abide by the following requirements during construction: a. Construction activities shall be limited to weekdays between 8:00 a.m. and 5:00 p.m. and Saturdays between 9:00 a.m. and 4:00 p.m. No construction shall take place on Sundays or holidays unless an exception is granted by the Building Official. b. All construction equipment with internal combustion engines used on the project site shall be properly muffled and maintained in good working condition. c. Unnecessary idling of internal combustion engines shall be strictly prohibited. d. All stationary noise-generating construction equipment, such as air compressors and portable power generators, shall be located as far as possible from noise- sensitive receptors such as existing residences and businesses. e. Use standard dust and erosion control measures that comply with the adopted Best Management Practices for the City of Campbell. Building Division: 9. Permits Required: A building permit application shall be required for the proposed demolition of most of the existing dwelling and addition to the existing structure. The building permit shall include Electrical/Plumbing/Mechanical fees when such work is part of the permit. 10. Project Description: This project may be proposed as a "remodel and addition to an existing dwelling". The scope of work proposed under this project more closely reflects the construction of a new single-family dwelling. The Building Inspection Division will consider this project as new construction, and fees will be calculated based on the comparative similarities to new construction. This project will be reviewed under the provisions of Chapter 18.32 of the City Campbell Municipal Code to determine how this project will be defined. 11. Plan Preparation: Portions of this project require plans prepared under the direction and oversight of a California licensed Engineer or Architect. Plans submitted for building permits shall be "wet stamped" and signed by the qualifying professional person. 70 North First Street•Campbell,CA 95008-1423•TEL(408)866-2140•FAX(408)866-5140•E-MAIL planning@cityofcampbell.com • CONDITIONS OF APPROVAL-PLN2014-85 - 1017 LUCOT WAY Pg. 3 12. Construction Plans: The conditions of Approval shall be stated in full on the cover sheet of construction plans submitted for building permit. 13. Size of Plans: The minimum size of construction plans submitted for building permits shall be 24 in. X 36 in. 14. Site Plan: Application for building permit shall include a competent site plan that identifies property and proposed structures with dimensions and elevations as appropriate. Site plan shall also include site drainage details. 15. Seismic Requirements: Additions and Alterations to (e) residential structures shall comply with Section 3404 of the 2013 California Building Code (CBC). 16. TITLE 24 Energy Compliance: California Title 24 Energy Compliance forms CF-1R and MF-1R shall be blue-lined on the construction plans. 8% X 11 calculations shall be submitted as well. 17. Special Inspections: When a special inspection is required by C.B.C. Chapter 17, the architect or engineer of record shall prepare an inspection program that shall be submitted to the Building Official for approval prior to issuance of the building permits, in accordance with C.B.C Chapter 1, Section 106. Please obtain City of Campbell, Special Inspection forms from the Building Inspection Division Counter. 18. The City of Campbell, standard Santa Clara Valley Non-point Source Pollution Control Program specification sheet shall be part of plan submittal. The specification sheet(size 24"X 36") is available at the Building Division service counter. 19. Approval Required: The project requires the following agency approval prior to issuance of the building permit: a. West Valley Sanitation District(378-2407) b. Santa Clara County Fire Department (378-4010) c. School District: Campbell Union School District (378-3405) i) Campbell Union High School District (371-0960) ii) Moreland School District (379-1370) iii) Cambrian School District (377-2103) Note: To Determine your district, contact the offices identified above. Obtain the School District payment form from the City Building Division, after the Division has approved the building permit application. d. Bay Area Air Quality Management District(Demolitions Only) e. San Jose Water Company (279-7900) 70 North First Street•Campbell,CA 95008-1423•TEL(408)866-2140•FAX(408)866-5140•E-MAIL planning@cityofcampbellcom CONDITIONS OF APPROVAL-PLN2014-85 - 1017 LUCOT WAY Pg. 4 20. P.G.& E.: Applicant is advised to contact Pacific Gas and Electric Company as early as possible in the approval process. Service installations, changes and/or relocations may require substantial scheduling time and can cause significant delays in the approval process. Applicant should also consult with P.G. and E. concerning utility easements, distribution pole locations and required conductor clearances. 21. Intent to Occupy During Construction: Owners shall declare their intent to occupy the dwelling during construction. The Building Inspection Division may require the premises to be vacated during portions of construction because of substandard and unsafe living conditions created by construction. 22. Construction Fencing: This project shall be properly enclosed with construction fencing to prevent unauthorized access to the site during construction. The construction site shall be secured to prevent vandalism and/or theft during hours when no work is being done. All protected trees shall be fenced to prevent damage to root systems. 23. Build It Green: Applicant shall complete and submit a "Build it Green" inventory of the proposed new single family project prior to issuance of building permit. 24. Storm Water Requirements: Storm water run-off from impervious surface created by this permitted project shall be directed to vegetated areas on the project parcel. Storm water shall not drain onto neighboring parcels. 25. This project shall comply with the mandatory requirements for Residential Structures, Chapter 4 of the California Green Building Code 2013 ed. 26. This Structure, if classified as a new Single Family Dwelling under Chapter 18.32 of the Campbell Municipal Code, shall be equipped with residential fire sprinklers compliant with Section R313 of the California Residential Code 2013 ed. Public Works: 27. Storm Drain Area Fee: Prior to issuance of any grading or building permits for the site, the applicant shall ay the required Storm Drain Area fee, currently set at $2,120 per net acre, which is $8 0 (set for R-1 land u e). I 1 J41u` 1. 28. Utilities: All on-site utilities shall be installed underground per Section 21.18.140 of the Campbell Municipal Code for any new or remodeled buildings or additions. Applicant shall comply with all plan submittals, permitting, and fee requirements of the serving utility companies. 29. Water Meter(s) and Sewer Cleanout(s): Existing and proposed water meter(s) and sewer cleanout(s) shall be relocated or installed on private property behind the public right-of-way line 30. Utility Coordination Plan: Prior to issuance of building permits for the site, the applicant shall submit a utility coordination plan and schedule for approval by the 70 North First Street•Campbell,CA 95008-1423•TEL(408)866-2140•FAX(408)866-5140•E-MAIL planning@cityofcampbell.com • CONDITIONS OF APPROVAL-PLN2014-85 - 1017 LUCOT WAY Pg. 5 City Engineer for installation and/or abandonment of all utilities. The plan shall clearly show the location and size of all existing utilities and the associated main lines; indicate which utilities and services are to remain; which utilities and services are to be abandoned, and where new utilities and services will be installed. Joint trenches for new utilities shall be used whenever possible 31. Pavement Restoration: Based on the utility coordination plan, the applicant shall prepare a pavement restoration plan for approval by the City Engineer prior to any utility installation or abandonment. The pavement restoration plan shall indicate how the street pavement shall be restored following the installation or abandonment of all utilities necessary for the project. 32. Additional Street Improvements: Should it be discovered after the approval process that new utility main lines, extra utility work or other work is required to service the development, and should those facilities or other work affect any public improvements, the City may add conditions to the development/project/permit, at the discretion of the City Engineer, to restore pavement or other public improvements to the satisfaction of the City. 33. Stormwater Pollution Prevention Measures: Prior to issuance of any grading or building permits, the applicant shall comply with the National Pollution Discharge Elimination System (NPDES)permit requirements, Santa Clara Valley Water District requirements, and the Campbell Municipal Code regarding stormwater pollution prevention. The primary objectives are to improve the quality and reduce the quantity of stormwater runoff to the bay. Resources to achieve these objectives include Stormwater Best Management Practices Handbook for New Development and Redevelopment ("CA BMP Handbook") by the California Stormwater Quality Association (CASQA), 2003; Start at the Source: A Design Guidance Manual for Stormwater Quality Protection ("Start at the Source") by the Bay Area Stormwater Management Agencies Association (BASMAA), 1999; and Using Site Design Techniques to Meet Development Standards for Stormwater Quality: A Companion Document to Start at the Source ("Using Site Design Techniques") by BASMAA, 2003 34. Plan Lines: Prior to issuance of any grading or building permits for the site, the applicant shall provide a plan layout showing the correct distance from the street centerline to the property line, dimensions of sidewalk and other relevant information in the public right of way. Fire Department: 35. Review of this Developmental proposal is limited to acceptability of site access and water supply as they pertain to fire department operations, and shall not be construed as a substitution for formal plan review to determine compliance with adopted model codes. Prior to performing ant work the applicant shall make application to, and receive from, the Building Department all applicable construction permits. Review of 70 North First Street•Campbell,CA 95008-1423•TEL(408)866-2140•FAX(408)866-5140•E-MAIL planning@cayofeampbellcom • CONDITIONS OF APPROVAL-PLN2014-85 - 1017 LUCOT WAY Pg. 6 this Development proposal is limited to acceptability of site access and water supply as they pertain to fire departments operations, and shall not be construed as a substitute for formal plan review to determine compliance with adopted model codes. Prior to performing any work the applicant shall make application to, and receive from,the Building Department all applicable construction permits. 36. Fire Sprinklers Required: (excluding existing second unit) An automatic residential fire sprinkler system shall be installed in one- and two-family dwellings as follows: In all new one- and two-family dwellings and in existing one- and two-family dwellings when additions are made that increase the building area to more than 3,600 square feet. Exceptions: A one-time addition to an existing building that does not total more than 1,000 square feet of building area. NOTE: The owner(s), occupants(s) and any contractors(s) or subcontractor(s) are responsible for consulting with the water purveyor of record in order to determine if any modification or upgrade of the existing water service is required. NOTE: Covered porches, patios, balconies, and attic space may require fire sprinklers coverage. A State of California licensed (C-16) Fire Protection Contractor shall submit plans, calculations, a completed permit application and appropriate fees to this department for review and approval prior to beginning their work. CRC Sec. R313.2 as adopted and amended by CBLMC 37. Water Supply Requirements: Potable water supplies shall be protected from contamination caused by fire protection water supplies. It is the responsibility of the applicant and any contractors and subcontractors to contact the water purveyor supplying the site of such project, and to comply with the requirements of that purveyor. Such requirements shall be incorporated into the design of and water-based fire protection systems, and / or fire suppression water supply systems or storage containers that may be physically connected on any manner to an appliance capable of causing contamination of the potable water supply of the purveyor of record. Final approval of the system(s) under consideration will not be granted by this office until compliance with the requirements of the water purveyor of record are documented by that purveyor as having been met by the applicant(s). 2010 CFC Sec. 903.3.5 and Health and Safety Code 13114.7 38. Construction Site Fire Safety: All construction sites must comply with applicable provisions of the CFC Chapter 33 and our Standard Detail and Specifications SI-7. Provide appropriate notations on subsequent plan submittals, as appropriate to the project. CFC Chp. 33 39. Address Identification: New and existing buildings shall have approved address numbers, building numbers or approved building identification placed in a position that is plainly legible and visible from the street or road fronting the property. These numbers shall contrast with their background. Address numbers shall be Arabic numbers or alphabetical letters. Numbers shall be a minimum of 4 inches (101.6 mm) high with a minimum stroke width of 0.5 inch (12.7 mm). Where access is by means of private road and the building cannot be viewed from the public way, a monument, pole or other sign or means shall be used to identify the structure. CFC Sec. 505.1 70 North First Street•Campbell,CA 95008-1423•TEL(408)866-2140•FAX(408)866-5140•E-MAIL planning@cityofcampbell.com • CONDITIONS OF APPROVAL-PLN2014-85 1017 LUCOT WAY Pg. 7 Plans not approved. To prevent plan review and inspection delays, the above noted Developmental Review Conditions shall be addressed as "notes" on all pending and future plan submittals and any referenced diagrams to be reproduced onto the future plan submittal. 70 North First Street•Campbell,CA 95008-1423•TEL(408)866-2140•FAX(408)866-5140•E-MAIL planning@cityofcampbell.com MEMORANDUM CITY OF CAMPBELL TO: Rick Smeaton, Project Planner DATE: 4/14/2014 FROM: � ' Lisa Petersen, Senior Civil Engineer SUBJECT: DRC APPLICATION Site Address: 1017 Lucot way For File No(s): PLN2014-85 Project Description: Site and Architectural Review Permit for demolition of the existing house and construction of a new house. Applicant: David Lopez PUBLIC WORKS DEPARTMENT CONDITIONS OF APPROVAL 1. Storm Drain Area Fee: Prior to issuance of any grading or building permits for the site, the applicant shall pay the required Storm Drain Area fee, currently set at $2,120 per net acre, which is $82 set for R-1 land u q--(4cDO -O(411q 2. Utilities: All on-site utilities shal_ be installed underground per Section 21.18.140 of the Campbell Municipal Code for any new or remodeled buildings or additions.Applicant shall comply with all plan submittals, permitting, and fee requirements of the serving utility companies. 3. Water Meter(s) and Sewer Cleanout(s): Existing and proposed water meter(s) and sewer cleanout(s) shall be relocated or installed on private property behind the public right-of- way line. 4. Utility Coordination Plan: Prior to issuance of building permits for the site, the applicant shall submit a utility coordination plan and schedule for approval by the City Engineer for installation and/or abandonment of all utilities. The plan shall clearly show the location and size of all existing utilities and the associated main lines; indicate which utilities and services are to remain; which utilities and services are to be abandoned, and where new utilities and services will be installed. Joint trenches for new utilities shall be used whenever possible. 5. Pavement Restoration: Based on the utility coordination plan,the applicant shall prepare a pavement restoration plan for approval by the City Engineer prior to any utility installation or abandonment. The pavement restoration plan shall indicate how the street pavement shall be restored following the installation or abandonment of all utilities necessary for the project. 6. Additional Street Improvements: Should it be discovered after the approval process that Page 1 of 2 WXYZ Campbell Avenue new utility main lines, extra utility work or other work is required to service the development, and should those facilities or other work affect any public improvements, the City may add conditions to the development/project/permit, at the discretion of the City Engineer,to restore pavement or other public improvements to the satisfaction of the City. 7. Stormwater Pollution Prevention Measures: Prior to issuance of any grading or building permits, the applicant shall comply with the National Pollution Discharge Elimination System (NPDES)permit requirements, Santa Clara Valley Water District requirements, and the Campbell Municipal Code regarding stormwater pollution prevention. The primary objectives are to improve the quality and reduce the quantity of stormwater runoff to the bay. Resources to achieve these objectives include Stormwater Best Management Practices Handbook for New Development and Redevelopment ("CA BMP Handbook") by the California Stormwater Quality Association (CASQA), 2003; Start at the Source: A Design Guidance Manual for Stormwater Quality Protection ("Start at the Source") by the Bay Area Stormwater Management Agencies Association (BASMAA), 1999; and Using Site Design Techniques to Meet Development Standards for Stormwater Quality: A Companion Document to Start at the Source ("Using Site Design Techniques") by BASMAA, 2003. 8. Plan Lines: Prior to issuance of any grading or building permits for the site, the applicant shall provide a plan layout showing the correct distance from the street centerline to the property line, dimensions of sidewalk and other relevant information in the public right of way. s PPRO22 a CK�P�Cninl5tCtlp(7 No C� DEVELOPMENT REVIEW COMMITTEE ROUTING SHEET DEVELOPMENT APPLICATION J k cu A R C Distribution: April 2, 2014 Presentation: April 8, 2014 Completeness: April 11, 2014 Conditions Comments: April 15, 2014 ROUTE TO: X Building Division Police Department X Fire Department Redevelopment Coordinator X Land Development Division Traffic Engineer Project Description: Site & Architectural Review Permit for demolition of the existing house (except for the foundation) and construction of a new house. File No.: PLN2014-85 APN: 406-24-029 Applicant: David Lopez Property Owner: David Lopez Project Address: 1017 Lucot Way Zoning District: R— 1 — 10 General Plan Designation: Low Density Residential PROJECT PLANNER: Rick Smeaton DEPARTMENTAL RECOMMENDATION: If it can be determined that this project will require minimal or no comments by your department/agency, please return this comment sheet with your initials to the Project Planner as soon as possible. Status Initial Conditions No Conditions Additional information/revisions (see attached) tr le , .0. - - 1, . .. ,,..., ,.. :. .., .444._ _.,..„, tcr _,,,„.. , ....0. ii • le- , ii! . -., -4 . . v, ' _, .., . _4:, .....looh .i..0, `4+,JFd"'. `.t s 414 -1. ,. �► ' ,r 1[. " - ter. - E Y J. .".9.! !a 7 ', mot' tilt oak • -.0464 ,112010440 it. Neit 3 [` 4 i. ' -.g.,. rt sir,, . 0147K R i 4• • 111 .. `':Lilw .4,. filiP IiiiiN .,. ,•4 . ',. .:14111) W . �+WER POLE P }`''�i! 4 ,. r F 'illek' r r or. '•-•-., NMI Offiiit 1. ii IUCOTWAY ___________________.„ .. , _ „. , Akillairlikili • � LL k ray, '> as Photos of 1017 Lucot Way 0 g' ,-...Ar.‘y.,0-, . =_-=_-- - -____ ,.-,,, -:- . -.. • kriir. --,-----T rr ti 16' DWY Front view of property facing North Driveway approach 1 6r. t.li4f y1 Y Y sx te ',let"' '; ' Water k Meter t _ , " i ti y. s� 25' r'` '%,.:*°.-..-:::'..' CL to PL Water meter and Power pole on Lucot Way 25' Right of Way on Lucot Way . '';''' .1 ..:41:::i ,..:,....',4):, -T.,..„0:'''..!‘„-- ... - , ' ' • , �rc�r 1 {� �{r���, F .t. *i'C� �^j�t„y_Fib,I I I �1 4 4-.. .d.w. - ;", 20' Gate Entrance Side view of property on Vale Ave. Gate on Vale Ave. Photos of 1017 Lucot Way t. + . r s pl . 25' CL to PL 30' Right of Way on Vale Ave. d Development Information shf Prepared by: AA APN: 406-24-029 Date: 4/7/2014 / Address: 1017 Lucot Way Lot size: 1 2(SF) Any found records of building permits in last five years? Yes❑ (provide info below)No Was permit issued? Yes❑ (provide info below)No If yes,what is nature of work: N/A Permit Number: N/A If this project is part of a larger development(new subdivision,new townhomes)or commercial development, skip A through D. Demolition of exisiting house and construction of new house A. Existing building area(SF): 2,444.8 B.Proposed addition area(SF): 1,903.2 (Use the area from five years back) C. Total area w/addition(A+B): 4,348.0 D. Percent increase(B/A): 77.8% (if less than 50%,stop research) Tract or Parcel Map : TR 329 Date recorded: June 1946 (Tract#or book&page) Any found records of Storm Drain Area fee previously paid? Yes❑ (provide info below) No (Fee initiated for residential subdivisions 4 8/15/55; all developments 4 5/16/60) None Date paid (file#&address or LID#) y Storm Drain Area fee: 0.39(area in acres) X $2,120.00(fee/acre) = $82 �I 2- 6— Within STANP? Yes® No❑ (check one) STANP Requirements: Curb® Gutter❑ Sidewalk❑ Rolled curb❑ None NA❑ Existing improvements present? Curb❑ Gutter ❑ Sidewalk (check all that apply) Sidewalk dimension(BOW to FOW): None Park strip dimension(FOW to BOC): None Driveway dimension(s): 16' on Lucot Way D/W ADA compliant? Yes❑ No Ramp ADA compliant? Yes❑ No El Street light info: JP❑ older pole❑ galvanized pole ❑ Water meter and sewer cleanout info: Not Found Street ROW half width(CL to PL): 25' on Lucot Way / 30' on Vale Ave. Date that street had been resurfaced: Not available Electrical panel relocation? Yes ® No ❑ NA ❑ Provide details and attach pictures(8.5x11),assessors map(11x17)and aerial map (8.5 x 11): J:\LandDev\Land Develop Information Sheets\Lucot Way 1017.doc NOT / I j� E BASIS OF BEARING IS CENTER LINE OF W. PARR AVENUE AS.SHOWN ON I / / 4 / 1 MAP OF W.J. PARR SUBDIVISION AS RECORDED IN BOOK A' OF MAPS, PAGE 95 / r / ' Q O / iI , a / 74' ., w/ f 1 6-O-�.3Z i(Z �I 'eo ao /ozoa ° zroa' 73.0° 7 N.89°48'45"E /446.0/ / , `. 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PARR SUbD'VISION PART OF RINCONADA DE LOS GATOS JAMES & WATERS - CIVIL ENGINEERS SAN JOSE- PALO ALTO- BURLINGAME SCAB-E 1" =100' JUNE 1946 __��_ v__ __ __�_-�___�• r- .__ SHE.E. , '' OF ' ,1- Ir.E S 1R . 32. _.