88-115
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CITY 01 CA"P~ELL
D~PT. or PUbLIC WOKKS
70 Noeth 'lr,t at. .
C,mpbell, CA >>~OO.
1.0111 lIh-21 ~O
hc.lt "0. J',Y - / / S-
X.X.t. tll. \I2~
Application Oet. ~ cfd?
..pir.. .
'"1
PUb~JC WORKS P. 11T
Tn! I""'"\nrrn'"nl, "Tn II!
p~blIC C1Vht-ot-~.yl
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APPLICATIOH - Applic.tion i. hec.by ..d. for a '~bllc Wock. ',ralt in accord.nc. wlth C.~pbell-
K~nicipa1 Code, lI.ction 11.0t.
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I
I'
1. WOtk addc." oc tc.ct .
3 Ct 75
S. 130.- SLom
~\l €-Y\\J-€-- - ~p be_II
1',
C
M.
Utlllty tc.nch locatlon
"at~ce of ~ock: G'~I'(\,~ IAI/I,J \~(()\f. Plo...v\ fu( \0wl'l ~OVC:""::>~s.
Att.ch flv. (~I copl., ot a d awlng ahowini the locatlon, a.tent and diaen.lon. or the woek
The drawin9 ahall .how the r.l.tlon ot tha propoa.d work to a.lating .urr,ca .nd ~nderground
improvement.. Wh.n .pproved by the CLty Engin.er, .aid drawing beco.., a pact of thi, pcr.it.
The Gener.l Condition. for aU permit. are Ihtod on tho rev.elle alde. Speci.l I'covi.lon. tor
thi. perait .re 11.ted belo~. ~.1lure to abide by the.e condition. and provlaiona aoy rc.~l[
ln jOb _hut-down .lId/or torre1t~fe ot Faithtul Peefou14lRce bonde and c.all dcpoaiu.. IScc
Conccal Condition. 1 and 21.
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'to
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c.
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D.
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t. An applleat10n t.e mu.t .ccompany thia appl1c.tlon. Thi. 1.
.... of Applle.", l.O()/S i DlrDE~C-)I /~i"
Addulill 77Jf A/. F/RC,T <:::::'J. SA-tV J[)~,f {. c-A
I,
non-elltund.ble. )-
Teh:phon.: (#pg') 2CJ7- 3/{)O ~.
ClS-// ,;{
_'I.. Lno
li thi. work being done 'by the property owner at th.lc own re~ldencc?
Co.plete .ttached WOCkec,' Co.pena.tion and Contractoc tor...
The App11c.nl/Per~lttec hcceby agr... by atfAling the1c .i~n.tuee to thi, permit to hold the CIty ot
Cal..pocll, tea; olliecrAi, .IJenta anu ..lpJOyeea tcee, ai.te and haCllleaAi feum any cl.U1. Of dCl&al,d for
dAlIIllgt:a teAiu1t!nij (roul the w(jek covceed by thl_ pec"'it.
TtH: Al'pl!cAnt/h:e8lUtee hereby aCknowledCjeli that they have read and underlltaod both Ule teont
b.ek ot th~1i peeuait. ~~t~ey "'111 LntoCII theh comractoC,llil of the informAtion.
Ammp ~;"'J ['lAD 1\JAFf-f>. --3l,.'i/'6'f!
NOTtS: ALL 'WOIU SIIALL CONI'OHH WI,'U THt: ATTACHED, APPHOVt:D P1.ANS AND ALL A1'1'LICAbLt CAHPb~LL
STANDAj(D DRAWINGS ANO COHOITI0N~.
Tilt: CONTHAC1'OU MUST IIAVl:: TillS PI::HHIT ANO APPROVJ::D PLANS ANLJ HUST Ht:I::T WITII Tilt: P.W. IN::;I'~C1'01t ON
Tilt.: SITE AT 1.t.:A5T "I'WO OAYS ULJ'Oj(E STAJtTING WORK.
.nd
NO'I'ICE: HUST tit.: CIVL:N TO l'UULIC WORKS AT 1.EAST 24 HOURS btl'OkE k~STAItTING ANY WOIt)<.
SPECIAL PltOVISION5
-Ll. Str~e:t /Iihall not be open cut tor underground lnlitallationl>. K101"~al CUtM iliA)' be: .ll".ed
tor connections or cxplOrAtion holc*. S~ch cut/li m~~t be: UP~CltlCaJJy approved by [11C:
I....pectur.
_____2. P4VI.~r-*AY b~ cut for und.rqco~na inutalllltion, .nd 81~at be: rcutorc:d 10 .ccocaanCe WIth
the Utlllty Trench Jtel>torUlon StAnd.rd Drawing.
Work [0 0<<: >>taked bV a l1cenllied LAnd 6~rveyor 01 Clvll 1::ng1o.er .nd two 121 cop1c:~ of the
e~l _hecla IIClll tu Lhe Public Wock Dept. betore atart10g work.
Tllo: tlour. ot' WOrk arc llluitcd to Q~tlliide the hour. of 'l-!; a.Ul. and J-ci p.ll. toe /Any ~oek
atfect1ng . trAttlc l.n..
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PE:kHIT APP1.ICATION rEi
PLAN CIlt:CK DEPOSIT
&WNO rOIt J'AITIIJ'U1. PEkl'OkMHCE
(&-1)
($J~.OO)
[',
ST~DAkO
$~O.OO
$:)00.00
(100' Or ENG. t6T.)
A)tOUNT
$ oS ()
i 500
$ ,-, \ ,Oa -
~ ., C>~ -
$ \ 2. ':><t -
kt:Ct:lI'T NO.
/772..Y
/ 7 7 .). >": ::
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,. P. (CASU) Dt:~SJT
I' t:k!l1 T 1'1;:i;:
($200) 14' 01' ~NO.$~OO HINI
/ it-'ll Or 1'.1'. ~NO
<. .~ 1.7//.. '''.PP .1.'
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APPHOVt:D 1'0k ISSUANCt:
t: 1'WPI:HHIT
k.vi..d 'l/U7
I/o
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- .-----.- - ..---...-
PUBLIC WORKS INSPECTION REPORT
Date p ;~i. Permit or Project No.
Address 3~7S-'...5:. ~ec.-r +e-.
~-R-//s-
Type of work; Stre~t Storm
Other (describe)
Sanitary
P.c..,.::..
Electrical ..,/"
o PRELIMINARY INSPECTION WITH DEFICIENCY LIST (attached)
o FINAL INSPECTION WITH DEFICIENCY LIST (attached)
~ INSPECTION - ACCEPTANCE
Signed plans?, Y ~(If signed, Council acceptance.)
Charges against deposit? Y
OVertime a hrs. @ $
Date '.rea5ona
~
-
$
Barricade rental (attach invoice)? y
Dat. , reason;
o
~
Other?
$
~
$
- Refund $
Total charges deducted from deposita
(Cash Deposit $ l.ss charges $
DONE YEAR MAINTENANCE WITH DEFICIENCY LIST (attached)
o ONE YEAR MAINTENANCE - ACCEPTANCE
(Release'maintenance bond. Check Request if cash.)
ck. req.)
~
~ineer
@J
Inspector
DAte
?/?~~
PUBLIC WORKS INSPECTION REPORT
Permit or Project No. '88 - //,5-
Address ,3C:,7S- ",5'. "E4SLo;-'
Type of work: Stre~t Storm
Other (describe)
Sanitary
Electrical ____
o PRELIMINARY INSPECTION WITH DEFICIENCY LIST (AttAched)
~NAL INSPECTION WITH DEFICIENCY LIST (AttAched)
[J FINAL INSPECTION - ACCEPTANCE
Signed plans? Y N (If signed, Council Acceptance.)
ChArges Against deposit? Y
Overtime: brs. @ $
Date 5.reason:
N
Ihr.
-
$
BarricAde rentAl (Attach invoice)? y
Date 5 reAson:
N
$
Other?
$
$
~otAl chArges deducted from deposit:
(Cash Deposit $ leas chArgea $
$
- Refund $
DONE YEAR MAINTENANCE WITH DEFICIENCY LIST (attached)
ck. req.)
o ONE YEAR MAINTENANCE - ACCEPTANCE
(ReleAse'maintenAnce bond. Check Request if CAsh.)
~
~neer
~
Inspector
Ate ~/1~9 Permit or Project No.
Address ~ c.... 7 S" . .5 . B~.5 Co,.",
PUBLIC WORKS INSPECTION REPORT
AB-/ /S---
Type of work I Street Storm
Other (describe)
SAnitary
Electrical ___
o PRELIMINARY INSPECTION WITH DEFICIENCY LIST (attached)
~NAL XNSPECTION WITH DEFICIENCY LIST (Attached)
D FINAL INSPECTION - ACCEPTANCE
Signed plAnS? Y N (If signed, Council acceptance.)
Charges against deposit? y
OVertime. hrs. @ $
Date 5 reason.
H
/hr.
-
$
BArricade rental (attach invoice)? y
Date 5 reaaon.
N
$
Other?
$
$
$
- Refund $
~otal charges deducted from deposita
(CAsh Deposit $ less chargea $
DONE YEAR MAINTENANCE WITH DEFICIENa LIST (attached)
o ONE YEAR MAINTENANCE - ACCEPTANCE
(Releaae'maintenance bond. Check Request if cash.)
ck. req.)
Engineer
~
Inspector
. '
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"""i#)".,,:j"'i[;i;>~
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CONTRACT IDENTIFICATION
Proje~t or 0<:;; -L (5 )/C fj/ 5' 2-
V Permit No. 72.JL _
Nam~ or 3 0 7~ .J> lJ/f5Co/Yl /I r/E
Location J Y
rt-Fc(, J/V5~Fc7IcJ/i./c)/f/ /-?-Sc; #1
:,
'~
CITY OF CAMPBELL
Department of Public Works
~
PROJECT INSPECTOR'S
DAILY REPORT
I of L
r;,-7-~)
Page
Date
/j) F( X 7i/ Il E-
O (PI!/!/1I~E I.-kA/5 ?/ltJ/Y7 SF~;Z-t'f/Tdr,.c 72Jt!1/7~~~
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.2) r US5 IIIli-bF/! A/t:J / 5 P/--I t FJj #)/??)l>~/2 L ;-
-
~
CITY ENGINEER
PROJECT ENGINEER
~/
CITY OF CAMPBELL
Department of Public Works
"-/
CONTRACT IDENTIFICATION
Proje?tor ~ -( /5 T/Z <;2/5' ~
V Permit No,
~~~~oo~ 30 /5' r1 Z4S~O/YI /! r/E
PROJECT INSPECTOR'S
DAILY REPORT
:2 of 2-
Date If; - ) ~ CC 9
Page
9 S"p/-'-I (' pS /IN]; 51-A {! t:-
j) R.EfUL-L /ILL Me-tV F/~Lb WIRr$v-- F/'?CJ/r7
?6'YE 5F/!//t(;€~~/AJT 7b 5T/PF/&T~/OC-/!T;=1 t(u~k:
;:::, (I /I
WIRE IAlSUJ.../l7/t:J/l./ S///1LL /:5E T//w
2) T//E~E S 1-/4LL BE 3 r.ccT &F 5L/}C t:. Itt/
14 11/1/7) !/tJt- E tOll Et2 /IN D //1/ f VL L 73 (J Y- ,
BE('IlV5E C) F 1/ /JtJ{/~I-E 130 'f- it;'l~X f f-~ /Je? T 1-/
AJEX7 70 TilE ?~rE 5F/2tJlr!E ?CJ(/l/T
TIIE/lE5///1L-[ t>E Sr/7~7{!JFtiLjJQ/L I/V
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1 WI/? E ::r/VSUI-Ii 7/6/J 5/;y::/L-L 13E (7-,#0 II e!-1C!K
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S?LIC~S 5r/4LL O/ULT bE I/LI ~ULL /50)(
IV 11."6
1V1k'e.
m
'PULL /50 X
'--../
CITY ENGINEER
PROJECT ENGINEER
L~
Ii' PROJECT INSPECTOR
9rct ~~I
REFUNDABLE DEPOSIT
CHECK REQUEST
.. ,-
i. t""""Cl
'.. '-w 'to 'J'.. t ... ~
- J iJ :... 0.
>.-
.j
JUL 19 1989
fiNANCE DEI~r.
TO: FINANCE DIRECTOR
CITY OF CAMPBELL
Please issue check payable to:
Emami/Wu Development
Address:
Line 1:
19601 McKean Rd.
(30 spaces)
(30 spaces)
(30 spaces)
State: CA Zip: 95120
(2) (10 spaces)
Line 2:
City:
San Jose
(20 spaces)
Description:
Cash Deposit Refund
(24 spaces)
Exact Amount Payable:
$2,708.00
Account Number:
905.4662
PURPOSE:
Release of cash deposit for excavation permit #88-115.
C'<~
See receipt #18939 for $708.00 dated 5/17/88 and
~
receipt #4523 for $2,000.00 dated 4/28/89.
Requested b~":7
Approved bY~
~Eaton ~ v>1~itle:
Dona '~er1Y Title:
P. W. Inspector
Date: 7/17/89
Date: .J..( nl ( <6,
Date: 7 jd1,JJ9
P.W. Director
Verified by:
~k ~b Accounts Receivable
SPECIAL INSTRUCTIONS FOR HANDLING CHECK:
Mail as is
xx
Mail in attached envelope
Return to:
(Department)
@. J2.~D~(~
!( rJI(; 01\989
t\l\' Of CAMPBELL
:E\N"~~CE DEPAR1MlNT
Other:
08/24/88
Please collect & receipt
for the following monies:
PUBLIC WORKS FILE NO. 88 - //s-
$7s .5, &SQ:>;vl.
l
TO: City Clerk
35-3396
ACCl ITEM AMOUNT RECEIPT NO.
3372
3521
3521
Project Revenues (specify project)
Public Works Excavation Permit Fees:
Application Fee
Plan Check Deposit
Faithful Performance (Cash) Deposit
$
R-1:
($ 35)
Other:
($ 50)
($500)
(100% of)
(ENGR. EST)
(4% of FPB)
($500 min.)
(7% of FPB)
($ 35 min.)
'-1;;'5 ~
3521
F'o~
($200)
.a€
3372
/6;>eo
eo
3373 Project Plans & Specifications ($10)
3373 General Conditions, Standard Provisions &
Details ($10 or $1/page)
3373 "No Parking" signs ($1/ea. or $25/100)
3373 Work Area Traffic Control Handbook ($5)
3373 Traffic Flow Map ($10)
3380 Traffic Data Services ($40/hr. + material costs)
3373 Map Revisions to Map Companies ($10)
3373 Copies of Engineering Maps & Plans ($.50/sq. ft.)
3520 Fire Hydrant Maintenance ($ 195/ea.)
3372 Tentative Parcel map Filing Fee ($350)
3372 Final Parcel Map Filing Fee ($300)
3372 Tentative Tract Map Filing Fee ($400)
3372 Final Tract Map Filing Fee ($350)
3372 Lot Line Adjustment Fee/Certificate of Compliance ($350)
3372 Vacation of Public Streets and Easements ($500)
3372 Assessment Segregation or Reapportionment
First Split ($500)
Each Additional Lot ($150)
3372 Environmental Assessment
Categorical Exemption ($500 plus actual cost
Negative Declaration above $500)
3370 Storm Drainage Area Fee per Acre (R-1, $1,875; Multi-Res.,
$2,060; all other, $2,250)
3395 Park Dedication In-lieu Fee per Unit ($1,132)
3380 Public Works Special Projects
3510 Postage
TOTAL
PERMITTEE E:~""""'i/klu, oet/e:L~e-NT c..o.
EMA~ 1/ INU .Dell LofW/ENT 6:::J .
NAME OF APPLICANT RTV KEFER..~ L NEr. TI'\.J.< .
$ 2 t::AOO .t'W
ADDRESS
,.
19'~of- /'"'7C.Z~AJ J2p.
- <; A-,.J Ios. E cA.
- /
ZIP 7'-5" / Z-'O
&J
(z7~9
PHONE 408-2'8"'4173
FOR
CITY CLERK
ONLY
RECEIVED BY
~
If -'J-~~'?/
DATE
0M
~
':T.
-------
35-3396
3372
3521
~
Ctty Clerk
J cY- //.~
I
PUBLIC WORKS FILE NO.
Please collect & receipt
for the following monies:
AMOUNT
$
(specify project)
PeJwlU eu :
R-7 :
($35)
($200)
-t VL:
($ 50)
'( 500)
(4% of FPB)
($500 min.)v
(7'K, of FPB)
($35min.)
7 ()? o-v
/279 c/U
Depos it
Plan Check & Inspection Fee
Other Cash Deposit (specify)
2373
3373
Project
General
&
3372
3372
'2
~)J 12
3372
3372
3372
3372
70
I
costs
.50/sq. ft.
Tentative Parcel Map Fil ing Fee ($350)
Final Parcel Hap Fil in Fee ($300)
Tentative Tract Map Fil ing Fee $ 00
Final TractMa Filin Fee ($350)
Lot Line Ad'ustment Fee/Certificate of Compl iance
Vacation of Publ ic Streets and Easements
Assessment Segregation or Reapportionment
First Spl it ($500)
Each Additional Lot ($150)
Envi ronmental Assessment:'
Categorical Exemption
Ne ative Declaration
Storm Drainage Area Fee per Acre Multi-Res.,
$2,060; all other, $2,250)
Park Dedication In-lieu Fee per Unit
7 )~. d-o
IS- ,cPY,J< (.10
3380 Publ ic Works Special Projects
3510 Postage
TOTAL
NAME f ~Li- e tV) ~ ,V / {j' (II/! u Ai u
ADDRESS / tJ t. 0 ) //Vl C /'<"Y-t:'--L J:? (!i/ ,..:;:' :r-
<JI- -;
$/' I S 5 . (; cJ
PH:lNE 2_ b cf - <7L-/ 7 ~
ZIP 9:> /2- 0
FOR
C I TV CLERK
CI'lLY
RECEIPT NO.
i 8131
JR I SSl, H;
I ~p
S-//7/d'K
1 I
July, 1987
AMOUNT PAID
RECE J VED BY
DATE
RECEIPT
CITY OF CAMPBELL
CAMPBELL, CALIFORNIA
NAMF KrUJ.V..J::: C4IA ClA1 " , f (!htUJ-
ADDRESB JC1001 fYJ c~tt.- RA I.l.Ju..-
~t l1::; - q5/~O
FOR~~__~ ~
Ae, .~5:J J - -:f~'-p, ll:fftXLP i-: 7() ~. ()-O
301:2. - ~ ClLLcL /~9 ' tJ-d
J~Zg--~~(;u! /01~tg~' f;
. / '! J S:S-I.. fH)
REVENUE ACCOUNT NO. 4..-u- ~
FUND NUMBER
HAY17~8 2010 -t*18,551.0ft
o MONY ORDER 0 CASH
HAY 17<t9 952010A *lS.,848.Ctz
DATE AMOUNT
IlAY 17; 7 no loA *. 1, Z39.CI:r."
HAY 17~8 C/201OA *** 708.C~ .
~ECK
QhcK:fF
i\~
THIS RECEIPT
MUST BE MACHINE
VALIDATED AND
SIGNED BELOW.
BY
<~
"'j, \ t"l ~
! (.
Thank You
CITY OF CAMPBELL
o M CITIZEN COPY
REFUNDABLE DEPOSIT
CHECK REQUEST
TO: FINANCE DIRECTOR
CITY OF CAMPBELL
Line 2: 778 N. FIRST STREET
(30 spaces)
(30 spaces)
(30 spaces)
State: CA Zip: 9511 2
(2) (10 spaces)
Please issue check payable to: LOUIS & DIEDERICH
Address:
Line 1:
City: SAN JOSE
(20 spaces)
Description: 3675 S. BASCOM-CASH DEPOSIT REFUND (24 spaces)
Exact Amount Payable: $500.00
Account Number: 905.4662
PURPOSE: RELEASE OF CASH DEPOST FOR EXCAVATION PERMIT 88-115. SEE RECEIPT
NO. 17724 DATED 3/2/88 FOR $500.00
G. EATON
Title: P. W. INSP.
Date: 4/28/89
Requested by:
Approved by:
D, WIMBERLY
Title: DIR. OF PUBLlCWKS Date:
Verified by:
Accounts Receivable
Date:
SPECIAL INSTRUCTIONS FOR HANDLING CHECK:
Mail as is
Mail in attached envelope
.
Return to:
(Department)
(Name)
Other:
08/24/88
PUBLIC WORKS FILE NO.
f'?-//';-
TO: City Clerk
:T.
35-.)396
Please collect & receipt
for the following monies:
ITEM
Project Revenues (specify project)
Pu.bUc. (~O:tlM Exc.ava.t-ion PeJt.r.1U fe.~:
A 1 i ca t i on Fee
Plan Check Deposit
Faithful Performance Deposit
AMOUIH
$
R-1 :
($'35)
s-o-
so c)
3372 Plan Check & Inspection Fee
3521 Other Cash Deposit (specify)
.2373
3373 &
3372
3372
"">72
~2
3372
3372
3372
3372
3370
3395
Tentative Parcel Map Filing Fee ($350)
Final Parcel Map Fi1 ing Fee ($300)
Tentative Tract Map Fi1 in Fee ($400)
Final Tract Map Fi1 in Fee $350
Lot Line Ad'ustment Fee/Certificate of Comp1 iance
Vacation of Pub1 ic Streets and Easements
Assessment Segregation or Reapportionment
First Sp1 it ($500)
Each Additional Lot ($150)
Env i ronmen ta 1 As se s smen t: .
Categorical Exemption
Ne ative Declaration
Storm Drainage Area Fee per Acre Multi-Res.,
$2,060; all 0 the r, $2,250)
Park Dedication In-1 ieu Fee per Unit ($1,132)
3S-C;
3380 Public Works Special Projects
3510 Postage
TOTAL
t: .P t /Z..../ c ry
yerU
L(}U,-J c! p(
NAME ._
PHONE
$
;2 7 7 - .3 / ()O
9S- 1/ 2-
ADDRESS
ZIP
77 Y Ai
/.6l-f'- ..rr
s~
J j!/
,\' / //1 ,( i
RECEIPT NO. / 77 d. r::
q DO ~o
RECE I VED BY a. m
....1 -,.:) ~ <R ff
FOR
: I TV CLERK
a-lLY
'~k 1/.1.(./;:" " ,[/'1
I j 'I.,~ ,,' ,
AMOUNT PAID
DATE'
July, 1987
f
CITY OF CAMPBELL
Department:
July 7, 1989
Public Works
-:-;',::--~;~,-\-'C;~;~':Nc-"'Tl
1""on',GE",.', I~ ........,..,-
L~[~~=:~:( '" :~i~/'__.' ,,' ',i
L,. '\ ,+ . \ -1\'"'' 'c<": ,
10"""'1' l ;c"(""'" \,
V-~~'--'-_--jj-';'-'\
ERU~- --t----- !
PENOYER.l-..._____ ~i
-
70 NORTH FIRST STREET
C AMP BEL L. C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
Louis & Diederich Inc.
778 N. First St.
San Jose, CA 95112
RE: Final Inspection - Deficiencies
Permit No.: 88-115
Location: 3675 S. Bascom Ave.
Gentlemen:
You have requested a final inspection on subject construction work. There
are deficiencies in the work which are indicated on the enclosed list.
These deficiencies must be corrected to the satisfaction of Public Works
Insp~ctor Gregg Eaton before we can make a Final Inspection or acceptance
of the work.
Upon completion of the corrective work, please submit a written request
for a Final Inspection and acceptance.
Sincerely,
Carlos M. Jocson
Associate Civil Engineer
CMJ.: sd
cc: G. Eaton
Enc.
f:88-1l5-2(Permits)
CITY OF CAMPBELL
Permit No. 88-115
Location: 3675 S. Bascom Ave., Tract 8152
ELECTRICAL INSPECTION
Inspection done on 7/6/89, #2
l. Pull box in front of street light pole
A. Wrong size fuse. Change from 20 amp to FNM 3 amp.
B. Grounding wire loose between conduit ends.
2. Pull box in front of P G & E service point
A. Wrong size fuse. Change from 10 amp to FNM 30 amp.
f:88-115-2(Permits)
I
CITY OF CAMPBELL
WlMBERl Y
HELMS
JOCSC-N
KRU\5ER
PEWOYER
70 NORTH FIRST STREET
C AMP BEL L, C A L I FOR N I A 9 5 0 0 8
(408) 866-2100
FAX # (408) 379-2572
Department:
Public Works
June 14, 1990
Louis & Diederich Inc.
778 N. First Street
San Jose, CA 95112
SUBJECT: ONE YEAR MAINTENANCE ACCEPTANCE
PERMIT NO.: 88-115
WCATION: 3675 S. Bascom Avenue
.,
We have made a one year maintenance inspection of subject public
works improvements and find that no maintenance is required.
By copy of this letter, we hereby release your maintenance bond.
Sincerely,
Gregg Eaton
Public Works Inspector
GE:sd
cc: Bond Company
f:88-ll5-3 (permits)
DAte (() J .I;; /90 .
! I
Address 3 h 7 S- - $-
Type: of work; StreetL' Storm
Other (describe)
PUBLIC WORKS INSPECTION REPORT
Permit or Project No. &8 - / / S-
#/Z-<} C' Q/)-n /
SAnitAry
Electrical
(JPRELIMINARY INSPECTION WITH DEFICIENCY LIST (attAched)
(]FINAL INSPECTION WITH DEFICIENCY LIST (attAched)
o FINAL INSPECTION - ACCEPTANCE
Signed plAn!;? Y N (If uigned, Council AcceptAnce.)
ChArges AgAinst deposit? Y
Overtime. hrs. @ $
DAte {, re4ltOn;
N
/hr.
-
$
BArriCAde rentAl (AttAch invoice)? Y N
DAte {, reAson; $
Other? $
$
TotAl chArges ded~cted from deposita $
(CAsh Deposit $ leas chArgeli $ - Refund $
ck. req.)
[JONE YEAR MAINTENANCE WITH DEFICIENCY LIST (AttAChed)
~ONE YEAR MAINTENANCE - ACCEPTANCE
(ReleASe'mAintenAnce bond. Check Req~est if CAsh.)
@)
Ineop.:ctor
/~,r-#88-//.s:-
~ Q, .&> ~*
ii ~.:j $' ';:it,.
.::-;' ~/ l ~
IV 0 ~ a- "~
~ . G .~' ~ C>.~ Q,.!l ~ ....
q C' ~~ c} ~" 'S ~ (lA'
.^.. ~ ~ ~~. ~Q, o.,V5 ":'r Q.'
~ ^-'t ~ ~ -s:Q. '$:'O,J; ~ 1:/:)0 ...0"
.....::: ~ ~ s!'"\.. .~ ;)
_~.> \:S.~Q, ~ Q,'i. a, ~ 0 ~ __
~'~~ ~ "l ,J ~QJ ~ ~(j ~' ,,~ ...
CITY OF CAMPBELL
DEPARTMENT OF PUBLIC WORKS
70 N. FIRST STREET 95008
RECEIVED
DEe 02 1988
PUBLIC WORKS
ENGINEERING
DEe 0 1 1988
Bond'No.: 1150186
Subdivider: ROBERT EMAMI AND CHAO WU
Tract No.: *
Amount: 17,700.00
Description of
Improvements: STREET IMPROVEMENTS TO 3675 S. BASCOM AVE.
CAMPBELL, CALIFORNIA
AMWEST SURETY INSURANCE COMPANY is Surety on the above captioned
bond. We would appreciate your cooperation in providing the
information requested below. Please return the form to us so that
we may have current status information on the above captioned
improvements. A postage-paid envelope is provided. Thank you
very much for your assistance.
1.
Have the improvements been completed?
Yes
/NO
2.
If not, what percentage has been completed?
Is the work progressing satisfactorily?
.5"\
/Yes
No
3.
4.
Has this work been accepted?
Yes
/No
5.
If not, what is the anticipated date of acceptance? /~
Comments:
~ TO ~7nA-7~ /~ e-/"~-;-
Above information provided by:
Name ~ ~~ Phone No.
Title ~&,~ Wo~~ Date
(~) /9~' Z/..,,)l)
;/1~~
F30 6/87
A
AMWEST SURETY INSURANCE COMPANY
WOODLAND HILLS, CALIFORNIA
BOND NO.
1150186
PREMIUM
-0-
MAINTENANCE BOND
KNOW ALL MEN BY THESE PRESENTS, That we,
Robert Emami & Chao Wu
(hereinafter
called Principal), as Principal, and AMWEST SURETY INSURANCE COMPANY, a corporation, organized and
existing under the laws of the State of California and authorized to transact a general surety business in the
State of California , (hereinafter called Surety), as Surety, are held and firmly bound unto
City of Campbell
(hereinafter called Obligee), in the sum of
****Four Thousand Four Hundred Twenty Five******
DOLLARS ($ 4,425.00 ),
lawful money of the United States of America, to be paid to the said Obligee, or its successors or assigns, to
the payment of which sum well and truly to be made, we do bind ourselves, our heirs, executors, administrators,
successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the Principal entered into a contract with the said Obligee, dated
May 1988
for
Stree Improvements to 3675 S. Bascom Avenue, Campbell, CA.
and,
WHEREAS, the Obligee requires that these presents be executed on or before the final completion and
acceptance of said contract and
WHEREAS said contract was completed and accepted on the
May 1989
day
of
,19_.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the Principal shall remedy
without cost to the Obligee, any defects which may develop during a period of
from the date of completion and acceptance of the work performed under the contract, caused by defective or
inferior materials or workmanship, then this obligation shall be void; otherwise it shall be and remain in full force
and effect.
One Year
SIGNED, SEALED AND DATED THIS
25th
DAY OF
May
,19~,
A
Robert Emami & Chao Wu
... . /~ Principal
B'~ //;<
y. =---.:J "
UN-A3014 7/88
RETY INSURANCE COMPANY
Rochelle P. WoessnerAttorney-in-Fact
LIMITED POWER OF ATTORNEY
(READ CAREFULLY)
To be used only in conjunction with the bond
specified herein.
VOID IF NOT USED BY:
JANUARY 1, 1990
No Power of Attorney on this form
shall be valid as to bonds, under-
takings. recognizances or other
written obligations in the nature
thereof executed on or after said
expiration date.
POWER NUMBER
E15587
BOND NUMBER
1150186
This Power of Attorney has been
delivered in connection with the
above bond number.
A AMWEST SURETY INSURANCE COMPANY
P.O. BOX 4500, WOODLAND HILLS, CA 91365-4500
... (818) 704-1111
NAME OF PRINCIPAL:
Robert Emami & Chao Wu
PENAL SUM $
4,425.00
NAME OF OBLIGEE:
City of Campbell
This Power of Attorney may not be used in conjunction with any other power of attorney. This Power of Attorney is void if altered or erased, This document
is printed on blue paper with black and red ink. This power of attorney bears a raised seal of AMWEST SURETY INSURANCE COMPANY. Only originals
of this Power of Attorney are valid. No representations or warranties regarding this Power of Attorney may be made by any person other than an authorized
officer of AMWEST SURETY INSURANCE COMPANY, and must be in writing. Questions or inquiries regarding this Power of Attorney must be addressed
to AMWEST SURETY INSURANCE COMPANY at the address and telephone number set forth at the top of this Power of Attorney, Attention: Underwriting
Department. This Power of Attorney shall be governed bY the laws of the State of California, Any power of attorney used in connection with any bond issued
by AMWEST SURETY INSURANCE COMPANY on or after February 21, 1989 must be on Amwest Form UN-A1007 (REV. 2/89). All other previous power
of attorney forms issued by AMWEST SURETY INSURANCE COMPANY have been revoked and are of no further force or effect.
KNOW ALL MEN BY THESE PRESENTS, that AMWEST SURETY INSURANCE COMPANY, A CALIFORNIA CORPQRATION, (the "Company"), does hereby
make, constitute and appoint
ROCHELLE P. WOESSNER AS EM.PLOYEE OF AMWEST SURETY INSURANCE COMPANY
its true and lawful Attorney(s)-in-Fact, with limited power and authority for and on behalf of the Company as surety, to execute and deliver and affix the seal of the
Company thereto if a seal is required, bonds, undertakings, recognizances or other written obligations in the nature thereof, as follows:
Bid Bonds to $250,000;
License, Permit & Miscellaneous Bonds to $25,000;
Contract, Court & Subdivision Bonds to $250,000.
and to bind AMWEST .SURETY INSURANCE COMPANY thereby. This appointment is made under and by authority of the following provisions of the By-Laws
of the Company, which are now in full force and effect:
Article III, Section 7 of the By-Laws of AMWEST SURETY INSURANCE COMPANY
This Power of Attorney is signed and sealed by facsimile under and by the authority of the following resolutions adopted by the board of directors of
AMWEST SURETY INSURANCE COMPANY at a meeting duly held on December 15, 1975.
RESOLVED that the president or any vice-president, in conjunction with the secretary or any assistant secretary, may appoint attorneys-in-fact
or agents with authority as defined or limited in the instrument evidencing the appointment in each case, for and on behalf of the Company to execute
and deliver and affix the seal of the Company to bonds, undertakings, recognizances, and suretyship obligations of all kinds; and said officers may
remove any such attorney-in-fact or agent and revoke any power of attorney previously granterl to such person.
RESOLVED FURTHER that any bond, undertaking, recognizance, or suretyship obligation shall be valid and binding upon the Company
(i) when signed by the president or any vice-president and attested and sealed (if a seal be required) by any secretary or assistant secretary; or
(ii) when signed by the president or any vice-president or secretary or assistant secretary, and countersigned and sealed (if a seal be required)
by a duly authorized attorney-in-fact or agent; or
(Iii) when duly executed and sealed (if a seal be required) by one or more attorneys-in-fact or agents pursuant to and within the limits of the
authority evidenced by the power of attorney issued by the Company to such person or persons.
RESOLVED FURTHER that the signature of any authorized officer and the seal of the Company may be affixed by facsimile to any power
of attorney or certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship obligations of
the Company; and such signature and seal when so used shall have the same force and effect as though manually affixed.
IN WITNESS WHEREOF, AMWEST SURETY INSURANCE COMPANY has caused these presents to be signed by its proper officers, and its corporate
seal to be hereunto affixed this
21
day of
February
19
89
~4~
Gary R. Peterson, President
~p~
Karen G. Cohen. Secretary
STATE OF CALIFORNIA, COUNTY OF LOS ANGELES - ss
On this ~ day of February A,D" 19 ~ , personally came before me Gary R. Peterson and Karen G. Cohen
to me known to be the individuals and officers of AMWEST SURETY INSURANCE COMPANY, CALIFORNIA who executed the above instrument, and they each
acknowledged the execution of the same. and being by me duly sworn, did severally depose and say: that they are the said officers of the corporation aforesaid,
and that the seal affixed to the above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed
and subscribed to the said instrument by the authority of the board of directors of said corporation,
:.............................:
:~. '- KARE~";:ORITA I
: 0. . NOTUI"f'.......1C CAt.1f<:JANlA :
. ~ ~PAl OFflCt IN .
. LOS ANGllESoCOVHTY .
:" MyComm fIC). Aua.14. 1990 :
:.............................:
(SEAL)
~ J !!(~~
Notary PubliC
STATE OF CALIFORNIA, COUNTY OF LOS ANGELES - ss
CERTIFICATE
I, the undersigned, secretary of the AMWEST SURETY INSURANCE COMPANY, a California corporation, DO HEREBY CERTIFY that the
foregoing and attached Power of Attorney remains in full force and has not been revoked, and furthermore, that the provisions of the By-Laws of the Company
and the Resolutions of the board of directors set forth in the Power of Attorney, are now in forcs.
Signed and sealed at San Jose, CA. this 25thdaYOf Hay 19~
A UN-Al007 (REV 21891
Y~t-~
A9~-_
Karen G Cohen. Secretary
CITY OF. CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CALIFORNIA 95008
(408) 866-2100
FAX # (408) 379-2572
Department:
July 17, 1989
Public Works
WIMBeRLY
HE~
JOCION
ICRUCER
PENOYER
"-r
.J
NOUNG
Louis & Diederich Inc.
778 N. First St.
San Jose, CA 95112
RE: Final Inspection and Acceptance
Permit No.: 88-115
Location: 3675 S. Bascom Ave.
Maintenance Bond Amount: $4,425.00
We have made a Final Inspection of subject public works construction and
find it acceptable and in conformance with City standards. Accordingly,
the work is hereby accepted subject to the one-yea~ maintenance
requirement indicated below. .
You are responsible for the maintenance, repair and/or replacement of all
work done should any failures occur within one (1) year of this date. To
guarantee this, you must either post a maintenance bond in the amount
indicated above, or maintain your exist~ng faithful performance bond. If
you post a separate maintenance bond, your current bond will be released
by a separate action.
We will inspect the work in one year and advise you whether or not
maintenance is needed.
Please feel free to call the undersigned if you have any questions.
Sincerely,
Carlos M. Jocson
Associate Civil Enginneer
CMJ : sd
cc: G. Eaton, P.W. Inspector
Suspense - 1 year
.~
V CITY OF CAMPBELL V
Department of Public Works
CONTRACT IDENTIFICATION
G ~~~~fttN~.~-1(5 J/C~/5"2-
~:C~tioo~ 3675 / d/l5cofr? /lVE
r?Fc?; ;71V5(.>ffcTIr1NtJ~ 1-7-97 IF!
PROJECT INSPECTOR'S
DAILY REPORT
Page
I of 2-
h-7-~c;
'7- 0-~c; IZ-2-
Date
o
.
t: .,
I O'.<\.'
:J ('J IJ- r-'() "::' 1:.- (t! 11 /./C-ji F kJ3 ;7/7
v '-
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.7J/SrEEc Tto~ f11S5- (:I3V I A/ u:-
PROJECT ENGINEER
CITY ENGINEER
CITY OF CAMPBELL
Department of Public Works
CONTRACT IDENTIFICATION
Project or (" ~
Permit No. " C
/ / (,.....-
/(
./ !~.
l !. ...:'
PROJECT INSPECTOR'S
DAILY REPORT
Name or
Location
/ (
./ 'r
Page of
r . /. " ".,;, z. .t
~.
Date
.' .. .i ,"/ .
,I , ,.... /'
/
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<)
CITY ENGINEER
PROJECT ENGINEER
'-".:----. ~---
PROJECT INSPECTOR
LOS ANGELES, CALIFORNIA
A
AMWEST SURETY INSURANCE COMPANY
BOND NO.
PUBLIC WORKS - LABOR Be: MATERIAL BOND
1150186
KNOW ALL MEN BY THESE PRESENTS,
That we,
ROBERT EMAMI AND CHAO WU
, as Principal,
and AMWEST SURETY INSURANCE COMPANY, a Corporation organized and existing under the laws of the State of Califor-
nia, and authorized to transact a general surety business in the State of California, as Surety, are held and firmly bound unto:
CITY OF CAMPBELL
, as Obligee,
in the sum of **SEVENTEEN THOUSAND SEVEN HUNDRED**************** uu DOLLARS
($ 17,700.00 ), lawful money of the United States of America, for the payment whereof, well and truly to be ma(' we
hereby bind ourselves, our heirs, executors, administrators, jointly and severally, firmly by these presents.
THE CONDITION OF THE FOREGOING OBLIGATION IS SUCH, that
WHEREAS, the above bounden Principal has been awarded and has entered into a contract dated
with the Obligee to do and perform the following, to wit:
STREET IMPROVEMENTS TO 3675 S. BASCOM AVENUE,
CAMPBELL, CALIFORNIA
MAY 26, 1988
NOW, THEREFORE, if the above-bounden Principal or his subcontractors fail to pay any of the persons named in Section 3181
of the Civil Code of the State of California, or amounts due under the Unemployment Insurance Code with repect to work or
labor performed by any such claimant, the Surety will pay for the same, in an amount not exceeding the sum specified in this
bond, and also, in case suit is brought upon this bond, a reasonable attorney's fee, to be fixed by the court.
This bond shall insure to the benefit of any and all persons, companies or corporations entitled to file claims under Section 3181
of the Civil Code of the State of California so as to give a right of action to them or their assigns in any suit brought upon
this bond.
SIGNED, SEALED AND DATED this
26TH
day of
MAY
19 88
4~~/ ~;f;~ ~
ROBERT EMAMI AND CHAO WU
BY
Principal
~. SU. RE~Y INS
BY ~~=~
CHERUM. !OLDHAN
I
,
ANCE COMPANY
A t't'o~ "e'';' - i n - F act--
C-l03 (7/78)
A
AM WEST SURETY INSURANCE COMPANY
WOODLAND HILLS, CALIFORNIA
BOND NO.
11 ')0186
I'RE:\IIl":\1
$885.00
PUBLIC WORKS - PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENTS:
That we,
ROBERT EMAMI AND CHAO WU
, as Principal,
and A:\I\\'EST SCRETY INSURANCE COMPANY, a Corporation organized and existing under the laws of the State of
California. and authorized to transact a general surety business m the State of
CALIFORNIA
, as Surety,
are Iwld and firml:, bound unto;
CITY OF CAMPBELL
, as Obligee,
in the sum of **SEVENTEEN THOUSAND SEVEN HUNDRED**************** DOLLARS,
($ 17,700.00 ), lawful money of the United States of America, for the payment whereof, well and truly to be made,
we hereby bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these
presents,
THE CONDITIONS OF THIS OBLIGATION IS SUCH, that
WHEREAS, the above-bounden Principal entered into a contract dated the
with said Obligee to do and perform the following work, to wit:
MAY 26, 1988
STREET IMPROVEMENTS TO 3675 S. BASCOM AVENUE,
CAMPBELL, CALIFORNIA
NOW, THEREFORE, if the above-bounden Principal shall well and truly perform or cause to be performed, each and all of the
requirements and obligations of said contract set forth, then this bond shall be null and void; otherwise it shall remain in force
and effect,
SIGNED, SEALED AND DATED this
26TH
day of
MAY
1988 _
ROBERT EMAMI AND CHAO WU
PRINCIPAL
BY
"{, L:~~:
/Ic~t:,,/r t~~t",,#--/
URETYINSURANCECOMPANY
c0
~--
BY
CHERYL M.
/
,
/
; ,
10Lo.~N
~
ATTORNEY-IN-FACT
REv 7/86
KNOW ALL MEN BY THESE PRESENT
does hereby make, constitute and appoint
AMWEST SURETY-INSURANCE CO.
P.O. Box 4500
Woodland Hills, CA 91365
-11
its true and lawful Attorney(s).in-Fact,
deliver and affix the seal of the comp
tions in the nature thereof, as folio
Con
and to bind AMWEST SURETY
presents, are hereby ratified
Laws of the company, whic
Article III, Section
This Power of At
the board of director
ce,president and attested and sealed (if a seal be required) by any see-
any vice-president or sec
y authorized attorney-in.fact
(if a seal be required) by one or rTlj)r$ia,t1 .. .. . .. ....... t
ced by the power of attorney issued by the company to such person or
he signature of any authorized officer
ney or certification thereof authorizing the
uretyship obligations of the company; and such
ct as though manually affixed.
d
IN WITNESS WHEREOF, AMWEST SURETY INSURANCE COMPANY has caused theSe presents to be signed by its proper of,
ficer, and its corporate seal to be hereunto affixed this 1st day of April 19 85
~/f. ~"..~o, p,,,,,,,,
AMWEST SURETY INSURANCE COMPANY
-1~ A:/. C~
Karen G. Cohen, Secretary
STATE OF CALIFORNIA, COUNTY OF LOS ANGELES - 55
On this 1st day of April A,O" 19~, personally came before me Gary R, Peterson
and Karen G. Cohen to me known to be the individuals and officers of AMWEST SURETY INSURANCE COM.
PANY, CALIFORNIA who executed the above instrument, and they each acknowledged the execution of the same, and being by me
duly sworn, did severally depose and say: that they are the said officers of the corporation aforesaid, and that the seal affixed to the
above instrument is the seal of the corporation, and that said corporate seal and their signatures as such officers were duly affixed
and subscribed to the said instrument by the authority of the board of directors of said corporation,
.
OFFICIAL SEAL
JANICE DRUEZ
NOTARY PUBLIC - CALIFORNIA
LOS MGELES COUNTY
My comm, expires MAY 1, 1989
(SEAL)
~4U
Cj
M~~P"bli'
STATE OF CALIFORNIA, COUNTY OF LOS ANGELES - 55
CERTIFICATE
I, the undersigned, secretary of the AMWEST SURETY INSURANCE COMPANY, a California corporation, DO
HEREBY CERTIFY that the foregoing and attached Power of Attorney remains in full force and has not been revoked, and further.
more, that the provisions of the By-Laws of the company and the Resolutions of the board of directors set forth in the Power of
Attorney, are now in force.
Signed and sealed at
SAN JOSE, CALIF.
this 26TH day of
MAY
19--8JL,
~ .--6( ~COh'" S,,""~
i- Ii ~ ~*
~ "t:-" o.~ .cs'>-
~#~ ,~ sY
~ (.;0 l #~ ~ iI" '* o,~
o/~, S'c:. (.~ .g.~ 'S" -: (~
t:- t ~\~~" ;:-" &,' ~ ~+ J"/A
~~/ ~ "n;, 'S: '$:-0 <.3) ;:-f>; "C ':f
-~ ~ ~~" ~q, ~Q;q,~ ~ 0' ;:- .....
~-~. tV,,~ (.;0 ~Qj ~ ~(:j~, ~ ...
CITY OF CAMPBELL
DEPARTMENT OF PUBLIC WORKS
70 N. FIRST STREET 95008
RECEIVED
FEB 02 1989
PUBLIC WORKS
ENGINEERING
rEa 0 1 1989
Bond No.: 1150186
Subdivider: ROBERT EMAMI AND CHAO WU
Tract No.: *
Amount: 17,700.00
Description of
Improvements: STREET IMPROVEMENTS TO 3675 S. BASCOM AVE.
CAMPBELL, CALIFORNIA
AMWEST SURETY INSURANCE COMPANY is Surety on the above captioned
bond. We would appreciate your cooperation in providing the
information requested below. Please return the form to us so that
we may have current status information on the above captioned
improvements. A postage-paid envelope is provided. Thank you
very much for your assistance.
1.
Have the improvements been completed?
Yes ".....- No
2. If not, what percentage has been completed? - 0 _ ,
__ ();.J~ 17e c::"oJ L-'j
3. Is the work progressing satisfactorily? ~ Yes No
4.
Has this work been accepted?
Yes
".- No
5. If not, what is the anticipated date of acceptance? '9.p,q
Comments:
~^ [1;::) -,-c:::> ~A-;iJ ;-/oJ (~-r
Above information provided by:
Name ~~ ~A7V.J
Ti tle 1Z6t.,'c W0tU::-5 '7:";/,
Phone No. (~ ~~"~/~
Date ~~~
F30 6/87
;2-7t/n / r #- B B - //5"
~,Q. ~ ~~
~ t:-.... Q.,~ ~
~ ~ ,Q. .~
,,- ~ ~ 'J> ~
Iv 00 ~ l " Q.,~
~. c ~ o...~ ~*~
~ Co' i c,Ci 8'-': -SQ. ~ C.A~
t:- $- ~ ~~~' ~Q. Q.,' ~ c"'r ll.'
:<or ~ '=' ~~;. ~o ~ 0.. ~ ...o~
~'\ "" "" ~ "'" ,;:;. ~
-~ ~ \:)" ~Q. ~ Q,"'~ ~ 0' t:- .....
~.~~ cV ,,:;s (} ......Q} ~ ~(j~, c,;. ...
CITY OF CAMPBELL
DEPARTMENT OF PUBLIC WORKS
70 N. FIRST STREET 95008
,Q . #:-
f~'" 88- (IS R E C E IVE D
,
APR 07 1989
PUBLIC WORKS
ENGINEERING
APR 0 5 1989
Bond 'No. :
--Subdivider:
Tract No.:
Amount: 17,700.00
Description of
Improvements: STREET IMPROVEMENTS TO 3675 S. BASCOM AVE.
CAMPBELL, CALIFORNIA
AMWEST SURETY INSURANCE COMPANY is Surety on the above captioned
bond. We would appreciate your cooperation in providing the
information requested below. Please return the form to us so that
we may have current status information on the above captioned
improvements. A postage-paid envelope is provided. Thank you
very much for your assistance.
1150186
. ROBERT---E.JolJl..MI AND CHAO WU- - .
*
1.
Have the improvements been completed?
Yes / No
2.
If not, what percentage has been completed?
Is the work progressing satisfactorily?
Has this work been accepted?
7~ ,
3.'
.,......-Ye s No
4.
Yes ___ No
-'--'--~ -.-------.. -~ ._~ .-
5. If not, what is the anticipated date of acceptance? /98'1
~~ 7C> :e~;;;~-~~ Er~~'-
.
Conunents:
Above information provided by:
Name h~ E~ ,Phone No. (~ ~b -2/.sr>
Title /b~J~ Waves 4~' Date P~/Bi
F30 6/87
~
~ 9.~ Q,
b'~_# iP <'ICV
~ G~.;s #' ';\<::Jv
~&~ (J #$
t;. -s ~vo!::l~' r;xlO ~
...~~qf~~ ~~
J: ~ ~ .~Q, t- ~~..
~ ~ cV '?~ CJ(j ~ <<.,()
A
Itil~
.. ""
tip f"
R 2 8 1989
PUBliC
ENGINE!::!
CITY OF CAMPBELL APRIL 27, 1989
DEPARTMENT OF PUBLIC WORKS
70 N. FIRST ST.
CAMPijELL, CA, 95008
oA.lt1J; e, ~ fadon
Bond No.: 1150186
Pr incipal: ROBERT -EMAMI-AND CHAO
Amount: 17,700.00
Description: STREET IMPROVEMENTS TO 3675 S. BASCOM AVE. CAMPBELL, CA.
PERMIT '88-115
AMWEST SURETY INSURANCE COMPANY is Surety on the above bond. We would
appreciate your cooperation in providing the information requested
below. Please return this form to us so that we may have current
status information on the above captioned job. A postage-paid envelope
is provided. Thank you for your assistance.
PLEASE COMPLETE ONE SECTION ONLY
1. IF THE CONTRACT HAS BEEN COMPLETED:
What was the completion date?
Date of acceptance?
What was the final contract price?
Was the work satisfactory?
Have all labor and material bills been paid?
2. IF THE CONTRACT HAS NOT BEEN COMPLETED:
What percent of work has been completed to date? ?o
Total amount paid to Contractor to date?
What is amount of retainage?
What is anticipated date of completion? ~~Ne /9~'
Is the Contractor paying labor and material b1lls?
Is the work progressing satisfactorily? ~~
Comments:
r30t.Jl\ "TO Rem"h~ /:V €~~L"
FIRM:
BY: ~~6 e-~
DATE: ~~9
ADDRESS:
PHONE:
(~) B~~Z/SD
29 6/87
'#' 1'\>10
$' OJ ~-.
~ (:0.:1 Oi ""
~#~l'.~ .#
~ (;0 O~ ~~ _~ ~. k) ~<.)
~ 6'...f CJi. ,g.'tJ"o ~OJ ~CJ, (;~
f... ~ ~.~~. ~/ (),. ~ :r ~'A
~ 9:-~ c,' ~ ~Qj ~o ~ S>J qf ~c5'
-~ ~ ~ ,~OJ ~~ '::-..1lJ~ g;' .~{:' Q' ~ ....
~. ~w tV c,~,(;Ci ,,OJ ~ ~CI ~. c; ...
CITY OF CAMPBELL
DEPARTMENT OF PUBLIC WORKS
70 N. FIRST STREET 95008
RECEIVED
JUN 2 1989
.'Ct,i/o
JUlY
~1I6/;c ~
~,
.. -~'.
'neerina
Public Works/En"
-- JUN 0
1989
Bond No.: 1150186
Subdivider: ROBERT EMAMI AND CHAO WU
Tract No.: *
Amount: 17,700.00
Description of :A
Improvements: STREET IMPROVEMENTS TO 3675 S. BASCOM AVE.~~/~~.~_//S-
CAMPBELL, CALIFORNIA
AMWEST SURETY INSURANCE COMPANY is Surety on the above captioned
bond. We would appreciate your cooperation in providing the
information requested below. Please return the form to us so that
we may have current status information on the above captioned
improvements. A postage-paid envelope is provided. Thank you
very much for your assistance.
1.
Have the improvements been completed?
2. If not, what percentage has been 'completed? /00 %
____ Yes
No
3.
Is the ,work progressing satisfactorily?
...-- Yes No
4.
Has this work been accepted?
5.
If not,. what is the anticipated date of acceptance?
Yes -- No
~~9
Conunents:. .~ TO Re-/n4/;,p ,",.J EPF{;;""C.~/#- 2S)3:{
NfA-/';v~A./ANCt-= ~ (/'::> ~LL .RtjPt:4cG"' ~ F'Z/577',..,-~
,eb"{/J ~,.,..~ *_U=-~C-~ 4~t> />'I4.57".L3F ':;'4-(.:v"9-/~
~ OAJ~ Y(C7d./l
Above information provided by:
~.r-=b6 Ed-rO.J
Ti tle ;c'At..,(.. fA./~5 ;7;.;~.
Name
Phone No.
'ffd..) f?&;~ - 2./ S c> \
~~~
Date
F30 6/87
CONSTRUCTION COST ESTIMATE FOR PERMIT NO. ,SX / /~) By IDate So - '-z.. _ ~~
Name & Address 3 (-f) f__') ~) {.)~~~ 0 ) \ r)' - /ll(',;'(,'I)~/~~-1 ! I
i'
Surface Construction
Clearing and Grubbing Lump Sum Estimate - $ 1 <;:::7") -
Sawcut Concrete ~ L.F. @ $ 4.00 - $ '-C:> -
Concrete Removal S.F. @ 3.00 - $ -
Curb & Gutter Removal .,,, L.r. @ 5.00 - $ ~ (oS' -
Inlot Drain with Pipe , EA. @ 500.00 - $ -S~-
Curb and Gutter ..,~ L.F. @ 15.00 -$l~ct~-
Sidewalk 16~c. S.F. @ 3.50 . $ "ac.:t4-
Driveway Approach ~'" I S.F. @ 5.50 .$\q~c.-
Handicap Ramp EA. @ 1000.00 . $ -
Extruded Curb - L.F. @ 6.00 . $ -
Barricade L.F. @ 50.00 - $
Street Excavation (- S.F.)x($0.15)x( ") - $
-
A.C. Pavement (- S.F.)x($0.45)x( ") -'$ -
-
Adjust Manhole to Grade EA. @ 300.00 - $
Adjust Handhole to Grade EA. @ 200.00 - $
Monument Box v Monument EA. @ 500.00 - $ -
Street Tree (15 gallon) " EA. @ 200.00 - $ ~-
Pavement Striping ($100 min) L.F.@ 0.65 - $
Pavement Legends (S100 min) EA. @ 40,00 - $
Stop.Street Name or Other Sign EA, @ 120.00 - $
Paveaent Markers - EA. @ 15.00 - $ -
Pavement Key Cut L.F.@ 8.00 - $ -
- $
- $
Surface Subtotal "s" - $ 0\04"2..-
Adjust. for aize: S $30,000 add 20%, S
$100.000 subtract 10%
\6 ~"So-
\
- $
-$~-
- $
$ 'it C.=>~L-
$ l-",~-
Street Lighting
Electrol1er
Conduit
Conductor. pair
Pull Box
\
\4,
14,
'-
EA. @ 3000.00
L.F.@ 12.00
L.F.@ 4.00
EA. @ 200.00
Storm Drdnage
12" or 15" Rep
18" or 21" RCP
Street Inlet
l'\
L.r.@ 60.00
L.F.@ 65.00
EA. @ 1800,00
EA. @ 2000.00
EA, @ 18Q<?do~O
Manhole (u ~
Break and Enter~nhole
-
TOTAL ESTIMATE
USE FOR BOND
Revised 6/85
- $ ,\(X:o-
- $ \, ~ -
- $ ~~~..
- $ 4-'->0"
- $
- $
- $
- $
...,~--
-
l-l
o
~
l-l
OJ
.jJ
.jJ
OJ
r-i
III
~
l-l
~
U
'';
r-i
~
ill
~
o
OJ
U
!::
III
~
III '
III .jJ
''; 'g
l-l
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0..
'0 tJI
OJ !::
l-l '';
''; '0
&;.:l
OJ ~
P::1Il
PUBLIC WORKS PERMIT ISSJANCE CHECK LIST
City of Campbell
~~-\\~
Public Works Permit No.
"2::J<O\~ c;. ~S~
V Applicant section complete
OJ
.jJ
III
'';
.jJ
'';
!::
'';
v'"
Applicant signature and date
~ Permit Application fee, $35.00 for R-l, $50.00 for
standard, paid. Receipt number \" -z..4-
~ Plan check deposit, $500.00 for standard only, paid.
Receipt number \ 1 1 "L.. +-
o .
.jJ~
U
'0 OJ
OJ..c:
l-l U
'';
~ !::
III
OJr-i
ll:: 0..
~ Five sets of improvement plans submitted
------------------------------------------------------------------------
v
Bond for faithful performance, 100% of City Engineer's
estimate for standard onlYl.~osted and appropriately noted
Amount $ n.l(;O.(.{) Form^J.-~e-'..T" I.D. # \\~, !l.c.
~ f2.&'T'-t
for R-l; 4% of FP bond, $500 min.
V'
Cash Deposit: $200.00
for standard, posted.
Amount $ , 6""'.00
Receipt No.
\~9~9
v
Permit fee of 7% of FP bond, $35.00 min., paid.
Amount $ I'l:~q. 00 Receipt No. lb<\''1:l9
"
Worker's compensation information received for Applicant
(see Information Sheet for Public Works Permits)
Land development requirements met (see separate letter
from land development section)
---------------------------------------------------------------------------
~Worker's comp and Contractor's Information received for
Contractor (see Information Sheet for Public Works Permits)
~'Certificate of Insurance with Additional
Endorsment received from Contractor (see
Insurance Requirements for Public Works
Insured's
General Summary of
Permits)
~ Three sets of off-site plans, stamped APPROVED (Tract or
Development and Public Works Permit number and property
address on plans)
~ Permit signed for City Engineer
WHEN ALL OF THE ABOVE ITEMS ARE COMPLETE, PERMIT MAY BE ISSUED
Issuer: Initial ~ and date 7- 14--t!!.t;!;l. and file with permit
UPON ISSUANCE, INITIATE PLAN CHECK DEPOSIT REFUND CHECK REQUEST.
4/88
f/permchklst
Permit No.
Applicant
INFORMATION SHEET FOR PUBLIC WORKS PERMITS
A separate form must be completed for the applicant and each contractor
that will work under this permit.
CONTRACTORS INFORMATION
Note that all contractors must have current City of Campbell Business
License, State Cont,a tor~s License and;wprkers' Compensation Insurance.
j). /) ~c..C-St CZ> ~--.vc'77Ur-/1
Name of Contractor./ . ~~~ " t J Telephox\e 7'DJ.....~.r- '1/"l3
Address / t((DfJ! /rJC/6~ V./ ~t-->.{ -' Q.vt../ d, cJS'/,,)()
. .Jfft;;Z;%;Jf2L?
State Contractor License No._5'DO.;(.;2/C.ZJ' City Business License No.
Expiration Date
Will do the following types of work:
~underground ~P.C. concrete ~A.C. paving _____electrical
_____other (specify)
WORKERS' COMPENSATION INSURANCE INFORMATION
Name of Contractor/Applicant ~j,{~f ~A/Y'M.J:' (~tlJ~,.(./
One of the following must be on file with the Public Works Department:
A Certificate of Consent to Self-insure issued by the
Director of Industrial Relations; OR
A Certificate~f Workers' Compensation Insurance
Insurance Co. /Lif}ornA.AAf'iPrAl.AAbA~0Cc Policy No. RI/33/...2-
Expiration date ,.;) - ;} t., ,- j<9 OR
The Certificate of Exemption from the Workers'
Compensation laws printed below (certificate must be
signed).
CERTIFICATE OF EXEMPTION
I certify that in the performance of the work for this permit, I shall not
employ any person in any manner so as to become subject to the Workers'
Compensation Laws of California.
Signed
Date
NOTICE TO CONTRACTOR/APPLICANT: If, after signing this Certificate of
Exemption, you should become subject to the Workers' Compensation
provision of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
f:PERMINFO
REV. 11/87
Lawson - Hawks Insurance Associates
July 13, 1988
Mr. C. S. Gomez
City of Campbell
70 North First street
Campbell, California 95008
Re: Telesis Construction Co.
Dear Mr. Gomez:
Please accept the enclosed copy of a Certificate and endorsment
which were sent to us via FAX this morning. The originals are
being issued by the insurance carrier in Arcadia, California
today and should be in our office early next week. At that time
we will forward them on to you.
If you have any questions regarding the enclosed please call me.
{1:~~ef:~4 ~
Doris Way~y~~IJ'~
Commerical Accounts Representative
Ene.
n
cc: Telesis Construction
883 N, Shoreline Blvd. . P,O. Box 39. Mountain View, CA 94042
(415) 964-8000 . (408) 733-0426 . FAX (415) 964-0816
PRODUCER
Lawson-Hawks Insurance
P.O. Box 39
Yntain View, CA 94042
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIACA TE HOLDER. THIS CERTIFICATE DOES NOT AMEND
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. '
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
Tri-Star Insurance Com an
INSURED
Telesis Construction Co.
19601 McKean Road
San Jose, CA 95120
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
PERSONAL INJURY
, Jt~..",:
.
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AU. THE TERMS, EXCLUSIONS, AND CONDI-
TIONS OF SUCH POLICIES.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POliCY EXPIRA nON LIABILITY LIMITS IN THOUSANDS
DATE (MMIllOIYY) DATE (MM/llllIYYl ~Jit.~i OCC~R~NCE
BODILY
INJURY $ $
PROPERTY
11/20/87 11/20/88 DAMAGE $ $
A
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISEs/OPERA nONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTs/COMPLETED OPERA nONS
CONTRACTUAL
x INDEPENOENT CONTRACTORS
lROAO FORM PROPERTY DAMAGE
PERSONAL INJURY
TMPH110138
BI&PD $. s;...
COMBINED '1.,000, ~, 000 ,
AUTOMOBILE LIABILITY
ANY AUTO
AlL OWNED AUTOS (PRIV. PASS,)
AlL OWNED AUTOS (OTHER THAN)
PRIV, PASS.
HIRED AUTOS
NON-<JWN ED AUTOS
GARAGE LIABILITY
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
BOOIL Y
I~RY $
(PER PERSON)
BOOIL Y
I/wRY $
(PER ACCIDENT)
PROPERTY
DAMAGE $
BI & PO
COMBINED $
BI & PO $
COMBINED STATUTORY
$
$
$
$
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
(EACH ACCIDEND
(DISEASE,POllCY lIMID
(DISEASE .EACH EMPLOYEE)
OTHER
DESCRIPTION OF QPERATlONSllOCATIONSNEHIClES/SPECIAllTEMS
City of Campbell
Attn: C. S. Gomez
70 North First Street
Campbell, CA. 95008
is an Additional Insured as per attached
..:::. ~'tot'
. .. I
JUL 13 '88 07:28
CRLIBRR
.~. . e
__.. . _ .:1.72 P02/02
ENDORseMENT
(The spaces below need be completlld only when thi~ endorsement is issued subs!quent to preparation of the policy.)
TH:S ENOCi'lSaMi:NT. :FFi:CTIVe
7/12/88
~XPIFlATION OAn OF POl.ICY
E:COM::S A PART OF POl.ICY NO. ISSUEO TO
FORM
TMPH110138 Telesis Construction Co.
. , ENDOR.SE~ENT NO,
I DATi TYPED
7 13.88
ACOIT. PREM,
TBD
t RETURN pn:~
:!
"
, ADDITIONAL INSURED ENDORSEMENT - GOVERNMENTAL/QUASI-GOVERNMENTAL ENTITIES
1. IT IS AGREED THAT THE "PERSONS INSURED" PROVISION OP THIS ~OLICY INCLUDES AS AN
ADDITIONAL INSURED, THE' Ci ty of Campbell
ITS BOARDS, ~~LO~EES OR OFFICERS WHILE ACTING WITHIN THE SCOPE OF THEIR AUTHORITY
BUT ONLY WITH RESPECT TO HAZARDS ARISING FROM ANY AND ALL ACTIVI~IES OF WORK
PERFORMED BY OR ON BEHALF OF THE NAM~D INSURED(S).
i
I:
j'
2. THE POLICY TO WHICH THIS ENDORSEMENT IS ATTACHED SHALL NOT BE SUBJECT TO CANCELLATI~
CHANGE IN COVERAGE OR LIMI~S EXCEPT AFTER WRITTEN NOTICE TO THE ADDITIONAL INSURED, ,
BY CERTIFIED MAIL, RETURN RECEIPT REQUESTED, NOT LESS THAN 30 r:
DAYS PRIOR TO THE EFFECTIVE DATE THEREOF. i
~ '
3. THE INSURANCE AFFORDED BY THE POLICY TO WHICH THIS ENDORSEMENT IS ATTACHED SHALL B~
, ,
PRIMARY INSURANCE AND ANY OTHER INSURANCE OF THE ADDITIONAL INSURED, SHALL BE IN
EXCESS & SHALL NOT CONTRIBUTE WITH THIS INSURANCE.
4. THE POLICY TO WHICH THIS ENDORSEMENT IS ATTACHED SHALL APPLY SEPARATELY TO EACH ;,
INSURED AGAINST WHICH CLAIM IS MADE OR SUI~ IS BROUGHT EXCEPT WITH RESPECT TO THE.
LIMITS OF THE CO~~ANY'S LIABILITY.
s. THE COVERAGES AFFORDED U~~ER THIS ENDORSEMENT SHALL ~ BE APPLICABLE IN THE CASE.
OF THE SOLE NEGLIGENCE OR WILLFUL MISCONDUCT OF THE ADDITIONAL INSURED OR I~S i
BOARD~, EMPLOYEES OR OFFICERS.
6. EXCEPT AS STATED ABOVE NOTHING CONTAINED HEREIN SHALL BE HELD TO WAIVE, ALTER OR
EXTEND ANY OF THE LIMITS, AGREEMENTS, OR EXCLUSIONS OF THE POLICY TO WHICH THIS
ENDORSEMENT IS ATTACHED.
ADDRESS CANC~LLATION NOTICE AS FOLLOWS;
ISSOE ENDORSEMENT TO:
City of Campbell
Attn: C. S. Gomez
70: North First Street
Campbell, California 95008
Telesis Construction
19601 McKean Road
San Jose, CA. 95120
1
j
Certificate of Insurance
Box
San
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION '_;NL y Me[) CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Al.TER THE COV~RACE AFFORDED BY 'HE POLICIES LISTED BELOW.
I
Brokers Incf CO~PANIES AFFORDING COVERAGES
=~:"'::;'i' A Fairmont Insurance
COMPAi\'y B
LE-Tl"FI"-I
COMPA1\, i' C
:...F.:TTER
COMPANY 0
L E TT E R
COMPANY E
L E TT E R
NAME AND ADDRESS OF AGE"CY
Atlantic Pacific Insurance
Lords Insurance Agency
5520
Jose, Ca 95150
NAME AND ADDRESS OF INSURED
Telesis
19601 McKean
San Jose, Ca
Company Inc.
Rd.
95120
This is to certity that policies of insurance listed below have been issued to the insured named above and are in torce at this time. Notwithstanding any requirement, rerm or con-
dition ot any contract or other document with respect to which this certificate may be issued or may pertain, the Insurance afforded by the policies described herein is subject to
all the terms, exclusions and conditions of such policies.
COMPANY
LETTER
DATE
TYPE OF INSURANCE
POLICY NUMBER
GENERAL LIABILITY
80Dj~Y INJURY
COMPREHENSIVE FORM
PREMISES-OPERA TIONS
EXPLOSION AND COLLAPSE
HAZARD
UNDERGROUND HAZARD
PRODUCTS/COMPLETED
OPERATIONS HAZARD
CONTRACTUAL INSURANCE
BROAD FORM PROPERTY
DAMAGE
INDEPENDENT CONTRACTORS
PROPERTY DAMAGE
BOOI L Y INJURY Af\lD
PROPERTY DAMAGE
COMBll\iED
$
PERSONAL INJURY
PERSONAL INJURY
AUTOMOBILE LIABILITY
BODILY INJURY
lEACH PEASON)
BODILY INJURY
lEACH OCCUARENCEI
$
COMPREHENSiVE FORM
OWNED
HIRED
I
I
I
I
~-~.
I
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
PROPERTY DAMAGE
$
NON.()WNED
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA
FORM
BODIL Y INJURY AND
PROPERTY DAMAGE
COMBINED
$
WORKER'S COMPENSATION
I
12-26-89
I
1 , 000 lEACH ACCIDENTI
A
and
EMPLOYER'S LIABILITY
OTHER
Rl13312
ESCRIPTlON OF OPERATIONSILOCATlONS/VEHICLES
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com,
pany will endeavor to mail 10 days written notice to the below named certificate holder, but failure to
mail such notice shall impose no obligation or liability of any kind upon the company_
NAME AND ADDRESS OF CERTIFICATE HOLDER
City of Campbell
Attn: Curz S. Gomez
70 North First St.
Campbell, Ca 95008
,)- S'~
DATE ISSuED
$
CITY OF CAMPBEll
r WIMBERLY ~-lHANDl;:"G-=O
KELMS _~ .,,__' ~~TU~~.~i.1J
! "-""50'1 dfI' 'trJ','~'~m. --r- "
.J ~-'v, \ f" I t !'~,;V,""\fll" I
.-....-.'.........' '.- 1..,_.____ .1-1
i t ~ -..~1-~~.,
I f<RUG:R I I , 1
fr~~o~E~~=[]~_,c..I+
70 NORTH FIRST STREET
C AMP BEL L, C A L I FOR N I A 9 5 0 0 8
(408) 866.2100
FAX # (408) 379-2572
Department:
Public Works
June 20, 1989
EmamijWu Development Co.
19601 McKean Road
San Jose, CA 95120
RE: Final Inspection - Deficiencies
Permit No.: 88-115
Location: 3675 S. Bascom
Gentlemen:
You have requested a final inspection on subject construction work.
There are deficiencies in the work which are indicated on the
enclosed list. These deficiencies must be corrected to the
satisfaction of Public Works Inspector Gregg Eaton before we can make
a Final Inspection or acceptance of the work.
Upon completion of the corrective work, please submit a written
request for a Final Inspection and acceptance.
Sincerely,
Carlos M. Jocson
Associate Civil Engineer
~MJ:t
cc: G. Eaton
Enc.
88 -115
PWP 88-115 TRACT 8152
3675 S. BASCOM AVENUE
ELECTRIC INSPECTION
DEFICIENCIES NOTED JUNE 7, 1989
A. FIXTURE
1.. Change lens from semi-cutoff to cutoff
2. Wires hanging outside of fixture
3. Fixture tilted - straighten
B. POLE (STANDARD)
1. Grout pole base
2. Base cover screw stripped - replace it
3. Wrong color wire being used from fuse holder to fixture-shall use
black (THW) , not blue.
4. No ground rod in pole base
C. PULL BOX NEXT TO STANDARD
1. Pull box lid shall have hold down bolts
2. Fuse holder not spliced properly - resplice
D. PULL BOX NEXT TO PG&E SERVICE POINT
1. Pull box lid shall have hold down bolts
2. Fuse holder not spliced properly
E. SPLICES AND SLACK
1. Repull all new field wiring from PG&E service point to street
light fixture. Wire insulation shall be "THW".
2. There shall be three (3) feet of slack in hand hole cover and in
pull box. Because of a double box depth next to the PG&E service
point, there shall be five (5) feet of slack in pull box.
3. When splicing to fuse holder, do not cut wires off to fix inside
holder.
.4. Wire insulation shall be "THW" black
5. Splices shall only be in pull box
6.
wire
wire
slack
PULL BOX
88 -115
Date tsl;;k9
Address 3 c-. 75
Permit or Project No.
REPORT ~
. AB -/ /~ ...~ ..;~~:2-~-~
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PUBLIC WORKS INSPECTION
5 .Bi"9.f, C-O,+1
Type of work: Street Storm
Other (describe)
Sanitary
Electrical .....--
[JPRELIMINARY INSPECTION WITH DEFICIENCY LIST (attached)
~NAL INSPECTION WITH DEFICIENCY LIST (attached)
o FINAL INSPECTION - ACCEPTANCE
Signed plans? Y N (If signed, Council acceptance.)
Charges against deposit? Y
Overtime I hrs. @ $
Date '.reason:
N
/hr.
-
$
Barricade rental (attach invoice)? Y
Date , reason:
N
$
Other?
$
$
$
- Refund $
Total charges deducted from depositl
(Cash Deposit $ less charges $
ek. req.)
o ONE YEAR MAINTENANCE WITH DEFICIENCY LIST (attached)
o ONE YEAR MAINTENANCE - ACCEPTANCE
(Release'maintenance bond. Check Request if cash.)
~~
~
Inspector
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CITY OF CAMPBELL
Department of Public Works
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CITY ENGINEER
PROJECT ENGINEER
CITY OF CAMPBELL
Department of Public Works
CONTRACT IDENTIFICATION
Proje~t or uC - (' /5
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PROJECT INSPECTOR'S
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CITY ENGINEER
PROJECT ENGINEER
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v PROJECT INSPECTOR