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CITY OF CAMPBELL
Public Works Department
`August 14, 2018
Chris Snyder
1140 Fawn Dr.
Campbell, CA 95008 ;
-SUBJECT: PERMIT NO. ENC 2017-00176
1140 Fawn Dr., Campbell, CA
FINAL INSPECTION AND ACCEPTANCE
Dear Chris:
The City- of Campbell has made the final inspection of the subject Public Works
improvements and finds that no remedial work is required.
Your warranty requirements and any surety, therefore, are hereby released.
Sincerely, .
Syed Wahidi
Public works Inspector
CC: File ENC2017-00176
70 North First Street • Campbell, California 95008-1436 • TEL 408.866.2150 • FAx 408.376.0958 • TDD 408.866.2790
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CITY OF CAMPBELL
Public Works Department
August 29, 2017
Mr. Chris Snyder
1140 Fawn Dr.
Campbell, CA 95008
SUBJECT: PERMIT NO. ENC 2017-00176
1140 Fawn Dr.
FINAL INSPECTION AND ACCEPTANCE
Dear Chris:
The. City of Campbell has made a final inspection of subject Public Works improvements
and finds the work to be acceptable and in conformance with City standards.
Accordingly, the City Engineer accepts the improvements.
The one year -maintenance period stated in the permit begins as of August 15, 2017. The
permittee is responsible for the repair and/or replacement of any defective work or
failures that occur within one year. The City will inspect the improvements within one
year and notify you, in writing, whether or not any repairs are required..
Your Faithful Security Deposit in the amount of $2,500.00 is enclosed.
If you have any questions, please call me at (408) 866-2165.
Sincerely,
Syed Wahidi
Public Works Inspector
Cc: Inspector /Suspense Files
Permit File ENC2017-00176
70 North First Street • Campbell, California 95008-1436 • TEL 408.866.2150 • FAX 408.376;0958 • TDD 408.866.2790
Encroachment Permit Final Sign Off
EncroachmentPermit. #
Address: '-t O .A�-JN�
Date of Final Inspection and Acce tance:
Inspected by: .
OK to release deposits: 100% 75.%
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CITY OF CAMPBELL R-1 ENCROACHMENT PERMIT Permit _MC 20t 7 —OC' 176
DEPT. OF PUBLIC WORKS (Non -engineered work within the public right-of-way) X-Ref File
70 North First Street ($10,000.00 maximum value of work) Application Date I
Campbell, CA 95008 � Application Expiration
Ph. (408) 866-2150 ' ISSUED: 7/'L(l ( Date Lr1
Fx. (408) 376-095S Permit Expiration Date: APN
APPLICATION -Application is hereby made fora Public Works Permit in accordance with Campbell Municipal Code, Section 11.04.
(Application expires in 6 months if the permit is not issued.)
A. Work Address: i I L qo 1^^w N ^'a
B. Nature of Work: r T�A-U_ - 5)tv �grLr,)
C. Attach three (3) copies of a drawing showing the location, extent and dimensions of the work. The drawing shall show the relation of
the proposed work to existing improvements. When approved by the City Engineer, said drawing become a part of this permit.
D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction; the General Permit
Conditions listed on the reverse side; and the Special Provisions for this permit, listed below. Failure to abide by these conditions and
provisions may result in job shutdown and/or forfeiture of Faithful Performance securities.
-6L(o-7 r3.2
NAME OF APPLICANT: C iv(-74 S S N Y ]\ Ce Telephone: qo� g�(o-1 CSC
Address:
l.' v. Awe-... �(L . C:A,r't...... ,L .., 4. __ `�5� ?�.........
E-Mail.Address: CI1 f
The Applicant hereby confirms that this work is being done by the property owner/applicant at their own residence.
The Applicant hereby agrees by affixing their signature to this permit to hold the City of Campbell, City of Campbell Redevelopment Agency, its
officers, agents, and employees free, safe and harmless from any claim or demand for damages resulting from the work covered by this permit.
The Applicant hereby acknowledges that they have read and understand both the front and back of this permit, and that they will inform their
contractor(s) of the informatior)17 /17 n /f
�. ACCEPTED:
(Sign)
7 I � I 'Zo l ?
Date
NOTES: All work shall conform with the attached approved plans and all applicable Campbell Standard Details and Conditions and applicable
insurance requirements.
The Contractor must nave this permit and approved plans and must arrange to meet with the Public Works Inspector at the `site at least two days
before starting work. Notice must be given to Public Works at least 24 hours before restarting any work.
Per Section 4216 of the Government Code this permit is not valid for excavations until Underground Service Alert (USA) has been notified and the
inquiry identification number (Ticket No.) has been entered hereon. USA Phone: 1-800-227-2600. Ticket No.:
Applicant is advised that upon issuance of this permit, property owner, or property owner's successors, shall be responsible for any and all
damages arising out of the design, installation or condition of private improvements in the public right-of-way.
SPECIAL PROVISIONS
1. Prior to any work, the property owner shall execute an Agreement for Private Improvements in the Public Right -of -Way, which shall be
recorded.
2.
3.
STANDARD AMQQNT RECEIPT NO.
SECURITY FOR FAITHFUL PERFORMANCE (100% Of Engr's Est.) $ 'G5<90) 270
R-1 PERMIT FEE $
APPP(11/Ffl F(1P ISSUANCE: 711Y 4
-fo`'tity Engineer rate
GENERAL PERMIT CONDITIONS
1. Payment of a security to insure faithful performance and completion of the work is required. This security is refundable upon
completion of the work and written acceptance by the City.
2. A one-year maintenance period for all work is required. Such period will begin on date of acceptance by the City. It is the applicant's
responsibility to remove and replace unacceptable improvements within the one-year maintenance period.
3. Refund or cancellation of the Faithful Performance Surety will be initiated by the written acceptance of the work by the City.
4. Submit project. schedule 10 days prior to proposed start of work. Special provisions may be required for work within City facilities
and downtown Campbell.
5. The Permittee must request in writing a final inspection and acceptance of the work upon completion. Acceptance by the City will be
made in writing to the Permittee.
6. Maintain safe pedestrian and vehicular crossings and free access to private driveways, fire hydrants and water valves.
7. Replace as directed by the City Engineer any damaged or removed improvements in accordance with City Standards and
. Specifications at the sole expense of the Permittee.
8. Sawcut for all PCC and AC removals. All PCC removals shall be to nearest scoremark and shall be doweled to existing improvements.
9. Adequate signing and barricading is required on the job site. Failure to provide such signing and barricading as specified by the City
Engineer may result in the City's providing such signing and barricades and charging the cost to the Permittee.
10. The Contractor or Permittee will have a supervisory respresentative available for contact on the project at all times during
construction.
11. This permit shall be kept at the site of work and must be shown to any authorized representatives of the City of Campbell or any
law enforcement officer upon demand.
12. No storage of materials or equipment will be allowed near the edge of pavement, within the traveled way, or within the shoulderline,
which would create a hazardous condition to the public.
13. This permit shall not be construed as authorization for excavation and grading on private property adjacent to the work or any other
work for which a separate permit may be required, nor does it relieve the Permittee of any obligation to obtain any other permit
required by law.
14. This permit does not release the Permittee from any liabilities contained in other agreements or contracts with the City and any other
public agency.
15. This permit is not transferable. Work must be performed by the Permittee or his designated agent or contractor as specified thereon.
16. Prior approval of inspector is required for any work done after normal working hours, on weekends or holidays and may require
reimbursement of inspection costs at the current overtime rate.
17. Call back (call out) due to emergencies regarding this permit shall be at the current overtime rate with a three (3) hour minimum
charge per occurrence.
18. If the public interest requires a modification of, or a departure from, the plans and specifications, the City shall have the authority to
- require or approve any modification or departure and to specify the manner in which the same is to be made for City -owned or
maintained facilities.
19. Pursuant to Chapter 14.02 of the Campbell Municipal Code, applicant shall not cause to be discharged any material into the
municipal storm drain system other than storm water. Applicant Shall adhere to the REST MANAGEMENT PRACTICES established by
the Santa Clara Valley Urban Runoff Pollution Prevention Program.
Applicant shall be responsible for ensuring that all those providing services under the applicant are aware of and understand all of the above
condltlotps.,, H `/
Applicant
J:\FORMS\Templates\Encroachment Permits\R-1 Encroachment Permit STATIC form2.pdf
Rev. 02/14
Date
...._..._...............:..............._........................_!..............:............_............... ......... .._... ... .............. i
- ------ - ------- . - ------ - ----
............. ._........... ......__, i ............:..............
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CITY OF CAMPBELL VENDOR NO. 10014530 CHECK No. .264139
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CHRIS SNYDER
1140 FAWN DR
CAMPBELL` CA 95008
CITY OF CAMPBELL
PUBLIC WORKS DEPARTMENT
CLEARANCE FOR FINAL INSPECTION
AND ACCEPTANCE LETTER
Encroachment Permit#: ENC 2017-00176
Name: Chris Snyder
Property Address: 1140 Fawn Dr.
Date of Final Inspection:
On File: Bonds �CD-----"-Cash
Faithful Perf rd mance: 500.
l
Labor and Material: $
Construction Cash Deposit to be released: $
Other overdue deposits to be released (Description):
Processed by:
Administrator
Reviewed by:
Reviewed by:
In
Land Development Engi
16l (-7
J:UoAnnaT\Deposit refunds\CHECKLISTS\l Checklist -Final Acceptance.doc (Rev. 10/11)
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•GkCHAR�•
CITY OF CA PBELL
Public Works Department
August 29, 2017
Mr. Chris Snyder
1140 Fawn Dr.
Campbell, CA 95008
SUBJECT: PERMIT NO. ENC 2017-00176
1140 Fawn Dr.
FINAL INSPECTION AND ACCEPTANCE
Dear Chris:
The. City of Campbell has made a final inspection of subject Public Works improvements
and finds the work to be acceptable and in conformance with City standards.
Accordingly, the City Engineer accepts the improvements.
The one year maintenance period stated in the permit begins as of August 15, 2017. The
permittee is responsible for the repair and/or replacement of any defective work or
failures that occur within one year. The City will inspect the improvements within one
year and notify you, in writing, whether or not any repairs are required.
Your Faithful Security Deposit in the amount of $2,500.00 is enclosed.
If you have any questions, please call me at (408) 866-2165
Sincerely,
1` V
Syed Wahidi
Public Works Inspector
Cc: Inspector /Suspense Files
Permit File ENC2017-00176
70 North First Street • Campbell, California 95008-1436 • TEL 408.866.21150 • FAX 408.376.0958 • TDD 408.866.2790
Encroachment Permit Final Sign Off
Encroachment Permit # g3L -2-- -7- ° 1-7
Address: LA N
Date of Final Inspection and Acceptance:
�v
Inspected by:
OK to release deposits: 100% 75%
Comments:
PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT
Effective July 1, 2017
TO: Finance PUBLIC WORKS FILE NO.
PROPERTY ADDRESS i ( 40 I X\N N
Please collect & receipt for the following monies:
ACCT. ITEM, = _ AMOUNT
LAND DEVELOPMENT.
4722
Encroachment Permit t—kp—pTication Fee
Non -Utility Encroachment Permit Ma•or >_$10 000 $425.00
Minor Encroachment Permit <sto,000 $240.00
Initial R-1 Permit N/C
Subsequent R-1 Permits within Two Year Period $240.00
Inspection Fee Minimum Charge per Location $420.00
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
4722
Utility and R-1 Permits no deposit required
Grading & Drainage Plan Review
Single Family Lot $295.00
Site < 10,000 s.f. $885.00
Site >_ 10,000 s.f. < 0.5 Acre $1,185.00
Site >_ 0.5 Acre $1 772.00
4722
NPDES Review C3 Requirements)
For projects not required to submit numeric sizing $175.00
For projects required to submit numeric sizing
Impervious Area 10,000 S . Ft to 1 Acre $740.00
Impervious Area 1 Acre or more $965.00
4722
For projects sent to Consultant for review Consultant Cost +20%
4722
Additional treatment facilities $315 ea
4722
4722
Plan Check & Inspection Fee(Non-Utility)
En r. Est. < $250 000 14% of Engineer's Estimate
Enqr. Est. >_$250 000 and <_$500,000 $35 000.00 + 8% of Engineers Estimate
4722
2203
2203
2203
En r. Est. >$500 000 $55 000.00 + 7% of Engineers Estimate
Emergency Cash Deposit 4% of En r. Est.* $500 min/$10 000 Max
Faithful Performance Security FPS 100% of ENGR. EST.*
Labor and Materials Security 100% of ENGR. EST.*
4721
Storm Drainage Area Fee Per Acre R-1 $2,120.00
(Multi -Res $2,385.00)
(All Other $2,650.00)
4722
Parcel Ma (4 Lots or Less) $4,200.00 + $90/lot
4722
Final Tract Map (5 or More Lots) $5,115.00 + $124/lot
2203
Monumentation Security 100% of Ci 's Monumentation Estimate
4920
Parkland Dedication Fee (75%/25% Due Upon Cert. of Occupancy)
4722
Lot Line Adjustment (includes Certificate or compliance) $1,990.00
4722
Vacation of Public Streets & Easements $2,700.00
47221
Certificate of Compliance $1,970.00
4722
Certificate of Correction $590.00
4722
4722
Document Recording Fees $15.00/first page $3 ea. Additional
Private Improvement in Public ROW $100.00
4722
Approved Plan Revision Fee $100/sheet
4722
Appeal Filing Fee $200.00
730.4924
Notice of Improvement Obligation Payment
4722
Assessment. begregation or Reapportionment
First Split $940.00
Each Additional Lot $295.00
511.7424
MISCELLANEOUS
Postage
-
ther (Please Specify)
*Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $
NAME OF APPLICANT c-146Z S 5N`1
NAME OF PAYOR G (L. S 15N`l FIK PHONE qoK- - 1057o
ADDRESS HO r ZIP
FOR
RECEIVED BY �UL _R. Z01T
CITYONLY CLERK
Date Recei t# OF CAMPBF-L �
.
J:TORMSff—pla
>tateFairm State Farm General Insurance Company
®® River Rd.
Bak rsd eld, CA 93311-9501
H-02- 0135-FBOC H W F
003733 0001
SNYDER, CHRIS & JENNIFER
1140 FAWN DR
CAMPBELL CA 95008-5113
CO
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Location: Same as Mailing Address
Loss Settlement Provisions (See Policy)
Al Replacement Cost - Similar Construction
B1 Limited Replacement Cost - Coverage B
Forms, Options, and Endorsements
Homeowners Policy
Increase Dwlg up to $67,940
Ordinance/Law 101/o/ $33,970
Jewelry and Furs $1,500/$2,500
Homeowners Policy Endorsement
Amendatory Endorsement
Back -Up Dwell/Listed Property
Form 438bfu NS Lndr Loss Pay
FP-7955.CA
OPT ID
OPT OL
OPT JF
FE-3422
FE-3247
FE-3560
FE-1313
RENEWAL CERTIFICATE
This policy includes Building Code Upgrade Coverage of $33,970.
Homeowners roucy
MAR 31 2017 to MAR 31 2018
TO BE PAID BY MORTGAGEE
Coverages and Limits
Section I
A Dwelling
Dwelling Extension Up To
B Personal Property
C Loss of Use
Deductibles - Section I
All Losses
J
$339,700
33,970
254,775
Actual Loss
Sustained
1,000
Section II
L Personal Liability $100, 000
Damage to Property of Others 500
M Medical Payments to Others 1,000
(Each Person)
Annual. Premium
Premium Reductions
Home/Auto Discount
Claim Record Discount
Inflation Coverage Index:
286.7
Please help us update the data used to determine your premium. Contact your agent with the year each of
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your home's utilities (heating/cooling, plumbing, or electrical) and roof were last updated.
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s
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W
$665.00
142.00
64.00
Anent JOE FRANGIEH
Moving? See your State Farm agent.
See reverse for important information.
Prepared FFR ni 2017