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N/ mr o6r.un2 e>:107 1 7 65.0 79.13 1 79.13 68.82 121.82 113.64 ' 122.48 1 LAWRENCE E. STONE-ASSESSOR -'•-- 835 819 803 787 0 wasw map for assessment purposes only. - C H A P M A N - -1� - C DRIVE- - J Compiled under R.&T.Code,Sea.327. Effeetive Roll Year 2009-2010 23 TRACT Ni 478• SAN TOM AS VILLAS•••UN. N'3 __ �® CERTIM rE OF LIABILITY INSUR 310E OP ID SL FDATE(MM/DD/YYYY) A 02/07/12 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGF..--PON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: PHONE FAA Bozzuto & Associates Insurance C,No,Ext: (A/C,No): One Almaden Blvd Suite 810 ADDRESS: San Jose CA 95113 �� C STONER ID#: ROBER02 Phone:800-989-8712 Fax:408�, , 8-7130 :y �, , r INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Century Surety Company 36951 Roberts Construction 10120 1663 6 Farl Road ey INSURER B: Everest National Insurance Co. Los Gatos CA 95032 � INSURERC: f+ INSURERD: 44�ry4�` INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBE REVISION NUMBER: R:° THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. 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 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ' LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYY�Y) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY CCP695895 04/01/11 04/01/12 PREMISES(Eaoccurrence) $ 100,000 CLAIMS-MADE ❑X OCCUR MED EXP(Any one person) $5,000 X PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1,00 0,000 X POLICY PRO LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ _:® $ B WORKERS COMPENSATION 7600006859121 02/01/12�tyT02/'01/]3�zlX TWCSTAORYITS ER AND EMPLOYERS'LIABILITY Y/N 8 ANY PROPRIETOR/PARTNER/EXECUTIVn /A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,0 0 0,0 0 0 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,0 00,0 00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,.if.more.space is required) RE: Mike Kaspar, 1250_Theresa:Ave ,, Camphell„_ CA.950ji mpbe a0-8_. The City, the City of-Call lo Redevepment Agency, its officers, employees and volunteers are named additional insured as respects general liability per attached endorsement. Insurance is primary & non-conributory. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CAMPBEL THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Campbell AUTHORIZED REPRESENTATIVE 70 N. First Street Campbell CA 95008 ©19 8-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD COMMERCIAL GENERAL LIABILITY CG 20 33 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these include as an additional insured any person or or- additional insureds, the following additional exclu- ganization for whom you are performing opera- sions apply: tions when you and such person or organization This insurance does not apply to: have agreed in writing in a contract or agreement that such person or organization be added as an 1. "Bodily injury", "property damage" or "personal additional insured on your policy. Such person or and advertising injury" arising out of the ren- organization is an additional insured only with re- dering of, or the failure to render, any profes- spect to liability for "bodily injury", "property dam- sional architectural, engineering or surveying age" or "personal and advertising injury" caused, services, including: in whole or in part, by: a. The preparing, approving, or failing to pre- 1. Your acts or omissions; or pare or approve, maps, shop drawings, 2. The acts or omissions of those acting on your opinions, reports, surveys, field orders, change orders or drawings and specifica- behalf; tions; or in the performance of your ongoing operations for b. Supervisory, inspection, architectural or the additional insured. engineering activities. A person's or organization's status as an addi- 2. "Bodily injury" or "property damage" occurring tional insured under this endorsement ends when after: your operations for that additional insured are completed. a. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than ser- vice, maintenance or repairs) to be per- formed by or on behalf of the additional in- sureds) at the location of the covered operations has been completed; or b. That portion of"your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcon- tractor engaged in performing operations for a principal as a part of the same project. CG 20 33 07 04 0 ISO Properties, Inc., 2004 Page 1 of 1 ❑ POLICY NUMBER: CCP 695895 COMMERCIAL GENERAL LIABILITY CG 20 37 07 04 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Location And Description Of Completed Or Organization(s): Operations CITY OF CAWBELL 1250 TFIERESA AVE. 70 N.FIRST STREET CAWBELL,CA 95008 CAWBELL,CA 95008 Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Section II—Who Is An Insured is amended to include as an additional insured the person(s) or organization(s)shown in the Schedule, but only with respect to liability for"bodily injury"or"property damage"caused, in whole or in part, by"your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the"products- completed operations hazard". CG 20 37 07 04 0 ISO Properties, Inc.,2004 Page 1 of 2 NOTE: REMOVE EXISTING PAVEMENT FULL DEPTIT TO CLEAN, STRAIGHT EDGE REMOVE EXISTING AC SECTION AND BASE(12"MIN) REPLACE AS SHOWN GRIND 2"DEEP PAVEMENT KEY TYPE A%"MAX-MED AC (95%COMPACTION) NEW PCC IMPROVEMENT'S 1�„ CURB,GUTTER,DRIVEWAY rl.— 9" - 1/11 APPROACH OR ACCESSIBILITY RAMP EXISTING PAVEMENT TO REMAIN - c - � _ PAVEMENT FABRIC OVER JOINT 6"-10"EACH SIDE OF JOINT -- %-�,� � _- =�.✓—%L_r'�--�; %:.-i: ,-- _ _ (PETROTAC OR APPROVED EQUAL) DOWEL TO EXISTING •._i� �:_/'`r{',�1 >`.._;! _ �-PCCIMPROVEMENTS 10"MIN 2 SACK SAND/CEMENT WITH REBAK,6"EMBEDMENT SLURRY BACKFILL,2 SACK CEtvfENT PER CUBIC YARD OF MATERIAL 6"CLASS 2 AGGREGATE BASE (95%RELATIVE COMPACTION) COMPACTED NATIVE NOTE: APPLY TACK OIL TO ALL (95%RELATIVE COMPACTION) SURFACES PRIOR TO PLACING NEW A.C. r;aq•C A�p�r A.C. PAVEMENT REMOVAL & RESTORATION DETAIL DR.CVV ED : AT NEW PCC IMPROVEMENTS A-3 ���ReHAR9 G1 APPROVED BY: J:\DRAN\llI4GS\STD-DETAILSIA-3 d 8" 10" i j R=6" R=2" (TYP) i 3" - � 1 Install ! PCC „ Weakened Class A _ 6 CL 2 AB, Plane Joints 95% R.C. at 20' O.C. ra 1t: ,fin.;o Rolled Curb and Gutter 6" Z-011 Slope � 1/4" per . FT I `'�__'"' `�_ 3/4 i (2" Max.) .•-_-i 6" �,�` 1 611 6„ R 2 �. 6" CL 2 AB, r _ 95% R.C. Vertical Curb and Gutter ► TS ag CA k b CITY OF CAMPBELL REV. DATE BY DETAIL 4 PUBLIC WORKS DEPARTMENT DRAWN BY: Curb & Gutter No. v ° o DATE CHECKED BY: DATE eta115 APPROVED BY: �RcHAF4 MICHELLE QUINNEY CITY ENGINEER JlOrawingslSid O0tai1sID20 ENCROACHMENT PERMIT ISSUANCE CHECK LIST City of Campbell Encroachment Permit No. ENC Z4 q 00 Department of Public Works Tract No. Address: ITEMS REQUIRED FOR PERMIT APPLICATION: 1IV, Applicant section complete Applicant signature and date(front and back) � � �^ ,(,n 3 Permit Application Fee$ 00 paid Receipt Nu r !Jr�`�`� Engineer's Estimate Submitted 5. Plan Check Deposit Paid(2%of Engineer's Estimate,$500 min) Receipt Number 6. Five Sets of Grading and Drainage Plans 0 Five Sets of Improvement Plans Submitted 8. Check Lists ITEMS RE UIRED PRIOR TO PUBLIC WORK CLEARANCE FOR BUILDING PERMITS Plan Check&Inspection Fee: If Engineer's Estimate<$250,000,then 13%of Engineer's Estimate. If Engineer's Estimate >$250,0001, tual Cost+20%. (Deposit off 88 p Zzer's Estima)e required;$30,000 minimum deposit. Amount$ 1k) Recei t-_ f1o) Security for aithful Performance and Labor and Materials, 100%each,of Engineer's Estimate,supplied or paid. Amount$ (Aco Form I.D.# 11.� Security for Monumentation Amount$ Receipt No. 12. Construction Emergency Cash Deposit: 4%of Engineer's Estimate.($500 minimum,$10,000 maximum) Amount Receipt No. 13. Storm Drainage Area Fee Amount$ Receipt No. 14. Right of Way Documents Completed and Fees Paid. 15. Worker's Compensation Insurance Information Sheet Received for Applicant. 16. All other Public Works requirements listed in the Conditions of Approval of the development. 17. Other Fees,Payments,Deposits Amount$ Receipt No. ITEMS REQUIRED PRIOR TO ISSUANCE OF ENCROACHMENT PERMIT: 18. VContractor's signature added to the permit application(front and back) e). Contractor's City of Campbell Business License # � �ut ��! 20. 1✓ Worker's Compensation Insurance Information Sheet received from Contractor. 21. y Certificate of Insurance with Additional Insured's Endorsement received from Applicant or Contractor. No 22. ` (axe mylar set and four blueline sets of off-site plans signed by licensed engineer,stamped APPROVED FOR CONSTRUCTION. 23. Permit signed by City Engineer. WHEN ALL OF THE ABOVE ITEMS ARE COMPLETE,PERMIT MAY BE ISSUED. Issuer: Initial and date and file with permit. UPON ISSUANCE,INITIATE CHECK REQUEST FOR PLAN CHECK DEPOSIT REFUND j:\LandDev\forms\streetimprovements\EP checklist rev. 1/20/04 'Print Form CITY OF CAMPBELL R-1 ENCROACHMENT PERMIT Permit No. .-(7D DEPT.OF PUBLIC WORKS (Non-engineered work within the public right-of-way) X-Ref File 70 North First Street ($10,00 00 maximu value of work) Application Date Campbell,CA 95008 2 1 Application Expiration Ph.(408)866-2150 ISSUED: Date Fx.(408)376-0958 Permit Expiration ate: APN APPLICATION-Application is hereby made for a Public Works Permit in accordance with Campbell Municipal Code,Section 11.04. (Application expires in 6 months if the permit is not issued.) A. Work Address: n B. Nature of Work: C u i2!$ �U L Acz o<j I 67, IJC?-i Dk v- e uUcv-ii ft-PPr_)0h0-t6 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. NAME OF APPLICANT: �(�l r� �m Telephone: C., �7,2 CX 7 Address: E-Mail Address: I !Y) ll 44 'fi"L 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 information. ACCEPTED: (Applicant/Permittee) (Sign) 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 have 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 4215 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. Priorto 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 U T RECEIP N�Q SECURITY FOR FAITHFUL PERFORMANCE (100%Of Engr's Est.) $ iU, f l APPROVED FOR ISSUANCE: /n, 41V for City Engineer Date Permit Expires 6 Months after Date of Issuance. 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. 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. 5. Maintain safe pedestrian and vehicular crossings and free access to private driveways,fire hydrants and water valves. 6. 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. 7. Sawcut for all PCC and AC removals. All PCC removals shall be to nearest scoremark and shall be doweled to existing improvements. 8. 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. 9. The Contractor or Permittee will have a supervisory respresentative available for contact on the project at all times during construction. 10. 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. 11. 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. 12. 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. 13. This permit does not release the Permittee from any liabilities contained in other agreements or contracts with the City and any other public agency. 14. This permit is not transferable. Work must be performed by the Permittee or his designated agent or contractor as specified thereon. 15. 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. 16. 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. 17. 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. 18. Pursuant to Chapter 14.02 of the Campbell Municipal Code,applicant shall not cause to be discharged any material into the municipal storm drain system other than storm water. Applicant shall adhere to the BEST MANAGEMENT PRACTICES established by the Santa Clara Valley Urban Runoff Pollution Prevention Program. Applicant shall be responsible for ensuring that all those providing services under the applicant are aware of and understand all of the above conditions. Ap�1icant \ Date r J:\FORMS\Templates\EncroachmentPermits\R-1 Encroachment Permit STATIC form2.pdf Rev.4/08 PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT&TRAFFIC RECEIPT Effective July 1,2010 ' 1� O`_ 0 13 TO: City Clerk PUBLIC WORKS FILE NO. tN 1 PROPERTY ADDRESS Please collect&receipt for the followin monies: ACCT`` ITEM uv a. LAND"(DEVELOPMENT ncroao ment Permit Application Fee Non-Utility Encroachment Permit $350.00 Minor Encroachment Permit<sio,000 $200.00 Initial R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $200.00 * 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 Famil Lot $250.00 Site< 10,000 s.f. $750.00 Site>_ 10,000 s.f. <Acre $1 000.00 Site>_ 1 Acre $1 500.00 Plan Check& Inspection Fee Non-Utili **2203 En r. Est. up to$250 000 14%of Engineer's Estimate 4722 En r. Est. ?$250 000 Actual cost+20%Admin Overhead Min$35 000 Deposit) * 2203 EmergencV Cash Deposit 4%of En r. 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 (Multi-Res$2,385.00) All Other$2 650.00 4722 Parcel Ma 4 Lots or Less $3 600.00+$80/lot 4722 Final Tract Ma 5 or More Lots $4 400.00+$108/lot * 22031 Monumentation Security 100%of ENGR. EST. 4920 Parkland Dedication Fee 75%/25% Due Upon Cert. of Occupancy) 4722 Lot Line Ad'ustment $1 400.00 4722 Vacation of Public Streets&Easements $2 250.00 4722 Certificate of Compliance $1 700.00 4722 Certificate of Correction $500.00 4722 Appeal Filin Fee $200.00 4722 Notary Fee(per signature) $10.00 4722 Assessment Segregation or Reapportionment First Split $800.00 Each Additional Lot $250.00 5117424 Postage TF?AFFIC„' f 4728 Traffic Flow Ma Dail Traffic Volumes $34.00. 4728 Signal Timing Information $72.00/Hr 4271 Truck Permits $16.00/ ertri 4728 No Parking Signs $1/each or$25/100 MI5CELL'ANEOU.S1. Other Please Specify) *Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. **Actual Cost Plus 20%Overhead(Non-Interest bearing deposit) TOTAL $ NAME.OF APPLICANTAP /}/ o NAME OF PAYOR PHONE ADDRESS oink ZIP � N FOR CITY CLERK ONLY .Date .. ., �_ *For plan`Cheak and Cash Deposits,-send yellow copy fo�mance s , J1pORM5\TemplatesWtlminisl tive\Reuipt Form land Oeve1opmen1TmRc 10-11(Rev.0&10) r S2 + cgGmL . R:S a: Jw 200027:36 fR: DI ELR«aE qa#% W+: GZmdi RE2SR ««: W »g 2+; G=S DESCRIPTION AMOUNT . Ry .+POS - 3! !««m A J: ISe THERESA AVE «2y ---�--�— TOTAL DUE,-, !m%m CHECK PAID: SWO ) . :RR q= lm TENDERED: y.D CHANGE: vm . \ & . - N '- Lu Effective July 1,2008 ? 1:: ( TO: City Clerk PUBLIC WORKS FILE NO PROPERTY ADDRESS Please collect&receipt for the following monies: 'A-'MOUNT --,:.ATEM LIAND3,3EVELORMENT, % 4722 Encroachment Permit Application Fee Non-Utility Encroachment Permit ($310.00) Minor Encroachment Permit<$10,000 ($140.00) R-1 First Permit(+4@=FE8)Subsequent<io,000 ($135.00) 2203 Plan Check Deposit 2%of Engineer's Estimate ($500.00 min) 4722 Grading&Drainage Plan Review Single Family Lot ($210.00) Site<10,000 s.f. ($625.00) Site> 10,000 s.f.<Acre ($835.00) Site> I Acre ($1,250.00) Plan Check& Inspection Fee(Non-Utility) **2203 Engr.Est. >$250,000 (Actual Cost+20%min.$30,000 Deposit 4722 Engr. Est. <$250,000 (13%of ENGR. EST.) 2203 Emergency Construction Cash Deposit (4%of Engr. 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) (Multi-Res$2,385.00) All Other$2,650.00) 4722 Parcel Map(4 Lots or Less) ($3,500.00+$78/lot) 4722 Final Tract Map (5 or More Lots) ($4,300.00+$105/lot) 2203 Monumentation Security (100%of ENGR. EST.) 4920 Parkland Dedication Fee(75%/25% Due Upon Cert.of Occupancy) 4722 Lot Line Adjustment ($930.00) 4722 Vacation of Public Streets&Easements ($2,200.00) 4722 Certificate of Compliance ($675.00) 4722 Certificate of Correction ($4 5.00) 4722 Appeal Filing Fee ($105.00) 4722 Notary Fee(per signature) ($10.00) 4722 Assessment Segregation or Reapportionment First Split ($735.00) Each Additional Lot ($200.00) 511.7424 Postage TRAFFIC.. 472-8'j`­ Intersection Turn Counts (Two-Hour Count ($80.00) 4728 Intersection Turn Counts (a.m.or p.m.peaks) ($155.00) 4728 Traffic Flow Map (Daily Traffic Volumes) ($33.00) 4728 Signal Timing Information ($64.75/Hr) 4271 Truck Permits ($16.00/per trip) 4728 No Parking Signs ($1/each or$25/100) MISCELLANEOUS Other(Please Specify) 47221 Street Tree Planting/Removal Permit ($150.00+$500 deposit) *Engineer's Estimate shall be as approved by the City Engineer. TOTAL Z122- , 00 NAME OF APPLICANT IA L La3paf- NAME OF PAYOR PHONE ADDRESS /� t�,s a 4 zip —Actual Cost Plus 20%Overhead(Non-jDtecept bearing deposit) -ErIv .il. RIEC FOR RECEIV.EbaY CITY CLERK —... ..... ryn ONLY ece pt'� DEC, !ForzPian'Check andtCa!gh'D,elpoi§its.,,(send Y6]i.ow(.cop o- Y."t LlFinirUfy CLERKS OFFICE :Oat 46itiais ek F— nd[---1 T,.N—9(k— S .:Print.Form CITY OF CAMPBELL R-1 ENCROACHMENT PERMIT Permit No. CJtIG —�D 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 Campbell,CA 95008 Application Expiration �7 Ph.(408)866-2150 ISSUED: Date 22 06 Fx.(408)376-0958 Permit Expiration Date: APN 9 APPLICATION-Application is hereby made for 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: ZS 0 •-f—L1EyLjFSn A� B. Nature of ).C. Attach three( co copies of a dra?win�show n�th location,extent and dimensions�"tUf✓ � L p' g g 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. NAME OF APPLICANT: {fin 1 � � Telephone: Z..j�0 Address: �� E Mail Address: C' i.:v" Cxi"` 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 information. ( / ACCEPTED: ,�\l�\ f' (Applicant/Permitl ee) (Sign) 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 have 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 4215 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 A UKIT RECEIP N SECURITY FOR FAITHFUL PERFORMANCE (100%Of Engr's Est.) APPROVED FOR ISSUANCE: for City Engineer Date Permit Expires 6 Months after Date of Issuance. 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. 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. 5. Maintain safe pedestrian and vehicular crossings and free access to private driveways,fire hydrants and water valves. 6. 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. 7. Sawcut for all PCC and AC removals. All PCC removals shall be to nearest scoremark and shall be doweled to existing improvements. 8. 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. 9. The Contractor or Permittee will have a supervisory respresentative available for contact on the project at all times during construction. 10. 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. 11. 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. 12. 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. 13. This permit does not release the Permittee from any liabilities contained in other agreements or contracts with the City and any other public agency. 14. This permit is not transferable. Work must be performed by the Permittee or his designated agent or contractor as specified thereon. 15. 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. 16. 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. 17. 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. 18. Pursuant to Chapter 14.02 of the Campbell Municipal Code,applicant shall not cause to be discharged any material into the municipal storm drain system other than storm water. Applicant shall adhere to the BEST MANAGEMENT PRACTICES established by the Santa Clara Valley Urban Runoff Pollution Prevention Program. Applicant shall be responsible for ensuring that all those providing services under the applicant are aware of and understand all of the above conditions. Ap�liAXi Date t J:\FORMS\Templates\Encroachment Permits\R-1 Encroachment Permit STATIC form2.pdf Rev.4/08 CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT ENGINEERING DIVISION Revised January 2007 ENGINEER'S ESTIMATE FOR: .._ LAND DE1iiE�bPMENT.P�20JECT5 Date: December 21, 2009 For File No BLD2009-00879 Site Addr 1250 Theresa Avenue ENC. No. ITEM UNIT PRICES FOR PROJECT AMOUNT NO. DESCRIPTION QTY UNIT < $250 K > $250 K $AMOUNT I. DEMOLITION/CLEARING 1. CLEARING&GRUBBING 1 LS $2,000.00 $1,500.00 $ 2,000.00 4. CURB AND GUTTER REMOVAL 43 LF $7.05 $3.45 $ 303.15 III. CONCRETE IMPROVEMENTS $ - 2. DRIVEWAY APPROACH 120 SF $14.00 $10.00 $ 1;680.00 3. CURB AND GUTTER 28 LF $45.00 $35.00 $ 1,260.00 SUBTOTAL $ 5,243.15 PREPARE Doris QH 10%MOBILIZATION, CONSTRUCTION TRAFFIC CONTROL/PHASING, REVIEWED BY: CONSTRUCTION STAKING CONSTRUCTION TESTING $ 524.32 APPROVED BY: 10% CONTINGENCY $ 524.32 10% SECURITY ENFORCEMENT $ 524.32 TOTAL FAITHFUL PERFORMANCE SECURITY $ 6,816.10 USE THIS AMOUNT FOR SECURITY1 $ 6,800.00 0 J:\LandDev\Form\SI\EngEst Page 1 Of 1 a CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT ENGINEERING DIVISION Revised 3/08 ENGINEER'S ESTIMATE FOR' LAND DEVELOP MENT"PROJECTS Date: For File No(s): , Site Address: ENC. No. ITEM UNIT PRICES FOR PROJECT AM UNT NO. DESCRIPTION QTY UNIT <S250 K >S250 K S AMOUNT I.DEMOLITION/CLEARING 1. CLEARING&GRUBBING LS $2,000.00 $1,500.00 2. SAWCUT P.C.C./A.C.(UP TO 6") LF $6.10 $4.10 3. P.C.C.REMOVAL SF $4.00 $3.00 4. CURB AND GUTTER REMOVAL LF $7.05 $3.45 5. MEDIAN REMOVAL SF $5.25 $2.65 6. DEMOLISH EXISTING INLET/PLUGRCP'S EA $1,800.00 $1,200.00 II.STORM DRAINAGE I, 12"R.C.P.(CLASS V) LF $210.00 $180.00 2. 15"R.C.P.(CLASS III) LF $225.00 $195.00 3. 18"R.C.P.(CLASS 111) LF $240.00 $210.00 4. 24"R.C.P.(CLASS 111) LF $260.00 $240.00 5. 30"R.C.P.(CLASS III) LF $280.00 $260.00 6. T.V.INSPECTION(12") LF $1.25 $0.80 7. STD.DRAINAGE INLET(C.C.DETAIL 5) EA $2,800.00 $2,300.00 8. FLAT GRATE INLET(C.C.DETAIL 6) EA $1,620.00 $1,275.00 9. STD MANHOLE(C.S.J.DETAIL D-11) EA $5,000.00 $4,000.00 10. STD MANHOLE(C.S.J.DETAIL D-12) EA $6,500.00 $6,000.00 11. BREAK AND ENTER M.H./D.I. EA $1,000.00 $835.00 III.CONCRETE IMPROVEMENTS 1, SIDEWALK SF $12.00 $8.00 2. DRIVEWAY APPROACH SF $14.00 $10.00 3. CURB AND GUTTER LF $45.00 $35.00 4. VALLEY GUTTER SF $20.00 $15.00 5. CURB RAMP EA $1,800.00 $1,500.00 6. TYPE 13-1 CURB LF $34.00 $29.00 7. TYPE AI-B3 CURB LF $20.00 $17.00 8. COBBLESTONE MEDIAN SURFACE SF $20.00 $15.00 9. P.C.C.DRIVEWAY CONFORM SF $8.20 $6.30 10. A.C.DRIVEWAY CONFORM SF $5.25 $4.40 J:\FORMS\Templates\Land Development\Street Improvements\EngEst(Rev.03/08) Page 1 of 4 r CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT ENGINEERING DIVISION Revised 3/08 ;ENGINEER'S ESTIMATE,FOR LAND DEVELOPMENT PROJECTS Date: For File No(s): Site Address: ENC. No. ITEM UNIT PRICES FOR PROJECT AMOUNT NO. DESCRIPTION QTY UNIT <S250 K >S250 K S AMOUNT IV.PAVEMENT I. ASPHALT DIGOUT AND REPLACE CF $5.80 $4.10 2. PAVEMENT WEDGE CUT(6) LF $5.00 $2.65 3. PAVEMENT GRINDING SF $0.95 $0.63 4. PAVEMENT FABRIC(PETROTECH) SY $2.30 $2.10 5. ASPHALT CONCRETE(TYPE A) T $210.00 $150.00 6. AGGREGATE BASE(CLASS 2) T $80.00 $40.00 7. SLURRY SEAL(TYPE II) SF $0.25 $0.20 8 AC REMOVALIOFFHAULIDISPOSAL CF $14.00 $12.00 V.TRAFFIC SIGNALS/LIGHTS 1. DETECTOR LOOP(6'ROUND) EA $520.00 $347.00 2. DETECTOR LOOP(6'x 30') EA $752.50 $626.25 3. DETECTOR LOOP(6'x 50') EA $1,042.00 $868.30 4. ELECTROLIER EA $4,000.00 $3,500.00 5. l 1/2"RIGID CONDUIT LF $10.40 $8.20 6. 2"RIGID TRAFFIC SIGNAL CONDUIT LF $19.70 $15.05 7. CONDUCTOR LF $0.85 $0.65 8. PULL BOX(NO.3 1/2) EA $347.00 $278.00 9. TRAFFIC SIGNAL PULL BOX(NO.5) EA $463.00 $405.25 10. PULL ROPE LF $0.57 $0.57 VI.STRIPING AND SIGNS 1. REMOVE PVMT.MARKINGS(PAINT) SF $2.65 $1.60 2. REMOVE PVMT.MARKINGS(THERMO) SF $3.70 $3.40 3. REMOVE PVMT STRIPING LF $1.50 $1.00 4. STRIPING DETAIL 9 LF $3.00 $2.00 5. STRIPING DETAIL 22 LF $3.00 $2.00 6. STRIPING DETAIL 29 LF $4.00 $3.00 7. STRIPING DETAIL 32 LF $4.00 $3.00 8. STRIPING DETAIL 37(THERMO) SF $5.00 $3.50 9. STRIPING DETAIL 38(THERMO) SF $5.00 $3.50 J:\FORMS\Templates\Land Development\Street Improvements\EngEst(Rev.03/08) Page 2 of 4 CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT ENGINEERING DIVISION Revised 3/08 ENGINEER'S ESTIMATE FOR LAND DEUELOPIVIENT PROJECTS Date: For File No(s): Site Address: ENC. No. ITEM UNIT PRICES FOR PROJECT AMOUNT NO. DESCRIPTION QTY UNIT <$2.50 K >S2.50 K S AMOUNT 10. STRIPING DETAIL 39 LF $5.00 $3.00 11. LIMIT LINE LF $6.00 $4.50 12. CROSSWALK,12"WHITE LF $6.00 $4.50 13. PAVEMENT MARKINGS(PAINT) SF $3.25 $2.50 14. PAVEMENT MARKINGS(THERMO) SF $6.60 $5.05 15. PAVEMENT MARKER(NON-REFL.) EA $5.20 $3.50 16. PAVEMENT MARKER(REFLECTIVE) EA $6.95 $4.75 17. TYPE K MARKER EA $109.50 $92.50 18. TYPE N MARKER EA $109.50 $92.50 19. SALVAGE ROAD SIGN EA $99.00 $87.35 20. RELOCATE ROAD SIGN(W81 ON NEW POST) EA $115.75 $99.00 21. INST.RD.SIGN ON EXIST.POLE EA $231.55 $168.50 22. ROAD SIGN WITH POST EA $347.30 $277.85 23. INSTALL 1226S SIGN WITH POST EA $350.00 $252.60 24. STANDARD BARRICADE LF $19.50 $15.75 VII.LANDSCAPING 1. IRRIGATION,PLANTING WORK SF $8.00 $7.35 2. PRUNE TREE ROOTS EA $147.35 $1 15.75 3. TREE REMOVAL EA $684.10 $526.25 4. ROOT BARRIER(12") LF $21.05 $10.50 5. ROOT BARRIER(18") LF $26.30 $15.80 6. STREET TREE EA $447.30 $342.05 7. STREET TREE(36"BOX) EA $710.40 $589.40 8. TOP SOIL BACKFILL CY $26.30 $22.60 9. IRRIGATION LS $1,368.25 $710.40 VIII.MISCELLANEOUS 1. PEDESTRIAN BARRIER LF $86.85 $69.45 2. CHAIN LINK FENCE(6) LF $17.35 $13.70 J:\FORMS\Templates\Land Development\Street Improvements\EngEst(Rev.03/08) Page 3 of 4 4 CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT ENGINEERING DIVISION Revised 3/08 -ENGINEER'S ESTIMATE FOR , LAND DEVELOPMENT PROJECTS Date: For File No(s): Site Address: ENC. No. ITEM UNIT PRICES FOR PROJECT AMOUNT NO. DESCRIPTION QTY UNIT <$250 K >$250 K S AMOUNT 3. RAISE MISC.BOX TO GRADE EA $315.75 $210.50 4. RAISE MANHOLE TO GRADE EA $421.00 $364.45 5. INSTALL MONUMENT BOX EA $1,500.00 $900.00 6. MEDIAN BACKFILL CY $22.10 $19.70 SUBTOTAL PREPARED BY: 10%MOBILIZATION,CONSTRUCTION TRAFFIC CONTROLJPHASING, REVIEWED BY: CONSTRUCTION STAKING, CONSTRUCTION TESTING APPROVED BY: 10%CONTINGENCY 10%SECURITY ENFORCEMENT TOTAL FAITHFUL PERFORMANCE SECURITY USE THIS AMOUNT FOR SECURITY J:\FORMS\Templates\Land Development\Street Improvements\EngEst(Rev.03/08) Page 4 of 4 MEMORANDUM CITY OF CAMPBELL TO: Bill Bruckart, Building Official DATE: 12/16/2009 FROM: Doris C. Quai Hoi, Engineer(408) 866-215 Ed Arango, P.E., Associate Engineer ¢� �) �l CC: Mike Kaspar SUBJECT: BUILDING PERMIT APPLICATION Site Address: 1250 Theresa Avenue For File No(s): BLD2009-00879 Project Description: 180 sgft new covered parking space (garage) Applicant: Mike Kaspar PiJBLIC WORKS DEPARTMENT CONDITIONS OF APPROVAL 1. Street Improvements: Prior to issuance of any grading or building permits for the site, the applicant shall cause plans for public street improvements to be prepared, pay various fees and deposits, post security and provide insurance necessary to obtain an encroachment permit for construction of the standard public street improvements, as required by the City Engineer. The plans shall include the following, unless otherwise approved by the City Engineer: a. Installation of City ADA compliant driveway approach and necessary curb and gutter. See attached details for construction. Detail D-16.3,A-3 and D-20. b. Removal of existing curb cut due to a conflict between the adjacent proposed driveway approach, and replace with new City Standard curb and gutter. c. Construction of conforms to existing public and private improvements, as necessary. 2. 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. 3. 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. J:U-andDev\Conditions\Bldg\Theresa Ave 1250.DOC Pagel of 2 b 1250 Theresa Avenue 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. J:\LandDev\Conditions\Bldg\Theresa Ave 1250.DOC Page 2 of 2 PUBLIC WORKS REVIEW PLAN REVIEW ROUTE SHEET DATE: ADDRESS: O 7��&� 104�4 PLAN CHECK NUMBER: D� G APPROVED:NO CONEVIENTS;: DATE: APPROVED: CONDITIONS BELOW' Q4 F -- IF 20 gi 41 A J�jd` RECEIVED }mow COMM { 2009 Valcc- AoM NlSMA-noN NOTES: *RETURN TO BUILDING DIVISION PERMIT APPLICATION PERMIT # CITY OF CAWBELL-BUILDING DIVISION DATE: BUILDING ADDRESS: -NU ESPr SUITE PERMIT TYPE: BUILDING ELECTRICAL PLUMBING MECHANICAL DEMOLITION SIGN GRADING OTHER DESCRIPTION OF WORD: (N)SFD RES.ADD REM �(N) COMM. DEMO SIGNS VALUATION OWNER'S NAME: Kj� KAS 0 PHONE#: yob 0S Z ADDRESS: 12 't"H�2P3s�4 CITY: P EC.A ZIP: $ APPLICANT'S NAME: _: A5 PHONE -' ii ADDRESS: CITY: ZIP: CONTRACTOR'S NAME: LICENSE# ' CONTACT PERSON: PHONE#: ADDRESS: CITY: ZIP: ARCHITECT/ENG NAME: ronrnr LA PSI 4114 CONTACT PERSON: A -AyoiJ i j le bjeo PHONE ADDRESS: Su,��a ry � � CITY: ZIP: HAZARDOUS MATERIALS: USED ON SITE: YES NO_,Y. STORED ON SITE: YES NO�k (For use or storage of hazardous materials,provide a HazMat Information Statement to the Fire Dept.Hazardous Materials Specialist for review and comment. FIRE' SPRUVELLERED: YES NO APN-4 Photos by: DQH Date: 12/14/2009 1250 Theresa Avenue ppmpwl -. South West View West View I � �5��►�1A11����111I� 1 � � � I � II � IIII I ► � � - t I 19.5' t, , m r ' West View North View Page 2 of 2 1250 Theresa Ave. 4/11/07 �v � r'n • South view West view e j _MO.'. NW view North view 4/11/07 1250 Theresa Ave. _ •, ".tie . F till'µ.tl �.Sj3• '..�:'»Y ... x'vi": t f '�-`",L-,�?, 'k` _ �^rfiiY' n j�a "'S�yl•t�.1y��9�t1 +��`� �C �x+� East view East view :-4 J� West view South view Yy {`lf 'r.I 1 y 77; _ - OF- ,y. `YI --.`•• - � f <, -• - i saw 6 r y1� M w 7CC • r k t � _� :�.� -_•-� -„ems_-,�_ � � - O F F I C E O F C 0 U N T Y A S S E S S O R S A N T A C L A R A C O U N T Y, C A L I F 0 R N I A BOOK PAGE 12 34 I �j 406 19 HACIENDA 4 AVE, - 808110 80o 766 P 156 744-6 734136 724 1 700 6 .60 I 80 I 80 I 80 I BO 1 80 I 100.59 14040 I I .2 ji 32 35 9 0 31 -w EJ - I -y 36 7 6 5I 4 m S 112.07 80.10 I 1 80.17 T 12131 / 73.02 B I 9 1 10 I 11 I 12 1 13 / 14 16/54 0 1 m c = :66.34 .�• 72e 6/ �1 60 d 59 58 o� 57 91 56 \\� 55 � PrN es' 92 > I I I I V 72 so I so 68.34 125/9 �� 4or 64 j 1" 100' TRACT NR2122 T/yl fell 1221 123/ 1241 a � 1 04 FAIRLANDS ,o-`ESA e AVE. --p s° �p W. J. PARR SUED. 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Eff-U.RDII Year 2005-2006 23 TRACT N2478••.SAN TOMAS VILLAS,--UN N23 Land Development Information sheet Prepared by: DQH Date: 12/14/2009 Address: 1250 Theresa Ave. Lot size: 7,861 (SF) If this project is part of a larger development(new subdivision, new townhomes) or commercial development, skip A through D. *Adding Detached carport A. Existing building area(SF): 1736 B. Proposed addition area(SF): 180 C. Total area w/addition(A+B): 1916 D. Percent increase (B/A): 12% (if less than 50%, stop research) Tract or Parcel Map (circle one): TR 2122 Date recorded: 8/19/1958 (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 --> 5/16/60) Date paid (file#&address or LID#) Storm Drain Area fee: 0.18 X $2120 = $382.00 (area in acres) (fee/acre) Existing Street Improvements: Within STANP? Yes No (circle one) STANP Requirements: Curb/Gutter Sidewalk rolled curb None NA Existing improvements present? Curb/Gutter Sidewalk (circle all that apply) Sidewalk dimension(BOW to FOW): NA Park strip dimension(FOW to BOC): NA Driveway 1 Dimension(s): 18' D/W ADA compliant? Yes No Driveway 2 Dimension(s): 10' D/W ADA compliant? Yes No Street light info: (on JP across the street, older pole, galvanized pole, distance/location from property) Location of water meter and sewer cleanout: 1 WM Street ROW half width (CL to PL): 30' Date that street had been resurfaced: Cape Seal, D/O,2" OL w/Fabric FY 01/02 Electrical panel relocation? Yes No NA(circle one) Provide details and attach pictures (8.5x11), assessors snap (I Ix17) and aerial map (8.5 x 11): J:\LandDev\Land Develop Information Sheets\Theresa Ave. 1250.doc z USN DRIV i lao F I m N 1 z N I I o � 0 0 105.00 N 00717 W 'y s I lz k I- tz i Y — w.w�ve.a ...s.�.,...re....a....aa.• .......r � ...,. rw.wT...r. ... >w..n.•.....+...w .e.,.......... w...�.... w..+w�a w,. a REMODEL TO: SIl'd7E PLAN ANOTHER SUCCESSFUL DESIGN BY: THE KASPAR RESIDENCE EMSMNO '���" I COkNERSTONE LIMITED a 1250 THERE5A AVENUE Rff1`1017CLJN6 0Jf516N 1Nc. CAMPBELL,CALIFORNiA 95008 DEMOI d®N PLAN ('�)370-33GG PAX(408)370-979G o (4Of3)892-0872 CORNERSTONEUMITED.COM � b BO GLLMAN AVE.#29 CAMPBEL L.CALIFORNIA 95006 PROGRESS PRINTS 1 2-17-10 not for construction '� /ram _ 65.39 _ 11y1L6AlIA1L�'$Q FALMY ROOM LN 8g:43'E LQ If hilchelm lo I kitchen ath#fl ULI C/) P=h j pwch Ljj ]BEDROOM all, PUT= PORCII DEL UN®INDICATE Dfn!NT 0FM5TINGCCreR1ORV,%LL5 1735.71' ----------------- -------------------------------- I I NEW DR/V PORR1 I EMSTO FLR.PLAN/DEMO PLAN 1/4" FPROPOSIED F1 -----------1� -9X20 PARKING. SPACE sPACE _tea I < Ld e. > SEPARATOR CONT5TfIUCMON ,0* LINE Or NEW DRIVEWAY jC:NT (m RADIUS) 01,1W S O�Ell PLANE JOINT R CUT 1.11T 1pDEEP WEAXMED PLN'EJO1,T-f CUT dal IT 62 4)' N 89-43'E OR 1I3*..BE4 2'DEEP PER FOOT CURB&GUTTER 9--a DRNILWAY APPROACH PER CITY AOF CAMPBELL DETAIL 1).14.2 o T H E R E S A A V E N U E CONFORM -62 MAXI CONCRETE 61 GLASS 2 AGGREGATE aAEF 'P` DOWEL T CENTER LINE SECTION A�A 1. WHEN ME DFINEWAy IS NOT POUREO AT ME SAME TIME AS ME CURB AND GUMEF1, 11-OF No.<REBAR AT 4' INTERVALS SHALL BE INSTALLED AS SHDWIN(RECkRS TO BE BENT DOWN AND COVERED UNTIL USED). 2. SCORE MARKS SMALL NOT EMCEED"-0'D.C.,AND USE mEC—CAI-SEPARATORAT EVER(OTHER SCORE RARK. D. DR]"Em APPROACHES(EXCEPT SINGLE I'MILY)SHALL HAVE A 6-X6 X10/10 WELDED"RE FABRIC 3-ABOVE Bono.of CONCRETE. 4. BOWEL AU.HV4 CONCRETE IMPRO�I,ENTS To EXISTING CONCRETE TmP�ENTS. 5, AT EL S WHERE NEW SIOEWAI.I<ENDS AND NESTS AN EXISTING SDEWAI.JK.M NEW S'�AU(SHALL muig P)LAN TR-IRON TO WIEET ME DDSTNG SIDEWALK AS DEITER-U)BY THE P CWEN=EER. A.P.N.0 40r-19-006 LOT AREA-78G 1.9G' crry 0"CAMPBELL SCALE: JZXS DEPARTMENT Residential N.T.S._ a—BL- -ATE .2m Driveway Detail DETAIL (Detached Sidewalk ) NO. a PUBLIC UB..7 wo,��mr D-14.2 I tYl t 5 ' �RQ �� e�N rER UNE � RE-rURN 7- E EWAYA E S � pr 1L 14. 2 E N U NINON ,T of •°�. i4ag P 1� . �ra w �a 105.00' N 00^1 /' YY i # \ I in, Qru } } f j ! # �ItIf I \ tj t t _ _ . - .� .. ., a ,. 1. r -- •, s .: S r. .>. r- 7. .n - - - _. > . _. >. s - t':�:_^ r .I F :. .=i> rt. : , s h• :i : t = :, ...� 4 mR t n ,. >. {• a .- r'the..•c .. _ t^ r ., , .>, n s.". "am<.aa ,... _. <. �e .t .:., .. .., reikt�ro � :,ar. i�a . t • • „ s i = .v a- - ... +,, , E . , N.t ..t e . r3 s � . a ,... .I�e e d �:rr ty E _ Ii,J= �ht r ,...t.t;.c a + .< n , J t, r >.. a ,. a. .,....., t=r=.sat. 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Any discrepancies shod be brought to the attention of the dedWw knmedlatety prior to the rx#namwornent or conthutance of at Pro&g Desie�r b6 Inc —arty work, be addressed to the oifixs Rertrade iha boation crxi phone mimbors b4cated in the tie biadc Arw use asdj or My sutunittol of any... and/ or my spocifibotlam Ad oarrtrto by eac#+ dWA of all drawingoond aN agec#icatiorsa and the aoceptoned of a Standard Design Agreement 17ti1CilC�it-1;--1 PROGRE5S PRINTS 12110/1 0 not for construction