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ENC2019-00304 Refundable Deposit Check Request To: Finance Director Check Payable To: Mark Lee Address-.Line 1: 1350 Westmont Ave. (0 1 I `. Line 2: City: Campbell State: CA Zip: 95008 Description; 1350 Westmont Ave/ . Account Number: 101.2203 Amount: $2,000.00 Account Number: 101.2203 'Amount: Account Number: 101.540.7448 Amount: (Finance Dept only)- Interest Earned (Finance Dept only) Total Payable: (Exact Amount) Purpose: FPS Refund Permit M ENC2018-00304 Receipt M 277631 Date: 10/11/2018 Receipt#: Date: Requested by: Title:. Inspector Date: Syed Wahidi, Iq V Approved by: % Title: Sr. Engineer Date:( JA Roger Storz y Finance Dept Only: Verified'by:. , Title: Accounting Clerk II Date: Approved by: Title: Accountant Date: ,Special Instructions For Handling 'heck, Mall AS IS: Mail in Attached Envelope: ' Interim C:heCK: Needed By: Return,To: JoAnne Thomason Public Works (Name) (Department) . Other: Please return check to JoAnne CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR FINAL INSPECTION AND ACCEPTANCE LETTER Encroachment Permit#: ENC2018-00304 Name: Mark Lee Property Address: 1350 Westmont Ave. Date of Final Inspection: 6/4/19 On File: Bonds CD Cash Faithful Performance: $ 2,000.00 Labor and Material: $ Construction Cash Deposit to be released: $ Other overdue deposits to be released (Description): Processed by: Admi istrator Reviewed by: f r Inspector b I Reviewed by: Land Development Engineer J:VoAnnaT\Deposit refunds\CHECKLISTSU Checklist-Final Acceptance.doc(Rev. 10/11) June 26, 2019 Mark Lee 1350 Westmont Ave. Campbell CA 95008 SUBJECT: PERMIT NO. ENC 2018-00304 1350 Westmont Ave., Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Mark: 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. Your Faithful Performance Security deposit in the amount of$2,000.00 is enclosed. Sincerely, Syed Wahidi Public works Inspector Cc: Permit #ENC 2018-00304 1 Encroachment Permit Final Sign Off Encroachment Permit# C-�3c ?-o 9-) - Gu 30� Address: Date of Final Inspection and Acceptance: Inspected by: OK to release deposits: 100% V . 75% Comments: ��'PrintEorsn , <TY�,GF`CAMP.6BLL :'R-'VENCP 0AC—KIV ENT?;P'ERMFT -Pe rmit:No. �_`00-soL L331 PT,.*r-,1P&IBB.RC?kA(,0.9K5 Nmra erng'rraeeree3 w:ar;kmXithin:the,pubi cxigbt-off way) XRef File 7U�lorthPirstStret I �n;000a00rilum*Valueofsork) APPli�cati�rnDate Cao9 pbelt CA 95.908 AppE.eation Expirati,bm )8)866.�15,0 ISSUED: �� IG Date Fu:{,408)37&0958 Perm it E.Wirfatign0a ,:. APN, � APPLICAMON-Appli cationis hereby-ma defor a iPdbFic`lfi7b&s)PerrWt-in a&o ance-With vCarhpbeJI'Municipll;Co doe;,Section 11:04. %pplication,expirkes irr6 months ifthe permit is not issueda A. Work Address: 11 1350 Westmont Ave Campbell,Ca 95008 B. Nature of Work; hift Driveway Cutout/Approach to Align with Garage C. Attach three(3)copies ofa drawing shov ing the lacatiorr,extentand dimensions.of the work.-fhe drawing shad show tt a retation�of the proposed work to existing improvements.When approved by the City Engineer,said drawing become apart of this permit. D. All avorkshall conform to the City of Campbell Standard SpecBfications 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 psavisiosis;rs3ay-restslt in job:shastdn:v i,ancifos frsrfeituse-csf F,aet333fu1 P'erforrnancesecu. n-ties: r NAME OF APPLICANT: Mark Lee Telephone: 10-985-5461 Address: F3�Westrnorrt Ave Campbell,Ca 95008 E-Mail Address: �arkhlee@gmaii.com .The Appticarrt rfnere6y,cdr�filrnsms Lfha�t[�9s w�rortir;is�beir7�g d`orae�y.�re.properly,o�uunesp�o!pticams:a!e�6e�irov�rn�resf�em�e: Thezl�pplicant-herebyagrees'by affiaiing fherrsic�naturs<to tiffs perrri(fita'.hn'I f Che Crty.ofiCampbeq,City-of Crarrob011,Redeuelapm-gntA�gency,' offi tiers,agents,and`em{�.Ic�yees free;safe arr�ci harniless�from;any cla,i rn�ore derr,�and fdr,d�rrrages,:res�rdtitlg,;frarrr th��warl rQ�aered Icy thi s percrnit;. Vie Applicant h,erebya:cfkruoWedaes that dkeyll r dta;n 'underrsttandbotf�thefz`ontam,d(backafrtrhiswirmii°aandrtrh�a�ttlaeywidkjln mrmrtheeisr- cantraut�or,(s)df tbheitrifo�rrnaition. �� �I , ica 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. TheContxactcxanust ktave`theis perzrriY antf a{ prayed p#airs andmustarra-go tameetwith-the PubhcWerks Inspecto.r..rat the- at leasttwo days beforestartiog,work: Notice,rmust.begivevttoFRublicWdrksratleast24;hours beforerestarting„any'work Per Section 4216 of the Government Codre this permit is r,Ot 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. SI?EOAL:PROVSIONS 1. ;P:riorto;arny�uork;?thteFpn®pertry owr�arsh�ill �neourtear�A reerr2errtyfa—r..?Perri{v�aG�e-lrrspriovemaentsiinit-heiPublictRidht=of-Way,Whichshall be :recorcie 3. STANDARD AMOUNT RECEIPT NO. SECURITY FOR FAITHFUL PERFORMANCE (100%Of Engr's Est.) R-1 PERMIT FEE S �' APPROVIFI?FOR1116S ANCL:. 0 ° for City Errgfneeer Date Permit Expires 6 Months after Date of Issuance. GENERAL PERMIT CONDITIONS 1. Payment of a securityto 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:rnaintena,nceper�od for.alt Work-,is.required Such,peri'od`wall beglb on elate ofacceptance.by the City, it is•the app6rcant's: responsiitiiidnty to nerve and repbce un%aeceptakike improwmenfts wit n the oine-year,main,temance period; 3' Perform ance' uret'y,willbe•initiatedby,the•writtenacceptance'cfthe'vvorlrby>therity., 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 :rnadeJ.n'wf t1ng to-the Fern-tittee. °6. )M&imtainsafepedest0am an,alkveIiGuiarcros`sink.s:ano.frtOe.acoess�to,,private;drivewayA,firehydraritts:and water vdiives. 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.requiredonthe job site. Failure to provide such signing-and.barricading.as.specified by.the.City Emgirneersiaais rukC ir3xheitpv's,providmg,such signipg and;:barrieades and.cfacging tfji~cosMtesthe Psrnituee. 10� The a:wa,supervi5Aryrespresentative!availablefgri contact onitheproje taCalltarnesrduring.t 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 willbe.ailow.ed near the edge of pavement,within the traveled way,or within the shoulderline, vaFtiich%x�noi ld create:a,hazarcl©us cGn?&iom=fio'the•'pdblic. 1.3, This pe-rm'rtshall not bQ construed:asautho"rriaation for•excavatron:arad goading on private propertyadJacent:tothennrork:or a'ny�other• work for which a separate permit maybe required,nor does it relieve the Permittee of any obligation to obtain any other permit required bylaw. 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. 1 y thePermi.ttee•orhis.designated�agent-or:contractor:as-specifiied+thereon;•: 15. Thisperrriitis•not.transferable: Worli..rnustbeperforroed U . 16. Prior approvaI ofinspector.ia required.for..arty;work:donesaftern arm.al working,hoursr:on weekends arhofidays 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 departu re-fro m,:the.plans.ano specifications,the.C4 shall.have-the.authority to. . nequire>pra_Rprove arry moi yfication or<departyre ndtospecif t'.e:rnenner;,in.whieh.tbesamfiisloib.etmade4or)Cl."wned,or !rnirimitair�ertl�fiacn�ities. -. 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 BEST MANAGEMENT PRACTICES established by the Santa Clara Valley Urban Runoff Pollution Prevention Program. Applicant shall be s nsible for ensuring that all those providing services under the applicant are aware of and understand all of the above conditions. leant Dater. J:\FORMS\Templates\Encroachment Permits\R-1 Encroachment Permit STATIC form2.pdf Rev.02/14 PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2017 TOt Finance, PUBLIC,WORKS FILE-NO: EtNC201(8x 0030WF AdDHdlr 58 135&MVestmo0A`u . Ptease,callect;&'reeei trforthe:followin monies ACCT. JNT LAND DEVELdiPM . 4722 Encroac ment'RermitApplZ tion Fee Non-Utifity Encroachment Pemiiifl Q 410,000 $425.00l Minor Encroachment Permit<ia,oaa, $2,40 00 ..Initial, -1 Permit: NIC'; Subsea nt-R-1,Permits�nrrthin.T vo Year�?.erK $240:t 3 s Jn,s ction,Fee Minim pmT'6h ..:$420s00 Stre.et7r.eee Plantin fflemoval 'N/.0 2203 $500 per Tree Planting Deposit Required) $500.00/tree 22031 Plan Check Deposit 2%of Engineers Estimate $500.00 min Utility and R-1 Permits no de osit required 4722 Grading &Drainage Plan Review Single Family Lot $295. 0 Site< 10,000 s.f. $885.00 Site•?f,O 0GO&f.<0.5 Acre. $1l 185,'0& I Site.>_0,.d Acre- 4722,N;PDiFS,`Revie+n C3,Fd.s: ui,emerrts,i For ro'ects:not required.to submit numericsizina $:T75: 0, For pro&ects 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 Plan Check&Ins ection,Fee„Non-Utilit 4722 Engjr.+Es't. <•$250Q00 141/o ofSn ireer's',Estimate k 4722 En r.Est.Z$250 000•�and<$500 D00 $3.5,0.00.0.0+:8°fo pf.En ineers Estimate A722. ,Engr..,Est >. 00,00D $5_jGG0Z0+7%,bfEa inae,rs::Estimate ;2.203 Emergency,Cash Deposit 4°la._of;r=n r_'Est": 5A0 min410 i100Max. 2203 Faithful Performance Security(FPS) 100%of ENGR. EST.* $2 000.00 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,Mw(4 Lots oa Less $4 200:00+.$00/la 4722 1,V EinaVTjract M,ap &or 4 toce Dots $5,N1'S 0> +S12413ot I 22031 MonumentatiQn,Securi 100%..ofiGi s Monumentation,Estimate. 4920>,-- Parkland Dedicatio-n,FL�e 75fal,26%Due UJ on et,.o,f'Occu panc 4122 Lot,L;rrQAd'ustmart $:1,990:00 4722 Vacation of Public Streets&Easements $2 700.00 4722 Certificate of Compliance $1 970.00 4722 Certificate of Correction $590.00 4722 Document Recording Fees $15.00/first paqe$3 ea.Additional 4722 Private Improvement in Public ROW $100.00 4722 Approved Plan Revision Fee $100/sheet 4.7.22 Appeal Filin Fee $20D.00 73D.4.924 Notice,,af Im ravementObligation Payment 4722 Assess- mentSpgregatian or"_p%rportiorrrmsnt „ Fiaskspli Ea&.kAdd'itfonal Lot;, $295:,00' 511.7424 Postage MISCE= D - Other Please Spec *Engineer's Estimate shall be pproved by the City'Ertgtneer-and shall iindLde all items dwark. TOTAL $2000.00 NAME OF-APPLI£A NAME OF PAYOR PHONE Cl i v -ot K' . ADDRESS zip 1' FOR RECE41 I3Y � Cfry CLERKr ONLY ate. ' Recea t ;' ��ly - �r 1 CITY OF CAMPBELL 10 N FIRST ST CAMPBELL,CA 95008 10/11/2018 10:11;22 CREDIT CARD VISA SALE Card# GI Y +it 'CAMPBELL X1aXXXXXX7(XX5431 REND BY; "CASHIER 810002277631 Chip Card; CHASE VISA A i A f rR e f"ARi. LE-- TC A ': AOOOOO00031010 +:�DAVS MATE: 10111118 TC; 0134 REBIJ:tr DATE: 1C,11 I1mE, 0C 110 TC; 0IABFF4E3BOE10CD IiESGRIPTIOr1 A S�3UNT SEQ#; 3 GUST IT:aE11C:�F�1 —Ov3G Batch#; 101 REF DEPOSIT — 131 'i:2 00,ri , 100 INVOICE 3 -------------- Approval Code; TOTAL DUE: $C1.CiC0 00 Entry Method; 01665I Chip Read TENDEREi{s Mode; Issuer CHANGE: a a O r CREDIT CARD. ai.i�Cri�ot3} SALE AMOUNT REF NUM;- $�000,00 CUSTOMER COPY 8• 5101, `O• P� `0•• PARKSTRIP W MECHANICAL R SEPARATOR CONSTRUCTION JOINT SIDEWALK WEAKENED SEE NOTE 5 0•• PLANE JOINT OR CUT JOINT p'f 1/8' WIDE, W 2" DEEP WEAKENED F.JOINT p OR CUT T 1/8" WIDE 2" D O N .� .� .� •y�G � 3/4" S_1" PER FOOT 5/8„ 1"R i —1/2„ R 4'-0" 4'_0" 2,_0' 6„ +10% MAX CONFORM SLOPE = 2.0% —6%'MAX '• '.::.. ••.:'.-: .:o-..• :d:: a:d::- •a.6.,. 6" CLASS A CONCRETE, TYP. :� : :; .,• : ; 6" 6" CLASS 2 AGGREGATE BASE, TYP. Q •'•: a • a .NOTES SECTION A—A DOWEL 1. WHEN THE DRIVEWAY IS NOT POURED AT THE SAME TIME AS THE CURB AND GUTTER, 12" OF NO. 4 REBAR AT 4' INTERVALS SHALL BE INSTALLED AS SHOWN (REBARS TO BE BENT DOWN AND COVERED UNTIL USED). - 2. SCORE MARKS SHALL NOT EXCEED 4'-0" O.C., AND USE MECHANICAL SEPARATOR AT EVERY OTHER SCORE MARK. 3. DRIVEWAY APPROACHES (EXCEPT SINGLE FAMILY) SHALL HAVE A 6"X6"X10/10 WELDED WIRE FABRIC 3" ABOVE BOTTOM OF CONCRETE. 4. DOWEL ALL NEW CONCRETE IMPROVEMENTS TO EXISTING CONCRETE IMPROVEMENTS. 5. AT LOCATIONS WHERE NEW SIDEWALK ENDS AND MEETS AN EXISTING SIDEWALK, THE NEW SIDEWALK SHALL TRANSITION TO MEET THE EXISTING SIDEWALK AS DETERMINED BY THE CITY ENGINEER. uF CA YA� CITY OF CAMPBELL REV. DATE BY SCALE: �-t PUBLIC WORKS DEPARTMENT 1 02/17 HE Residential N.T.S. DRAWN BY: EA DATE 10 04 DETAIL :;Qp9 / Driveway Detail • °'��' CHECKED .BY: DATE (Detached Sidewalk ) NO. APPROVED BY: 0R0sAtm CrFY ENGINEER J:/11)rawings/Std_Details/D14.1 D— 14.1 ` PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2017 Rot fio� 1?I0 e1 ._ : i E-I EIRC201( Please=calfact?&mcesat`�for.•ttiefc�llovrina manias; " �4�Z2 :Encraaohrnent ;ermitAppteat�on F Nan--wilrt Encroachment Penud g Ql'QIi It<hnbr:.Encrci -hrh6h :P0xttt ,Q a $ 40 OQ- hiW R1;. P xri?it P :irds eti�n F ;ll8lmiir Gl;ir Lt+aari:. 12+3D7 . "StibP-Tree Plarttm jeinD tat N1,Q 2203 $5.00 per Tree Planting Deposit Required) $500.00/tree 22031 Plan Check De dsit 2%of Engineers Estimate. $500.00 min Utility and R-.1 Permits no deposit required 4722 Grading&Drainage Plan Review Single Family Lot $295.00 Site<10 000 s.f. $885.00 Pn €2i3aie is n'at reams u rdd fo,submif nume flft•swnea $17 •011 For projects required to subrriit numeric sizing Impervious Area 10,000 Sq_ Ft to 1 Acre $740.00 Impervious Area 1 Acre or more $965.00 4722 For proiects sent to Consultant for review Consultant Cost+20% 4722 Additional treatment facilities. $3.15 ea Plan Check&1ns ectioa:Fee. �lnn=UtilJf 47221 ' 4.722 r�gr Est:?u5250,7Q0 ar t� 4,p13 . 8 ,00f?IJO+8° <iif Engineers firm.t.e... q�722, ,Engr_.�E'k: _451a GOD .rnom»_r' cFt rlan' cif E n '�_ ..'r_' } f,$C, 2203 'Faithful P&Iorrhaned Security(FPS) 100%of ENGR. ESI.* $2,000.00 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,. 4 Lots car Less 2Q_00.+,$90/bt. 4122 :": FrneG':?t Gt 5: .d L+ $6 y1'S 00, L'2 4/teaf . 2102, .. Irutrrtabe :Sectrri. - i00Wfo ciftsiM r�errr€nat ?rt Esti 40243 _._.::Farislaad 13erfia o F E? %1 �i�l ie Uumbert 66 a} a?�2 .Lcf E r:7r ada:.�st°rant •ce<.»�ra�:oF:.ar,a+,�:�a9 '.'. $=t��Q:i�i7 '4722 Vacation of Public Streets&Easements $2 700.00 4722 Certificate of Compliance $1 970.00 4722 Certificate of Correction $590.00 4722 Document Recording Fees $15.00/first page$3 ea.Additional. 4722 Private improvement in Public ROW $100.00 4722, AxwrovedPiari Revision Fee $100/sheet 422'. . 11 at;t Ali Pae. . . . :$21JD:DD 73W*24: Rlo#ice;af Jm rc rnent0blrgaf1on Pavn Iwe,*A&tro t Lof $2€i5 flQ' 511 7424 .;.._fFostag I. 0 r a?1ease --- -- t `'"=�::�er`s 1a�~ �"� 1�- . - a�- . . . : •q€�.®:ss�: �?.: :€It1t3 a'Q ' HAM OF APPEFrAW PHOW FOR CL Flace CITY OF CAMPBELL 70.N FIRST ST CAMpBEL1,CA 45008 1DJ1fJ2018 10;17:22 CREDIT CARD VISA SALE Card# C. TY O LEMP ELL Chip Card: XXXXl0 AXX5437 RECUR BY; CAOi'IER 0:0Du2 77631 CHASE VISA PAYOR s NARY LEE AID; A0000000031010 Tip f'8 0€TE: 1 :.rlii8 ATC: 0134 REGISTER DATE: 10 11/18 TIME. 00:00 TC: 07ABFF4E3B0Et0CD OEBCRIPTIOi4 Ag00�"T Batch#' 3 CUST Ilta£s L2Qf0-003 i�i #: 701 - INVOICE ttE; i?Ci' �J'aT $i�aC Aproval Code: 3 Ot665I TOTAL 10E: $2.900.00 fty Pei : Chi Read T@4DERED: $2,000.00 �. CHANGE, e00 REF W1 SALE AMOUNT : CUSTOMER COPY TOO V s 694 +s1 Q N may bAW bAW n C� X y i is 0 e,. CD W �i mm ` �m C) CD No + r • r � > i` - ` r r , no Iml 1 1/3 CD [/n SOO CPR Vj r"00 M (10'00� Aomfto, co If M �-j b. ------------------ U Q CD 0) , • '�* t �. Q 0 < C/) X X SF-- ��- 16 ' N � � n 4 � 5 { P *,, V M O O a. b 2 o � � Z d n In N Za- 2 112 OF �p2 C? 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