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ENC2018-00196 i U [A ('kCHAR9 CITE' OF CAMPIBELL Public Works Department August 23, 2019 Goon Jong Chun 1246 Bracebridge Ct. Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2018-00196 1246 Bracebridge Ct. Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Mr. Chun: 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. If you have any questions, please call me at(408) 866-2165. Sincerely, Syed Wahidi Public Works Inspector 70 North First Street • Campbell, California 95008 TEL 408.866.2150 • FAX 408,376.0958 TDD 408.866.2790 Encroachment Permit Final Sign Off Encroachment Permit# 1�4c 201 R—Do G� Address: Date of Final Inspection and Acceptance: Inspected by: Cw OK to release deposits: 100% 75% Comments: pF C9'ltA UR'CHAO. CITY OF CAMPBELL Public Works Department August 20, 2018 Goon Jong Chun 1246 Bracebridge Ct._ Campbell, CA 95008 SUBJECT: PERMIT NO. ENC 2018-00196 1246 Bracebridge Court, Campbell, CA FINAL INSPECTION AND ACCEPTANCE Dear Mr. Chun 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 1, 2018. 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 Performance Deposit in the amount of$500.00 is enclosed. If you have any questions, please-call me at (408) 866-2165. Sincerely, tom_�..._._.... Syed Wahidi Public Works Inspector Cc: Inspector/Suspense Files Permit File ENC2018-00196 70 North First Street • Campbell, California 95008-1436 TEL 408.866.2150 FAX 408.376.0958 TDD 408.866.2790 . ............ ............................. ............... ......... .......... ................... ............... .. . --------- - ----- > VENDOR NO. 10015077 CHECK NO. 269365 I CITY OF CAMPBELL . 'D ;; ilccourit : Purchase Order 1... Invnlce Number ? Amount .... :. �.. 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":,.�-,�__,`r.-_-..:I-�"-,%.-.,.,.­.��'�"_.,_-­��.,.�"­,,",...�,.-_,­'­.;,'"!,­.V,,._.-�.`,,'',_f-'.r.I.�.'­�1,,_,-I,_'-'_ ,,�,;,':,..-r.,,,­:,,�,'��,--�_,_,-­,-�",`--"_;;-"�L Address,;Lme 1, ..1246 Bracebridge Ct ..­:_�..,',�,"f..t.,.,,,.'_��1,r.�`.1I..r!,:-.-.---,-_�.;-,',.,,'..,'-.�..,.��� .1b Lm.e:-2 F - -- , ,_ F �L,".%-,",.�� ��. :-,r-'�__,,.2��",;I�,-�%._.��,.,- a; ` City. Cam.Abell :State CA Zip 95008 .._VI,�.-,��*-.'.,-,, --,!.i,,,--,1`. `7 _ t ;m Descnptior ENC2018-00166 ".�"-"�.,��.-_"''­-:,,%.I�,-.�'--,,.­,'1­..�z�,..'",l_`...-.­-�.l:..-.�.I I­�,!'-- ''._,..,;�..,_'­-:-­.!;,��:_._'.._1-,,,-:_:- ,,�.,-f"_,_-.I..,'_":.,-,',-� :",L7,,�,,-_-�,.--",-,-:."-,,�. .._-- �!�.­_c�-1 .r: Account Number 101 2203 Amount $500 00 Account:Nurnber =101 2203 Amount Account'.Number 1'01540.7448 _ - Amount `` t (Finance Dept only) Interest Earned r (Finance Dept only) x- ''J H l t. W - , . Totei Payable '-_ (Enact Amount)= ,`. , _ - °l P:' pose'' FPS refund ' . 1 „ r 4 Permit# ENC2018 00196 s '' 3 Receipt# ,:_2 7/13/,2018 76197 `Date . Receipt# ` z Date :, `r i 8 7 i Title .'.-._l.�..".,'I.-"-:,..-"-.._�,4,I,�.,',_-",.1.ri...,-,,.-...--,.,_-.,..,"I:.,.,�7-._-.­.,,!,,.�--.-_'��,..-.-."I,.i-�"��.',,r,I%,t�_".,.-_'�,..r_,�-�,,"_-.-_,"',.'.�.,.,';.."_r,,.�­-"l._�,--Z-r,,--"-.,.';-�-,_�,.!!-�L p�"..,.,I1.�-,_--,r1.!-" Reque,"sted by ,_ 1 Date: 1 A _ S l::t _ ° _ t i I` y Y +i Approved by" t Title Sr Engineer Da#e f t: Finance Dept Only J Verified by_ .,l. Title Accounting Clerk ll Date; J w Approved by - tle Accountant Date: . .: . , ,.. . .. . ..,•.;, . :, .. Ti S'pec;i a I Instructions For :Hand li n Check ; _ _ Mau-AS is : nnau in Attacnea tnveiope mierim �neciic i^ i4 r ..Needed_.By t _, 7. .3. r t. Return To JoAnna Thomason Public Works �, ' (Nam`e) (Department) t ' ,; 1 • Other. Please return check to JoAnna , ` ,. _ _ _ - , j:, ' e� - _ '- r - , , j - r ., i t-s k ,i ,Print Form, CITY OF CAMPBELL R-1 ENCROACHMENT PERMIT Permit No. 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 7�12/IPi Campbell,CA 95008 � Application Expiration Ph.(408)866-2150 ISSUED: Z ��J/1'e Date I�)(p Fx.(408)376-0958 Permit Expiration Date: APN - 4C 7 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: C l- (1-71AMPP ELL I C'11 9fV4 B. Nature of Work: (r Lt r GCS=1itL� ©M vl!rf.e tJ 6t C[< CQLq%e3— k n etl5r> 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: ��1, 1 �' ) , ChL + _ ; Telephone:/i J/: Address: _...........13a �f'3�Cr`(cJL--C __ -`/.... ....Iz ill�G`� �v.Q- E-Mail Address: (`�i �-e, CC) J The Applicant hereby confirms tha his 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: 07 ao (Applicant/Permittee) (Si Da e 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 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 AMOUNT ECEIPT NO. SECURITY FOR FAITHFUL PERFORMANCE (100%Of Engr's Est.) $ CJo R-1 PERMIT FEE $ APPROVED FOR ISSUANCE: 71 3 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. 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 dany 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 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. / tO7La0/� Applicant Date 'U J:\FORMS\Templates\Encroachment Permits\R-1 Encroachment Permit STATIC form2.pdf Rev.02/14 CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR FINAL INSPECTION AND ACCEPTANCE LETTER Encroachment Permit#: ENC 2018-00196 Name: Goon Jong Chun Property Address: 1246 Bracebridge Ct. Date of Final Inspection: On File: Bonds CD; ' Cash Faithful Performa e: $ 500.00 Labor and Materi 1: $`---- --- Construction Cash�peposit to be released: $ Other overdue deposits to be released (Description): Processed by: / Adm nistra or Reviewed by: l 7�f Inspector Reviewed by: Land Development Engineer JA\JoAnnaT\Deposit refunds\CHECKLISTS\1 Checklist-Final Acceptance.doc(Rev. 10/I 1) Encroachment Permit Final Sign Off Encroachment Permit# 5,3 � Address: 2 y� Date of Final Inspection and Acceptance: Inspected by: OK to release deposits: 100% V 75% Comments: PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2017 `-0 LS - ce r4 TO: Finance PUBLIC WORKS FILE NO. L I PROPERTY ADDRESS E-f-CL CT Please collect&receipt for the followin monies" r s T t Ip1lELOP1il1E1�IT 4722 Encroachment Permit Application Fee Non=.Utili Encroachment Permit Major>_$10 ODO. . $425.00 Minor Encroachment Permit�io,000. $240.00 - - Initial Ft-1 Permit NtG f.. - Subse iaen#.R-1 Permits wlthin.Two Year PEriod 52,40.00. ------ In'sp,ectioh Fee Minimum:.Ghar a p6r Location $420.00 Street Tree Plaritin (Removal IV/C, 2203 '($.5.0.0 per Tree Planting.Deposit Required) $500.00/tree 2203, Plan Check Deposit:Z!16 of.Engineer's Estimate $500.00 min. utllity and R-1 Permits no deposit required .4722 Grading&:Drainage.Plan Review . Siri-le FamllV Ldt $295:00 . Site:-10000,s-f: $885AM Site?10:DOD s:f- <.0:5 Acre $.l 185:D0 Site..>_0.5 Acre $1 772:00 4722. NPDES.R.eytew C3 Re utrernents . .... .... ..—.1 .- . : ..- . . .$175:00. Fdr. ro ect9 not required to submit numeric sizin For.: ro ects re. lired.to.sUbmit numeric sizing Im erviou9 Area.I.0 uoa s .Ft to.1.Acre.. $74.0M. .. Im erurous Area 1 Acre or more $965 00 4722 For �ro ects.sent to.Consultant for review, Cansultant Cost+200° . 4722 _. Qditional#catment factlitres. $31'5 ea Plan Gheck&Ins eet on;Fee INon Utih 4722 En r .Est <.$250-0-D0. rneer`s Estimate 4722' Engr.Est.>$250 OOO.and<_$500.;D00 $35 000 DD+:-S°!°of Cj wineers Estirriate . 4722, En r- Est. >$500 OD0 . $551 u t3Q+.7°!°of.Eri sneers..Estimate - -er - - 4fl/�df.Engr: Est�.(�00 mini$10,ODO tVlaz . .. 2203. Em enc.Gash De osit 2203 .11 Faithful Performance.Security LEES). 1 oowo.`of iENGR EST . 100%of ENGR EST:". ..:. 2203, ... Labor and'Materials.Secudtv 4721 Storrft Drainage.Area Fee Per Acre,. R 1 $2'120 00 . (1'>rJwltt=Res$2,385 0�.)_ 4722 Parcel Ma (4 Lnts or Less $4 2DO OO t$.90/lot 4722 Final-Tract Map(5 or-More Lots) $5175 00 f$I24llot . 1 DD°J of City' M 220,3 Monumenta'tion Security o: s onumentation Estirna'te. 492D Parkland Dedlcafion Fee_(75°JD125%Due Upon Cer(:of�ccupanc 4722 Lot Line Jadiustrnent llncivdes r�iiid�a�e or comPl�aii�e�.. . $7O Op:.. .4722 Vacation of.Public.Streets&Easetberits $2 7D'p OD 722 $1,97fl1D0 Certificate of Compliance 4722 . Certificatebf Corret bon 4722 Document Recording Fees $15 0offirst page$3 ea Additionaf 472:2 Private.l.m;provement-in Public.ROV1/ 4722 Approved Plan Revision Fee $100lsheet 4722 Appeal Filing Fee.. $200.00 730:4924' Notice of Improvement Obligation Payrnent 4722 Assessment' egregation or Reapportionment First Split $940.00 Each Add-itional Lot $295.00 5l 17-4241 Postage ther(Please peci. ) :ngineers Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $ AME OF APPLICANT �! G AME OF PAYOR B PHONE 7 V DDRESS t C7 C. +, W Q r Y r FOR �9r=c.E1-VEDjB TYCLERK ONLY r - . . - .. ..Receipt# _.,•-��. �: �- - �-`�.���_��"�� � � t� � ti.. � t� L'-. StafeFarm State Farm General Insurance Company +� 90001d River Rd. ppL1NdM0Ef3; © . * F1834 Bakersfield,CA 93311-9501 HOMEOWNERS AVAILABLE COVERAGE NOTICE -:_;- H-02- 3315-FBOO H W F . ._ SEE RENEWAL CERTIFICATE CHUN, GOONJONG & HONG, SO YOUNG 1246 BRACEBRIDGE CT CAMPBELL CA 95008-6427 IT IS IMPORTANT THAT YOU OCCASIONALLY REVIEW THE COVERAGES AND LIMITS IN YOUR HOMEOWNERS POLICY TO BE CERTAIN YOUR NEEDS ARE BEING MET.THE FOLLOWING INFORMATION WILL ASSIST YOU IN THE REVIEW PROCESS. THE COVERAGE LIMITS FOR COVERAGE A-DWELLING,COVERAGE B-PERSONAL PROPERTY, COVERAGE L- PERSONAL LIABILITY,AND COVERAGE M-MEDICAL PAYMENTS TO OTHERS ARE LISTED ON THE ACCOMPANYING RENEWAL NOTICE. PLEASE REVIEW THESE LIMITS TO DETERMINE IF THEY ARE ADEQUATE IN THE EVENT OF A LOSS. a a_ THE FOLLOWING IS A PARTIAL LIST OF THE OPTIONAL COVERAGES YOU HAVE&QT ADDED TO YOUR POLICY. THEY MAY BE AVAILABLE TO YOU FOR AN ADDITIONAL PREMIUM. Back-Up of Sewer or Drain (for damage caused by water from outside the plumbing system which backs up through sewers or drains) Building Ordinance or Law(for higher limits) Business Property(for higher limits) o Business Pursuits Liability(for teachers,school administrators,sales persons,and clerical employees) Child Care Liability(for those providing child care in their home) Firearms(for broadened coverage and higher limits) Home Computers (for higher limits) Identity Restoration Incidental Business Liability(for those with an incidental office,studio,or school in the home) g Jewelry and Furs (for broadened coverage and higher limits) Loss Assessment(for neighborhoods with Homeowners Associations) Nurses'Professional Liability(for those in the nursing profession) **Optional Coverages continued on the reverse side** cy This notice contains only a general description of the coverages and is not a contract.All coverages are subject to 2 the provisions in the,policy itself.Should you have a need for any of these coverages or higher limits,contact your State 2? Farm Agent to discuss details,cost and eligibility. o IMPORTANT INFORMATION ABOUT DAMAGE CAUSED BY FLOODING This policy does not cover damage to your property caused by flooding.You may be eligible for such coverage through the National Flood Insurance Program ("NFIP"), if you live in a participating community. For more information,contact your State Farm®agent or visit floodsmart.gov. 17095 4011 1 Agent JOHN HONG 109 2N,DR,NP,12,Po Telephone (408)777-8700 REP Prepared MAR 06 2018 THE FOLLOWING IS A PARTIAL LIST OF THE OPTIONAL COVERAGES YOU HAVE NOT ADDED TO YOUR POLICY. THEY MAY BE AVAILABLE TO YOU FOR AN ADDITIONAL PREMIUM. Personal Injury(for your liability to others caused by certain acts of libel,slander, invasion of privacy,or false arrest) Silverware/Goldware(for broadened coverage and higher limits) Increased Personal Property(for higher limits above the standard policy limit,which is a percentage of your Coverage A-Dwelling amount) 315