ENC2018-00288 of C4
°kc.•ynao
CRTY OF CAMPBELL
Public Works Department
November 26, 2019
Ms. Ryan Valtscheff
35 S. Leigh Ave.
Campbell, CA 95008
SUBJECT: PERMIT NO. ENC 2018-00288
35 S. Leigh Ave., Campbell, CA 95008
FINAL INSPECTION AND ACCEPTANCE
Dear Ryan:
The City of Campbell has made the final one year maintenance 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.
If you have any questions, please call me at (408) 866-2165.
Sincerely,
P.,
NZ
Syed Wahidi
Public Works Inspector
Cc: Permit File ENC2018-00288
70 North First Street • Campbell, California 95008 • TEL 408.866.2150 • FAX 408.376.0958 • TDD 408.866.2790
a
1 1,
Encroachment Permit Final Sign Off
Encroachment Permit# ;�L 2`'( ''0c,2e)&
Address: S S Lti Gi E /AdL:.
Date of Final Inspection and Acceptance: 1/22 I 1 c
Inspected by:
OK to release deposits: 100% 75%
Comments:
L ®F cAM
�-4,
U aw r
CITY OF CAMPBELL
Public Works Department
November 8, 2018
Ms. Ryan Valtscheff
35 S. Leigh Ave.
Campbell, CA 95008
SUBJECT: PERMIT NO. ENC 2018-00288
35 S. Leigh Ave., Campbell, CA 95008
FINAL INSPECTION AND ACCEPTANCE
Dear Ryan:
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.
c,
The one year maintenance period stated in the permit begins as of November 8, 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.
If you have any questions, please call me at (408) 866-2165.
Sincerely,
Syed Wahidi
Public Works Inspector
Cc: Permit File ENC2018-00288
70 North First Street Campbell, California 95008-1436 TEL 408.866.2150 FAX 408.376.0958 TDD 408.866.2790
Evidence of Insurance for Mortgagee/Other
F
Interests
This form is not the contract of insurance.It is a memorandum of coverage limited to mortgagee/other interests,provided at their
request and applicable to the dwelling orb uilding at the location below.The provisions of the policy will prevail in all respects.This
certificate of insurance does not affirmatively or negatively amend,extend,or alter the coverage afforded by the insurance policy.
Should the insurance policy be cancelled by the company before the expiration date thereof,notice will beg iven in accordance with the
policy provisions.
Policy Number: 96797-87-57 Underwritten By: Fire Insurance Exchange
Policy Type: Next Generation Homeowners 6301 Owensmouth Ave.
Policystatus: In Force Woodland Hills,CA91367
Term Effective: 8/17/2018 12:01 AM Your Farmers Michael Guarino
Renewal Date: 8/17/2019 12:01 AM Agent: 1570 the Alameda#226
Insured: Ryan Valtscheff San Jose,CA 95126
ASingle Man (408)248-7858
863374142 mguarino@farmersagent.com
35 S Leigh Ave
Campbell,CA95008-3321
Your Insured Property
PropertyAdoress
35 S Leigh Ave,Campbell,CA 95008-3321
Coverages
Coverage Limit Coverage Limit
Coverage A-Dwelling $522,000 Coverage B-Separate Structures $258,200
Extended Replacement Cost 50%($261,000) ---ove.........D...Lo...of....--•-•-------------------••-------------------------------- -------
Extended D-Loss of Use $208,800
(In Addition to Coverage A Limit) Additional Living Expense Term 24 Months
------------------•---....................................................------------------------
...--•--.. •....... ...... .......................
Coverage C-Personal Property $391,500 Wild Fire Smoke...,..Soot. .,..Char;.. Ash.or..Odor. . $5,000
--••---------•---••............................................................................•--------••---•.
Identity Fraud Coverage $30,000 Damage
......................••---------------------------••---......................................................... ..................................................----•-------------..................------.------------------.
Coverage E-Personal Liability 1 $1,000,000 Coverage F-Medical Payments To Others $5,000
-•.............................................................................................................. ------------------.................................----------------------------------------
Association Loss Assessment Not Covered Building Ordinance or Law
(10%of Coverage A or B)
Coverage A $52,200
Coverage B $25,820
Deductible
Deductible
Applicable to each covered loss $2,500
farmers.com
25-8975 9-13 Page 1 of
Evidence of Insurance for Mortgagee/Other Interests(continued)
Mortgagees and Other Interests
1st Mortgagee Loan Number Effective Date 2nd Mortgagee Loan Number Effective Date
Wells Fargo Bank NA#936 0474582046 8/26/2016 First Bank ISAOA 419143274244 8/17/2016
ISAOA Collateral Management
PO Box 100515 M1-199-060
Florence,SC 29502-0515 PO Box 790269
Saint Louis,MO 63179-0269
Premium Details
Annual Premium: $2,635.81
Fees: $0.00
Total Premium: $2,635.81
Balance Due:
Who Pays: Insured
Mortgagee Deductible Clause
The following provision applies only if a mortgagee is named in the declarations or renewal notice,and the mortgagee has foreclosed on
the property prior to the date of loss:the applicable deductible for any interest of any mortgagee will be the smallest of the following
amounts:
1) The deductible stated in the declarations or renewal notice;or
2) $1,000.
This provision does not apply to loss or damage from earthquake,wind or windstorm including hurricane,tropical storm or cyclone,
where a separate,increased deductible applies to loss or damage caused by any of these perils.
V 9/25/2018
Authorized Representative Date
438BFUNS Endorsement Included
farmers.com
25-8975 9-13
Page 2 of
Evidence of Insurance for Mortgagee/Other Interests(continued)
Lender's Loss Payable Endorsement(Form 438BFU NS-Rev. May 1, 1942)
1. Loss or damage,if any,under this policy,shall be paid to the Payee named in the Declarations of this policy,its successors and
assigns,hereinafter referred to as'the Lender',in whatever form or capacity its interests may appear and whether said interest be
vested in said Lender in its individual or in its disclosed or undisclosed fiduciary or representative capacity,or otherwise,or vested in
a nominee or trustee of said Lender.
2. The insurance under this policy,or any rider or endorsement attached thereto,as to the interest only of the Lender,its successors
and assigns,shall not be invalidated nor suspended:(a)by any error,omission,or change respecting the ownership,description,
possession,or location of the subject of the insurance or the interest therein,or the title thereto;(b)by the commencement of
foreclosure proceedings or the giving of notice of sale of any of the property covered by this policy by virtue of any mortgage or trust
deed;(c)by any breach of warranty,act,omission,neglect,or non-compliance with any of the provisions of this policy,including
any and all riders now or hereafter attached thereto,by the named insured,the borrower,mortgagor,trustor,vendee,owner,
tenant,warehouseman,custodian,occupant,or by the agent of either or any of them or by the happening of any event permitted
by them or either of them,or their agents,or which they failed to prevent,whether occurring before or after the attachment of this
endorsement,or whether before or after a loss,which under the provisions of this policy of insurance or of any rider or endorsement
attached thereto would invalidate or suspend the insurance as to the named insured,excluding herefrom,however,any acts or
omissions of the Lender while exercising active control and management of the property.
3. In the event of failure of the insured to pay any premium or additional premium which shall be or become due under the terms of
this policy or on account of any change in occupancy or increase in hazard not permitted by this policy,this Company agrees to give
written notice to the Lender of such non-payment of premium after sixty(60)days from and within one hundred and twenty(120)
days after due date ofsuch premium and it is a condition of the continuance of the rights ofthe,Lender hereunder that the Lender
when so notified in writing by this Company of the failure of the insured to pay such premium shall pay or cause to be paid the
premium due within ten(10)days following receipt of the Company's demand in writing therefor.If the Lender shall decline to pay
said premium or additional premium,the rights of the Lender under this Lender's Loss Payable Endorsement shall not be terminated
before ten(10)days after receipt of said written notice by the Lender.
4. Whenever this Company shall pay to the Lender any sum for loss or damage under this policy and shall claim that as to the insured
no liability therefor exists,this Company,at its option,may pay to the Lenderthe whole principal sum and interest and other
indebtedness due or to become due from the insured,whether secured or unsecured,(with refund of all interest not accrued),and
this Company,to the extent of such payment,shall thereupon receive a full assignment and transfer,without recourse,of the debt
and all rights and securities held as collateral thereto.
5. If there be any other insurance upon the within described property,this Company shall be liable under this policy as to the Lender for
the proportion of such loss or damage that the sum hereby insured bears to the entire insurance of similar character on said property
under policies held by,payable to and expressly consented to by the Lender.Any Contribution Clause included in any Fallen Building
Clause Waiver or any Extended Coverage Endorsement attached to this contract of insurance is hereby nullified,and also any
Contribution Clause in any other endorsement or rider attached to this contract of insurance is hereby nullified except Contribution
Clauses for the compliance with which the insured has received reduction in the rate charged or has received extension of the
coverage to include hazards other than fire and compliance with such Contribution Clause is made a part of the consideration for
insuring such other hazards.The Lender upon the payment to it of the full amount of its claim,will subrogate this Company(pro rata
with all other insurers contributing to said payment)to all of the Lender's rights of contribution under said other insurance.
6. This Company reserves the right to cancel this policy at any time,as provided by its terms,but in such case this policy shall continue
in force for the benefit of the Lender for ten(10)days after written notice of such cancellation is received by the Lender and shall then
cease.'
7. This policy shall remain in full force and effect as to the interest of the Lender for a period often(10)days after its expiration unless an
acceptable policy in renewal thereof with loss thereunder payable to the Lender in accordance with the terms of this Lender's Loss
Payable Endorsement,shall have been issued by some insurance company and accepted by the Lender.
farmers.com
25-8975 9-13
Page 3 of 4
Evidence of Insurance for Mortgagee/Other Interests(continued)
8. Should legal title to and beneficial ownership of any of the property covered under this policy become vested in the Lender or its
agents,insurance under this policy shall continue for the term thereof forth e benefit of the Lender but,in such event,any privileges
granted by this Lender's Loss Payable Endorsement which are not also granted the insured under the terms and conditions of this
policy and/or under other riders or endorsements attached thereto shall not apply to the insurance hereunder as respects such
property.
9. All notices herein provided to be given by the Company to the Lender in connection with this policy and this Lender's Loss Payable
Endorsement shall be mailed to or delivered to the Lender at its office or branch described in the Declarations of the policy.
Approved:
Board of Fire Underwriters of the Pacific,
California Bankers'Association,
Committee on Insurance.
farmers.com
25-8975 9-13
Page 4 of
Department of Tax and Collections Online Bill Payment Page 1 of 1
From: scctax<scctax@fin.sccgov.org>
To: Ryanvaltscheff<Ryanvaltscheff@aol.com>
Subject: Department of Tax and Collections Online Bill Payment
Date: Tue, Mar 27, 2018 8:18 pm
Thank you for using the Santa Clara County Department of Tax and Collections electronic
payment system.
Payment Details
Transaction Number: 3725474676
Transaction Date: 3/27/2018 8:18 PM
Name: Ryan valtscheff
Property Address: 35 LEIGH AV CAMPBELL
Total Taxes: $2,990.52
Transaction Fee: $67.29
Total Charge: $3,057.81
Bill Type Tax Year Parcel/Assessment Installment My Payment Amount
Number
Annual Tax Bill 2017/2018 288-18-004-00 2 $2,990.52
E-Check payments are processed identically to paper checks. They are not cleared in real
time but are passed on to your bank for payment. There is the possibility that a check will
NOT clear, usually caused by insufficient funds in the account or incorrect account
information entered by you in the online payment process. A confirmation number for your
transaction is only confirming the attempt to make payment, but is not a guarantee that the
check will be paid by the bank. A returned item from your bank can have the following
consequences for you as the taxpayer:
• You become liable for a Returned Check Charge of$85.00.
• If the deadline for paying your taxes passes while the returned check is being
processed, you are also liable for a late payment penalty, currently 10 percent of the
amount due, plus other related charges.
If you have questions about this transaction, contact Department of Tax and Collections at
scctax@fin.sccgov.org
https:Hmail.aol.com/webmail-std/en-us/PrintMessage 9/25/2018
of C4N
U t .� r•
A G�
Ok CH A1t9•
CITY OF CAsMPBELL
Public Works Department
November 8, 2018
Ms. Ryan Valtscheff
35 S. Leigh Ave.
Campbell, CA 95008
SUBJECT: PERMIT NO. ENC 2018-00288
35 S. Leigh Ave., Campbell, CA 95008
FINAL INSPECTION AND ACCEPTANCE
Dear Ryan:
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 November 8, 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.
If you have any questions, please call me at(408) 866-2165.
Sincerely,
Syed Wahidi
Public Works Inspector
Cc: Permit File ENC2018-00288
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
Encroachment Permit# 2-C,
Address:_ �> S L91 14 ./\,jL
Date of Final Inspection and Acceptance: / /IS
Inspected by:
OK to release deposits: 100% V 75%
Comments:
Print Form
CITY OF CAMPBELL R-1 ENCROACHMENT PERMIT Permit No. Cs1 CJ:
DEPT.OF PUBLIC WORKS (Non-engineered work within the public right-of-way) X-Ref File
70 North First Street ($10,000.0 maxi um value of work) Application Date 2S
Campbell,CA 95008 7(� Application Expiration
f5
Ph.(408)866-2150 ISSUED: I I Date
Fx.(408)376-0958 Permit Expiration Date: 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: 35 South Leigh Ave Campbell CA 95008
B. Nature of Work: New Driveway Entrance
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: Ryan Valtscheff Telephone: 08-568-0668
Address: 35 South Leigh Ave.Campbell CA 95008
E-Mail Address: RyanValtscheff@aol.com
The Applicant hereby confirms that this work is being done by the property owner/applicant at their own residence.
i
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 a Howled es at they have read and understand both the front and back of this permit,and that they will inform their
contractor(s)of the inf ation. l
ACCEPTED:
U,1Aica /Per e) (Sign) Date
NOTES: All work shall coith 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 AMOUN RECEIPT NO.
SECURITY FOR FAITHFUL PERFORMANCE 100%Of Engr's Est.) $ Ar
R-1 PERMIT FEE �+ $ ;
APPROVED FOR ISSUANCE: / %5 Cb
for City Engineer Dat
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 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 BEST MANAGEMENT PRACTICES established by
the Santa Clara Valley Urban Runoff Pollution Prevention Program.
Applican s all be respon 'ble for ensuring th II those providing services under the applicant are aware of and understand all of the above
con
ditio
Applicant Date
J-.\FORMS\T - 'i� VV
mplates\ ncroachment Perm its\R-1 Encroachm t Permit STATIC form2.pdf
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-NOTES SECTION A—A
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.
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