ENC2018-00188 CITY OF CAMP EL
Public Works Depurtirent
May 7, 2019
Fred Lee
2236 Century Park.Dr.
Campbell, CA 95008
SUBJECT: PERMIT NO. ENC 2018-00188
2236 Century Park, Campbell, CA
FINAL INSPECTION AND ACCEPTANCE
Dear Fred:
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 Refund is enclosed.
Sincerely,
Syed Wahidi
Public works Inspector
70 Nt3t-kh RYSf{3(i-e&- Qtn1j)bC11, C:Aif0ri)i&!)5008 TEL 408,866.27 i0 rAX 40,8 370.0 i5 8 1"DD 4(j'i'.-'ti(5,279(}
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CITY OF CAMPBELL VENDOR NO. 10015482 CHECK NO. 273142
Aceornt Z'rzrchase Oiler trrvoicr Nr tuber Anrounf Descry troni: ..
101 2203 CR042319 500.00 FPS REFUND
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10015482 FRED LEE I
+ p Otp> CITY OF CAMPBELL CHECK DATE CHECK NO.
WELLS FARGO BANK, N.A. 11-24
36 47..0 MONMOMERY STREL�f 1210 05/06/19 273142
NORTH FIRST STREET
$AN,FRANCZSCO, CA 94104
Illll�� CAMPBELL CALIFORNIA 85008
d o AMOUNT *******500. 00* r
3 DRr�rp�t0 V VOID AFTER 90 DAYS 4I
s PAY THE SUM OF FIVE HUNDRED DOLLARS & ZERO CENTS m
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TO THE FRED LEE
ORDER2236 CENTRAL PARK DR.
Oe CAMPBELL CA 95008 t !!
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CITY OF CAMPBELL
70 NORTH FIRST STREET
CAMPBELL, CALIFORNIA 95008
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FRED LEE
2236 CENTRAL PARK DR.
CAMPBELL CA 95008
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Refundable Deposit Check Request
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To: finance Director -
1 Check Payable To: Fred Lee
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Address- Line 1: 2236 Central Park Dr. j
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iLine 2: i
I City: Campbell State: CA_ Zip: 95008
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Description: 2236 Central Park Dr.
Account Number: 101.2203 Amount: $500.00
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! Account Number: 101.2203 Amount:
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Account Number: 101.640.7448 Amount:
(Finance Dept only) Interest Earned (Finance Dept only)
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Total Payable: (Exact Amount) l{
Purpose: FPS Refund
I Permit#: ENC2018-00188
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Receipt#:` 276130 Date: 7/10/2018
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{ Receipt#: Date:
Requested by: _ Title: Inspector Date: �j23
Syed Wahidi
Approved by: Title: - Sr. Engineer Date:
Roger Storz I
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Finance Dept Only:
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Verified by: Title: Accounting Clerk II Date:
Approved by: Title: Accountant Date:
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Special Instructions For Handling Check
mall AS IS: Mail in Attached Envelope: Interim UneCK:
IRUN—
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y Neede
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eturn To:. JoAnna Thomason Public Works
(Name) (Department)
i Other: Please return check to JoAnna
v :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 I I
Campbell,CA 95008 / Application Expiration ( l
Ph.(408)866-2150 ISSUED: 7l (a I Date f
Fx.(408)376-0958 Permit Expiration Date: o APN 1 d
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 a3 66—NTIAV_ PA--Y— bi2ioe-
B. Nature of Work T�C� P�'A1177 N� ��� 'Z�( ii V� ��/kU'-CU(�� 121^ t�APLG_ "
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: F-4"' D Lt: Telephoner 71 L ®y?_a
Address: 2�3(p C�7� L p/j�I{G j2/l✓G
E-Mail Address: 1f1?L1=_bYU:ie(g AMA�� C®�•y
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 ve reaydu erstand both the front and back of this permit,and that they will inform their
contractor(s)of the information.
ACCEPTED: � f� �l�
(Applic t/Permittee) ign) 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 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.
s
STANDARD AMOUNT RECEIPT NO.
SECURITY FOR FAITHFUL PERFORMANCE (100%Of Engr's Est.) $ 5on
R-1 PERMIT FEE $
APPROVED FOR ISSUANCE: - 7 fa t
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_accep tan ce 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 damagedremoved 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 maybe 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.
1.8. .. 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 respon le for ensur g that all those providing services under the applicant are aware of and understand all of the above
conditions. /
'7 (o 20/8'
Applicant Date
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 2018-00188
Name: Fred Lee
Property Address: 2236 Central Park Dr.
Date of Final Inspection:
On File: Bonds CD Cash
Faithful Performanc C
500.00
Labor and Material: $
Construction Cash Deposit to be released: $
Other overdue deposits to be released (Description):
Processed by: LA \ I
Adm nist for I
Reviewed by: 23/1 5
Inspector 1
Reviewed by: Z�
Land Development Engineer
JAJoAnnaT\Deposit refundACHECKLISTS\Central Park 2236.doe(Rev. 10/11)
Encroachment Permit Final Sign Off
Encroachment Permit#
Address: �23� G��712aYi- Ili k' 1�iR
Date of Final Inspection and Acceptance: If/ I11.9
Inspected by:
OK to release deposits: 100% 75%
Comments:
Homeowners Policy Declarations ,s
AAA Insurance
underwritten by CSAA Insurance Exchange
Winsmance PO Box 22221 Oakland, CA 94623-2221 (800) 922-8228
Revised Renewal
For questions or changes call: "(800) 922-8228
Named Insured and Mailing Address Policy Number' CAH3-105003066
""I"III'IIIII'IIII"II"'I'IIIIIIIIIIIIIII'I'llll'll"IIII'lII Membership Number: 429005-09653368-17
NGA T VOx ''; 12:01 A.M. Standard Time,
" FREDERICK Y LEE but not prior to the time
From: applied for or, if this is a
2236 CENTRAL PARK DR You► 09/13/2017 ; replacement Declarations,
CAMPBELL,"CA 95008-4929
not prior to the time coverage
Pere° 1 six' change was re uested.
t To: ! 12:01 A.M. Standard Time.
Agency Information ._ 09/13/2018
HOUSE AGENT LOS GATOS Notice Date: 08/24/2017
15450 LOS GATOS BLVD Home Phone#: (408) 712-7602
STE 300 Business Phone#:
LOS GATOS, CA 95032
Named Insured(s)
Insured Location NGA T VO
2236 CENTRAL PARK DR FREDERICK Y LEE
CAMPBELL, CA 95008
Description of Property Premium to be paid by NGA VO
` 1'R Bu�1t Constru tom no e,'r �� Oocupacy #ofantlyUnis y
1963 Frame owner Occupied 1-Single Family "
Coverages and Limits of Insurance: Insurance is provided for the following coverages only when a limit is shown. The limit of
liability for this structure (Coverage A—Dwelling) is based on an estimate of the cost. to rebuild your home, including an
approximate cost for labor and materials in your area, and specific Information that you have provided about your home.
t
} h 3 t "
Dwelling Other Personal Loss of Use Personal Liability Medical Payments to Others
Structures Property Each Occurrence Each Person Each Accident
$362,400 $36,240 $271,900 $145,200 " $1,000,000 $1,000 $25,000
Section I Only:Your Section l Coverage Limits have been changed to reflect changes in Construction costs and other matters
affecting replacement costs.,
$1,000 (In case of loss under Section I, we cover only that part of the loss over the deductible)
This policy does not provide Earthquake Insurance.
This policy does not provide Flood Insurance.
Forms and Endorsements
s
Form Numbs Farms antl indorsements Made Partf thrs Policy s f Premium
61 2000 CA 10012010 (CA 7/2015) Homeowners Policy Special Form Included
438BFUNS Lenders Loss Payable Included
HO-28 01 05 - Limited Home Replacement Cost Included
HO-60 10 86 $1,000 Deductible $281.00
HO-90 10 86 Workers' Compensation and Employers' Liability Insurance Included
HO-29.08 05 Replacement Value- Personal Property $189.00
Basic Policy Premium: $982.00
Endorsements Premium: -$88.00
Seismic Safety Fee: $0.15
Total Policy Premium: $894.15
1075 09012015 Page 1 of 2
1'-6" MIN.
(2) DEEP WATERING TUBES AT FERTILIZER
EDGE OF ROOTBALL . !
z ® I 1 GAL. 2 TABLETS
(2) 4-PLY, 1"x 2'0" MIN. 2 OR 5 GAL. 3 TABLETS s
z RTJBBER TIES INSTALLED WITH
TWIST & NAILED TO STAKES 15 GAL. 6 TABLETS
a 2 MIN. (TYP.) 24" BOX 10 TABLETS f
PINE ,STAKE (2 TYP.)
TREE 2" GALV, ROOFING
1"x4" RWD. NAIL (1 EACH END)
1
S
2 RUBBER TIES PLACED 6" MAX.
BELOW MAIN FORK OR BRANCH
i
(2) 2" DIA. LODGE POLE PINE STAKES
w^ TREATED WITH CHEMONITE OR
APPROVED EQUAL. INSTALL STAKES
x aW OUTSIDE ROOTBALL (USE (2) 3" DIA.
H c7 LODGE POLE PINE STAKES FOR 24
o BOX OR LARGER)
og 1'-6"
a 1"x4" ROUGH REDWOOD WITH (2) t
o �E MIN 2" GALV. NAILS EACH CONNECTION
(LOCATE ON PREVAILING WIND SIDE)
0
H
o �a o �'� PLACE ROOT CROWN 1/2"-3/4"
pq �� ABOVE FINISHED GRADE
Q O C�2
H z a 2" OF FINE SCREENED
w o REDWOOD OR FIR BARK MULCH
w - FINISHED GRADE
FERTILIZER TABLETS
E, I (AGRIFORM)
iq ROOT BALL
C" SCARIFY SIDES OF ROOT BALL
AND SIDES AND BOTTOM OF
6 J' M—IN. PLANTING HOLE i
E
AMENDED PLANTING 4" DIA. X 3'0" LONG PERFORATED
FILL MIX -STYRENE PIPV WITH PLASTIC SLOT
2 X CONTAINER GRATE SET 1 ABOVE GRADE. FILL F
BOTTOM WITH 3 4" RAIN ROCK (TYP.
(3' MIN.) EACH SIDE OF REE�
REVISED STREET TREE PLANTING & STAKING DETAIL
DATE: JANUARY 2008
DRAWN BY E&CHECKED BY _
APPROVED CITY OF CAMPBELL DETAIL 12
APPROVED
E
4
s
NOTES; (unless otherwise specified in the plans or special provisions)
1. All trees shall be a minimum of 15—gallon size and of the variety indicated
on the , plans or specified by the City Engineer.
2. Each tree shall be approved by the Engineer prior to planting. Contractor
may request Engineer to pre—approve tree at local nursery.
3. The exact location of each tree shall be approved by the Engineer
prior to planting.
4. Vertically cut the root ball at three or four places to loosen roots and
discourage circling. Vertically scarify sides and bottom of planting hole.
5. When planting, hold tree so that previous planting level is even with
sidewalk level and gradually place top soil about the root ball.
6. Top soil fill shall be an approved garden mix loam that is mixed at a
1:1 ratio with the native soil removed from the planting hole.
7. When hole is three—quarters full, fill with water to compact the soil and
eliminate air pockets.
8. -Fill planting hole with loose soil to ground level.
9. Construct a watering basin around each tree as shown.
10. Planting operations must be followed by a deep, thorough watering of
each tree.
11. Substitutions in tree varieties are permitted only upon writter authori—
zation from the City Engineer.
12. All street trees installed in commercial and industrial shall be
installed with an irrigation system (fed from on—site).
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REVISED STREET TREE PLANTING NOTES
DATE: JANUARY 2008 E
DRAWN BY WHECK.ED BY ISM APPROVED CITY OF CAMPBELL DETAIL 13 I
S
i
PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT
Effective July 1,2017
TO: Finance PUBLIC WORKS FILE NO. 6,m,C t cc., L Ole)
PROPERTY ADDRESS 2 2,3( C
Please collect&receipt for the following monies:
OuN
722 Encroachment Permit Application Fee
Non-Utility Encroachment Permit Major�:$10,000 $425.00
Minor Encroachment Permit<sio,000 $240.00
Initial R-1 Permit N/C
Subseouent R-1 Permits within Two Year Period $240.00
Inspection Fee Minimum Charge per Location $420.00
Street Tree Planting/Removal - N/C
2203 . ($500 per Tree Planting DepositRequired) $500.00ftree
2203 Plan Check Deposit 2%of Enqineer's Estimate $500.00 min
jUtility
and R-1 Permits no deposit required
4Grading&Drainage Plan Review
Single Family Lot $295,00
Site< 10,000 s.f. $885.00
Site 10,000 s.f. <0.5 Acre $1,185.00
Site 0,5 Acre $1,772.00
4722 NPDES Review(C3 Requirements) AT I MIP
- For projects not required to submit numeric sizing $175.00
For projects required to submit numeric sizing
Impervious Area 10,000 Sq. Ft to 1 Acre $740.00 OF C-AMPSEi
Im ervious Area 1 Acre or more $965.00
4722 For proiects sent to Consultant for review Consultant Cost+20% 0- 7
4722 Additional treatment facilities $315 ea
Plan Check& Inspection Fee(Non-.Utility)
4722 Enqr. Est. <$250=0 .14%of Engineer's Estimate
4722 Enqr. Est.'2:$250,0.00 and:5$500,000 $35,000.00+8%of Enqineers Estimate
4722 Enqr. Est. >$500,000 $55,000.00+7%of Engineers Estimate
.2203 Emergency Cash Deposit 4% of Enqr. Est.*($500 min[$1 0,000 Max)
2203 Faithful Performance Securitv(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) .$4,200.0.0+$90/lot
4722 Final Tract Mar)(5 or More Lots) .$5,115.00+$124/lot
2203 Monumentation Security 100% of Gitv's Monumentation Estimate
4920 Parkland Dedication Fe I e(75%125% Due Upon Cert. of Occupancy)
-4722 Lot Line Adjustment(Includes Certificate of Compliance) $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 page$3 ea.Additional
4722 Private Improvement in Public ROW $100.00
4722 Approved Plan Revision Fee $100/sheOt
4722 Appeal Filing Fee $200.00
730.4924 Notice of Improvement Obligation Payment,
Assessment Segregation or Reapportionment
First Split $940.00
Each Additional Lot $295.00
511.7424 Postage
71 .................la...............
.. .........
Ot.her(Please Specity)
*Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL
-r
AME OF APPLICANT
NAME OF PAYOR PHONE
ZIP ?s4tz:ADDRESS
4.
FOR RECEIVED BY RECc.
CITY CLERK
etp ONLY t# —_4,;
J
Syed Wahidi
From: Fred Lee <fredylee@gmail.com>
Sent: Friday,July 06, 2018 1:37 PM
To: Bob Siudzinski
Cc: Syed Wahidi
Subject: Re: Street tree
Hi Bob,
Thanks. What prompted the change from October glory? Is it the drought tolerance?
Fred
On Fri, Jul 6, 2018 at 1:23 PM Bob Siudzinski <Bob S @cityofcampbell.com>wrote:
Hi Fred,
I approved an Acer x freemanii, 'Autum Blaze Maple'.This tree is more drought tolerant than the October Glory, but
looks much the same.
Respectfully,
Bob
From: Fred Lee [mailto:fredyleeftmail.com]
Sent: Friday, July 06, 2018 12:46 PM
To: Bob Siudzinski
Subject: Street tree
Hi Bob,
I'm just emailing you to confirm the street tree species we agreed to in front of our house.
The address of our house is 2236 Central Park drive. I'm in the process of filling out the R-1 encroachment
permit and I was told an email confirmation from you on the tree species would be very helpful.
You're okay with the October glory?
. 1