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HomeMy WebLinkAbout420 34th StreetENCROACHMENT PERMIT CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE c`�LIFOR�1� BAKERSFIELD CA 93301 (661) 326 -3724 TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD CALIFORNIA: Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to place, erect, use and maintain an encroachment on public property or right of way as therein defined. Application Number . . . . . 08- 30000081 Date 10 /10 /08 Property Address . . . . . . 420 34TH ST Application type description PW - ENCROACHMENT PERMIT Owner ------------------------ BAKERSFIELD MEMORIAL HOSPITAL 420 34TH ST BAKERSFIELD CA 93301 Contractor ------------------ - - - - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . Phone Access Code 853127 Permit Fee . . . . 208.00 Issue Date . . . . 10/10/08 valuation . . . . 0 Qty Unit Charge Per Extension 1.00 208.0000 EA PW ENCROACHMENT 208.00 ---------------------------------------------------------------------------- Special Notes and Comments Medians, landscaping, monument signs Improvements to be maintained decorative lighting and utilities across by Memorial Hospital. PER AGREEMENT 09 -069 — 34th St. Monument & Landscaping plans LANDSCAPE MAINTENANCE AGRMNT still pending on project. ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ------ ----- - - - - -- ---- - - - - -- -- -- - -- - -- ---- - - -- -- - -- - - - - - -- Permit Fee Total 208.00 208.00 .00 .00 Grand Total 208.00 208.00 .00 .00 Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the permit at any time. Signature of Applicant (Owner /Agent) Print Name I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACTS STATED IN THE FOREGOING APPLICATION AND FIND THAT THE MAINTENANCE OF SAID ENCROACHMENT (1) WILL (NOT) SUBSTANTIALLY INTERFERE WITH THE USE OF THE PLACE WHERE THE SAME IS TO BE LOCATED AND (2) WILL (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFORE (GRANTED) (DENIED). Said permit shall expire on date stated above. Signa re of City Engineer Additional Terms on the Back Public Works Department 1501 Truxtun Avenue Bakersfield, California 93301 (661) 326 -3724 APPLICATION FOR ENCROACHMENT PERMIT Permit Fee $208.00 To the City Engineer of the City of Bakersfield, California: Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to place, erect, use and maintain an encroachment on public property or right -of -way as therein defined. 1. Full name of applicant and complete address including phone number: L$A4r_0;t1d Im ewer'I a) Hy,SpiTWA. 4U 340, 0 93-2,0/ idol - 327- 4" 2. Nature or description of the encroachment for which this application is made: (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc...) rh L GL Ile, f a ld5 Ca o/ rw rn o rt i elta id S i q i 1S 7 dewa;hye /iaAfinq u, ti-fie -5 acrv_sS 3. Location of proposed encroachment: (Example: Side yard at back of sidewalk or front yard at back of sidewalk) 34-4 Sf-ret-f `redbiao plate rned -urns � ac✓ ar_JOrpVa C; plQn . 4. Period of time for which the encroachment is to be maintained: Indefinite or Other. ircle) Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless the City, its officers agents and employees against any and all liability, claims, actions, causes of action or demands, whatsoever against them, or any of them, before administrative, quasi-judicial, or judicial tribunals of any kind whatsoever, arising out of, connected with, or caused by applicant's placement, erection, use (by applicant or any other person or entity) or maintenance of said encroachment. The applicant further agrees to maintain the aforesaid encroachment during the life of said encroachment or until such time that this permit is revoked. Applicant further agrees that upon the expiration of the permit for which this application is made, if granted or upon the revocation thereof by the City engineer, applicant will at his own cost and expense remove the same from the public property or right of way where the same is located, and restored said public property or right of way to the condition as nearly as that in which it was before the placing, erection, maintenance or existence of said encroachment. Applicant further agrees to obtain and keep all liability insurance required by the City Engineer in full force and effect for however long the encroachment remains. Applicant shall furnish the City Risk Manager with a Certificate of Insurance evidencing sufficient coverage for bodily injury or property damage liability or both and required endorsements evidenc- ing the insurance required. The type(s) and amount(s) of insurance coverage is: Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke the permit at any time. S:\ EncroachmentPermits\ApplicationforEncroachment OF- 300000$I • E Public Works Department 1501 Truxtun Avenue Bakersfield, California 93301 (661) 326 -3724 APPLICATION FOR ENCROACHMENT PERMIT Permit Fee $208.00 To the City Engineer of the City of Bakersfield, California: Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to place, erect, use and maintain an encroachment on public property or right -of -way as therein defined. 1. Full name of applicant and complete address including phone number: L$A4r_0;t1d Im ewer'I a) Hy,SpiTWA. 4U 340, 0 93-2,0/ idol - 327- 4" 2. Nature or description of the encroachment for which this application is made: (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc...) rh L GL Ile, f a ld5 Ca o/ rw rn o rt i elta id S i q i 1S 7 dewa;hye /iaAfinq u, ti-fie -5 acrv_sS 3. Location of proposed encroachment: (Example: Side yard at back of sidewalk or front yard at back of sidewalk) 34-4 Sf-ret-f `redbiao plate rned -urns � ac✓ ar_JOrpVa C; plQn . 4. Period of time for which the encroachment is to be maintained: Indefinite or Other. ircle) Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless the City, its officers agents and employees against any and all liability, claims, actions, causes of action or demands, whatsoever against them, or any of them, before administrative, quasi-judicial, or judicial tribunals of any kind whatsoever, arising out of, connected with, or caused by applicant's placement, erection, use (by applicant or any other person or entity) or maintenance of said encroachment. The applicant further agrees to maintain the aforesaid encroachment during the life of said encroachment or until such time that this permit is revoked. Applicant further agrees that upon the expiration of the permit for which this application is made, if granted or upon the revocation thereof by the City engineer, applicant will at his own cost and expense remove the same from the public property or right of way where the same is located, and restored said public property or right of way to the condition as nearly as that in which it was before the placing, erection, maintenance or existence of said encroachment. Applicant further agrees to obtain and keep all liability insurance required by the City Engineer in full force and effect for however long the encroachment remains. Applicant shall furnish the City Risk Manager with a Certificate of Insurance evidencing sufficient coverage for bodily injury or property damage liability or both and required endorsements evidenc- ing the insurance required. The type(s) and amount(s) of insurance coverage is: Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke the permit at any time. S:\ EncroachmentPermits\ApplicationforEncroachment OF- 300000$I B A K E R S F I E L D Public Works Department 1501 Truxtun Avenue Bakersfield, California 93301 (661) 326 -3724 TO WHOM IT MAY CONCERN: We the undersigned, have no objection to the construction of a fence 06side the sidewalk within the public right -of -way. $y: (Street for proposed encroachment) (Owners Name) Of Phone (Address of proposed encroachment) % SIGNED: 1.) Name: Date: Address: 2.) Name: / Date: Address: 3.) Name: Date: Address: 4.) Name: Date: Address: 5.) Name: Date: Addres,' 6.) Nary6: Date: Address: B A K E R S F I E L D Application. Number Property Address . . . . . . ATN (11 Digits): Application type description AoulicaL1on valuation . . . . CITY OF BAKERSFIELD BUILDING DEPARTMENT 1715 CHESTER AVE BAKERSFIELD, CA 93301 Office Phone: (661) 326 -3720 08- 00007911 Date 5/08/09 420 34Th ST 120- 310- 34 -00 -4 SIGN PEP -MIT C. Owner Contractor ---------- -------- - - - - -- MAKER3FI£LD MEMORIAL HOSPITAL ------------------------ COLOMBO CONSTRUCTION CO INC 420 34TH ST 3211 RIO MIRADA DR BAKERSFIELD CA 93301 BAKERSFIELD CA 93308 316 -0100 -------- --- ----- - - - - -- work Description. Information ---------------------- PERMANENT SIGN 1 ---------------------------------------------------------------------------- Permit . . . _ . . SIGN - PL'RMAN -PaU Additional desc . . Phone Access Code . 871.434 Permit Fee . . . . 104.00 Plan Check Fee .00 Issue Date . . . . S /Ce /09 Valuation . . . . 0 Expiration Date . _ -------------------------------------------------------------..-...----------- 11/04/09 Special Notes and Comments (2) monument signs IMEN,ORIAL MEDICAL CORRIDOR" ------------------------------------ Fee summary ---------- .---------------------------------------- Charged Paid ---- ---- Credited Due - --- --- Permit Fee Total -- ---- - - - 104.00 104.00 - -- - -.... - -- - --- .00 --- - -- .00 Plan Check Total .00 .00 _00 .00 Grand Total 104.00 104.00 .00 .00 CALL FOR INSPECTION (661) 323 -INSP (or 4677) Please input the Permit Number, the Job Address, and the Type of Inspection. Requests for inspection are accepted until 7 AM of the same day. To schedule inspections on the Internet site: https: //bakeweb. cf.bakersfield.ca. us /Click2GovBP /Schedulel nspections.isp BUILDING PERMIT DECLARATIONS Permit is issued in accordance with all applicable Federal, State and Local Ordinances. The permittee has property signed and dated the reverse side of this form. This Permit expires after 180 days of inactivity. I have reviewed the above application, and find it to be correct/complete. Inspector's office hours are: 8:00 — 8:30 AM i I Permittee: Date: ACO a CERTIFICATE OF DATE (MMIDDIYYYY) LIABILITY INSURANCE 12/01/2008 WORKERS COMPENSATION AND TORY LIMITS LIMITMIT S ER ER $ THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION PRODUCER MARSH RISK & INSURANCE SERVICES ANY PROPRIETOR'PARTNER/EXECUTIVE Y r N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 345 CALIFORNIA STREET, SUITE 1300 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. CALIFORNIA LICENSE NO. 0437153 (Mandatoryy in NH H yyees. describe under SPECIAL PROVISIONS belour SAN FRANCISCO, CA 94104 90135 - CAS - -2009 GL CA INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Illinois Union Insurance CO 27960 BAKERSFIELD MEMORIAL HOSPITAL INSURER e: N/A N/A C/O CHW RISK SERVICES 185 BERRY STREET, SUITE 300 INSURER C: N/A N/A SAN FRANCISCO, CA 94107 INSURER D: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWTSTANDNG ANY MAY BIEFISSUEDIOR MAY PERTAIN, nTHE INSU INSURANCE AFFORDED ED BY THE POLICIES DESCRIBED HEREIN NIS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIPATION LIMITS LTR INSRD TYPE OF INSURANCE DATE(MWDDNYYY) DATE(MWDWYYYY) GENERAL LIABILITY 12/01/2008 12/01 /2009 DAMAGE TO RENTED 1,000,000 A X HPLG21687583003 DAMAGE TO RENTED 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ MED EXP (Any one person) $ 5,000 X CLAIMS MADE OCCUR GENERAL AGGREGATES LIMIT APPLIES PER PRO- POLICY JECT LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS I UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP/OP AGG$ 1,000,000 COMBINED SINGLE LIMIT $ (Ea accident) BODILY INJURY $ (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EACH OCCURRENCE $ AGGREGATE $ RETENTION $ WC WORKERS COMPENSATION AND TORY LIMITS LIMITMIT S ER ER $ EMPLOYERS' LIABILITY E.L EACH ACCIDENT ANY PROPRIETOR'PARTNER/EXECUTIVE Y r N E.L. DISEASE - EA EMPLOYEE $ OFFICERIMEMBER EXCLUDED? E.L DISEASE - POLICY LIMIT $ (Mandatoryy in NH H yyees. describe under SPECIAL PROVISIONS belour OTHER DESCRIPTION OF OPERATIONS ILOCATIONSIVEHICLES /EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS THE CITY OF BAKERSFIELD, ITS MAYOR, COUNCIL, EMPLOYEES. AGENTS, AND VOLUNTEERS ARE ADDITIONAL INSUREDS UNDER THE BY OR FOR BAKERSFIELD MEMORIAL IN GENERAL LIABILITY THE ENCROACHMENTO ROJECT WHICH INCLUDES MEDIANS, LANDSCADPING, MOVEMENT OF SIGNS. DECORATIVE LIGHTI G CONNECTION AND U ILIITIESITH ACROSS 34TH STREET AT BAKERSFIELD, CALIFORNIA. CERTIFICATE HOLDER SEA - 001393987 -01 CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTON AVENUE BAKERSFIELD. CA 93301 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND THE INSURER, ITS AGENTS OR REPRESENTATIVES. Myrna Lee ACORD 25 (2009101) ©1998 -2009 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD B A K E R S F I E L D CITY OF BAKERSFIELD - - BUILDING DEPARTMENT 1715 CHESTER AVE BAKERSFIELD, CA 93301 Office Phone: (661) 326 -3720 BUILDING PERMIT Applicatior. Number . . . . . 08- 00007911 Date 5/08/09 Property Address . . . . . . 420 34TH ST ATN (11 Digits): 120 - 310- 34 -OO -q Application type description. SIGN PERMIT Application valuation . . . . 0 Owner Contractor --- --- -- -- ---- ---- - - - - -- BAKERSFIELD MEMORIAL HOSPITAL ------------------------ COLOMBO CONSTRUCTION CO INC 420 34TH ST 3211 RIO MIRADA DR BAKERSFIELD CA 93301 BAKERSFIELD CA 93308 316 -0100 ----- ------ ---- - - - -• -- 'Rork Description Information ---------------------- PERMANENP SIGN ---------------------------------------------------------------------------- 1 Permit . . . . . . SIGN - PERMANM4T Additional desc . . Phone Access Code . 871434 Permit Fee . . . . 104.00 Plan Check Pee .00 Issue Date 5108109 Valuation . . . . 0 Expiration Date 11/04/09 ---------------------------------------------- Special Notes and Comments ------- ------- --- ---- --- - - - --- (2) monument signs '61EMORTAL MEDICAL CORRIDOR" Fee summary Charged - --- -- -- --- ---- -- -- -- --- --- - --- -- --- Paid Credited --- --- - -- - -- ---- - - --- Due Permit Fee Total 104.00 - --- - - ---- -- -- 104.00 .00 - -- --- .00 Plan Check Total .00 .00 -00 .00 Grand Total 104.00 104.00 .00 .00 CALL FOR INSPECTION (661) 323 -INSP (or 4677) Please input the Permit Number, the Job Address, and the hype of Inspection. Requests for inspection are accepted until 7 AM of j the same day. To schedule inspections on the Internet site: j hltps:ll bakeweb. ci. bakersfield. ca. us/ Click2GovBP /Schedulelnsoections.isp Inspectors office hours are: 8:00 — 8:30 AM i DECLARATIONS Permit is issued in accordance with ag applicable Federal, State and Local Ordinances. The permittee has properly signed and dated the reverse side of this form. This Permit expires after 180 days of inactivity. I have reviewed the above application, and find it to be correct/complete. Permittee: Date: