HomeMy WebLinkAbout1128 Valdes CtENCROACHMENT PERMIT
CITY OF BAKERSFIELD
PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
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 . . . . . 17- 30000015 Date 3/24/17
Property Address . . . . . . 1128 VALDES CT
Application type description PW - ENCROACHMENT PERMIT
Owner Contractor
---------------- -- - - - --- ------------------------
DELUNA ALFREDO CONTRERAS & CAR OWNER
1128 VALDES CT
BAKERSFIELD CA 93307
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Permit . . . . . . ENCROACHMENT PERMIT
Additional desc . .
Phone Access Code . 1990795
Permit Fee . . . . 213.00
issue Date . . . . 3/24/17
Valuation . . . .
0
Qty Unit Charge Per
BASE
Extension
213.00r1�
-FEE
----------------------------
Special Notes and Comments
3' block retaining wall with 6'
wood
*wall must be
min. 4' away from
NWIt+'
{� �n
fence behind sidewalk on Quest
St.
mailboxes.
�� ��1��•
Alfredo Deluna 444 -3600
�Kh'1
----------------------------------------------------------------------------
Fee summary Charged
- -- ----
Paid
- - - - --
Credited
-- -- - -- - -- ----
Due
-- ----
- ---------- -- - - -- --- - - --
Permit Fee Total 213.00
213.00
.00
.00
Grand Total 213.00
213.00
.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.
�s (r.►�`( C L 1, Vie; VU`— c�Y \�V\ &I ��� U YN' cl�—
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) (DE ) Sai permit shall expire on date stated above.
Signature of City Engineer
Additional Terms on the Back
Applicant agrees that if this application is granted, applicant shall indemnify, defend, and hold harmless 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 or judicial tribunals of any kind whatsoever, arising out of connected with, or caused by applicant,
or in any way arising from, the terms and provision of this permit or the placement, use (by applicant or any other person or
entity) or maintenance of said encroachment, whether or not caused in part by a party indemnified hereunder, except for CITY's
sole active negligence or willful misconduct. The applicant further agrees to maintain the aforesaid encroachment, including, but
not limited to, repairing or replacing the encroachment at Applicant's cost even if CITY inadvertently damages or destroys the
encroachment in the ordinary course of CITY's business, during the life of the 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 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 restore 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 must contact Dig -Alert at 811 at least 2 full working days prior to all excavating.
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 issuance evidencing sufficient
coverage for bodily injury or property damage liability of both and required endorsements evidencing the insurance required.
l ha���read and acknowledge the above.
�'JApplicant's Initials
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!f there is no address adjacent to work describe limits of work by distances from nearest existing street intersection.
FULL NAME
COMPLF.
APPLICANT
PROJECT INFORMATION
DESCRIPTIO/N OF ENCROACHMENT (Example: Wood or+ wrought iron fence, concrete block wall, raised
planter, etc.):
PERIOD OF "TIME FOR ENCROACHMENT: DEFINITE Zr OTHER:
(Please Circle) r '/
,I p "tte�&- CONTACT PERSON . �/ I�-C' PI -TONE
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 Cily Engineer applicant will at his own cost and expense remove the same from the public
gropertx or right of way where the same is located, and restore 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 evidencing
the insurance required. The type(s) and amount(s) of insurance coverage required are:
Residences: Homeowners General Liability coverage in an amount of at least $300,000.00
Commercial: Commercial Liability coverage in an amount of at least $1,000,000.00
The Commercial Liability policy must identify City and City's mayor, council, officers, agents, employees, and designated
volunteers as Additional Insureds.
Encroachment Permit Fee: $300 0'Z 13 . � o
Aug. 2016
SAPERMITMENC'ROAC I N:ncroachment Permit Req Form.DOC
40
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Public Works Department
1501 Truxtu n Ave n u e
Bakersfield, California 93301
(661) 326 -3724
TO WHOM IT MAY CONCERN:
We the undersigned, have no objection to the construction of a fence beside the sidewalk within the
public right -of -way.
(Street for proposed encroachment)
It Z F 11o'l cis c-r.'
(Address of proposed encroachment)
SIGNED:
By• --I6y-Ay belalLCk-
(Owners Nam/e)
Oc)
�'
1.) Name: �/ Date
Address: /lam' (/'9�ii✓�5
2.) Name: he Date:
Address:�j�V�`
`i f Date (i r 17
3.) Name: v. ��l �ryc" t
Address:���
4.) Name:� Date-"'?
Address:
5.) Name:
:5 ,f� C t �U S Date::i•._ / . —�
Address: 1> 5 7
6.) Name: Date:
Address:
See Signatures needed for approval page
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S F T E 1. I
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ed Murphy, Engineer III
FROM: Kirk Boland, Engineering Tech I
DATE: April 7, 2017
SUBJECT: Encroachment Permit Application for: 1128 Valdes Ct
Name of Applicant: Alfredo Deluna
Description of Encroachment: 3' block retaining wall with 6' wood fence
behind the sidewalk on Quest St.
Z-fn" -- -
It`� Please review the attached encroachment permit and return to me at your earliest convenience.
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PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Jena Covey, Risk Manager *j
FROM: Kirk Boland, Engineering Technician I
DATE: April 7, 2017
SUBJECT: Encroachment Permit Application for: 1128 Valdes Ct
Name of Applicant: Alfredo Deluna
Description of Encroachment: 3' block retaining wall with 6' wood fence
behind the sidewalk on Quest St.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S \ PERMITS \ENCROACH \INSURANCE \1128 Valdes Ct.doc
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4�4 c4 - HOMEOWNERS POLICY
FirstAinerrcan AMENDED DECLARATIONS
�\ Specialty Insurance Company POLICY NO: CASH 333177
Customer Service
888.47 t -75001 www.fapcig.com
4 First American Way, Santa Ana, CA 92707
A California domiciled company
BROKER NUMBER: 002602 BROKER PHONE: (661)833 -0300
BROKER NAME:
NAMED INSURED:
ALFREDO DELUNA
CAROLINA DELUNA
1128 VALDES CT
BAKERSFIELD, CA 93307
MCA INSURANCE SERVICES
1731 HASTI -ACRES DRIVE, 11205
BAKERSFIELD, CA 93309
Location of property insured:
1128 VALDES CT
BAKERSFIELD, CA 93307
REMARKS: INCREASE PERSONAL LIABILITY TO 300K PER INSURED REQUEST
Due to the change noted in Remarks, coverage shown on this Declaration page is effective 0312112017
Insurance is provided only with respect to the following coverages for which a limit of liability and/or premium is specified, subject to all
conditions of this policy. We will pay only that part of the total of all loss payable under Section I that exceeds the deductible amount
shown in the Declarations, subject to the policy limits that apply. The deductible applies per occurrence. Based on the information
available to us. the premium shown is the lowest we offer for which you qualify.
Policy Period. 12 months From: 0611412016 To: 06/1412017 12:01 a.m., STANDARD TIME at the location of property insured.
NOTICE: THIS POLICY DOES NOT PROVIDE COVERAGE FOR THE PERIL OF EARTHQUAKE
Dec 1 of 2 WEB ID. 162C609642 BKR FILE COPY
Forms and
Coverage/
Policy
Coverage
Endorsements made
Coverage Description
Limit
Deductible
Premium
part of this policy
Amount
at time of issue:
COVERAGE A - DWELLING
5230,788
$646.00
FSH01 06 11
COVERAGE B - OTHER STRUCTURES
$23,079
INCL.
FSH021 04 14
COVERAGE C - PERSONA_ PROPERTY
S115.394
INCL
FSH073 01 14
COVERAGE D - LOSS OF USE
$46.158
INCL.
HO 00 03 04 91
COVERAGE E - PERSONAL LIABILITY
S300,000
516.00
HO 01 04 02 98
COVERAGE F - MEDICAL PAYMENTS TO OTHERS
S1,000
INCL.
438 BFU NS 05 42
DEDUCTIBLE
S1,000
S- 125.00
HO 04 16 04 91
t OIMEOWNERS PLUS EiZ3RSENIEN T
iNOL.
iiv v" 5ii ur �-;; i
ORDINANCE OR LAW
$23,079
INCL.
HO 24 90 0193
CREDIT CARD COVERAGE
S500
INCL.
FIRE DEPT SERVICE CHARGE COVERAGE
$500
INCL.
BUSINESS PROPERTY
$2.500
INCL.
JEWELRY, WATCHES AND FURS
S1,000
INCL.
LOSS ASSESSMENT COVERAGE
S1.000
INCL.
SILVERWARE, GOLDWARE AND PEWTERWARE
$2.500
INCL.
WORKERS COMPENSATION -OCC EMPLOYEE
INCL.
New or Revised Form
25% EXTENDED REPLACEMENT COST COVERAGE A - DWELLING
TOTAL PREMIUM. $537.00
A $5.00 per installment service charge
Countersigned: 03/22/17 Santa Ana, CA By: applies if you pay in Installments. Payment
in full will avoid this service charge.
James J. Court. CPCU ARe
President
Authorized Representative
NOTICE: THIS POLICY DOES NOT PROVIDE COVERAGE FOR THE PERIL OF EARTHQUAKE
Dec 1 of 2 WEB ID. 162C609642 BKR FILE COPY
POLICY NO CASH 333177
MORTGAGE LIENH ER NAME AND ADDREraS
WELLS FARGO BANK N.A. #936 ITS SUCCESSORS AND /OR ASSIGNS PO BOX 100515 FLORENCE. SC 29502-0515.0414948463
ADDITIONAL INSURED/ ADDITIONAL INTEREST
VESTING
ALFREDO DELUNA AND CAROLINA DELUNA
REPORTED SQ. FT. OF DWELLING: 1512 Occupancy Type: OWNER
INSURANCE PURCHASED PER SO. FT: $153 Protection Class: 3
# of families /units: 1
The limit of liability for this structure (Coverage A) is based on an estimate of the cost to rebuild your Year of Construction: 2005
home, including an approximate cost for labor and materials in your area, and specific information Tier: 1
that ou have provided about our home.
y p y Inflation Guard %: 2.6%
It is important to keep in mind that the decision regarding the limit applicable to your dwelling
(Coverage A) is solely your decision to make provided that you purchase at least the minimum limit
acceptable to First American and meet our underwriting requirements.
It is equally important to keep in mind that you need to carefully review the information about your
dwelling shown above and if it requires any change please contact your insurance broker or First
American immediately. Additional y, if you have any questions or concerns regarding the amount of
coverage on your dwelling. please contact your insurance broker or First American.
DISCOUNTS
VALUED CUSTOMER SINCE 05/28/2012 - S53.00
SMK ALRMr'DEADBOLTr1= XTINGUISHER - 530.00
NEW HOME DISCOUNT - S46.00
DEDUCTIBLE - $125.00
THESE DISCOUNTS APPLIED TO YOUR POLICY ARE BASED ON THE CURRENT ANNUAL PREMIUM.
THIS DISCOUNT IS PART OF YOUR PREMIUM CALCULATION AND HAS NO AFFECT ON YOUR INSURANCE COVERAGE
THESE DECLARATIONS TOGETHER WITH POLICY JACKET. HOMEOWNERS FORM. AND ENDORSEMENTS. IF ANY. ISSUED TO FORM A
Dec 2 of 2 PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY