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HomeMy WebLinkAbout2001 H STo��RS ENCROACHMENT PERMIT 'Ns' - men CITY OF BAKERSFIELD o PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE .un ® BAKERSFIELD CA 93301 c9GIFOt , (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 . . . . . 12-30000019 Date 5/15/12 Property Address . 2001 H ST Application type description PW - ENCROACHMENT PERMIT Owner Contractor FOX THHATEH FOUNDATION OWNER 2001 H ST EAXERSFIEDD CA 93301 ----------------------------------------------------------------------- Permit . . . ENCROACHMENT PRRXIT Additional desc . . Phone Access Code . 1201029 Permit Fee . . . . .00 Issue Date . . . . 5/15/12 Valuation . . . . 0 Qty Unit Charge Per Extension 1.00 .0000 EA PW ENCROACHMENT .00 ---------------------------------------------------------------------------- Special Notes and Comments Walk of Fame m ents in the sidewalk along H a 20th Ste. Also included is city installed colored concrete sidewalk, terrazzo tile within mai. entrance of theater, all awnings E any arch. structural features of the building that are within A or hang aver the road ROW. Contact: Rick Davis, President 661-636-0916 Fee surnurry Charged Paid Credited Due Applicarlj-afrN19cee ides the tfghtpgf the CRy Fngineer,-p suantio top Bakersfield Municipal Code Chapter 12.20 tc revoke thtapemai6at any time. . oo . oo .00 .00 X D Signature of Applicant (Owner/Agent) Print Name I HEREBY CERTIFY THAT I HAVE MADE AN INVESTIGATION OF THE FACTS STATED IN THE FOREGOINC 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) CO, A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IE THEREFORE ((r�C� NTE ENIED) Said permit shall expire on date stated above. Signatufle of City Engineer Additional Terms on the Back ACORD, CERTIFICATE OF LIABILITY INSURANCE 06/26/20121 PRODUCER (661)324-2424 FAX(661)324-2323 Fallgatter Rhodes Insurance Services, Inc. 1701 G Street Bakersfield, CA 93301-4320 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED The Fox Theater Foundation 2001 H Street Bakersfield, CA 93301-3919 INSUBERA'. Great American Ins Co INSURERS'. Great American Alliance Ins Co INSURMC: INSURER D. INSURER E'. V THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. /NSR OC' rypE WJN3URANCE POLICY NUMBER POLICY EWECTIVE 05/03/2012 POLILYEXPIRAPON 05/03/2013 LIMITS SW FAI W RE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABOU TY GENERALLIABILITY PAC3070379 EACHOCCURRENCE S 1,000,00 Grego" Hash GIL X COMMERCIAL GENERAL LIABILITY DAMAGE TO BENITO $ 100,00 MEDEXP(A�mePmon) $ 5,00 GWMS MADE OOCCUR PERSONAL&ADV INJURY $ 1,000,00 A GENERALAGGREGATE $ 2,000 00 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS-OCMPA)PAGG 5 2 000,00 X POLICY F FE -0 MLCG AUTONORaELweRm ANYAUTO COMBINDq IPGLE UMIr 5 BODILY INJURY (Per Pemn) 5 ALL OWNED AUTOS SCHEDULED ALTOS BODILY INJURY 5 IP.r..KFR HIRED AUTOS NONDNNEDAUTOS PROPERTY DAMAGE $ )Fer—w G) GARAGELIABILITY AUTO ONLY m EA ACCIDENT S OTHER THAN EA ACC S ANY AUTO AUTO ONLY: AEG 5 EKCESSAMBREW UARIUTY UMB3070380 05/03/2012 05/03/2013 EACH OCCURRENCE 5 1,000,00 AGGREGATE $ 1,000,00 X OCCUR F-1 CLAIMS MADE 5 g S oEDUCTBLE 3 X1. RETEMION S 10100 NC SLIN OTH' KERS COMPENBA90N ANP — EL FACHACOIDENi Is EMPLOYERS' UARILITY ANY PROPRETORMARNERIEKECUTIVE ELDISEASE-EAEMPLOYE $ OFFIOERIMEMBER EKGLUDEDL Il Yes PL—PAOWtler SPECWL PROVISIONS bdow EL DISEASE- POLICY LIMIT 5 OT -ER DESCRIPDON OF OPERATORS I LOCATONS I VEHICLES I UFLUSIONS ADDED BY ENDORSEMENT I SPECIAL PRWISIONS ACORD 26 (2091/06) ©ACORD CORPORATION 19W SHOULD ANY OF IDE ABWE DESCRIBED POLICIES BE CANCELLED BEFORE INE EXPIRATION DATE THEREOF, TIE ISSUING INSURER WILL ENDEAVOR TO MAIL _ DAYS WRITTEN NOTICE TO TIE CERTFICATE HOLDER NAMED TO THE LEFT, SW FAI W RE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABOU TY OF ANY KIND UPON THE INSURER, ITS AOENT& OR. REPRESENTATVES AUMORQED REPRESENTATIVE Information only Grego" Hash GIL ACORD 26 (2091/06) ©ACORD CORPORATION 19W IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does net confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the tens and conditions of thepolicy, certain policiesmay require an endorsement. A statement on this certificate doesnot confer rights to the: certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer,. and the certificate holder, nor does it affirmatively or negatively amend extend or alter the coverage afforded by the pdicies listed thereon. ACORD 25