HomeMy WebLinkAbout5501 ANNETTE STBAK
ENCROACHMENT PERMIT
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CITY OF BAKERSFIELD
o PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
CBAKERSFIELD CA 93301
LIFO (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 12-30000038 Date 10/09/12
Property Address 5501 ANNETTE ST
Application type description PW - ENCROACHMENT PERMIT
Owner Contractor
------------------------ ________________________
PEREZ LOIS OWNER
5501 ANNETTE ST
BAKERSFIELD CA 93313
(661) 808-3373
_
_________1_________________________________________
Permit . . . ENCROACFIIMENT PERMIT
Additional desc . .
Phone Access Code 1252436
Permit Fee 208.00
Issue Data 10/09/12 Valuation
0
Qty Unit Charge Per
Extension
1.00 208.0000 EA PW ENCROACHIMENT
208.00
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Special Notes and Comments
October 9, 2012 11:24:08 AM mmendenhal.
6- high fence on side of house - 5' back
from curb - up to middle of house.
contact: Luiz Perez 661-559-3148
Fee summary Charged PaidCredited
__________ __________ _ ________
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. -
�
Signatureooh lic 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.
Signature of City Engineer
Additional Terms on the Back
� 2 30�38
Public Works Department
1591 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 permit to
place, erect, use and maintain an encroachment on public property or right-of-way as therein defined. (oC
I Full name of applicant and complete address including phone number: 4,110 el, -e z Sr ? 3/ 4{
ssa/ l�nre� ��(kersri� / cA 43313
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 ...
3. Location of proposed encroachment: (Example: Side yard at back of sidewalk or front yard at back of sidewalk)
4. Period of time for which the encroachment is to be maintained. Indefinite or Other.
(Please Circle)
1
5. Is property part of a Homeowner's Association Yes No
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 quoitc
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
S1E ncroachmentPennitsMpplicationforEncmachment
13 A I: E R S F. I B L D
Public Works Department
1501 Truxtun Avenue
Bakersfield, California 93301
(661)326-3724
TO WHOM [T MAY CONCERN:
As the undersigned, have no objection to the construction of a fence beside the sidewalk within the
public right -Of -way, -
79 eh et foi pi oposad anmbndvnent)
of pr000se l eneroirhmenQ
SIG
I ) Name:
Address:
By:
(Owners Name)
2.) Name:
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4.) Name.–v�C✓�/
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6.) Name.
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�.6.) Name,
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Date.
Date: e 1 �ezZ
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Date:
Memorandum of Fire Insurance - FARM E RS
and Subscription Agreement
Policy Number: 95213246'_
This is a Menmrand mu of Insurance and a Subscription Agreement. Your signature at the end of this document is required. If
our records do not show that you have provided us with a signed copy of this document, we reserve the right to terminate your
coverage. Please keep a copy for your records.
This Memorandum oflnsnance is asummary description of due coverages For which you applied. When you applied for
your insurance, Fanners' used an estimating program to calculate an Estimated Recmtmrucuou Cost to rebuild your home.
(See below.) You may have chosen to insure Your home for the amount of the Estimate, or you may have selected a different
amount. (See below.) It is your right and responsibility to determine the amount of your insurance coverage. Your agent cannot
choose your coverage amounts for you. Please verify that all the information on this document. and your policy when you
receive it, e, complete and correct. Advise your Farmers agent crony changes chat need to be made and thank you for doing
business with Farmers.
Policy Information
Company Name: Fire Insaronce Exchange
Policy Number: 952132462 Effective Date: 08,06/2012
Household Number 0545286211 Policy Type: Special Front Dwelling
Primary Insured and Property, Address: Agent Information:
LUIS PEREZ GUS IAVO ADOLFO HIDALGO
5501 ANNETTE S'1 4705 NEW HORIZON BLVD SI E I
BAKERSFIELD, CA, 93 31 3-2 90 8 BAKERSFIELD, CA, 93313-2369
661-847-9770
Mailing Address: 5501 ANNETTE ST, BAKERSFIELD, CA.93313-2908
Coverage Information
Deductible applicable to each covered loss:
$1,000
Coverage Description: Coverage Limit
DWELLING FIRE- COV A - DWELLING
S 176,000.00
DWELLING -COVB- SEPARATE STRUCTURES
$17,600.00
DWELLING FIRE - COV C- PERSONAL PROPERTY
$25,000.00
DWELLING - COV D- FAIR RENTAL VALUE
517,600.00
EXTENDED CVG -COV D- FA I R RENT AL VALU E
$17,600.00
DWELLING - COVE - ADDITIONAL LIVING EXPENSE
$17.600.00
LIABILITY - DWELLING POLICY
$300.000.00
MEDICAL PAYMENTS - DWELLING POLICY
$1,000.00
EXTENDED COVERAGE - COV A - DWELLING
$176,000.00
EXTENDED COVERAGE - COVB- SEP STRUCTURES
517,600.00
EXTENDED COVERAGE -COVC- PERSONAL PROPERTY
$25,000.00
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4409 Rouse Avenue - Google Maps
Google Address 4409 Rouse Avenue
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http://maps. google.com/maps?f=q&source=s_q&hl=en&geocode=&q=5501+Annette+Str... 12/17/2012
TO:
FROM:
DATE:
SUBJECT:
H A h E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
John Ussery, Engineer II
Bob Wilson, Supervisor II, Subdivisions
October 12, 2012
Encroachment Permit Application for: 5501 Annette St
Name of Applicant: Luis Perez
Description of Encroachment: 6' High fence on side of house 5' behind the
curb up to the middle of the house.
Please review the attached encroachment permit and return to me at your earliest convenience.
S: WERMITSIENCROACKTRAFFICt.5501 Annette Stdoc
•
B _-1 I-: E R S F I E L 1)
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO:
Jena Covey, Risk Manager o
FROM:
Bob Wilson, Supervisor II, Subdivisions
DATE:
October 12, 2012
SUBJECT:
Encroachment Permit Application for: 5501 Annette St
Name of Applicant: Luis Perez
Description of Encroachment: 6' High fence on side of house 5' behind
the curb up to the middle of the house.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S:IPERMITMENCROACHINSURANCEl5501 Annette St doc