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HomeMy WebLinkAbout1606 19TH STBAKg ENCROACHMENT PERMIT CIN OF BAKERSFIELD v d PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE C ® BAKERSFIELD CA 93301 LIFO (661) 326-3724 TO THE CIN ENGINEER OF THE CIN 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 . . . . . 13-30000012 Nate 3/14/13 Property Address 1606 19TH ST Application type description PW - ENCROACHMENT PERMIT owner contractor -------------- __________ 19TH A I INV GROUP LLC OWNER 1925 WARM LANDS AV VISTA CA 92084 _______________ Perrit ENCROACTRIENT PERMIT Additional doss . . Phan. Access Code . 1302209 Permit Fee . . . . 208.00 Issue Date . . . . 3/14/13 Valuation 0 Qty Unit Charge Per Extension 1.00 208.0000 EA PW ENCROACHMENT 208.00 ---------------------------------------------------------------------------- Special Notes and Comments March 14, 2013 3:50:02 PM mmendenhal. True address is 1608 19th Street. Place wrought iron fence and gate in trust of heel identical and 9800 location as neighbors at 1604 19th Street. Contact Person Christina Sweet 661-340-4791 Fee m--- Charged ---d Credited Dae Permit Fee Tot I208.00 208.00 .00 .00 Applicant acknowl the/ iAso44he CipffAgineer, puftant to the°Bakersfield Municipal Code Chapter 12.20 to CI-W-ISTINA c'�WrC 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) CONST UTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFORE) (DENIED) Said permit shall expire on date stated above. Signature of City Engineer Additional Terms on the Back 30avoo z �, ENCROACIMIENT PERMIT / 3 APPLICATION FORM CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE BAKERSFIELD CA 93301 LOCATION OF ENCROACHMENT(Address required where available): �� CH l� -Wai If there is no address adjacent to work describe limits of work by distances fiom nearest existing street intersection. FULL NAME OF COMPLETE ADDRESS: PHONE: 1 �O,,0 (9 Ja+hf,1Vf Q.� FAX: _ Bokunfipi /V l aR' g330 I CELL: PROJECT INFORMATION DESCRIPTION^ IOF ENCROACHMENT Example: Wood or wrought iron fenceconcrete block wall, raised planter, etc.): WV0- lf41+ ('t6 f.Vl(f aC_Yn.�-QY)W PERIOD OF TIME FFOIREN�.C�ROAfCHME�' 1 .. INDEFINATE r OTHER:' ^ -1 CONTACT PERSON e ^` iJI t .1.�, �N Q e PHONE: 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, orjudicial 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 property or right of way where the same is located and restore said public property or nearly as that in which it was before the placing, erection, maintenance or existence of 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 =conks) of insurance coverage required are: Residences: Homeowners General Liability coverage in an amount of at least $300,000.00 oirweroial: Commercial Liability coverage in an amount of at least $1,000,000.00 Encroachment Permit Fee: 8208.00 S:iPERMFFSIENCROACH1Encroachment Permit Req Form.DOC January 2009 '�✓ �® CERTIFICATE OF LIABILITY INSURANCE ATE D/14/I01 Y, 3/14/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the Certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Lupe Vargas ext. 237 NAME PNONE . (661)835-4542 FAX INA.(6E1)a35-4500 KIA Insurance Associates, Inc. License # 0415101 E.MNL ,lvargas@kia-ins.code P.O. BOX 11390 INSURERS AFFORDING COVERAGE NAICN INSURER A:Hartford Casualty'Ins. 29424 Bakersfield CA 93389-1390 INSURED INSURER B: INSURER C: CHRISTINA SWEET DBA THE FOUNDRY SWEET DESIGN INSURER 12506 CRYSTAL COVE AVE INSURER E: -DAMAGE TO —RENTED PREMISES REV occurea, 5 300,000 INSURER F: BAKERSFIELD CA 93311 NIIMRFR-12-13 GL THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. JaR LTR TYPE OF INSURANCE ADDLBUBR INGIR E. POLICY NUMBER POLICY EFF MMIDDIYYYY) POLICY EXP MMJDDNYYYI LIMBS GENERAL LIABILITY IOCCURRENCE 5 1/000,000 X COMMERCIAL GENERAL LIABILITY -DAMAGE TO —RENTED PREMISES REV occurea, 5 300,000 A CLAIMS -MADE 1XI OCCUR 1SBAZO3319 812412012 8/24/2013 MED EXP (Any one person) S 10,000 PERSONAL R AW INJURY s 1,000,800 GENERALAGGREGATE $ 21000,000 GENL AGGREGATE LIMIT APPLIES PER: PROOUCTS-COMP/OPAGG $ 2,000,000 $ X POLICY 7ECT PRO LOC AUTOMOBILE LIABILITY COMBB tlEDI SINGLE LIMIT BODILY INJURY (Per Person) $ ANY AUTO BODILY INJURY (Pera[citlenp $ ALL OWNED SCHEDULED AUTOS AUTOS Y DAMAGE $ PROPERTY HIREOAUTOS NON-011NED AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE 5 AGGREGATE 5 EXCEBS LIPS CLAIMS MADE DEO I I RETENTIONS 5 M00a ERSCOMPENSATON WC BTATU- 0TH. AND EMPLOYERS' LIABILITY Y/M ANY PROPRIETOWPARTNER@XECUTIVE❑ EL EACH ACCIOENi $ OFFICER/MEMBEREXCLUDEDY NIA BE. DISEASE- EA EMPLOYS $ (M-ruteory In NR) 1y deserne under DESCRIPTION OF OPERATIONS late, EL. DISEASE -POLICY LIMIT I S DEBCRIPTIONOFOPERA1ONSILOCATIONS I VEHICLES (Atlacl, ACORD 101, Additional Remarks Schedule, if one cWce Is raqube0) Encroachment Hermit application. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Bakersfield ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Department Attn: City Risk Manager AUTHORIZED REPRESENTATIVE 1501 Truxtnn Avenue Bakersfield., CA 93301 Christina Sweet/LIIPE D 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. IN5925 (201005101 The ACORD name and logo are registered marks of ACORD • E A K E R S F I E L. I7 PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer II FROM: Bob Wilson, Supervisor ll, Subdivisions DATE: April 10, 2013 SUBJECT: Encroachment Permit Application for: 1606 19" Street Name of Applicant: 191" & I Inv Group LLC Description of Encroachment: Place wrought iron fence and gate in front of business identical and same location as neighbors.. Please review the attached encroachment permit and return to me at your earliest convenien j6m- lyre 0 P'Vt' S9PERMITS\ENCROACHITRAFFIC11606191h.Coc E A K E R 5 F I E L 7) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Bob Wilson, Supervisor II, Subdivisions DATE: April 10, 2013 SUBJECT: Encroachment Permit Application for: 1606 19" Street Name of Applicant: 19' & I Inv Group LLC Description of Encroachment: Place wrought iron fence and gate in front of business identical and same location as neighbors. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. 19th St doc