HomeMy WebLinkAbout7003 PINE FLAT DRENCROACHMENT PERMIT
OF u4pp°0P'f� ,+
• i'+ CITY OF BAKERSFIELD
v a PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
4a„ >• BAKERSFIELD CA 93301
o 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 . . . . . 13-30000027 Date 5/01/13
Property Address 7003 PIN& PLAT DR
Application type description PW - ENCROACHMENT PERMIT
owner Contractor
------------------------ --- --------------------
MARTINEZ JOSE SR & ROSALINDA OWNER
7003 PINE PLAT DR
EAPERSPIELD CA 93311
----------------------------------------------------------------------------
Permit . . . ENCRGACNMb PERMIT
Additional desc . .
Phone Access Cede 1319706
permit Pee 208.00
Issue Date . . . . 5/01/13 Valuation . . .
. 0
Qty unit Charge Per
Extension
1.00 208.0000 EA PW ENCROACHMENT
------------------
208.00
•
Special Notes and Comments
May 1, 2013 3:21:31 RM mmendenhal.
Extend wooden side fence out to
sidewalk. Contact person: Rosalinda
Martinez - 661-412-4378
------------------------------------i----------------------
pee summary Charged Paid Credited
----------------------------------------
Due
-----------------
Permit Pee Total 208.00 208.00 .00
.00
Grand Total 206.00 208.00 .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.24
j
Signature of Applicant (Ownergent) 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
I o 0000 2%
B a K E R 5 F I E L D
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 12.26 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 ndeefinetl 1
1. Full name of applicant and complete address including phone number Jose - 1�("�Q11(�C1 CC,
Mafkri e'r -IbCZ Lnnfo E -V 01: 4- Citi lobi-�iiQ `13D 9
2. Nature or description of the encroachment for which this appiicat,'on is made: (xample: Wood or wrought 'roti
fence, concrete block wall, raised planter, etc...) -f x 'l I`x f" t 1 i t� e b CnC-lt' A.�. r -.
;. Location of proposed encroachment: (Example:
Side yard at back of sidewalk or front yard at back of sidewalk)
c Period of time for which the encroachment is to be maintaine . IndefiNteor Other.
ease Circie)
5. is property part of a Homeowner's Association as No
Applicant agrees that if this application is granted applicant shall indemnify, defend and hold harmless the City, its
officers agents antl employees against any and all liability, claims, actions, causes of action or demands, whatsoever
'against them, or any of them, before administrative, quasyudicial, orjudicial tribunals of any kind whatsoever, ansing out
of, connected withor 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 lite
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
property or richt 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 evideri
,ng the insurance required. The type(s) and amount(s) of insurance coverage is:
Applicant acknowledges the right of the City Engine,, pursuant to Bakersfield Municipal Code Chapter 12.20 torevoke the permit at
any time.
i•@�wroacbmantPmmitsW pplkaPonbranvoachment
6 a K E R S F I B L LD
Public Works Department
1501 Truxwn Avenue
Bakersfield, California 93301
. (661)326-3724
TO WHOM, IT MAY CONCERN:
'Ale Ne unde-sioned, have no: objection to the constmctidn of a fence beside the sidewalk within the '
Pubic righl-of-way.
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(Addresl of pr000eed xnerandimenp
SIGNED
1)Name
:
Address
2.) Name:
Acdress.
3.) Name:
Address
4.)Name
Address _ -1lki,'v,sL
G�-CV on
5) Name: /c6K wdllV s
E.). Name, `V CIG 3 ^2�,tiR--
Address
Date: `7 -2CI- 13
Date. -,-/ - �) q `1 i)
Date: e1 &,:fz
Dates Ll --)� ^ �3
Date 2`3
Date: n )F /3
Universal North America Ins. Co.
Praceasb,y
Center LI -ITT ,,E__..: LL✓ 'P-FGC ET -N!'. PAGE : 1
P.O. Boz 9061. Carlsbad. CA 92018-9061 NE. Pu, ICY
CA: PRODUCER: _} 661, 431-1,60
aPRnt .xF _ _=:n-Ec ,EUPs:22iTE '"n NE7c S[ .pm I7*.77i7. ^ Cy ri7r
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�. ...... ... .... .�: ..... _.._ _ _ ... u.. ._.. . ..
NAMED INC1IRED AND ADDREcg - — LOCATION !a d ,n boo, !—,—,j aad,*sr
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I �,_� 1•IY'.Y 111:3.. .. .. .".:`Ia I
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BAi1.ERS1-lELU. CA 99311
POLICY NO: HCA1005915 Policy Period: 1/02/2013 to 1/02/2014
HOMEOWNERS DECLARATIONS 12:01 A.M. Standard Time at the Address of the Named Insured as Stated Herein.
COVERAGE PROVIDED WHERE PREMIUM OR LIMIT OF LIABILITY SHOWN FOR THE COVERAGE
- - - - - -
- - SECTION I - - - - - -
- - I - - -SECTION II- - -
COVERAGES A.DWELLING
B OTHER C.PERSONAL D.LOSS E.PERSONAL F.MEDICAL
AND LIMITS
STRUCTURES PROPERTY OF
USE LIABILITY PAYMENTS
OF LIABILITY
278,000
27,800 194,600 111,200
100,000 1,000
THIS POLICY INCLUDES BUILDING
CODE UPGRADE .COVERAGE
OF 10%
FOR LOSS UNDER
SECTION I,
WE COVER ONLY THAT PART OF
LOSS OVER THE DEDUCTIBLE
STATED: $1000
LOSS DEDUCTIBLE
SUMMARY OF PREMIUM:
BASIC PREMIUM
$742
TOTAL PREMIUM $394.00
ADDITIONAL PREMIUM
$348CR
POLICY FEE $50.00
TOTAL PREMIUM
$394
TOTAL POLICY $444.00
POLICY SUBJECT
TO THE FOLLOWING
SURCHARGES, CREDITS,
ENDORSEMENTS AND FORMS:
FORM NO
EDITION
DESCRIPTION
LIMITS .PREMIUM
HO 00 03
4/91
SPECIAL FORM
AHHO-SP CA
6/09
SPEC PROVISIONS CA
AHHO-GRID
7/11
INSURANCE DISCLOSURE
CA PHMITV
6/09
DWELLNG LIMIT NOTICE
HO 04 95
11/92
WATER BACKUP
$30
AHHO-60
6/09
PREMIER SPECIAL COV
$82
UI GLB
3/09
UNA PRIVACY POLICY
USP 00
9/11
UNA SIGNATURE PAGE
HO 04 16
4/91
PREM ALARM/FIRE PROT
$15CR
NEW HOME CREDIT
$186CR
LOSS FREE CREDIT
$37CR
TILE ROOF CREDIT
$22CR
DEDUCTIBLE $1000
$126CR
HOME INSPECT CREDIT
$74CR
CA BOR
7/11
INSUR DISCLOSURE BOR
AHHO-10
6/09
CA INS GUARANTEE ASN
AHHO-50
6/09
MOLD EXCLUSION
AHHO-7
6/09
CA HOMEOWNERS ENDMNT
MODIFIED REPLACEMENT COST 50&
AHHO-9
6/09
LENDERS LOSS PAY END
OCC: PRIMARY
PGM: ELITE
TERR: 046 BUILT:
2011 FRAME PRT CLS: 003
* CONTINUED
Date Issued: 01/02/13
Universal North America Ins. Co.
Processing Center D -BILL: WELLS FARGO BANK PAGE: 2
P.O. Boz 9061. Carlsbad. CA 92018-9061 ADDITIONAL INFORMATION
GA: 1 PRODUCER, 154945 (661) 431-1780
ARROWHEAD GENERAL INSURANCE TRENEA SMART INSURANCE AGENCY INC
AGENCY, INC. 5550 CALIFORNIA AVE #101
P 0 BOX 9061 BAKERSFIELD, CA 93309
CARLSBAD, CA 92018-9061
NAMED INSURED AND ADDRESS LOCATION (if different from insured address)
JOSE MARTINEZ JR AND
ROSALINDA MARTINEZ
7003 PINE FLAT DR
BAKERSFIELD, CA 93311
POLICV NO: HCA1005915 Policy Period: 1/02/2013 to 1/02/2014
HOMEOWNERS DECLARATIONS 12:01 A.M. Standard Time at the Address of the Named Insured as Stated Herein.
POLICY SUBJECT TO THE FOLLOWING SURCHARGES, CREDITS, ENDORSEMENTS AND FORMS
FORM NO
EDITION
DESCRIPTION LIMITS PREMIUM
CA OOL
6/09
ORD OR LAW DISCLOSUR
CAH03-HPD
6/09
PREM DISC AVAILABLE
HO 24 90
1/93
WORKERS COMPENSATION
UG 105C
6/09
CONSUMER AFFAIRS
** IMPORTANT **
POLICY DOES NOT PROVIDE EARTHQUAKE COVERAGE
** IMPORTANT **
THE LIMIT
OF LIABILITY FOR THIS STRUCTURE (COVERAGE A) IS
BASED ON AN ESTIMATE OF THE COST TO REBUILD YOUR HOME,
INCLUDING
AN APPROXIMATE COST FOR LABOR AND MATERIALS IN
YOUR AREA,
AND SPECIFIC INFORMATION THAT YOU HAVE PROVIDED
ABOUT YOUR
HOME.
1ST LOAN NO. 381681865
MTG WELLS FARGO BANK
P.O. BOX 680001
ISAOA
DALLAS, TX 75368
*FEE SCHEDULE:
THIS POLICY IS SUBJECT TO THE FOLLOWING FEES WHEN APPLICABLE.
INSTALLMENT PAYMENT FEE $7.00 PER PAYMENT
IF FULL ANNUAL PAYMENT NOT ELECTED
REINSTATEMENT FEE $15.00 PER REINSTATEMENT
IF POLICY CANCELLED AND WE AGREE TO
REINSTATE THE POLICY
ALL FEES APPROVED BY THE CALIFORNIA DEPARTMENT OF INSURANCE.
THE POLICY FEE DISCLOSED ON THE FRONT PAGE OF YOUR DECLARATIONS PAGE AND
THE ADDITIONAL FEES DISCLOSED ABOVE ARE FULLY EARNED AND ARE NOT SUBJECT
TO REFUND IN THE EVENT THE POLICY IS CANCELLED.
* END OF POLICY DECLARATIONS
Date Issued: 01/02/13
2013-05-01 14:31 BKRORP1 0000000000 » Fax Server P 1/1
ARROWHEAD*GENERAL INSURANCE AGENCY, INC.
Endorsement TD: 1203049
M -N
POLWYINFORMATION
PROOUCERINPORMATION
lanae Nemo: JOSEMARTING2JR
Nemo: TRENEA $mnRT INSVRANCG AGENCY, INC
Cbengr ERenlmone: D510=1313Al AM PST
TnmmROeteI 0V0IM0100AHPMl'ST
Pmgnm Code. CAUIIPraduwr
Coda: 151965
ame
P.1h,srmard: HCA1005915
Ma0lna Atltlrreq.
Sound S,mnaa IPI -RT
5550CALIFORNMAVEpl01
LI—fEuelnm.: HOME
SA63NRSFIEL0.EA;5)N
CumpuAv:
Submlllydbye TRENEASMART
UNIVERSAL NORTH AMERICA INSURANCE COMPANY+ELITE
PMno: "IA31.17K
COVRRAGRR
CURRGNTLIMIT MW LIMIT
COVERAGE E-Parsonal Lidbility
$100.000 5300,000
PRE HI MSUMMARY
ORIGINAL POLICY PREMIUM;
$394.00
PMIW POLICY PREMIUM:
$,110.00
•T PREMIUM DIFFERENCE FOR THIS TERM (PRO -RATED):
Small
Please campldc Ihls requast I. Wapdimty, sign the appropriate line and retain a copy of this Corm for your records.
Producer X DaW-Timc_am/pm
Signature
1.grdo to the aforementioned a.", rcqueal(a). I understand that ndditionol underwriting will lake plxe whcn this cadarremcnt is me Iw d
and preemed and may affect the acceptability ofdlil Hale i further understand that ifmy polity is eunrntly cancelled, this endarsemeat can
not take cfiber unloss my eovemga in.;.,Wed. Tf my policy is r.idstmcd, the aorliest etfcetive data will be tho min nah ment date.
Transmission of this request is nota guamaitm ofeavamga.
Insured x Date _Tim. _MNpm
Sivature
Y I E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Jena Covey, Risk Manager
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: May 13, 2013
SUBJECT: Encroachment Permit Application for: 7003 Pine Flat Dr
Name of Applicant: Jose Jr. & Rosalinda Martinez
Description of Encroachment Extend wooden side fence out to the
sidewalk.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S: IPERMITS\ENCROACHIINSURANCEV003 Pine Flat Dcdoc
•
B A k E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO:
John Ussery, Engineer II
FROM:
Bob Wilson, Supervisor II, Subdivisions
DATE:
May 13, 2013
SUBJECT:
Encroachment Permit Application for: 7003 Pine Flat Dr
Name of Applicant: Jose Jr & Rosalinda Martinez
Description of Encroachment: Extend wooden side fence out to the
sidewalk.
Please review the attached encroachment permit and return to me at your earliest convenience.
5ie rTGf/
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