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Home My WebLink About4800 FRUITVALE AVEA ENCROACHMENT PERMIT CITY OF BAKERSFIELD o PUBLIC WORKS DEPARTMENT �, 1501 TRUXTUN AVE BAKERSFIELD CA 93301 LIF (661) 326-3724 TO THE CITY 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 . . . . . 13-30000074 Data 10/14/13 Property Address 4800 FRUITVALE AVE Application type description PW - ENCROACHWENT PERMIT owner contractor VALLEY BAPTIST CHURCH BAK A -C ELECPRIC CO. 4800 FRUITVALE AV PO BOK 1834 BAKERSFIELD CA 93300 BAKERSFIELD CA 93301 ( 66) 393-5683 (661) 327-0973 ---------------------------------------------------------------------------- Permit . . . ENCROACHMENT PERMIT Additional dead . . Phone Access Code . 1383579 Permit Fee . . . . 208.00 Issue Date . . . . 10/14/13 Valuatian . . . . 0 Qty Unit Charge Per Extension BASE FEE 208.00 Special Notes and Comments Place underground conduit acre.. olive Springs Drive to be maintained by A -C Electric. Dave Benu2zi 303-0116 ____________________________________________________________________________ Fee s mmary Charged PaidCredited Due Permit Fee Total 208.00 208.00 .00 .00 Grand Total 208.00 208.00 .00 .00 Applicant cknowledge the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revokeliper it a y 'mem Si of ant er/Agsnt 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) C TE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFORE RANTED (DENIED) Said permit shall expire on date stated above. Signature of City Engineer Additional Terms on the Back BA x ENCROACHMENT PERMIT APPLICATION FORM CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT C ® 1501 TRUXTUN AVE IFO BAKERSFIELD CA 93301 (661)326-3724 Fax: (661) 852-2012 LOCATION OF ENCROACHMENT(Address required where available): If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection. APPLICANT INFORMATION FULL NAME OF APPLICANT A -L E\ k C. - COMPLETE ADDRESS: 3tS * PHONE: FAX: ,QL l •�i�• o -'t Ino CELL: 0--o \. - �'l-c \� PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter,etc.): PERIOD OF TIME FOR ENCROACHMEN(INDEFINITE OTHER: e) CONTACTPERSON - t - -_ - PHONE: ..\- ` c•'3 c,\\gyp 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 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: $208.00 xTERMM\ENCROACH\Encmwhment Pmmit Req FmmDOC Sept. 200 Ali CERTIFICATE OF LIABILITY °"'°jNM1°"""""' INSURANCE 093D 013 THIS CERTIFICATE IS ISSUED AS A MAUER 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 INSURERISI, AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(Rul must be endorsed. If SUBROGATION IS WAIVED, subject to due terms and conditions, of Um policy, Certain policies may requlre an endorsement. A a memem on this cer0ficats does not confer rights to the certlNcats holder In llau of such a dormemen s . PRODUCER MARSH NBA, ING, ATIWRAFRES-FAX31139 950 WD RENAISSANCE CENTER, SIE,, ZI00 COIRACT NAME: PHONE. 7. ..AIL DETROIT, MI 4520 ADDREAR— PERSONN.&AWINJURY E 1,000,000 INSUREaeAEFORDINeCOVERAM ou" INSURERA: ZIGGIAnaMCEn MSUraxe CwRMnY 1553E RAFRERAFFL-RAF-M4 G. SER IRBURI ELECTRIC COMPANY m6UFEF a: WA WA IHBURER C: 2921 HANGAR WAY WERSFIELD, CA 933M INSURER D: INSURER E: FolonEA R: 1N012BI3 :ATE 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, EXCLUSIONSAND CONDITIONS OFSUCH POLICIES: LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS 1UL TYPE OF INSURANCE A MAIN POLICY NUMBER MMIOeCiYE1'VY Po U YFSF LltlllB A OERESNLUAwLIN X COMMERCIALGENEMLWBILITY CLAIMSM<DE OCCUR X GL05NKDQDDG 10DIM13 M112014 EACNoccURRENCE E LW90m R N a M,= MEO E%PIM aq I ' $ 10800 PERSONN.&AWINJURY E 1,000,000 GENERA -AGGREGATE 8 2.OWp00 GEN'L AGGREGATE PoLICYX LIMIT WFUMS RO- P PER LOC PRODUCTS-COMPIOPAGG E 2.1100.000 E A AUTOMOBILaLWOUTY X X A YARD. PLL OWNED SCHEDULED —a AUi0. MORECAMBE X g10jTApS:- BAP5503201'DO 1N012BI3 MIM14 MCOMR%D DINGLE LIMIT 1,00,Gjj BODILY IWURY(P[rpunw) 8 BOD0.Y INJURY Ter a ant) E PROPE�RTYpM'AGE S S UMeREiIA We "Calls UAW OCCUR CLAIMS MAGE EACHOCCURRENCE S AGGREGATE S LNG I I RETENTION 8 A WORNEBBCOMPEHBATION ANDEMPLOYERS'UNDRITY YIN ANY OFFICEWMEMBEoFA`AFTNEMXUU.ECURI EO IWndan M No °ASLRIPTIQY °F °PEMTWN6 minv NIA WC55Q11SSA0 T0101304N11 1 WCSTAN °TH- EL EACH ACCIDENT S I'WD'WD EL.DISEASE-EA EMPLOYE $ LOOO,WO EL FE ;F E I`DLD'003 DESCFDRONOFOPERJAR BILMC ONSIVW LM(AINMIACORD10i.MdlUondR .ft&bduN,Ummntpw Hrp ) RE: ALL CA OPFPATIONS. CITY OF BAKERSFIELD, ITS MAYOR COUNCIL, OFFICERS, AGENTS, EMPLOYEES& VOLUNTEERS ARE INCLUDED AS AN ADDITIONAL INSUREDS FOR GENERAL LIABILITY AS REWIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT, PER POLICY EMS AND CONDITIONS. WORKERS COMPENSATION ODES NOT APPLY TO MONWOLSTICSTATES IND, W. WA, AND. Wil, PUERTO RICO OR THE VIRGIN ISLANDS. CERTIFICATE HOLDER CANCELLATION GIN OF BNIERSFIELD LDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATN:GENEMLSERVICES EXPIRATKINDATE THEREOF, NOTICE WILL BE DELIVERED IN JIM TRUXTUNAVE RDANCE WRH THE PoLICY PROVISIONS. BANERSFIEW. CA 93MI LA l REPRESEMATNE U8AHUHey ®1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/06( The ACORD name and logo are registered marks of ACORD TO: FROM: DATE: SUBJECT: Y. K E R S F I E L I7 PUBLIC WORKS DEPARTMENT MEMORANDUM John Ussery, Engineer 11 Bob Wilson, Supervisor 11, Subdivisions October 22, 2013 Encroachment Permit Application for: 4800 Fruitvale Ave Name of Applicant: A -C Electric Description of Encroachment: Place underground conduit across Olive Springs Or to be maintained by A -C Electric. Please review the attached encroachment permit and return to me at your earliest convenience. S:WeRMITS\ENCR0ACH\TRAFFIC\0800 FIWNale Ave.d. TO: FROM: DATE: SUBJECT: • E Ii E i". '; F I E L i) PUBLIC WORKS DEPARTMENT MEMORANDUM Jena Covey, Risk Manager Bob Wilson, Supervisor ll, Subdivisions October 22, 2013 Encroachment Permit Application for: 4800 FruiNale Ave Name of Applicant: A -C Electric Description of Encroachment: Place underground conduit across Olive Springs Dr to be maintained by A -C Electric. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S:\PERMITS\ENCROACH\INSURANCEW800 FruiNale Ave.doc .v e m m C) yx �0 �� DGJAmZ aJ IT1 O O (10 Z pmO SOC R a fTl pnmxo�. G) � or ti ^�n�no C D r m�mcziAo N m y0000 mm <xmzzE I C) m z m m (E)PLANTER i z � m a x C_ APPROX 105' D STREET CENTERLINE _ Fr' OLIVE SPRINGS DRIVE I rn (E)PLANTER I I I m I m v n C ^ I m 7 (/7 x W O � D � C � � a m � a a.• VALLEY BAPTIST ; •' J-1 �-T---T I Iii 'art w�1 -,- 'repare0 Ly Ide City of Bakers(eIE� G. 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