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Home My WebLink About800 KINGSCROSS AVEENCROACHMENT PERMIT CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE BAKERSFIELD CA 93301 (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 13-30000075 Date 10/30/13 Property Address 800 KINGSCROSS AVE Application type description PW - ENCROACHMENT PERMIT Owner Contractor BARASAS FRANK S WENDY OWNER 800 KINGS CROSS AV' BAKERSFIEM CA 93307 Permit . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 1390178 Permit Fee . . . . 208.00 Issue Date . . . . 10/30/13 Valuation 0 Qty Unit Charge Per Extension 1.00 208.0000 EA PN ENCROACHMENT 208.00 ,______-__- _ _____ _ Special Notes and Comments October 30, 2013 2:20:06 PM mmendenhal. Existing 9' chain link fence at back of sidewalk. Contact person: Wendy Barajas 661-343-7525 see e _____________________. mary Charged Paid Credited Due -------__________ __________ ______________________________ Permit Fee Total 208.00 208.00 .00 .00 Grand Total 208.00 208.00 .00 .00 Applicant ackn wledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to rev a th pe it ata time. �1 SI ahire o Applic t (QA r/Agen 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 (GRANTbD) (DENIED) Said permit shall expire on date stated above. 4�- Signature of City Engineer Additional Terms on the Back /3 3"0075- A ENCROACHMENT PERMIT APPLICATION FORM o CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE BAKERSFIELD CA 93301 (661)326-3P-4 Fax: (661) 852-2012 LOCATION OF. ENCROACHMENT(Address required where available): a �S�, \&, Ca, G�3u� If there is no addres jacent to work describe limits of work by distances from nearest existing street intersection. \ APPLICANT INFORMATION FULL NAME OF APPLICANT W 2r - COMPLETEADD,R/ESS: le--��d0�,� row u PHONE: L6i- S'S�- 833$ S'�e def S�. EI ck 1 CA- Ct FAX: CELL: !Q I e l - 343- ISds PROJECT INFORMATION DESCRIPTION OF EN OACHMENT (Ezample: Wood or wrought iron fence, concrete block wall, raised planter, etc.): _ SQL ti (' �GL1 N G I7GC� 0 A PERIOD OF TIME FOR ENCROACHMENT: INDEFINITE or OTHER: CONTACTPERSON��kYVC� �j Circle) PHONE: tp�o I 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 rooked. Applicant further agrees that upon the expiration of the permit for which this application is made, if granted or own the revocation thereof by the City Enaineer, applicant will at his own cost and expense remove the same from the public pronerty 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 fm 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 types) 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: 5208.00 S�rMEWROACr�noacrmm �t Req F..p Sept Mm3 B A K E R S F I E L D Public Worke Depoubnent 1501 Tmstun Avenue Bakersfleld, Cakfomia &1301 (661)326-3724 TO WHOM IT MAY CONCERN: We the undersigrad, haft m ob)ectim to the ccroucdon of a fence besme the sktewaik within me Public agm-of+way. 1.) Name: Address: 2.) Name: / ( Address O' .t C /v, 5 WP /� 3.) Name: C.�— Address: Wj(-10 3a1o.1owc t,4- \,�Prnn 4.) Name: Address: Js,� -toss nJP 5.) Name: Address: i t//'rc s5 ri tet. 6.) Name: ll tYt� 6.t/IA JW.WLKw ' Address: ��arCrdss� w4C�{'ifQ�/ Date: /u Date: % ' ICbI 3 - Date: ojs,l3 Date: (b11SLL3 ,yam Date: b ?q i" �6 Declaration Number: 003 Effective Date: 09/17/2013 Page 3 Policy Number: XH0215801-11 Frank & Wendy Barajas COVERAGE DECLARATIONS Location Address: 800 Kings Cross Ave Bakersfield, CA 93307 Basic Coverages: Limit Deductible Section I Coverages: Cov A - Dwelling $ 207,000 $ 500 Cov B - Detached Structures $ 20,700 $ 500 Cov C - Personal Property $ 144,900 S500 Cov D - Lass of Use $ 41,400 Section R Coverages: Cov E - Personal Liability $ 300,000 Cov F - Medical Payments Each Person $ 1,000 Each Accident $ 25,000 Property Insurance Disclosure: This location Includes Specified Additional Amount of Insurance for Coverage A - Dwelling. This location Does Not Include Earthquake Coverage. This location Does Not Include Building Code Upgrade (Ordinance or Law) Coverage - Form PHOO41009 Not Purchased- urchasedThis Thislocation Includes m Annual Inflation Guard of4%. Additional Coverages Form Limit Premium Personal Property Replacement Cost H004901OW Refer to Form $ 0 Speeded Add? Amt Insurance Cov'A' PHOO81009 Refer to Form $ 10 H.O. Plus PH0011012 Refer to Foran $ 25 Identity Theft Coverage PH061761009 Refer to Form $ 25 Workers Compensation H024900801 $ 100,000 $ 5 Data Printed 10/07/2013 INSURED xomw.mv�rxa�.,Ro� • B A h E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager . u FROM: Bob Wilson, Supervisor Il, Subdivisions DATE: November 12, 2013 SUBJECT: Encroachment Permit Application for: 800 Kingscross Ave Name of Applicant: Frank and Wendy Barajas Description of Encroachment: Existing 4' high chain link fence at back of sidewalk. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. 8]PERMITS\ENCR0ACH\INSURANCE\800 Kingsaws Ave,doc • h E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer II FROM: Bob Wilson, Supervisor II, Subdivisions DATE: November 12, 2013 SUBJECT: Encroachment Permit Application for: 800 Kingscross Ave Name of Applicant. Frank and Wendy Barajas Description of Encroachment: Existing 4' high chain link fence at back of sidewalk. Please review the attached encroachment permit and return to me at your earliest convenience. �� Lf/V�'�t• ,c,f7G OP�Sygue7' U✓�5 GK ll-r5'l3 A S; PERMITSENCROACMTRAFFIC\800 Kingscross Aw,dtl