HomeMy WebLinkAbout1212 EUBANKS 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 Numbst . . . . . 14-30000020 are 3/10/14
Property Address 1212 EUEANKS AVE
Application type description PW - ENCROACHMENT PERMIT
Owner Contractor
HERNANDEZ NOELIA OWNER
1212 EUBANKS AV
BAKERSFIELD CA 93307
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Permit ENCROACHMENT PERMIT
Additional desC . .
Phone Access Code . 1441203
Permit Fee . . . . 208.80
Issue Date . . . . 3/17/14 Valuation
0
Qty Unit Charge Per
Extension
EASE FEE
208.00
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Special Notes and Comments
March 17, 2014 11:37:48 AM penriquez.
6' high block wall starting behind face
of house and going around aide yard
behind sidewalk.
Contact Scalia Hernandez (661) 205-0612
Fee summary Charged Paid Credited
v___________ __________ __________
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.
---a��ovr0.
Signature of A00cant (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) CON TE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
THEREFORE PRANTE(DENIED) Said permit shall expire on date stated above.
ti`. \1Ocu�
Signature of City Engineer
Additional Terms on the Back
o�awvo„s ENCROACHMENT PERMIT �'
APPLICATION FORM
d CITY OF BAKERSFIELD
PUBLIC WORKS DEPARTMENT
C y 1501 TRUXTUN AVE
IPO BAKERSFIELD CA 93301
(661)326-3724 Fax: (661) 852-2012
LOCATION OF ENCROACHMENT(Address required where available):
tknf dl a. cG X330-,
If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection
FULL NAME OF APPLICANT
COMPLETE ADDRESS: 1�.(-L Lv i�c,�.,�z.S f Vl — PHONE:
Pry kxf s j" e 1 A C x cv330::t FAX:
CELL:
DESCRIPTION bOF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised
planter, etc.):
PERIOD OF TIME FOR ENCROACHMENT: INDEFINITE or OTHER:
1 (Please Circle)
CONTACTPERSON Jy'tb��r. Px vv�o�_�_ PHONE: �oytaOS-D(o�a.
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 upon the
revocation thereof by the City Engineer, applicant will at his own cost and expense remove the same from the public
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 requited 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 mount 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
S TER 1TSTNCR0ACH\Encmwhmmt Pmmit Req Fnan WC Sept. 2013
6 A K E R S E l E L D
Publio Works Department
1501 Truxlun Avenue
Bakersfield, California 83901
(661) 326-3724
TO WHOM IT MAY CONCERN:
We the undersigned, have no obje0tion to the mnstruckm of a fence beside the sidewalk within the
public right-of-way.
CA.p „na----.s �_�VrL By: 1 -t QAC, \At r npk r .�.V�7—
rrce rpropoSe angrgaCMnenlj (Ownfrs Name
nr 12.11. X, t<(a6l�
(Addmc of pmoosed eneroechmeni)
SIGNED:
1;) Name.
Address:
2-) Name:
IAT•n r�iv Afq.v���r,
Address:
(� ya4 2F�L,n.ApY
3.) Name:
%n . ,� ro,
Address:6.1/
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4.) Name:
(l
Address:
5.) Name:
)PS VS ISalt+,ntY
Address;
AvF
Address'
Di
Date: 031011 g
Date: 63- 03- a
Date:
Date. /p /
Date: 3/—/ o & C f
SPECIAL FORM DWELLING FIRE
FIRE INSURANCE EXCHANGE, LOS ANGELES, CALIFORNIA
A Reciprocal Company
Repktes oR Prim Ir demf ist, R ary
TRANSACTION TYPE: OFFER OF RENEWAL
PoO(YNONRER
PoINYPERgO'•'.� ___ r...r....t ,,,,,,,,,,,,,,
PROPERTY
LIABILITY (OPTIONAL)
A DW[UIIIG DR
FRON:
SE12:0I1
B -FAIR RENTAL
93707-03-25
01-07-2014
0 01-07-2015
12:91 A.M.
01
inls PWry will WNnlme for suuessive
successive n.I oeuod as .P—i—d
NOELIA HERNANDEZ
1212 EUBANKS AVE
BAKERSFIELD CA 93306
.EE Xas
g`4ROVP„
ISSUING OFFICE:
23175 DTWBennett St.
Hillsboro, OR 97124
If" (1) we elect to continue this Pusurence, and (2) if you pay the renewal premium for each
ms, rules and forms III. in effecc
LOCATION OR DBUIPTION Of PROPERTY MARTIN
FSmaroaaa Imeod4arsn al: . wl
YRROF(OXSMC(IION OIRSTIRINNIYPE ':.. _. 0(NPAR(Y
1988 FRAPYE 1 OR 2 FAMILY DWELLING NON -OWNER OCCUPIED
COVERAGES- We aroeide v— —1,, r- .F...a ....._.,.n .:....:....... 1. ----------
PROPERTY
____-_,.
o
other cetnls of the policy. CountersigsamrCCCe---'''��l
AGENT:MAXIMO G. SANCHEZCI 7�
AGENTPNONE: (661) 834-7300 AGENTNUMBER: 95-41-365 /1
Authorord Represcract.
56-5103 NN EDNON IOII 93707-03-25 (Coutintred on Reverre Side)11-14-2013 (5103811
PROPERTY
LIABILITY (OPTIONAL)
A DW[UIIIG DR
B DINER
C -PERSONAL
B -FAIR RENTAL
E-ADNEIGIAI WING
-PERSONAL
F-MEDIfAI PAY
MOAIIF NOME
SBU(NR(S
PROPERTY
VALUE
EXPENSES
OABILITY
TO OTHERS
$214,000
$21,400
$25,000
$21,400
$21,400
$100,000
$500
huh(museas
fish Peu.I
PERILS INSURED AGAINST/COVERAGES PROVIDED
PRENNIf
FIRE AND LIGHTNING
449.
SPECIAL FORM PERILS
$ Ei
PERSONAL LIABILITY
$ 247.43
$ 36.92
TOTAL PREIRIUM.
$ 739.21
OWRSEMENT Wom
fDUNNpNUR
ENDORSEMENT REUIPTION
DP3
9-83
DWELLING FIRE - SPECIAL FORM
CA033
IED
ENDORSEMENT AMENDING CONDITIONS
CA035
IED
AMENDED LOSS SETTLEMENT CONDITIONS
CA042
IED
ENDORSEMENT AMENDING OTHER COVERAGES &
GENERAL EXCLUSIONS
CA047
IED
ENDORSEMENT AMENDING - CONDITIONS (DPI,
DP2 AND DP3)
DP300
3-88
DWELLING FIRE - SPECIAL STATE PROVISIONS
.IMPORTANT NOTICE ADDITIONAL ENDORSEMENTS
SEE E0052
DISCOUNTS
EXPERIENCE RATING PLAN DISCOUNT HAS BEEN APPLIED TO YOUR POLICY.
DEDUCTIBLES
POLICY ACTIVITY
$1,000 Deductible is applicable to covered losses.
$ Previous Balance
734.21 Premium
Am.....IAUmR 01
Fees*
REN S7 NO0 IES "LL
GASuiaM1age
VY APPDN IN -As NIX(
Pun' "IIVR
ts
Paymenor
Credits SIXio"REBPoN sm"
$ Total`
MORTGAGEE PAYS
'SEEADDITIONAL FEE
INFORMATION BELOW
This Declarations page is part of your policy. It supersedes and
o
other cetnls of the policy. CountersigsamrCCCe---'''��l
AGENT:MAXIMO G. SANCHEZCI 7�
AGENTPNONE: (661) 834-7300 AGENTNUMBER: 95-41-365 /1
Authorord Represcract.
56-5103 NN EDNON IOII 93707-03-25 (Coutintred on Reverre Side)11-14-2013 (5103811
;�
S
1
U
�_
•
B A1-: E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Jena Covey, Risk Manager V
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: March 26, 2014
SUBJECT: Encroachment Permit Application for: 1212 Eubanks Ave
Name of Applicant: Noelia Hernandez
Description of Encroachment: 6' high block wall starting behind face of
house and going around side yard behind
sidewalk.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S:NERMITS\ENCROACHMNSURANCE\1212 Eubanks Ave.dm
•
B A IS E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: John Ussery, Engineer II
FROM: Bob Wilson, Supervisor II, Subdivisions
DATE: March 26, 2014
SUBJECT: Encroachment Permit Application for: 1212 Eubanks Ave
Name of Applicant: Noelia Hernandez
Description of Encroachment: 6' high block wall starting behind face of
house and going around side yard behind
sidewalk.
Please review the attached encroachment permit and return to me at your earliest convenience.
S TERMITSIENCROAMTRAFFICN 212 Eubanks Ave.tlac