HomeMy WebLinkAbout1702 18TH STENCROACHMENT 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 . . 09- 30000039 Date 11/03/09
Property Address . . . . . . 1702 18TH ST
Application type description PW - ENCROACHMENT PERMIT
Owner
---------------- -- - - - - --
PADRE HOTEL LP
1600 NATIONAL AV
SAN DIEGO CA 92113
Contractor
------------------ - - - - --
OWNER
----------------------------------------------------------------------------
Permit . . . . . . ENCROACHMENT PERMIT
Additional desc . .
Phone Access Code . 956003
Permit Fee . . . . 208.00
Issue Date . . . . 11/03/09 Valuation . . .
. 0
Qty Unit Charge Per
Extension
1.00 208.0000 EA PW ENCROACHMENT
--------------------.--------------------------------------------------------
208.00
Special Notes and Comments
INSTALL BACK FLOW PREVENTER ON NORTH
SIDE IN ALLEY. CONTACT: JOHN STARR,
858 - 254 -4381.
----------------------------------------------------------------------------
Fee summary Charged Paid Credited
-- ---- -- --- - - - - -- ---- -
Due
- - --- ---- -- - - -- ---- - - -- -- ---
Permit Fee Total 208.00 208.00 .00
- - - - - --
.00
Grand Total 208.00 208.00 .00
.00
Applicant ad
permit at any
Signature of
right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the
(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) 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
•
'000e
S A K E R S F I E L D
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Raul M. Rojas, Public Works Director
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: November 18, 2009
SUBJECT: Encroachment Permit Application for: 1702 18th St.
Name of Applicant. Padre Hotel LP
Description of Encroachment: Install backflow preventer on north
side of bldg. in alley.
Engineering and Traffic staff has reviewed the attached encroachment permit to allow the
applicant to install fence as described above.
The applicant has provided proof of appropriate insurance coverage to Risk Management.
Based on their review, staff recommends approval of the permit.
SAPERMITS \ENCROACH \2009 approval letters \1702 18th StAoc
I E R S F I E L I:
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ralph Korn, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: November 6, 2009
SUBJECT: Encroachment Permit Application for: 1702 18th St.
Name of Applicant: Padre Hotel LP
Description of Encroachment. Install backflow preventer on north side
of bldg in alley.
Please review the attached insurance certificate and encroachment permit and return to me at
your earliest convenience.
S: \PERMITS \ENCROACH \INSURANC \1702 18th StAoc
B A E R S. F I E I, I
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: John Ussery, Traffic Engineer
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: November 6, 2009
SUBJECT: Encroachment Permit Application for: 1702 18`" St.
Name of Applicant: Padre Hotel LP
Description of Encroachment: Install backflow preventer on north side
of bldg. in alley.
Please review the attached encroachment permit and return to me at your earliest convenience.
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SAPERMITS \ENCR0ACH \TRAFFIC \1702 18th st.doc
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Public Works Department
1501 Truxtun Avenue
Bakersfield, California 93301
(661) 326 -3724
APPLICATION FOR ENCROACHMENT PERMI'
Permit Fee $208.00
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.
1. Full name of applicant and complete address including phone number: PAb ~Z.E �Ao-rE L., L LC
1-702 18" 5TR- 15157-
2. Nature or description of the encroachment for which this application is made: (Example: Wood or wrought iron
fence, concrete block wall, raised planter, etc...)
d
3. Location of proposed encroachment: (Example: Side yard at back of sidewalk or front yard at back of sidewalk)
s PVo ,Slae i',v � y
4. Period of time for which the encroachment is to be maintained: I�Firlcle) or Other.
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 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 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 enda��grthQD15,,evidenc-
ing the insurance required. The type(s) and,:ampunt(s) of insurance coverage is:
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke the permit at
any time.
S:\ EncroachmentPermits \ApplicationforEncroachment
B A
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Public Works Department
1501 Truxtun Avenue
Bakersfield, California 93301
(661) 326 -3724
APPLICATION FOR ENCROACHMENT PERMI'
Permit Fee $208.00
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.
1. Full name of applicant and complete address including phone number: PAb ~Z.E �Ao-rE L., L LC
1-702 18" 5TR- 15157-
2. Nature or description of the encroachment for which this application is made: (Example: Wood or wrought iron
fence, concrete block wall, raised planter, etc...)
d
3. Location of proposed encroachment: (Example: Side yard at back of sidewalk or front yard at back of sidewalk)
s PVo ,Slae i',v � y
4. Period of time for which the encroachment is to be maintained: I�Firlcle) or Other.
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 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 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 enda��grthQD15,,evidenc-
ing the insurance required. The type(s) and,:ampunt(s) of insurance coverage is:
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke the permit at
any time.
S:\ EncroachmentPermits \ApplicationforEncroachment
B A K E R S F I E L D
Public Works Department
1501 Truxtun Avenue
Bakersfield, California 93301
(661) 326 -3724
TO WHOM IT MAY CONCERN:
We the undersigned, have no objection to the construction of a fence beside the sidewalk within the
public right -of -way.
- F1 02 1 qi,' 'S-'Lec-c By:
(Street for proposed encroachment) (Owners Name)
Of
(Address of proposed encroachment)
SIGNED:
1.) Name: Date: 1(1 0-4) Oq
Address: _
2.) Name: Date:
Address:
3.) Name:
Address:
4.) Name:
Address:
5.) Name:
Address:
Date:
Date:
Date:
6.) Name: Date:
Address:
ACORD,� CERTIFICATE OF LIABILITY INSURANCE
=DA (MMIDDIYYYY)
08/2009
PRODUCER (831) 624 -6065.
MBK ` Insurance Services
PO BOX 222634
Carmel. CA 93922-
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Gold Coast Renovations
17667` Vickers Street
San Diego CA 93940-
INSURER A: First Specialty Ins
POLICY EFFECTIVE
DATE MMIDDIYY
INSURER B:
LIMITS
INSURER C:
INSURER D
IRG62138 -1
1 INSURER E:
12/31/2009
COVERAGES
THE POLICIES OF INSURANCE LIHTED 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.
AGGREGATE LIMITS, SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
AOD'L
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDIYY
POLICY EXPIRATION
DATE MMIDDIYY
LIMITS
A'
GENERAL LIABILITY
IRG62138 -1
10/27/2008
12/31/2009
EACHOCCURRENCE
$ 1,000,OOD
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 50,000
X COMMERCIALGENERALLIABILITY
CLAIMS MADE F-I OCCUR
MED EXP (j!Ln'y one erson
_,...
$ _
PERSONAL BADVINJURY
S 1,000,000
GENERALAGGREGATE
$ 2,000,000
�'
✓
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP /OP AGG
$, 2,000,060
POLICY X JEST LOC
AUTOMOBILE LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ee accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
I I
I I
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
!
PROPERTYDAMAGIE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY -EA ACCIDENT
$
OTHERTHAN EAACC
$
ANY AUTO `
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
I I
I . I
EACH OCCU I RRENCE
$
OCCUR I CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
S
RETENTION..
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
I
CC gg TTUU
TRY LIMIT ET
ANY PROPRIETOMPARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFMCERIMEMBER'EXCLUDED?
If yes, desc�ke under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Rai Walkway Encroachment at ,Padre Hotel
10 day, notice for. cancellation by non payment of premium
RFRTIGIf`ATF 41A1 nFR
1567aar44 a0W%drela
A ORD CORPORATION 1988
Page 1 of 2
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City Of Bakersfield
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
1715 Chester 'Blvd
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
Bakersfield, CA 93301
INSURER ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE n
-
A ORD CORPORATION 1988
Page 1 of 2
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