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Home My WebLink About324 S H 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 . . . . . 14- 30000073 Date 12/30/14 Property Address . . . . . . 324 S H ST Application type description PW - ENCROACHMENT PERMIT Owner Contractor ------ ------- ----- - - - - -- ------------------------ ROCHA AUGUSTIN & TORRES HERMIN OWNER 324 S H ST BAKERSFIELD CA 93304 ---------------------------------------------------------------------------- Permit . . . ENCROACHMENT PERMIT Additional desc . Phone Access Code 1572205 Permit Fee . . . . 208.00 Issue Date . . . . 12/30/14 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 208.00 ---------------------------------------------------------------------------- Special Notes and Comments Existing 4' tall block wall behind sidewalk around front yard. Agustin Ortiz (661) 316 -2371 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------- - - - - -- ---- - - - - -- ---- -- - - -- ---- -- - - -- ---- - - - --- Permit Fee Total 208.00 208.00 .00 .00 Grand Total 208.00 208.00 .00 .00 Applicant ac edge the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke th ermit t any time. Signature pp scant 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. gnature of City Engineer Additional Terms on the Back ENCROACHMENT PERMIT APPLICATION FORM CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE BAKERSFIELD CA 93301 (661) 326 -3724 Fax :(661)852 -2012 LOCATION OF ENC ACHMENT(Add s�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 COMPLETE ADDRESS:. DESCRIPTION OF ENCROA planter, etc.): Q r-- FAX: I U ??kC' -_7 3 5�_ CELL: C;�C„ l 3� 23 7 �-=-- PROJECT INFORMATION ENT (Example: Wood or wrought iron fence, concrete block wall, raised- (r-\. ;z l0 11 4' PERIOD OF TIME FOR ENCRO CHMENT: INDE CITE or OTHER: Please CONTACT PERSON L � �. -, PHONE: �.:� Applicant agrees that if this application is r ted, applicant shall lad�ionsf causes of action or demandstwh whatsoever officers agents and employees against any and all liability, claims, against them, or any of them, before administrative, quasi-judicial, , u er b d a 1plicant or any other person or entity) or mg out g (Y P of, connected with, or caused by applicants placement, erec , 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 fo'r c st h this a pli remove the samef r nt dt or ubl� lc revocation thereof b the Ci Engineer, a licant will at >s o roe or ri ht of wa where the same is located and restore said maintenance public or existence property ofrigh of way to the condition as nearly as that in which it was before the placing, erection, Applicant further agrees to obtain and keep all liability insurance require dR by skhManage far PP with a Certificate of Insurance however long the encroachment remains. Applicant shall furnish the evidencing sufficient coverage for bodily injury or property damagliability uir boare:nd required endorsements evidencing th the insurance required. The type(s) and amount(s) of insurance coverage q 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 employees, and designated The Commercial Liability policy must identify City and City's mayor, council, officers, agents, employ volunteers as Additional Insureds. -k)\ Encroachment Permit Fee: $208. `'� Encroac 00 Sept. 2013 S:\P F .RMITS \ENCROACf-1 \1sncroachment Permit Req Form.DOC S p u E R 5 E 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 bdside the sidewalk wits the public right -of -way. By. wners mo� 'troet or pro osa eitcroac anent (� (Address of proposed encroachment) _e SIGNED: 1.) Name: / ✓"" — Address'. 2.) Name: Address: 3) Name: Address: 4.) Name: Address: 5.) Name-. Address: 6.) Name: Address: Date' / 1 c"-- DptG —�j ` 1q D e Pt Date: Date: Date: i SAL SRITO STATE FARM PAGE 01102 _2/2912014 15:51 6613985147 Applicant Name: ORTIZ, AGUSTIN R State Parts General Insurance Company Binder Effective Date: 11- 13-2014 CA Rental Dwelling mcP- N774 -3 Application I Binder- Receipt NEW BUSINESS APPLICANT: pRTIZ, AGUBTiN R MAILING AAARESS B"Login K RSF EDLD, CA 93$04-2604 MORTGAGES TERESTS: ae astaneda, Trustee of the AHS Land Trust Th! ST STE 8110 -123 FIELD, CA 93301 -2300 private beney BILLING: Put application on SFPP: No Renewal Bills to: Named Insured COVERAGES t PREMIUM SECTION: Type: RENTAL DWELLING Policy Coverage Section I Dwelling (Coverage A) Dwelling Extta Replacement Cost Dwelling Extension Personal PropertY (Coverage B) Soctlon It Business Liability (Coverage L) each Occurrence Coverage L) annual Business Liability aggregate Premises Medical Peyments (Coverage M) each person Loss of Rents (Actual loss Sustained) Accepted Options CO-APPLICANT: MADRIGAL, yERMINDA PROPERTY LOCATION BAKERS 1D, CA 93304 -3439 Endorsement Bills to: Named Insured Policy Deductible: 5,000 Limit premium Endorsements 1,196,00 Form 438 BFUNS Lenders Loss 281,000 Payable Endorsement 56,200 10.00 92,100 41.00 14,050 300,000 600,000 1,000 Discounts 1 Charges 72.00 Utility rating plan (394.00) Policy deductible $924,00 Total Premium: $0.00 Amount Paid: Credit Amount: $924.00 Balance Due: UNDERWRITING: Has applicant had any losses, insured or not, in the past 3 Years: No EB 2012 CA.1 Rev. 01 -2011 Decllned Options I Endorsements Building Ordinance or Law Building ordinance or Law Building Ordinance or Low CA Fair Plan Policy Peril Excl Inflation Coverage Deletion Loss Assessmant Modified LOSS Settlement Replacement Cost on Contents - Opt RC Stored Personal Property vacancy Rate IV: 100% I-ImIt Premium 10% 26% 50% Page 1 Of 2 12/29/2014 15:51 6613985147 SAL SRITO STATE FARM PAGE 02102 State Farm General Insurance Company Applicant Name: ORTIZ, AGUSTIN R Finder Effective Date: 11 -13 -2014 CA as any insurer or agency canceled or Rental dwelling 90�CP- N774 -3 Application 1 plindar- Recelpt or renew similar insurance or any in the past 3 years: No Has the applicant been convicted of arson, fraud, or other insurance related offenses: o APPL.ICANT(S) ACKNOWLEDGEiMENT: e that: (1) You have road this application, () y 2 our statements on this application are correct, (3) the Coverages, By submission of this application, you agre including options and endorsements, and the amounts of coverage on this application are those chosen by you, and (4) the premium Charged must comply with State Farm's rules and rates and may be revised. BINDER; described for up to ninety (90) days from the Effective State Farm will provide coverage to the applicant and his or her legal representative application the property olicy for which application has been made or when Date, subject to all terms and conditions welpbe'void when the deal�arat�onsllp gepslissued on the boon matle, If no Effective Date is Indicated, this Binder does not provide any coverage. This Binder coverage under this Binder Is canceled in accordance with policy provisions. The premium due state Farm for the coverage provided �d tunder thlsrBlndee the full annum premium for the policy for which application has been made, and will be pro -rated for the length of time coverage AGENT INFORMATION: App date and time: 11.13 -2014, Q9 :07 AM Agent: Sal Brito CPCU Location Address: O R SIG 107 akersfield,CA 93304.4100 Agent / AF'O Code: 3072 / 12FA98 IMPORTANT NOTICES Agent Phone: (681)398 -5144 REGARDING CONSUMER REPORTS•,. junction with this appllcatlon. These reports provide information that assists with determining your eligibility for Consumer reports maybe ordered In con insurance, roximate Cost for labor REGARDING YOUR RENTAL DWELLING COVERAGE AMOUNT.... os and limits The limit of liability for this structure (Coverage A) is based on an estimate of the cost #o rebuild your rental dwelling, including en app limit at least equal to the estimated replacement cost of your rental dwelling. and materials In your area, and specific information that you have provided about your rental dwelling. It is up to you to choose the covera ' that meet your Hoods. We recommend that you purchase a appraisers, or, our a ent can provide an estimate from a third - our rental dwelling. We can accept the type of estimate you Choose as long as it provides a reasonable Replacement cast needs. We re are available from building contractors and replacement cost app , y party vendor using Into you provide about y requirements. level of detail about your rental dwelling State Low elldoe' aroe also aVtailablet as long as the amount of coverage meets our underwriting req dwelling. ts Higher limits are available at higher p es or additions to your rental dwaliing. We encourage you to periodically review your coverages and limits with your agent and to notify us of any Chang REGARDING PERSONAL, FAMILY OR HOUSEHOLD INSURANCE TRANSACTIONS,.. We occasionally collect personal information from persons other than the individual or individuals applying for eaverage. Such personal Information may, r certain circumstances, be disclosed to third parties without your authorization. If you would like additional information Concerning the collection and disclosure of personal In -and your right to see and correct any personal information In your flies - it will be furnished upon request, Page 2 of 2 EB 2612 CAA Rev. 01.2011 --JWAFAk yy h6 MA r. nm ' tT 77 PA. --JWAFAk yy h6 MA r. f. 77 f. E _-k K E R S F I E L. L� PUBLIC WORKS DEPARTMENT MEMORANDUM TO: John Ussery, Engineer III FROM: Bob Wilson, Supervisor II, Subdivisions DATE: December 31, 2014 SUBJECT: Encroachment Permit Application for: 324 S H Street Name of Applicant: Agustin Rocha & Herminda Torres Description of Encroachment: Existing 4' high block wall behind sidewalk around front yard. Please review the attached encroachment permit and return to me at your earliest convenience. xt ock Aw- nab �1 G dhst 5�G�Z�N/l fZ e7�(�n er�l �2¢ SAPERMITS \ENCROACH\TRAFFIC\324 S H St.doc B A K E I. S F I E L T PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Bob Wilson, Supervisor Il, Subdivisions DATE: December 31, 2014 SUBJECT: Encroachment Permit Application for: 324 S H Street Name of Applicant: Agustin Rocha & Herminda Torres Description of Encroachment. Existing 4' high block wall behind sidewalk around front yard. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S: \PERMITS \ENCROACH \INSURANCE \324 S H St.doc