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HomeMy WebLinkAbout2730 21st StretENCROACHMENT 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 . . . . . 18- 30000016 Date 9/17/18 Property Address . . . . . . 2730 21ST ST Application type description PW - ENCROACHMENT PERMIT Owner ------------------------ GALYAN NEIL EDWARD & JENNIFER 2730 21ST ST BAKERSFIELD CA 93301 Contractor ------------------ -- - - -- OWNER ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 2248334 Permit Fee . . . . 420.00 Issue Date . . . . 9/17/18 Valuation . . . . 0 Qty Unit Charge Per Extension BASE FEE 420.00 ---------------------------------------------------------------------------- Special Notes and Comments Will construct a 6' concrete block wall around side and back yard minimum 5' from eqlkre of curb. a G Jill Galyan (661) 472 -8603 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due --- -------- - ----- ---- - - - - -- ---- - - - - -- ---- -- - - -- ---- --- - -- Permit Fee Total 420.00 420.00 .00 .00 Grand Total 420.00 420.00 .00 CC Applicant acknowledges the right of the City Engineer, revoke the permit at any time. m i l (Nqo �V& Signature of pp'(icant (Oj r�r /Adept) pursuant to the Bakersfield Municipal Code Chapter 12.20 to ' 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. (.QENIED) Said permit shall expire on date stated above. Signature of City Engineer Additional Terms on the Back Applicant agrees that if this application is granted, applicant shall indemnify, defend, and hold harmless 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 or judicial tribunals of any kind whatsoever, arising out of connected with, or caused by applicant, or in any way arising from, the terms and provision of this permit or the placement, use (by applicant or any other person or entity) or maintenance of said encroachment, whether or not caused in part by a party indemnified hereunder, except for CITY's sole active negligence or willful misconduct. The applicant further agrees to maintain the aforesaid encroachment, including, but not limited to, repairing or replacing the encroachment at Applicant's cost even if CITY inadvertently damages or destroys the encroachment in the ordinary course of CITY's business, during the life of the 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 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 must contact Dig -Alert at 811 at least 2 full working days prior to all excavating. 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 issuance evidencing sufficient coverage for bodily injury or property damage liability of both and required endorsements evidencing the insurance required. 1 have read and acknowledge the above. Applicant's Initials 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 ENCROACHMENT(Address required where available): Gorn�i- 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 wo `.�! +, � ( -)4 Luc1 n (rte) COMPLETE ADDRESS: `J� U "�J�lfi 4 • PHONE: (gefl L4 I 13-1 , - ��r✓y��t�l�� ;Cn FIFAX:- �' /�i ( CELL: 3111 PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised planter, etc.): �N PERIOD OF TIME FOR ENCROACHMENT: DEFINIT , or OTHER: (Please Circle) CONTACT PERSON PHONE: (UW) — 4L4 C � ri'CYa C"fGl' 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 prope - 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: $420.00 S :\PERMITSIENCROACH\Encroachment Permit Req Form.DOC Aug. 2017 • BAKERSFIELD Public Works Department 1501 Truxtu n Ave n ue 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. (N(-fle � By: W11 � .fi11I 6u1�a�� (Street fd2r proposed en roachmentt)/ _ 2 ` (Owners Name) l '] ' C 'J�1 Phone• ll� �' LAI r r 7 V (Address of proposed encroachment) 1.) Name: �-- - - Address: 2.) Name: Address: at " Date: eb I I3I1q) Date: Si l S 1 3.) Name: � �v c r ` , Date: Address: .Z ( a f! S l-yg -o 4.) Name:�llr�' �N�f�?t,�►� ?/U Date: / la Address: ? Sf -'� lurzf5 t' C-L -0 5.) Name" Date: Z� I h 6.) Address: a as Name: ► `�u ya �An�, Date: Address: J-26 • See Signatures needed for approval page 1 ! ! 1 i i i i i ! ! 1 Y 1 1 / 1 1 1 1 1 1 i i------------------ l 1 i 1 i ! ! ! 1 ! ! ! ! ! 1 ! ! 1 i i ! ! 1 1 i i i i ! 1 1 1 1 1 1 1 V= 341' cp� ti .91 Z zi — %;u of ko f.d tV 40 10 10 co 75-) Bakersfield, California - Google Maps Go gle Maps Bakersfield, California 2730 21 st Page 1 of 8 Image capture: Dec 2011 P 2018 Google Google, Inc. Street View - Dec 2011 wESTCHI 2730 215 21st https: / /www.google.comlmaps / @35. 3786816, - 119 .0339771,3a,75y,125.5h,92.82t /data =! 3... 10/2/2018 2100 Myrtle St - Google Maps Go gle Maps 2100 Myrtle St 2730 21 st Street Pagel of 8 Image capture: Dec 2011 © 2018 Google Bakersfield, California Google, Inc. Street View - Dec 2011 WESTCHI 273021s 21 st https: / /www.google.com/maps/ @35.3784087; 119. 0339595,3a,60y,50.97h,84.25t /data =! 3... 10/2/2018 Policy Endo aarnent (Insured Copy) Policy No: WHO 070548600 (03) May 31, 2DI8 Page 1 Insurance Provided by MCGRAW INSURANCE SERVICES P.O. BOX 40 ANAHEIM, CA 92815 -0040 Named Insured NEIL GALYAN GALYAN, JENNIFER J 2730 21 ST BAKERSFIELD, CA 93301 CALIFORNIA HO -3 Preferred Homeowners Insurance This is your Endorsements Page Policy N,..: WHO 070548600 I'o!icy Type: HO.3 PREFERRED PERSONAL HOMEOWNERS Policy Term: April 13, 2018 to April 13, 2019 at 1101 m Standard Time at the address of Named Insured as stated herein This policy has been endorsed for the following reasons and enderaemem dab is 05518018. IU INSPECTION COMPLETED Coverage Summary Insured Location: 2730 21 ST BAKERSFID.D CA 93301 05131018 -00t!�� Pacific Specialty Undern-ritten By PACIFIC SPECIALTY INSURANCE COMPANY FINANCIAL RATING: 'A' (EXCELLENT) BY AM BEST STATUS: ADMITTED Insuramn Noducer PRODUCER: B26391, (661)- 327 -1000 FRANK@GONGI.US CA NEW GENERATION INS SVCS INC 4801 WILSON RD BUILDING A BAKERSFIELD, CA 93309 w AcificspecWty.com Manage your account. Pay bills. For policy service /questions contact your producer at (661)-327-1000 or CIS at 1. 800.303 -5000 1. 8049624172 (For claims service) Please see next page for a full list of coverages, credits and adjustments applied to your policy, as well as other available options. Coverage Limit Deductible DED, UNLESS SPECIAL DED. BELOW $1,000.00 ............................... ................................................................................................................................. A DWELLING $490,000.00 ............................... ................................................................................................................................. AP PREMIER PACKAGE ............................... ................................................................................................................................. Al 25% EXTENDED REPLACEMENT COST ............................... ................................................................................................................................. A2 ORDINANCE OR LAW COVERAGE 10.00% ............................... ................................................................................................................................. A3 INFLATION GUARD 4% ............................... ................................................................................................................................. A6 LIMITED SEWER OR DRAIN BACKUP $2,500.00 ............................... ................................................................................................................................. B OTHER STRUCTURES $49,000.00 ............................... ................................................................................................................................. C PERSONAL PROPERTY $245,000.00 ............................... ................................................................................................................................. C1 REPLACE COST PERSONAL PROPERTY ............................... ................................................................................................................................. D LOSS OF USE ................................................................................................................................. $98,000.00 ............................... Policy Fndontetttent (Inured Copy) Policy No: WHO 0705486-00 (03) May 31, 2018 Page 2 E PERSONAL LIABILITY $300,000.00 ............................... ................................................................................................................................. EIE ANIMAL LIABILITY EXCLUSION ............................... ................................................................................................................................. F MEDICAL PAYMENTS $1,000.00 ............................... ................................................................................................................................. I4 IDENTITY THEFT ............................... ................................................................................................................................. MPD MULTI POLICY DISCOUNT 1 - Tier ............................... ................................................................................................................................. NEW NEWLY ACQUIRED HOME DISCOUNT ............................... ................................................................................................................................. PPG AGE OF PLUMBING SURCHARGE 20 No. of years ............................... ................................................................................................................................. P18 TRAMPOLINE EXCLUSION ............................... ................................................................................................................................. P19 DIVING BOARD & SLIDE EXCLUSION ............................... ................................................................................................................................. RFR ROOF REPLACEMENT COST ............................... ................................................................................................................................. SLC ................................................................................................................................. SERVICE LINE COVERAGE ............................... Policy Coverage Pmniun (excluding iera): You saved S229A0 by being a Pacific Specialty policyholdorl THIS IS NOT A BILL — Any paylnent i1 formation hill be requested separatelY f fapplicable). Please read your policy carefully for coverage details. Please be aware that an independent inspection company will conduct the required exterior inspection of your property. You do not need to be present for the inspection to occur. 05.3112018 $1,382.00 Policy Fadonement (Insured Copy) Policy No_ WNG 0705486-00 (03) May 31, 2018 Page 3 Outline of Coverage Detail Coverage Limits Deductible Premium ................................................................................................................................. ............................... Dwelling A DWELLING $490,000.00 $1,482.00 ................................................................................................................................. ............................... Al 25% EXTENDED REPLACEMENT COST INC. ................................................................................................................................. ............................... 8 OTHER STRUCTURES $49,000.00 INC. ................................................................................................................................. ............................... RFR ROOF REPLACEMENT COST INC. ................................................................................................................................. ............................... Pasaoal Property C PERSONAL PROPERTY $245,000.00 INC. ................................................................................................................................. ............................... C1 REPLACE COST PERSONAL PROPERTY INC. ................................................................................................................................. ............................... Liability E PERSONAL LIABILITY $300,000.00 INC. ................................................................................................................................. ............................... EIE ANIMAL LIABILITY EXCLUSION INC. ................................................................................................................................. ............................... F MEDICAL PAYMENTS $1,000.00 INC. ................................................................................................................................. ............................... P18 TRAMPOLINE EXCLUSION INC. ................................................................................................................................. ............................... P19 DIVING BOARD & SLIDE EXCLUSION INC. ................................................................................................................................. ............................... Otha AP PREMIER PACKAGE $148.00 ................................................................................................................................. ............................... A2 ORDINANCE OR LAW COVERAGE 10.00% INC. ................................................................................................................................. ............................... A3 INFLATION GUARD 4% INC. ................................................................................................................................. ............................... A6 LIMITED SEWER OR DRAIN BACKUP $2,500.00 INC. ................................................................................................................................. ............................... D LOSS OF USE $98,000.00 INC. ................................................................................................................................. ............................... SLC SERVICE LINE COVERAGE $23.00 ................................................................................................................................. ............................... Additional Cre it MPD MULTI POLICY DISCOUNT 1 - Tier $82.00 - ................................................................................................................................................................ NEW NEWLY ACQUIRED HOME DISCOUNT $147.00 - ................................................................................................................................................................ Additional Chug. PPG AGE OF PLUMBING SURCHARGE 20 No. of years $33.00 ................................................................................................................................. ............................... Doductibla • DED, UNLESS SPECIAL DED. BELOW $1,000.00 INC. ................................................................................................................................. ............................... Policy coverage premium: $1.482.00 ................................................................................................................................. ............................... POLICY FEE (Fully earned) $30.00 ................................................................................................................................. ............................... 0 513 1 f2018 Policy Fadomment (Inured Copy) Polley No, WNG 0705486 -00 (03) May 31, 2018 Page 4 INSPECTION FEE (Fully earned) $40.00 ................................................................................................................................. ............................... Total Policy Premium after the change: Total Policy Premium before the change: Difference: Total Prorated Premium Change: You aawd $229A0 by being a Pwifio SpecWvy policybolder: Policy and inpoetion fees, if charged, am fully eamod tmtained i. — Plcaae be a%vm that the following fm may apply: A mintatement (cc of $10 will apply if your policy is cancelled aW then minim ed. - A ca ollatioo fee of S25 will apply if the policy is c lled at your mquest. R* 1WS IS NOT A BILL— Any payment information r still be requested separately (if applicable). Please read your policy carefully for coverage details. THIS POLICY DOES NOT INCLUDE OPTIONAL EARTHQUAKE COVERAGE. 05312018 $1,552.00 $1,552.00 $0.00 $0.00 Policy Fndoeem t (Insured Copy) Policy No_ WNG 0705486-00 (03) May 31, 2(118 Page 5 Lknboldm information we send certain notices such as coverage summaries and cancellation notices to the following: l.ienhoidar CALIBER HOME LOANS, INC. ISAOA /ATIMA PO BOX 7731 SPRINGFIELD, OH 45501 Loan No.: 9738752055 05131201 B Lionhoklor CALIBER HOME LOANS, INC. ISAOA /ATIMA PO BOX 7731 SPRINGFIELD, OH 45501 Loan No.: 9738752055 Pocky Eldasumnt (Insumd Copy) Policy No. MING 070548600 (03) May 31, 2018 Page 6 Dwelling's Eatimated Replacement cat Thank you for choosing to insure your dwelling through Pacific Specialty Insurance Company. Our assessment of the information you provided on the application, as well as the inspection of the dwelling's exterior, has been used to calculate the estimated replacement cost of your home using the 360Value estimating tool. The estimated replacement cost and some of the information you provided about your home appears below. Estimated Cost to replace your home based on 36OValue estimating tool: Insurance amount you selected on your Homeowners Policy: $468,738.34 $490,000.00 Estimate Number: B86XS3F.04 Estimate Date: Mar 29, 2018 Year built: 1934 Total living area: 2,567 Square Footage Quality grade: Above Average Use: PRIM Roof Type: 100% Wood Shingles or Sha Garage Type: 2 Car (397 - 576 sq. ft.) Attached / Built -In Porches: 45 Square Footage Decks: None Fireplace(s): None Number of Stories: 2 Stories Foundation Type: 10% Concrete Slab Exterior Wall Finish: 100% Masonry Stucco Exterior Wall Construction: 100% hood Framing Additional Adjustment: None The replacement cost calculation containing the valuation used to determine the estimated cost to rebuild your home is available by using the following URL: http: // producers. mcgrawgroup. com /webappsY/ verisk/ RCE36OV/ CA /HO3/WNG705486- B86XS3F- V4.pdf The online version of the estimate is available for approximately 60 days and will show the features of your home that you provided to your producer. The dwelling coverage should be an amount sufficient to replace the home in the case of a total loss. Please be aware that it is ultimately the insured's responsibility to obtain adequate insurance coverage. If you feel that the dwelling replacement cost estimated above is insufficient, you should increase the coverage to the amount you feel is appropriate. The following statement is required by California Insurance Code 10103: 'The limit of liability for this structure (Coverage A) is based on an estimate of the cost to rebuild your home, including an approximate cost for the labor materials in your area, and specific information that you have provided about your home. We encourage you to review your complete estimate online to confirm estimate details. Your producer can assist you with any estimate changes, such as adding more detailed information about features of your home. The more detail you can add, the more the estimate will reflect the actual features of your home, and the less the estimating tool will need to rely on assumptions about your home. If you have any questions regarding the 360 Value estimate or the coverage amounts you selected or if you would like an additional copy of the complete 360 Value estimate that was created for your home based on the informatin you provided, please contact your producer CA NEW GENERATION at (661)- 327 -1000. Thank you for choosing Pacific Specialty Insurance Company. 0531=18 Policy Endorsement (Inured Copy) Policy No: WNG 0705486-00 (03t May 31, 2018 Page 7 Your policy does not contain the following coverage options: - AU ULTRA PREMIER PACKAGE - AS 50% EXTENDED REPLACEMENT COST - CR4 UNSCHED. PERS. PROPERTY (ACV) - C2 ENHANCEMENT - JEWELRY, GOLDWARE - C3 COMPUTER EQUIP.(SEE SUBLIMITS) - C3A PERSONAL COMPUTER SYSTEMS - C38 PERSONAL COMPUTER PROGRAMS - C3C DATA RE- CREATION - C4 HOME FREEZER CONTENTS COVERAGE - C5 SCHEDULED PERSONAL PROPERTY - C6 INCR.UNSCHED.PROP.IN BUSINESS - D1 SUPERIOR HOME PROT. PACKAGE - EBC EQUIPMENT BREAKDOWN COVERAGE - E1 ANIMAL LIABILITY - E2 PERSONAL INJURY LIABILITY - E3 PERS. LIA. EXTENDED TO OTHER - H EARTHQUAKE - H05 SPECIAL PERSONAL PROPERTY - I1 ID THEFT W/ CREDIT MONITORING - I2 IDENTITY THEFT WITH ID ALERT - U 4388FU MORTGAGEE CLAUSE Please contact your producer to learn about these coverage options. Your policy premium does not incude the following premium credits: CRF TILE ROOF CREDIT - CRG GATED COMMUNITY CREDIT CRR RETIREMENT COMMUNITY CREDIT CRI BURGLARY PROTECTION CREDIT CR2 FIRE PROTECTION CREDIT GRC GATED RETIREMENT COMM. CREDIT - QPP AFFINITY DISCOUNT - S AGE OF HOME CREDIT Please contact your producer to see if you qualify for any additional premium credits. Important: If a payment plan is utilized, a fully earned service charge will be added for each installment payment made by the Insured. The maximum service charge applied per installment payment is $10.00. Service charges are determined at the time a payment plan is selected. Service charges are not charged on down payments, on installments not tendered due to early payment of your premium balance, or on the entire premium payment. An installment invoice will be sent to the Insured detailing the required payment amount and payment due date. Payments must be received in our office prior to the due date or the policy will be cancelled for non - payment of premium. Fraud Stuemem For your protection California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. 053 i f2018 Poky Fadomn mt (Insured Copyl Polky No: WNG 070548600 (03) May 31, 2018 Page 8 Any revisions, changes and /or corrections made on the printed application after the information has been submitted online are not reflected on this Declarations page and are not part of the application for insurance. If any information on the Declarations page is inaccurate, please notify us in writing via US Mail to: McGraw Insurance Service ATTN: Underwriting Dept. PO BOX 40 Anaheim, CA 92815 -0040 For claims reporting, please call: 1- 800 - 962 -1172. For policy service, please call: 1- 800- 303 -5000. 05/31=8 Policy Fnduaement (Enured Copy) Policy No: WNO 0703486,00 (03) May 31, 2018 Page 9 Forum Information About Your Policy Based on the information you have provided, your policy has been issued subject to the following coverage forms and endorsements. Please note that some of these endorsements may limit certain portions of your coverage. Others add optional coverages that you have selected. These are summary descriptions only. Please read the actual policy forms and endorsements to determine the exact level of coverage your endorsed policy provides. We highly recommend reviewing your coverage with your insurance producer. CA 110-3 (Ed. 81 110-3 11omecmxa Policy This is your basic coverage form and it is subject to the various endorsements noted below. CAM 1 (Ed. 1 i Registered Domestic Partner Coverage This endorsement provides state - mandated coverage for a registered domestic partner. HO -90 (9-841 Workers' Comperrmtion This endorsement provides state - mandated workers compensation coverage for residence employees. NM CA-MF.PI.(0402. Mold Exclusion This endorsement excludes coverage for losses stemming directly or indirectly from mold, fungi, mildew, spores, wet or dry rot, or similar organisms, regardless of cause. NNI -CA. P01 f I 1 171 1 Pathog.nic Organisms Grclwion This endorsement excludes coverage for losses stemming directly or indirectly from bacteria, yeasts, mildew, virus, fungi, mold, or their spores, mycotoxins or other metabolic products. NM.C'A -TW I (05,021 'Terrorism and War Exclusion This endorsement further defines the terms 'terrorism' and 'war' and excludes loss due to either from your policy. NYXIi Your Priv-y mid Its Protection This endorsement memorializes the steps we will take to safeguard your personal information. NY07 Mortgage Claw. This endorsement outlines the loss payable procedure when a mortgage company is listed in the Declarations. PM I I I Fd. 51 Increased Deductible for Loss or Dung. Cawed by Tenanu This endorsement notes that, should a loss occur by deliberate act(s) by a present or past tenant of the property, the deductible will be increased to $2,500. This endorsement is not applicable if the policy deductible stated in the Declarations is $5,000. PM I8 i E4. I I Trampoline Exclusion This endorsement excludes coverage for any loss stemming from the use or presence of a trampoline on the insured premises. P \719 (W. 1, Swimming Pool Diving Bond wW Slidc E-1mion This endorsement excludes coverage for any loss stemming from the use or presence of a swimming pool slide, diving board, or similar structure on the insured premises. PM'_0 ( Ed. 3 r Inflation Guard This endorsement automatically increases your dwelling coverage limit 4% annually to help the amount of coverage provided by your policy to keep pace with inflation. However, it is important that you periodically review the coverage provided by your policy as the amount and type of insurance you purchased is ultimately your decision. This includes ensuring that you have adequate coverage in the event of a large or total loss. PM31 Ed. 47 Occupancy Fidonaem.ni (Primary Residence Ord)•i 03131/2D18 Policy Fadorsemem (Inaumd Copy) Policy No: WNO 0705486-00 (03) May 31, 2018 Page 10 This endorsement notes that, should your property become vacant or unoccupied, your policy will only provide coverage for the perils of fire or lightning, windstorm or hail (unless otherwise excluded), smoke, or volcanic eruption. No other coverage will be afforded by your policy until the property is no longer vacant or unoccupied. PM34 (Fd. 2( 52,500 Sublhnit for late Wiklrm Claim Reporting This endorsement adds a special limit of coverage to your policy of $2,500 total property and dwelling coverage for wildfire smoke, soot and ash damage not reported to us within forty -five (45) days. Pbl4 tFd. I i Satellite Dish Fxclwion This endorsement excludes coverage for satellite dishes, antennas, their components and mounting hardware. Fotn No. P044 I lid.'_ ) rxtetdod Reply •nmm Cost Coverage - 125 % This endorsement provides additional dwelling coverage (Coverage A) of 25% above the limit specified on your Declarations in the event of a total loss of your insured dwelling. Form No. P016 (Ed. 2( Ordi -or Law Coverage This endorsement amends the loss settlement provision of your policy to include coverage, subject to your policy limits, for upgrades in building construction that are required due to building codes, laws or ordinances. Form No. P040 (1'd. 31 Limited Sewer or Drain Backup Coverage This endorsement provides water damage coverage as indicated on the Declarations page for water which backs up through sewers or drains. Forth No. P03 -HO (Fd. 2) Replacement Coat Coverage Pereottal Propcny This coverage amends the loss settlement provisions of your policy form to provide coverage for personal property (Coverage C) on a replacement cost basis. If this endorsement is not applied, personal property is settled on an actual cash value basis, with the deduction of depreciation. Font No. PM' (Ed. 31 Animal Liability lixclwinn This endorsement excludes liability and medical payments coverage for bodily injury or property damage caused by or originating from any animal. Furm No. P042 (Ed. 4, Identity Then Coverage. This endorsement provides $25,000 for expenses incurred by an insured as a direct result of identity theft discovered during the policy period. Form No. P056110 (Ed. I 1 Service Lim Coverage This coverage offers $10,000 to cover damage to underground piping, wiring, valves, or attached devices that connect a home to a public utility service provider or private system. Inwmal prints Ica: CA. H03 (PI.POI.(rd.41:CA.HO3(P).EKD(Fd. 12) 05131/2018 40 '0-0� B \ I: E R F I E T_ T_) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager FROM: Michelle Mendenhall, Engineering Technician DATE: September 21, 2018 SUBJECT: Encroachment Permit Application for: 2730 21St Street Name of Applicant: Neil & Jennifer Galyan Description of Encroachment: Construct a 6' high concrete block wall around side and back of property. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S. \PERMITS \ENCROACH \INSURANCE \2730 21st Street doc 40 '0-0� Y _-\ K E R S F I E I- L) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ed Murphy, Engineer III FROM: Michelle Mendenhall, Engineering Tech DATE: September 21, 2018 SUBJECT: Encroachment Permit Application for: 2730 21S` Street Name of Applicant: Neil & Jennifer Galyan Description of Encroachment: Construct a 6' high concrete block wall around side and back of property. Yr Please review the attached encroachment permit and return to me at your earliest convenience. S: \PERMITS \ENCROACH \TRAFFIC\2730 21st St.doc