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HomeMy WebLinkAboutTract 7288ENCROACHMENT PERMIT 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- 30000024 Date 10/10/18 Property Address . . . . . . 7288 TRACT ST Application type description PW - ENCROACHMENT PERMIT Owner Contractor ------ --------- --- - - - - -- ---------------- -- - - - - -- SIERRA OAKS PARTNERS, LLC 1518 MILLROCK WAY, STE 101 BAKERSFIELD,CA BAKERSFIELD CA 93311 (661) 851 -5002 ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 2259422 Permit Fee . . . . 420.00 Issue Date . . . . 10/10/18 Valuation . . . . 0 Qty Unit Charge Per Extension 1.00 420.0000 EA PW ENCROACHMENT 420.00 ---------------------------------------------------------------------------- Special Notes and Comments October 10, 2018 3:19:37 PM mmendenhal. Temporary construction trailer to be There is to be road access to the trailer at located at the end of the street all times. No blocking of the whole road at construction for T7288 phase 1 on Park Square Drive, south of Campus Park Drive any time for Fire Department access. for 3 -4 months. Contact person: Jeff Eittreim 949 - 254 -3225 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------- -- - - -- --- - - - - - -- ---- - - - - -- ---- - - - - -- ---------- Applicanf *h�a a §� the ri jM :6o the City &gineer, ptftuant to thV Bakersfield Municipal Code Chapter 12.20 to revoke the jrn'ii' a any time. Signature A1*1icant (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) D) Said permit shall expire on date stated above. Signature of City Engineer Additional Terms on the Back CITY OF BAKERSFIELD «... PUBLIC WORKS DEPARTMENT aRrIw� 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- 30000024 Date 10/10/18 Property Address . . . . . . 7288 TRACT ST Application type description PW - ENCROACHMENT PERMIT Owner Contractor ------ --------- --- - - - - -- ---------------- -- - - - - -- SIERRA OAKS PARTNERS, LLC 1518 MILLROCK WAY, STE 101 BAKERSFIELD,CA BAKERSFIELD CA 93311 (661) 851 -5002 ---------------------------------------------------------------------------- Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 2259422 Permit Fee . . . . 420.00 Issue Date . . . . 10/10/18 Valuation . . . . 0 Qty Unit Charge Per Extension 1.00 420.0000 EA PW ENCROACHMENT 420.00 ---------------------------------------------------------------------------- Special Notes and Comments October 10, 2018 3:19:37 PM mmendenhal. Temporary construction trailer to be There is to be road access to the trailer at located at the end of the street all times. No blocking of the whole road at construction for T7288 phase 1 on Park Square Drive, south of Campus Park Drive any time for Fire Department access. for 3 -4 months. Contact person: Jeff Eittreim 949 - 254 -3225 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------- -- - - -- --- - - - - - -- ---- - - - - -- ---- - - - - -- ---------- Applicanf *h�a a §� the ri jM :6o the City &gineer, ptftuant to thV Bakersfield Municipal Code Chapter 12.20 to revoke the jrn'ii' a any time. Signature A1*1icant (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) D) 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. I have read and acknowledge the above. 'Itf— applicant's Initials ENCROACHMENT PERMIT APPLICATION FORM CITY OF BAKERSFIELD L� PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE BAKERSFIELD CA 93301 (661) 326 -3724 Fax: (661) 852-2012 LOCATION OF ENCROACHMENT(Address required where available): PG,t V, S Sam -yn trT C t PcfV, fit, JL If there is no- address adjacent to work describe limitstof work by distances from nearest existing street intersection. APPLICANT INFORMATION FULL NAME OF APPLICANT Seff eJk r-e,'. en % S, ef(a Or Vs Pr-A COMPLETE ADDRESS: 1 I1,d 1 Ba 116 -,,- Dr. -jr, SQL _v PHONE: ��.V.LISf 60 Cpl A 3 311 _ FAX: CELL: _ qL11" ZSLJ - 3ZZ5. PROJECT INFORMATION DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised PERIOD OF TIME FOR ENCROACHMENT: INDEFINITE d OTHER: 3 -1'o LI (Please Circle) . CONTACT PERSON —Ze�f Et - 'irc,.'n PHONE: qqI- Z5�I' 3ZZS. 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 yjmn the revocation thereof b the he City Engineer, applicant will at his own cost and expense remove the same from the public pro�rt��t 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 \PFRM1TSTNCR0ACH1Fncroachmcnt Permit Req FOrrn.D(X Aug. 2017 ti ._ _ t; -" 4 CERTIFICATE OF LIABILITY INSURANCE DATE(MMI ON ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Clifford & Bradford Insurance Agency 1800 19th Street Belinda Yohe PHONE CONTACT FAX • 661 - 283 -8100 A/C No): 661 -283-8111 ADORess: ohe cliffordandbradford.com Bakersfield CA 93301 -4315 INSURERS AFFORDING COVERAGE NAIC # INSURER A : United Specialty Ins. Co. 4/4/2016 4/412019 INSURED SIERROS Sierra Oaks Partners LLC INSURER B: Starr Surplus Lines Ins. Co. 13604 INSURER C: First Mercury Ins. Co 10657 Woodbridge Pacific Group LLC INSURER D: 27271 Las Ramblas, #100 Mission Viejo CA 92691 INSURER E: INSURER F: MED EXP (Any one person) L:UVtKAUl=5 CERTIFICATE NLIMRER* R99Q9R1 n9 OCVISInN Kit IMRCO• THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE A DL POLICY NUMBER MMIDDYfYYYY MM/DD/YYYY LIMITS A X COMMERCIALGENERALLIABILITY Y 4/4/2016 4/412019 EACHOCCURRENCE $2,000,000 PREMISES Ea occurrence $ EXCLUDED CLAIMS MADE � OCCUR 7BT01618266 MED EXP (Any one person) s EXCLUDED PERSONAL &ADV INJURY S 2,000,000 AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- JECT F] LOC GENERAL AGGREGATE s2,000.000 GEN'L PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY Ea aBINED SINGLE LIMI $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per aoc der>t $ 8 UMBRELLALIAB X OCCUR 1000015422 414/2016 4/4/2019 EACHOCCURRENCE $8,000,000 X EXCESS LIAR CLAIMS -MADE AGGREGATE $ 8,000,000 DED I I RETENTION $ S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? ❑ NIA PER H- STATUTE ER E.L EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ C EXCESS LIABILITY OF S8M PRIMARY EXCESS LIABILITY CAEX000007584701 12/112017 4/4/2019 Occurrence Aggregate $15,000,000 $15,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace is required) ANY ENDORSEMENTS ATTACHED AND /OR DESCRIBED HEREIN APPLY WITH RESPECTS TO THE OPERATIONS OF THE NAMED INSURED AS REQUIRED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS; SUBJECT TO STATUTE AND POLICY PROVISIONS. RE: TRACT 7288 PHASE 4 & 5 CITY OF BAKERSFIELD, ITS MAYOR, COUNCIL, OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE ADDITIONAL INSURED UNDER GENERAL LIABILITY PER ATTACHED FORM CG20120509 ENDORSEMENT. CITY OF BAKERSFIELD OFFICE OF RISK MANAGEMENT 1501 TRUXTUN AVENUE BAKERSFIELD CA 93301 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 2012 05 09 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: State Or Governmental Agency Or Subdivision Or Political Subdivision: Per Written Contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Section II — Who Is An Insured is amended to include as an insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to opera- tions performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or au- thorization. 2. This insurance does not apply to: a. 'Bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state or municipality; or b. 'Bodily injury" or "property damage" included within the "products- completed operations hazard ". CG 20 12 05 09 0Insurance Services Office, Inc., 2008 Page 1 of 1 I3 _ h E R S I I F±, T. I -) PUBLIC WORKS DEPARTMENT MEMORANDUM M TO: Ed Murphy, Engineer III FROM: Michelle Mendenhall, Engineering Tech Y DATE: October 19, 2018 SUBJECT: Encroachment Permit Application for: Tract 7288 Name of Applicant: Sierra Oaks Partners LLC Description of Encroachment: Temporary construction trailer on Park Square Drive Please review the attached encroachment permit and return to me at your earliest convenience. S: \PERMITS \ENCROACH \TRAFFIC \T7288 PARK SQUARE DR.doc PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Jena Covey, Risk Manager ^�,1� FROM: Michelle Mendenhall, Engineering Technician DATE: October 19, 2018 SUBJECT: Encroachment Permit Application for: TRACT 7288 Name of Applicant: Sierra Oaks Partners, LLC Description of Encroachment.- Temporary Construction Trailer at end of end of street on Park Square Drive Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S.\ PERMITS \ENCROACH \INSURANCE \T7288 PARK SQUARE DR.doc