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1612 19th STREET
ENCR®ACHMENT PERMIT ~ - . -~ d CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE '''~.+R,r 1L~ ~, BAKERSFIELD CA 93301 gLIF~R~~ (661) 326-3724 TO THE CITY ENGINEER OF THE CTTY 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 07-30000035 Date 9/11/07 Property Address 1612 19TH ST Application type description PW - ENCROACHMENT PERMIT Owner ------------------------ 19TH & I INV GROUP LLC 1925 WARMLANDS AV VISTA CA 92084 Contractor ------------------------ OWNER ------------------------------------------------------------- Permit ENCROACHMENT PERMIT --------------- Additional desc Phone Access Code 725606 Permit Fee 200.00 Issue Date 9/11/07 Valuation 0 Qty Unit Charge Per Extension 1.00 200.0000 EA PW ENCROACHMENT -------------- 200.00 --------------- ----------------------------------------------- Special Notes and Comments Removing existing awnings and fire escapes, And the replacement of the same work will be on buildings and the alley. --- --------------- ---------------------------------------------------------- Fee summary Charged Paid Credited ------ ---------- ---------- ---------- - ---- Due --------- ------ - Permit Fee Total 200.00 200.00 .00 .00 Grand Total 200.00 200.00 .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 ti e Signature of ~pplicant (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~~CONST E A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFO~ (GRANTED) (DENIED). Said permit shall expire on date stated above. L .. Signature of City Engineer Additional Terms on the Back i S A I< 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: September 18, 2007 a ~/ a ~~~ R(/ SUBJECT: Encroachment Permit Application for: 1612 19th St. Name of Applicant: 19th & 1 INV Group LLC Description of Encroachment: .Remove existing awnings and fire escapes, and the replacement of the same, work will be in alley and on the building. Engineering and Traffic staff has reviewed the attached encroachment permit to allow the applicant to put new fire escapes and awnings on this building The applicant has provided proof of appropriate insurance coverage to Risk Management, and has provided signatures of all immediate neighbors stating that they have no objection to the proposed construction. Based on their review, staff recommends approval of tl~~:permit. S:\PERMITS\ENCROACH\1612 19th St..doc o~ 3S ~ ~ I~ E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ryan Starbuck, Civil Engineer III FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions DATE: September 13, 2007 SUBJECT: Encroachment Permit Application for: 1612 19t" St. Name of Applicant:. 19t" & 1 INV Group LLC Description of Encroachment: Removing existing awnings and fire escapes, and the replacement of the same work will be on building and the alley. Please review the attached encroachment permit and return to me at your earliest convenience. `1~9-~°7 6•K- S:\PERMITS\ENCROACH\TRAFFIC\1612 19th St.doc ~~ _~ I~ E R S F I E L D PUBLOC WORKS DEPo4RTMENT MEMORANDUM TO: Ralph Korn, Risk Manager FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions DATE: September 12, 2007 SUBJECT: Encroachment Permit Application for: 1612 19th St Name of Applicant: 19th & I INV Group LLC Description of Encroachment: Removing existing awnings and fire escapes,and the replacement of the same work will be on buildings and the alley. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S:\PERMITS\ENCROACH\INSURANC\1612 19th St.doc APPI.ICAsTI®Y FOR ENCRGACHI~IENT PER'~1IT ~di 2~ ~s~~ ' T'O THE CITY ENGINEER ®F THE CITY OF BAKERSFIELD, CALIFORI~TL~a ~S' .333 Pursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Cade, the undersigned applies for a permit to place, erect, use and maintain an encroachment on public property orright-of--way as therein defined. 1. Full name of annlicant and comtzlete address including phone number: ~~~ ~ ~L '/ ~1~~~~('~'TI" 2. Nature or description of the encroachment for which this application is 3. ~,ocation of the proposeeY encroachment: - ~ _ _, • i. _ ~ ~.. ,. 4. Period of time for which the encroachment is to be maintained: .~ A licant agrees that if this application is granted, applicant shall indemnify, defend and hold harniless City, its officers, agents and em Ioyees against any and all Iiabiltty, claims, actions, causes of action or demands, whatsoever against them, or any of them, before administrative, quasi ~udFCial, 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 i'or which this application is made, if granted, or_u~on rp opertv or right of way where the carne is located, and restore said public property or ri t of way to tt~e conattion as nearly as that in which it was before the placing, erection, maintenance or existence o said encroachment. Applicant fiarther agrees to obtain an~ keep all liability insurance required by the City Engineef in full force and effect for however long the encroachment remarns. 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 is: Applicant acknowledges the right of the City Engineer, pussuan~io Ba~e<rsfield Municipal..Cgde,Ch~,py~r~l•?.20 to revoke theQpermit/ Lat any time. Date: O'~i~7!~ ~_ ignature o Ap t weer or epresentative ' PERti1IT I HEREBY CERTIFY THAT I II.~YE N~1ADE AY PiVESTIGATION OF THE FACTS STATED Pti' THE FOREGO~G APPLICATION AND FIND TH.~T THE MAPtTENANCE OF SAID ENCRO ACHrIi ENT (t) WII.L (NOT) SU'BST:3~ITIALLY IlYTERFERE WITH THE liSE OF THE PUBLIC PLACE WHERE THE SAME IS TO BE LOCATED A~1D (Z) WII.L (NOT') CONSTITUTE A HAZARD TO PERSONS USID1G SAID PUBLIC PLACE; S.jiID APPLICATION IS THEREFORE (GRA.YTED) (DEVIED). SAID PER~tiiIT SHALL EXPIRE Date: No. ~i ignature o ity ngtneer AUG 31 2007 CITY OF BKi~EHSFIELD D ~ 3 S PUBLIC WORKS - SUBi~IVISION - ~!'~ r~~ ~~)~CERS~6EL~ ~~~~~~~~~~ ®F ~~~~~~ ~®R~~ l 1°® VYH~M i~' iV1AY C®NCERIV: V11e the undersi ned .have n® ob"ectian to the construction of a fe~esPde~~ 9 1 sidewaik withan the public right of way. {street f®r pupased encroach snt} (4 ers Narne) of ~ ~~~~ 9 ~ ~ . , ~ ~ Phe~e~ ~6~ ~~~..~ ~ ~~ {address ®f purp®sed encraac ent ) SIGNED o 9) Name: Address: ~) Name: !address: ~) name: Address: ~, f~Iame: Address: ~) Name: Address: ~) Name: Address: ~G Qate: ~ ' ~~ ~. Date: Oate: ~l / b . Date: ®ate: ~ ~ ~ cD Date: ~ ~ .~ ~ ~~~~ i C~a~ED AUG.,3 ~ 2007 '~~r,~'~ CITY OF BAKERSFIELD PUBLIC WORKS -SUBDIVISION s ~t :~ O~ BaxFRSFiF~a ' ~EP~i~tT1~1ENT OF .PUBLIC WORKS 2 TO WHOM IT MAY CONCERN: We the undersigned ,have no abjection to the construction of a fence beside the sidewalk wi#hin the public right of way. ~ :~ B ~' { treat for pupase encroachmen (Owner arse of ~~ ~ Phone: .J • (Address of purposed encraachme ) StGNEO 7) Name: Address: 2j Name: Address: 3} Name: Address: 4} l~tame: Address: 3) Name: Address: 6} Name: Address: ~ Date: ~ ' ~~''/ •. ,. ' Dat ~ O - l ~/-/mar ~ . • .Cate: ' Date: ~ . Oate: Cate: I CEIVED AUG 31 2001 CITY OF BAKERSFIELD PUBLIC WORKS -SUBDIVISION ACORD CERTIFIC 4TE OF LI ~ Y' ,M ~ / -BILITY INSURANCE $i28i2o ~ PRODUCER (661) 324-9614 FAX: (661) 324-2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Hay Insurance Agency Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE , . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Ca Lic # 0308408 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 2001 F Street Bakersfield CA 93301 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA:peerleSS Insurance 19th & I Investment Group LLC INSURER B: 1925 Warmland Ave. INSURER C: INSURER D: Vista CA 92084 INSURER E: COVERAGES 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 8Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. G C INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYY DATE MMIDD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence 10 0 , 0 0 0 S A X CLAIMS MADE ~ OCCUR CBP8066405 8/12/2007 8/12/2008 MED EXP An one arson 5 5, 000 PERSONAL&ADV INJURY S 1, 000, 000 GENERAL AGGREGATE S 2, 000, OOO GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMPlOPAGG S 2,000,000 X POLICY JEC LOC AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) S ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) S HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN S AUTO ONLY: AGG S EXCESSIUMBRELLA LIABILITY U C S OCCUR ~ CLAIMS MADE AGGREGATE S S DEDUCTIBLE S RETENTION S S WORKERS COMPENSATION AND ' WC STATU- OTH- EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT S OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE S If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEM ENTISPECIAL PROVISIONS The City Of Bakersfield, itrs mayor, council, employees, agents, and volunteers are added as additional insureds with respects to the work performed by the named insured. Endorsement to follow from the company. *10 Notice of Cancellation applies to Non-Payment of Premium CE City Of Bakersfield 1501 Truxtun Ave ,P~ p~ Bakersfield, CA 93301 ~~C~~~~~.s SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. AUG ~ -- cUU l ACORD 25 (2001/08) CI-~ pF BAKERgFIELD I nl cn~~ ,n, ear ea.. PUBLIC WQRKS - SUHAIVI~1 AUTHORIZED REPRESENTATIVE _ Roger Hay/EI -1-=~-:-".. - _ _.--- :..: ="~-- ©ACORD CORPORATION 1988 Pane 7 of 7