HomeMy WebLinkAbout04-30000072
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ENCROACHMENT 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,
Owner
Contractor
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Application Number . .
Pin number , , , , . .
Property Address . . ,
Application description
04-30000072 Date 12/28/04
858680
402 A ST
PW - ENCROACHMENT PERMIT
RAMOS TERESA R
402 A ST
BAKERSFIELD
OWNER/BUILDER
CA 93304
BAKERSFIELD
CA 93301
Permit , . , . ,
Additional desc ,
Phone Access Code
Permit Fee . , .
Issue Date . . .
ENCROACHMENT PERMIT
311977
150.00
12/28/04
Valuation
o
Qty Unit Charge Per
1,00 150.0000 EA PW ENCROACHMENT
Extension
150.00
Special Notes and Comments
take out and replace fence with like of
same heighth and lerighth
Fee summary Charged Paid Credited Due
Permit Fee Total 150.00 150.00 .00 .00
Grand Total 150.00 150.00 ,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 time.
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Signature of Applicant (Owner! Agent)
\m~'lC-~
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.
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Signature of City Engineer
Additional Terms on the Back
(9/4=-/7/)--
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 provisions 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 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 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,
A licant's Initials
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BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
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TO: Raul M. Rojas, Public Works Director
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: January 31, 2005
SUBJECT: Encroachment Permit Application for. 402 A Street
Alvaro Ramos
Build 4' high fence behind sidewalk
Engineering and Traffic staff has reviewed the attached encroachment permit to allow the
installation of description of encroachment. The site is located at address of encroachment.
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 the permit.
S:\PERMITS\ENCROACH\402 A st..DOC
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BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ryan Starbuck, Civil Engineer III
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: January 31, 2005
SUBJECT: Encroachment Permit Application for 402 A Street.
Alvaro Ramos
Build 4' high fence behind sidewalk
Please review the attached encroachment permit and return to me at your earliest convenience.
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Bi~KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO:
Pat Flaherty, Risk Manager
FROM:
Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE:
January 31, 2005
SUBJECT: Encroachment Permit Application for 402 A Street
Alvaro Ramos
Build 4' high fence behind sidewalk
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
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APPLICATION FOR ENCROACHMENT PER."IIT
TO THE CITY ENGIN"EER OF THE em' OF BAKERSFIELD, CALUOR.~L\:
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 nazne of ape.!.icant and comp~ address including phone nwnber:
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nt for which this application is made:
t.
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4. Period of time for which the encroachment is to be maintained: ))?I' ~ 04 ~ ~ '
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Applicant agrees that if this application is ~ted, 3'p'plicant shall indemnify, defend and hold harmless City, its
officers. agents and employees against any and allliablhty, claims, actions, causes of action or demands, whatsoever
a~t them. or any pfthem, before administrative, quasi-Judicial, or judicial tribunals of any kind whatsoever, arising
out of, connected with, or caused by awlicant's placement, erection, use (by applicant or any other person or entity)
or maintenance 0 f 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 me permit for which this application is made, if granted, or 'YQQ!1
the revocation thereofbv the Cltv enlrineer. aoolicant will at his own cost and exoense remove the same from the oublic
prooertv 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 Certificat~ 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: '
~60Dl)OD ~ L Al.;8 ~.w",^,CV
Applicant aclc:1o.wledges ~e right of me City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to
revoke the pcrrrut at any tune. '
Date: 1Z./z-J04 - si~~~tp2~)
PER."\IIT "
I HERIBY CERTIFY THAT I HAYE MADE A.~ ~'VESTIGATION OF THE FACTS STATED IN THE
FOREGO~G APPLICATION ~~D FIND m-\.T THE MAlNTENA. ~CE OF SAID ENCROACHMENT (1) Wn.L
(NOT) St'BSTA.;'ULUL Y INTERFERE "lTH THE USE OF THE PUBLIC PLACE WHERE THE SA.'dI IS TO
BE LOCATED A.~ eZ) wn.L (NOn CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE;
SAID Al'PLlCATlON IS THEREFORE (Glt-\.~TED) (DENIED). SAID PERMIT SHALL EXPIRE
Date:
Sl~ngrneer
No.
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TO WHOM IT MAY CONCERN:
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I ,~ . CITY OF. BAKERSFIELD
1 .., DEPARTMENT OF PUBLIC WORKS
, We the undersigned, have no objection to the construction of a fence beside the
sidewalk within the public right of way. .
(Street for puposed encroachment)
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(Owners Name)
Pr,S~~
of
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(Address. of purposed encroachment)
y
2) Name:
SIGNED:
1) Name: ~~ ~
Address: .~~S I b (J~, "
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Address:
Date:
JName: tY.
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, 'Address: r (); :hI fJ1t~ 111J
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Address: ' 4 Db /9 .if jJ ,
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Power of Attorney
O~=~,=~~~ For-the" Purpose{)fBuildin~ Permit="=~~=~~=-~~,=~=_o
'I..J~~ ~Sp.herebygiv.pennission toJ\-\\J Poc-riJ ~
Propert)' Ov.ner Grantee Name
obtain a permit for me on my behalf for ~ld.~ J G A A,.(_e-
Typeofworlc ~
--40C) A ~e.-e:t- . I have owned the said property since _\ 9 9D
Property Address Purchase Date
to"__,,, __"
at
I authorize the permit to be marked as follows:
O\\'"1\"ER-BUILDER DECLARATION
, 1 hereby affirm that WJder penalty of perjury 'that I am exempt from the Contractors License law for the following reason (Sec.
7031,S Business and Professions Code: ADy city or county which requires a pemlit to eonstl'llct, alter, improve, demolish. or repair
any structure prior to its issuance also requires the applicant for such permit to file a signed statement that he or she is licensed
pursuant to the provisions of the Contractors License Law (Chapter 9 commencing with Section 7000 of Division 3 or the Business
and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any .ppHew for' pci-mi, lubjeCl5 the <pplican, to . civil penal~ .of 00' IIloJ< thao five hlUldml don... (SSOO)): ,
_1. as owner of the property or my employees with wales IS their sole compensation, will ~t:the worle: and the SUUC~ is Dot intended or offcrui for sale (Sa:.
7044 Business and Professions Code: The ConllXtOlS LicClSe Law docs not apply Ie an 0 ofpmpcny who bWlds Of improves thereon,llld who does such
won: himself Of hcrscl.f through his or her OWIl c:mploycc:a, provided that such improv. are not intended or offCl"ed (or sale. If, however. the buildin& or
,improvC::lent is sold \\ithiD ODe year of cOlllpletion, the owner-builder will have the ~ of proving that he; or she did not build or improve for the pUI'pOSe of
ale).
_I. as owner of the propeny, am exclusively contl'3'ctin& with licc:n.scd contractolS to constrUCt the project (Sa:.' 7044 Business and Professions Code: The
Contractors LicCIlSe UW does not apply to an owner of property who builds, or improves thc:rcon and who COntl'3CU for sw:hprojec:t with I COnt!laCtor(s) Iiccmed
~\Wlt to the Contnctor License Law): .'
~I am ex::npt WIder Sec:. , B.U.C. for this l'CISOD
I hereby certify under penalties of perjury that the answers I have given are true and correct to the best of my
knowledge and belief, and I understand and agree to the provisions, conditions and restrictions herein or
otherwise imposed. I further understand that any fraudulent act will be prosecuted to the fullest extent of the law
and is subject to fines and/or jail time.
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( ~rs Signature ' Contact Phone #
l~/ 2lo 104
Date
J.eJ p, l . 3:;)3. 54(0~
Contact Phone #
12/ ~ft;! DLf
Date
For Office Use Only:
Receind b~'
Permit #
Issued date
Form 1:401
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State Farm General Insurance Company .
,A Stock Company With Home Offices in Bloomington, Illinois
900 Old River Rd
Bakersfield, CA 93311-6000
Named Insured
DECLARATIONS PAGE
Policy Number 87-E8~5532-5
AMENDED DEe 3 2004
Policy Period Effective Date , Expiration Date
12 Months NOV 27 2004 NOV 27 2005
The policy period begins and ends at 12:01 am
I standard lime at the residence premises.
L
Loan 1/ 0001983516
Mortgagee
NEW CENTURY MORTGAGE CORP
ITS SUCCESSORS AND/OR ASSIGNS
PO BOX 11052
ORANGE CA 92856-8152
D-1919-F784 F H
RAMOS, TERESA R
402 A 5T
BAK~RSFIELD CA 93304-1907
11111111111111111111'1111111111111111111111111111111111.1111111
HOMEOWNERS POLICY
Automatic Renewal _ If the policy period is shown as 12 months, this policy will be renewed automatically subject to the
premiums, rules and forms in effect for each succeeding policy period. If this policy is terminated, we will give you and the
Mortgagee/Lienholderwritten notice in compliance with the policy provisions or as required by law.
e Location of Residence Premises "four policy is'amendedDEC32004 ...' .,'
Same as Insured's Address SECTION n COVERAGE LIMITS CHANGED
,This policy does not provide coverage for loss by earthquake
This policy includes Building Code Upgrade Coverage of $ 32,925
Coverages & Property Limits of Liability Inflation Coverage Index: 182.8
SECTiON I Deductibles - Section I
A Dwelling , . I 131,700 ' All Losses
Dwelling Extension up to 21,000
B Personal Property 98 775
C Loss of Use Actual: LOSS
Sustained
$
500
SECTION II :;p
L Personal Liability $ 300,000
ffach Occurrence)
amage to Property $ 500
of Others
M Medical Payments to
Others (Each Person) $ 1,000
In case of loss under this policy, the deductibles will be applied
",'. per occurrence and will be deducted from the amount of the
.., loss. Other deductibles may apply - refer to policy.
Loss Settlement, Provision (See Policy)
Ai Replacemerit Cost - Similar Construction
B1 Limited Replacement Cost - Coverage B
Forms, Options, & Endorsements
. Homeowners Policy
Lenders Loss Payable End
Policy, Endorsement '
Cov A' Loss Settlement
Seepage or Leakage Exclusion
$5,000 Fungus. (IncIMold) Lim!
Fungus (IncludmgMold)~xcl
Motor Vehicle Enaorsement
Endorsement Premium
INCREASE
$
24.60
FP-7955.CA
438
FE-5320
FE-5363
FE-5400
FE-5427
FE-5424
FE-5452
Discounts Applied:
Home/Auto
Claim Record
I Other limits and exclusions may apply. refer to your policy
I ~
Your policy consists of this page, any endorsements
and the policy form. Please keep these together.
FP-7018C Continued on Reverse
MIKE ALEXANDER
M...., ~,,~ I 661-322-9244
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12'
----
-1-'3.0'
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6' from
flow line
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fence line
. '
67.0'
98.67'
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14' fromJ
flow line
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City of Bakersfield
, ill!! CUSTOMER RECEIPT lHl!!
Oper: BHAYSLET Ty~: OC Dral1er: 1
Dats: 12/28/04 01 Receipt no: 68575
'Description Quantity Amount
2004 30000072
BP BUILDInG PERMITS
1.es $150.00
Tender detail
CIi CHECK 9424
Total tendered
Total paYlJsnt
Trans date: 12/28/04 Tine:
"HAPPY HOLIDAYS"
$150.00
$150.00
$159.0$
9:113:35
ENCROACHMENT PERMIT
CITY OF BAKERSFIELD
PUBLIC WORKS DEPARTMENT
1501 TRUXTUN A VB
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 . .
pin number . , . . . .
Property Address . , .
Application description
04-30000072 Date 12/28/04
858680
402 A ST
PW - ENCROACHMENT PERMIT
Owner
Contractor
RAMOS TERESA R
402 A ST
BAKERSFIELD
OWNER/BUILDER
CA 93304
BAKERSFIELD
CA 93301
Permit . , . . ,
Additional desc ,
Phone Access Code
Permit Fee , . .
Issue Date , . .
ENCROACHMENT PERMIT
311977
150.00
12/28/04
valuation
o
Qty Unit Charge Per
1.00 150.0000 EA PW ENCROACHMENT
Extension
150.00
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 150.00 150.00 .00 ,00
Grand Total 150.00 150,00 .00 .00
~(
hft
Special Notes and Comments
take out and replace fence with like of
same heighth and lenghth
Applicant acknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the
permit at any time,
\..t7...t ~'JC- ~J ~)
I Signature of Applicant (Owner/Agent)
-=-1 €ra.s: A; lC ~J~
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
~.~
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, betore
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 provisions 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 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 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.
_Applicant's Initials
c:::?~