HomeMy WebLinkAbout03-30000037
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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.
Application Number
pin number . , , , , ,
Property Address
ATN (11 Digits) :
Application description
Owner
SOLORIO IRENE T
3804 PHAFFLE AV
BAKERSFIELD
(661) 831-2817
03-30000037 Date
,486362
3804 PHAFFLE AVE
355-171-11-00~6
PW - ENCROACHMENT PERMIT
12/16/03
Contractor
OWNER/BUILDER
CA 93309
BAKERSFIELD
CA 93301
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Permit , , , , ,
Additional desc ,
Phone Access Code
Permit Fee , , .
Issue Date , . ,
ENCROACHMENT PERMIT
161604
150,00
12/16/03 Valuation
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Qty Unit Charge Per
1,00 150,0000 EA PW ENCROACHMENT
Extension
150,00
Special Notes and Comments
4' tall wrought iron fence in front yard
Fee summary
FENCE CONSTRUCTED PRwOR TO APPROVAL
,OF ENCROACHMENT PERMIT
Cred~ted Due
Charged
Paid
Permit Fee Total 150,00 150,00 ,00
Grand Total 150,00 150,00 ,00
.00
.00
Applicantacknowledges the right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the
penru, . t at . ny time.
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of Applicant (Owner! Agent)
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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 APPLlCA nON IS
THEREFORE (GRANTED) (DENIED). Said permit shall expire on date stated above.
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Signature of City4[ngineer
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Additional Terms on the Back
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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.
"/five redJ and acknowledge the above
, .' Applicant's Initials
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BAKERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO:
Raul M, Rojas, Public Works Director
FROM:
Marian p, Shaw, Civil Engineer IV, Subdivisions
DATE:
May 17,2004
SUBJECT:
Encroachment Permit Application for 4' wrought iron fence along frontage at back of
s/w,
Irene T. Solorio
3804 Phajjle Avenue
Engineering and Traffic staff has reviewed the attached encroachment permit to allow the installation of
shoring system, ambulance canopy and flag poles, The site is located at 2615 Eye Street.
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\03-04 Pennits\3804 Phaffle Ave,doc
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APPLICATION FOR ENCROACHMENT PERMIT
TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD, CALIFORNIA:
Pursuant to the P, rovisions 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 name of applicant and complete address including phone number: :IV' ~h0 r. ~ C) l C) v- ~ 0
StOD4 'PhCLf+le- l}-r:,ve...- D4J:::..eV',,-Be..{ d I CA - q ~3 O~
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2.. Nature or description oft~e encroachment for which this application is made: \^/(Ollt~ ~t-- lv-or..
*nCL.- SL<,'YOLltY'di?j ~ PvVF2' IO(c..fe-e{ tU-' 5X'D'-P
EhMB..e.. 1ft- IV'V \ Y' lSt-\,lC.e v-sf\ .eJ
3. ~ation of the proposed encroachment: A\Dn~ S; b".};:d~ ;l<)b.eA---f/ rei' l i~
b-P~Y'~ ' ' , '
4. Period of time for which the encroachment is to be maintained: -fe v,..,.-..t:Vr-e..^-'t---' .~~vc'-h'\,r-e......-
Applicant agrees that if this application is granted, ap'plicant shall indemnify, defend and hold hannless City, its
officers, agents and employees against any and allliablhty, claims, actions, causes of action or demands, whatsoever
against them, or any ofthem, 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 !!lliill
the revocation thereofby the CIty engineer. applicant will at his own cost and expense remove the same from the public
propert~ or right of way where the same is located, and restore said public property or ricl1t of way to the condition
as near y as that in which it was before the placing, erection, maintenance or existence 01 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 is:
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Mu . ipal Code Chapter 12.20 to
revoke the permit at any time. r " , ,-....
Date: 1'2.-(0-03 9u;;Y-wV
PERMIT
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 PUBLIC 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
Date:
No.
r '"t (f(P !~
03. '3(JjffJ31
Signature of City Engmeer
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T'" Cll~ OF., BAKERSFIELD
DEPARTMENT OF PUBLIC WORKS
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.
fJ.-..~ J)r'IV ~
(Street for puposed encroachment)
By: ~'LL/ )~0
(Owners Name)
Phone: Le(Q.(
83 ( - 2~ l 7
of '3tz')oL} '?h~fFk- :Drt~
(Address of purposed encroachment)
SIGNED:
2) Name:
Address:
, 3) Name:
Address:
4) Name:
Address:
5) Name:
Address:
6) Name:
Address:
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Date: /Z--f6 -0 ~
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Date: / :z -j 1/ -d3
Date: /). - Ie) , f).J
Date: (..;).- {U "-01
Date: It., -i 0-03
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Personal Express Insurance Services, Inc.
5301 Truxtun Avenue Suite 100, Bakersfield, CA 93309
Underwritten by Sequoia Insurance Company
Policy Number: XHOI01851
Irene T. Solorio
HOMEOWNERS INSURANCE POLICY
Effective 12/16/2003 Declaration Number 002
12 Month Policy Term Continuous from 07/31/2003 at 12:01 AM Local Time or Until Cancelled or Non-renewed
Mail To:
Irene T. Solorio
3804 Phaffle Drive
Bakersfield, CA 93309
Local Office:
5301 Truxtun Avenue Suite 100
Bakersfield, CA 93309
(661) 327-6940 (800) 499-3612
Claims Emergency After Hours Number:
1-800-235-8784
CHANGE POLICY DE CLARA TION
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Your policy has been changed effective 12/16/2003, This change will be referred to as Declaration Number 002 and performs the
following: Change Liability Limit.
This change in your policy resulted in an additional premium of $ 22. This amount has been added to your payment plan.
Insurance is to be provided only with respect to the location(s) and/or coverage(s) for which a limit of liability is specified
and premium is charged, subject to all of the conditions of this policy.
Named Insured: Irene T, Solorio
Legal Text: A single woman
Property Description: Address: 3804 Phaffle Drive, Bakersfield, CA 93309
Construction: Frame Year Built: 1961
Protection Class: 3 Roof: Composition Shingles
Territory: 54
Section I Coverages: HO 3
A - Dwelling:
B - Other Structures:
C - Personal Property:
D - Loss of Use:
Limit
$ 128,000
$ 12,800
$ 89,600
$ 25,600
Deductible of $ 500
applies to Coverages A, B or C
for anyone loss.
Premium
$407
Included
Included
Included
Section II Coverages:
E - Personal Liability:
F - Medical Payments:
Each Person
Each Accident
$ 500,000
$ 1,000
$ 25,000
$ 35
Included
Included
Sections I & II:
Additional Coverages:
Credits/Debits:
CA Surcharge:
TOTAL:
$442
$102
$ -110
$0
$434
This policy is subject to the following forms and endorsements attached to and made part of the policy:
H00003-0491, 438BFU NS,0542, H00446,0491, H00490,0491, H00496,0491, H02490,0193, H0300-1292, H052,0484, SH001-
0500, SH004,0797, SH008,0797, SH013,0998, SH014,0500
Countersigned:
PH Dec1,a
INSURED
Date Printed 12/16/2003
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j' Petsonal Express Insurance Services, Inc.
5301 Truxtun A venue Suite 100, Bakersfield, CA 93309
Underwritten by Sequoia Insurance Company
Policy Number: XHOI01851
Irene T. Solorio
Effective 12/16/2003
HOMEOWNERS INSURANCE POLICY
Declaration Number 002
12 Month Policy Term Continuous from 07/31/2003 at 12:01 AM Local Time or Until Cancelled or Non-renewed
Additional Coverages: Form Limit Premium
Personal Property Replacement Cost H00490,0491 Refer to Form $ 41
Specifed Add'l Amt Insurance Cov 'A' SH008,0797 Refer to Form $10
H,O. Plus Endorsement \ SH001,0500 Refer to Form $ 20
Ordinance or Law SH004-0797 Refer to Form $ 26
Workers Compensation H02490-0193 Refer to Form $5
""'---"-'--e---~~ <, --,-.,.-~_-.,.-.---,._-------~-.....,...o- __ ..---____________ __________.___=__"' ~,
Additional Coverage Premium $102
Credits Savings included in Total Annual Premium
Renewal Credit $ -41
Protective Device Credit $ ,20
Policy Deductible Credit $ ,49,
Property Insurance Disclosure:
This Location Includes Specified Additional Amount of Insurance for Coverage A - Dwelling.
This Location Does Not Include Earthquake Coverage.
This Location May Include Building Code Upgrade, up to 10% of Coverage A Limit, as per Form SHOOI-0500,
This Location Includes an Annual Inflation Guard of 2%,
Mortgagee 1: Washington Mutual Bank, FA Its Successor
&/or Assigns
P.O, Box 25064
Santa Ana, CA 92799
Loan Number: 0093543389
PH Dec2,a
INSURED
Date Printed 12/16/2003
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B,i\.KERSFIELD
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Pat Flaherty, Risk Manager
FROM: Marian p, Shaw, Civil Engineer IV, Subdivisions
DATE: January 12, 2004
SUBJECT: Encroachment Permit Application for 3804 Phaffle Avenue,
Irene T. Solorio
4' wrought iron fence at back of sidewalk along frontage.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience,
S:\PERMITS\ENCROACH\INSURANC\3804 Phaffle Ave,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 12, 2004
SUBJECT: Encroachment Permit Application for 3804 Phaffle Avenue,
Irene T. Solorio
4' wrought iron fence at back of sidewalk along frontage.
Please review the attached encroachment permit and return to me at your earliest convenience,
S:\PERMITS\ENCROACH\TRAFFIC\3804 Phaffle Avenue,doc
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