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Home My WebLink About07-30000019 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 , . . , , Property Address , . . . . , Application type description 07-30000019 Date 2531 CHESTER AVE PW - ENCROACHMENT PERMIT 5/16/07 Owner Contractor CENTRAL CARDIOLOGY LLC POBOX 12290 BAKERSFIELD CA 93389 OWNER ---------------------------------------------------------------------------- Permit . , , . , Additional desc , Phone Access Code Permit Fee Issue Date ENCROACHMENT PERMIT 678623 150.00 5/16/07 Valuation o Qty Unit Charge Per 1,00 150,0000 EA PW ENCROACHMENT Extension 150,00 ---------------------------------------------------------------------------- Special Notes and Comments Place footing for building in alley and pave for parking stucture, ---------------------------------------------------------------------------- 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 th right of the City Engineer, pursuant to the Bakersfield Municipal Code Chapter 12.20 to revoke the permit at any ti Signature of Applic~nt (Owner/Agent) (/) /1~ LE ~ S:;M ,....M ~v S - 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) A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREF (GRANTED) (D D). Said permit shall expire on date stated above. Additional Termson 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 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 ~ ~ . ~ J~ 'Po ~ BAKERSFIELD PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Raul M. Rojas, Public Works Director FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions DATE: June 1, 2007 SUBJECT: Encroachment Permit Application for: 2531 Chester Ave. Name of Applicant: Central Cardiolgy Description of Encroachment: Place 4 footings for a building in alley then pave over. Engineering and Traffic staff has reviewed the attached encroachment permit to allow the applicant to place footings under the surface of the alley then pave over. , The applicant has provided proof of appropriate insuran~e 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 ~errt,it. S:\PERMITS\ENCROACH\2531 Chester Ave..doc 07- " ~ . - B~~KERSFIELI) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ryan Starbuck, Civil Engineer III FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions DATE: May 29, 2007 SUBJECT: Encroachment Permit Application for: 2531 Chester Ave. Name of Applicant: Central Cardiology Description of Encroachment: Place 4 footings for a building in alley and then pave over. Please review the attached encroachment permit and return to me at your earliest convenience. ,,( 'bo! 'ZOO 7 6'fc - er S:\PERMITS\ENCROACH\TRAFFIC\2531 Chester Ave.doc o 7 ---- f Of. ~ . - OB .~ K E R S FIE L I) PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ralph Korn, Risk Manager FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions DATE: May 23,2007 SUBJECT: Encroachment Permit Application for: 2531 Chester Ave. Name of Applicant: Central Cardiology Description of Encroachment: Place 4 footings for a building in alley and then pave over. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S:\PERMITS\ENCROACH\INSURANC\2531 Chester Ave,doc APPLICATION FOR ENCROACHl\-IENT PER..\1IT TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD, CALIFORNL.\: c. ivc-/( 9 7 Of - ;2. 3 J.5 " Pursuant to the provisions 0, f Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to place, ere~t, use and maintain an encro~c~ent on public property o~ right-of-way as therein defined. 1. Full name of aoolicant and comDlete address including phone nwnb~r: <S'(Vl...... 0<-1 S t-ou.s T I /J c-- ~1I1 UUV<:-(J ,.~R...;. gl\ (52-SHEd) I t.+ 9~~o 8 2. Nature or description of the encroaciunent for whi!h this application is made: NE-r"J1 t t ~ ,I.U L ~ l:L-~ T l ' ~~ e 's ([fI (IoA-OH- ~ ~ I A.-' -10 ~L~~S ~ v is ~iL~c.? . . . .. -.. 3. Location of the proposed encroachment: -Z~3 l e'1E/ST~fL' ,AvE - .. ...., 4. Period oHime for which the encroachment is to be maintained: -D-It -6'1 IZ-~/ 2--,-?? 7 :-' .. Applicant agrees that if this application is granted, al?plicant shall indemnify, defend and hold hannless City, its officers, agents and employees against any and all liabll1t:y, claims, actions, causes of action or demands, whatsoever against them. or any pfthem, 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 tlie aforesaid encroachment during the life of said encr~achment or ~ti1 such time that this pe~t is ~ev~ked. .: " ','.' , Appli~ant ~rther agrees that upon,th~ expiratio~ of th~ pe~t for which this application is made, if granted, or'~ , the revocatIon thereofbv the Cltv engIneer. aDDhcant WIll at his own cost and exocnse remove the same from the public prooerty or right .of w~y ~her~ the same is loca!ed, and r~store s~d public prop~rty or right.of way to the condition as nearly as that 10 which It was before the placmg. erectIOn, mamtenance or eXIstence of saId encroachment. .' . , Applicant further agrees to obtain and keep allliabilio/ insurance required by the City Engineer in full force and effect , for however' long the encroachment remains. Apphcant shall furnish the City Risk Manager with a Certificate of Insurance evideI:1cing sufficient coverage for bodily injury or property damage liability or both and required , endorsements evidencing the insurance required. The type(s) and amount(s) ofinsurancc'coverage is: ~. '\ . -. leJd MunicipatCgde):hwJeyl.2.20 to Applicant acknowledges the right of the City Engineer,pursuanttQ , revoke the permit at any time. Date: epresentatJ ve PER..'iIT I HEREBY CERTIFY THAT I HAVE MADE A.'i INVESTIGATION OF THE FACTS STATED IN THE FOREGOING APPLICATION Ai.'iD FIND THAT mE MAINTENk~CE OF SAID ENCROACHMENT (1) WILL (NOT) Sl.j'BST.'\l~TIALL Y INTERFERE WITH THE USE OF THE PUBLIC PLACE WHERE THE SA6~IE IS TO BE LOCATED AL~ (l) WILL (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID Al'PLICATION IS THEREFORE (GRA.~TED) (DENIE.U). SAI:>> PERMIT SHALL EXPIRE Date: ~ru.eOfc~meer No. 11-1-\ }O 1.9 r " .. APPLICATION FOR ENCROACHl\-lENT PER.\UT TO THE CITY ENGINEER OF THE CITY OF BAKERSFIELD, CALIFOR:.~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 name of aoolicant and comolete address including ohone nwnber: SIMMONS CONSTRUCTION, INC. 3111 LANDCO DRIVE BAKERSFIELD, CA 661-636-1321 2. Nature or description of the encroachment for which this application is made: NEW SIrE, _WO:RK ,@,I\ALLEY , F90TIN~S ENCROACH INTO ALLEYS, SUBGRADE . .. -. - ... ~.. . ... 3. Location of the proposed encroachment: 2531 CHESTER AVE 4. Period oftime for which the encroachment is to be maintained: 5> ~ 12 70'7 & to 12 -12 7" 07. - Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless City, its officers, agents and employees against any and allliabfhtr, claims, actions, causes of action or demands, whatsoever against them. or any pfthem, 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. Tbe applicant further agrees to maintain the aforesaid encroachment during the life of said enc~achment or ~ti1 such time that this permit is ~ev?ked. ': ' . ' .' , Applicrant further agrees that upon,the expiration of the permit for which this application is made, if granted, or 'Y11Q!l the revocation thereofbv the CItv engineer. aoolicant will at his own cost and exoense remove the same from the DubHc prooertv or right of way where the same is located, and restore said public property or ri2ht of way to the condition as nearly as that in which it was before the placing, erection, maintenance or existence or 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 cvideI.1cing 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. pursuanqo..B revoke the permit at any time. , Date: May, 11, 2007 . cipalC9de j:hJrPJey1.2.20 to PER."llT I HEREBY CERTIFY THAT I HAVE MADEA..~ INVESTIGATION OF THE FACTS STATED IN THE FOREGOING APPLICATION AL~D FIND ffi-\T THE MAINTENA.~CE OF SAID ENCROACHMENl' (1) WILL (NOT) StiBST.'\l.~TlALL Y INTERFERE WITH THE USE OF THE PUBLIC PLACE WHERE THE S~'IE IS TO BE LOCATED Ai.'ID (2) WILL (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS THEREFORE (GRA.'4TED) (DE~IED). S~ PERMITS HALL EXPIRE Date: Signature of City Engmeer No. ~ 11 : 12 MAY 22, 2007ID: KERN INSURANCE ASSOCmX NO : 835--:4500 *25257 PAGE: 2/5 ^ tkJJc 'S 1M nl\1l--J ~ Q7Cf. Z7 z ~ A CORD". CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDDIYYYY) 5/22/2007 PRODUCER (661)835-4542 FAX: (661)835-4500 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Kern Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR License # 0415101 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 11390 Bakersfield CA 93389-1390 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Century Surety Co Central Cardiology LLC INSURER B: I!';SURER C: I POBox 12290 INSURER D: Bakersfield CA 93389 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, TER~OR CONDITION OF ANY CONTRACT OR..DTHf'RnOC:IJMFNT WITH RF~PFC:T TO ,WHICH TI-l1S CFRTlFIr.ATF MAY BE 1S~IJFr) OR MAY PFRTAlN.. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITlONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM<l I~~: ~9.~~ TYPE OF INSURANCE POLICY NUMBER P8.k+~\~~~ggM\E Pgk!fJf~~~A:~N LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 - ~~~~~J9~~J;,?encel COMMERCIAL GENERAL LIABILITY S - ~GLAIMS MAD:: [!] OCCUR CS10003007 5/22/2007 5/22/2008 A X MED EXP fAnv cne oersonl $ - incl x Owner, Contractors I PERSONAL & ADV INJU~Y $ Protective Liab I GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT nS PER: PROOUCTS-COM~OPAGG $ i.ncl Xl ' n PRO- POLICY JECT LOC ~TOMOBILE LIABILITY COW.BiNED SINGLE LIMIT $ (Ea accident) - ANY AUTO - ALL OWNED AUTOS BOD,L Y INJURY $ (Per person) - SCHEDULED AUTOS - HIRED AUTOS BODILY I!l:JURY $ NON.QIJIJNED AUTOS {Per acciden~ - . PROPERTY DAMAGE , (per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDEilIT $ =! PM'( AUTO OTHER THAN EA ACC S AUTO ONLY: AGG $ EXCeSS/UMBRELLA LIABILITY EACH OCCURRENCE $ ::J OCCUR DCLA'MS MADE ! AGGREGATE $ r I $ tJ DEDUCTIBLE S I RETENTION $ , $ WORKERS COMPENSATION AND I T~~T~W<.I OJ~' EMPLOYERS LIABILITY ANY PROPRIETORIPARTNERlEXECUTIVE E.L. EACH ACCIDENT $ 'OFFICERhv1EMBER EXCLUDED? E.L. DISEASE - EA EMP'~OYEE $ If yes, desClibe under I E,L, DISEAS;; - POLICY LIMIT S SPECIAL PROVISIO!l:S below OTHER DESCRIPTION OF OPERA TlONSlLOCATIONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS REF: Project at 2521 Chester Ave Bakersfield, Ca The City of Bakersfield, its Mayor, Council, Officers, Agents, Employees & Designated Volunteers as well as John J. Ulman ConstructionManagement are additional insureds per attached endorsement CG2935. *10 days notice for nonpayment, CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE, DESCRIBED POLICIES BE CANCELLED BEFORE THE The Ci.ty of Bakersfield EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1501 Truxtun Ave 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT Bakersfield, CA 93301 FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE 4; Bruce Lynn/DOROTH ~ ~ > , ACORD 25 (2001/08) @ ACORD CORPORATION 1988 n,lc-n"c ,""."."...... 11:11 MAY 22, 2007 ID: KERN INSURANCE ASSOC FAX NO: 835-4500 #25257 PAGE: 1/5 I I I I I Kern Insurance Associates 5407 Stockdale Highway Bakersfield, CA 93309 Voice (661) 835-4542 FAX (661) 835-4500 To: Company: Fax Number: 325-6803 Phone Number: Phone Number Dorothy Ferrell (661) 835-4500 (661) 835-4~42 x240 From: Fax Number: Time Sent : Tuesday, May 22, 2007 11:10AM 5 Pages : Description : Central Cardiology LLC OCP Cvg. ATTN: John Ulman John here is the certificate for the OCP coverage along with the additional insured endorsement for the City of Bakersfield. I have also included the invoice for the premium as I understand this is part of the construction cost. Dorothy 11: q MAY 22, 2007 ID: KERN INSURANCE f3?SOC FAX NO: J335-4500 #25257 PAGE: 4/5 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the ~_overage afforded by the policies listed thereon. I I I i I I I ! \ ACORD 25 (2001/08) INS025 (0108).080 Page2of2 11:13 MAY 22, 2007 ID: KERN INSURANCE ASSOC FAX NO: 835-4500 *25257 PAGE: 3/5 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR POLITICAL SUBDIVISIONS - PERMITS This endorsement modifies insurance provided under the following: OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART SCHEDULE State or Political Subdivision: Tile City or 6<lKerSTleICl, ItS Mayor, counCil, OTTlcers, Agems, Employees ana aeslgnatea vOlumeers (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured any state or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit 2. This insurance does not apply to: a. "Bodily injury" or "property damage" arising out of operations performed for the state or municipality; or b. "Bodily injury" or "property damage" included Within the "products-completed operations hazard." CG 29351188 Copyright, Insurance Services Office, Inc., 1988 Page 1 of 1 o . . . " 1- ~ ~ c::r::' Z&-lk- ~- l \ ... .. ). -:--.- '\ ). i ~ . , '1- . . \ /",-0 , <z-V ,. .I" ?;~ : r;/ ',-' T ,.... ,'~ - 'j .; " ' I ';, .' I . \' ' i , . I '------ ""v] ~'\~ , ---- I