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HomeMy WebLinkAbout830 21ST STENCROACHMENT PERMIT - jtw.~' t=j CITY OF BAKERSFIELD PUBLIC WORKS DEPARTMENT 1501 TRUXTUN AVE ✓''`U"RY 1L BAKERSFIELD CA 93301 9LjF~R'~ (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 . . . . . 05-30000108 Date 1/09/06 Property Address . . . . . . 830 21ST ST Application type description PW - ENCROACHMENT PERMIT Owner Contractor JOBIM REAL ESTATE PARTNERS OWNER/BUILDER 2914 21ST ST BAKERSFIELD, CA BAKERSFIELD CA 93301 BAKERSFIELD CA 93301 (661) 204-1978 Permit . . . . . . ENCROACHMENT PERMIT Additional desc . . Phone Access Code . 482083 Permit Fee . . . . 150.00 Issue Date . . . . 1/09/06 Valuation . . . . 0 Qty Unit Charge Per Extension 1.00 150.0000 EA PW ENCROACHMENT 150.00 Special Notes and Comments encroachment permit for two landings CONTACT NUMBER 204-1978 DAVID COFFEY 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 tat any time. --b[A-V[ Signature of Applicant (Ow r Age 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) 5Cq.M-T-rT E 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 P A K 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: January 11, 2006 SUBJECT: Encroachment Permit Application for 830 21st Street. Name of Applicant. . David Coffey Description of Encroachment. Landings for Exterior Doors. Engineering and Traffic staff has reviewed the attached encroachment permit to allow the installation of Exterior Door Landings. 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. SAPERMIMENCROACH\830 21st Street.doc K E R S F I E E D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Ryan Starbuck, Civil Engineer III FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions DATE: January 10, 2006 SUBJECT: Encroachment Permit Application for 830 21St Street. Name of Applicant. David Coffey Description of encroachment. Landings for exterior doors. Please review the attached encroachment permit and return to me at your earliest convenience. 1/!o16G 6. ~c . S:\PERMITS\ENCROACH\TRAFFIC\2912 21st Street.doc /r D A K E R S F I E L D PUBLIC WORKS DEPARTMENT MEMORANDUM TO: Pat Flaherty, Risk Manager FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions DATE: January 10, 2006 SUBJECT: Encroachment Permit Application for 830 21St Street. Name of Applicant. David Coffey Description of encroachment. Landings for Exterior doors. Please review the insurance certificate with the attached encroachment permit and return to me at your earliest convenience. S:\PERMITS\ENCROACH\INSURANC\830 21st Street.doc APPLICATION FOR ENCROACH11~1ENT PEILMIT TO THE CITY ENGINEER OF THE CITY OF BAKERSFIEL D, CALIFORNU: Pursuant to the provisions of Chapter 1220 of the Bakersfield Municipal Code, the undersigned appplies for a permit to place, erect, use and maintain an encroachment on public property or right-of-way as thcrciaa defined. 1. Full name of aonlic t and complete address including phone number. fj3o k3g[1J1D CA 9 l 2. Nature or description of the eacroachrn which rt f f this application is made. I Chi . 3. Location of the proposed encroachment: t?k2 2.1 4. Period of time for which the encroachment is to be maintained: Applicant agrees that if this application is granted, appplicant shall indemnify, defend and hold harmless City, its officers, agents and employees against any and all UAL ity, claims, actions, causes of action or demands, whatsoever against them, or any ofthent, before administrative, quasi-judicial, or judicial tribunals ofany kind whatsoever, ansin out of, connected with, or caused by agglicant's placement, erection, use (by applicant or any other person or entity or maintenance of said encroachment. The ap licant further agrees to maintain the aforesaid encroachment during the life of. said encroachment or until such time t t this permit is revoked. Applicanf further agrees that upon.the expiration of the ggC=t for which this application is made, if granted, or •t~ on thcrcyocation. then f b the City engineer, icantwill4this t wn cost and exoSM y the saMe m th u .lie or right o way where the same is located, and restore said public property or right o way to the condition as~y as that in which it was before the placing, erection, maintenance or existence o said encroachment. Applicant further agrees to obtain and keep all !lability insurance required by the City Emg~neec` 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 inn or property damage liability or both and required endorsements evidencing the insurance required. Th4 type() and amount(s) of insurance-coverage is: Applicant acknowledges the tight of the City Engineer, pursuant to-B-k field Municipal.Code,Ch p~2.20 to p revoke the permit at any time. Date: iff tgnature a Ap t w er r epresentative PERriTT I HEREBY CERTIFY THAT I IUVE MADE AN DtVESTIGATION OF THE FACTS STATED IN THE FOREGOING APPLICATION AND FIND THAT THE MAMENANCE OF SAID ENCROACHMENT (1) WILL (NOT) SUBSTANTULLY MTERFERE WITH THE USE OF THE PUBLIC PLACE WHERE THE SAME IS TO LOCA WILL PERSON SAID APPLICA~ON LS THEREFORE oNRS.ANTED) (DENTE AID PERINUTS G'SAM P SHALL, EXPIREBZIC PLACE; Date: No. ttSF6 ~ minty ngarlCer JGAaGg XVA tOOIZ00 ROVd LT: TT 5002/STIZT X1e31112TU CITY CF BAKERSFIELE? DEPARTMENT OF PUBLIC WORKS TD WHOM IT MAY CONCERN: We the undersigned, have no objection to the construction of a46Me beside the sidewalk within the public right of way. '(~Y T (Street for pupomW encroachment) (Owners Name} 2-.6- Phone: 2OV of (Address of purposed encroachment) SIGNED : 1) Name. L --c~- Address; 21 Name: Address: 3) Name: - - Addresw - 4) Name: Address: 3) Name: Address: 4) Name: Address: Date: 1 Z - 1 Date: I g-/q - v Date: date: aaAIGS xVjr DQO/600 HOVd LT:TT GJOZ/ST/ZT xv-44VTH ENCR©ACt&LENT PERMIT I SMANCE REQtMffMENTS 1) Type and Amount of Insurance Cowrrsge for installation er corotructicn ~an~iN~s . 1) for residences Hottteawners coverage in nit amount of at (east S300,000 For businesses boo, ovo.m CornmercW General Liability coverage in an amount of at least 53890" , 11) Additional Insured Verbiage The City cf Bakersfield, its mayor. council, employees. agents and volura ers are added as additional insureds with rapects to 2 (i.e. the insmRstion cfa ehairi link fence at I MM TIMMMa Ave.). JeAa8S x@,4 1i00/DOO H ;Vd LT : TT SQQZ/8T/ZT Xvdju2TjI 12/13/05 16:57 FAX 6618354500 KIA INSURANCE 10001 Kern Insurance Associates, Inc. P.O. Box 11390 Bakersfield, CA 93389-1390 Phone: (661)835-4542 Fax: (661)835-4500 000415101 Kern Insurance Associates, Inc, Business Fax To., Ross Skarphol Architects Fax 334-2743 From: Janice G. Diehl, AAI, CPIW Account Representative Email: jdiehl@kia-ins.com Telephone: 661-835-4542, ext 253 RE Customer: Dice Real Estate Partners, LLC dba: Modern Office Environments Policy No.,. 51 SBATJ6079 Date: 12113/2005 # Pages (including cover) 4 Ross: See attached Certificate of Insurance issued on behalf of our insured, Dice Real Estate Partners, LLC per your request. Let us know if you have any questions. Thank ou, Cc: David Coffee Dice Real Estate Partners, LLC VIAU5lt1hit- 12/13/05 16:57 FAX 6618354500 KIA INSURANCE 0002 Co AGES NCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING N SURA THE POLICIES OF I TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH ANY REQUIREMENT 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, AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. I SR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POL CY EXPIRATION UMRB SISBAT36079 09/01/2005 09/011-Z006 EACHOCCURRENCE s c1-0.00..000 GENERAL LIABILITY DAMAGE TO RENTED S 100 00 X COMMERCIAL GENERAL LIABILITY , CLAIMS MAOE ® OCCUR MED EXP (Any one person) $ J.U 000 A PERSONAL &ADV INJURY S 1 , 000 000 GENERAL AGGREGATE z, coo 00 GFWL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG S 2,000,000 POLICY E& LOCI AUT OMORILELIAB[LITY COMBINED SINGLE LIMIT S ANY AUTO , (En sodden) ALL OWNED AUTOS BODILY INJURY £ SCHEOUL€D AUTOS (Par person) HIRED AUTOS SODILYINJLRY 6 NON•OWNEO AUTOS (Per aaidenl) PROPERTY DAMAGE s (Per awidonl) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT s ANY AUTO OTHER THAN EA ACC 5 AUTO ONLY AGG S EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE 5 OCCUR ID CLAIMS MADE AGGREGATE S S DEDUCTIBLE S RETENTIDN S $ WORKERS COMPENSATION AND OTH- STATU• MR-, EMPLOYERS' LIABILITY E.L. EACH ACCIDENT 8 " ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? E.L. DISEASE • EA EMPLOYE S S PEC, a unda DeIOw SPECIAL PROVISIONS E.L.DISEASE -POLICY LIMIT 3 OTHER FSCRIPTI N OF OPERA QN ! OCf~tOVS I VEHICLES I EXCLUSIONS.pDDEDB J NDORSEMENT! SPECIAL PROV IONS Tty ® t3akers ~e~iw`~, -it s mayor, council, QTTjCers, agents, employees and volunteers are included as additional insured as provided by the policy and as required by written contract. dditional insured wording is included in the policy form and no separate endorsement is ecessary. See attached, #f. - 10 Day notice of cancellation for non-payment of premium CITY OF BAKERSFIELD Public Mork Department 1501 Truxtun Avenue Bakersfield, CA 43306 ACORN 25 (200110E) FAX: (661)334-2743 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OQUGATION OR LIABILITY OF ANY KIND UPON THE INSURER, 116 AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Sohn Pryor, CPCU, ARM17AN-C @ACORD CORPORATION 1988 12/13/05 16:57 FAX 6618354500 KIA INSURANCE 0 003 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 after the coverage afforded by the policies listed thereon. ACORD 26 (2001109) 12/13/05 16:57 FAX 6618354500 KIA INSURANCE 0 004 BUSINESS LIABILITY COVEtt„GE FORM a. Your "employees", other than either your (2) Until your legal representative has "executive officers" (if you are an been appointed. organization other than a partnership, joint d. Your legal representative if you die, but venture or limited liability company) or your only with respect to duties as such. That managers Of you are a limited liability representative will have all your rights and company), but only for acts within the duties under this insurance. scope of their employment by you or while e. Any "employee" of the insured while acting performing duties related to the conduct of in the scope of bis/her duties as a retail your business- However, none of these " " pharmacist, or optician or optometrist.. is an insured for: employees f• Additional Insureds by Contract, (1) "Bodily injury" or "personal and Agreement or Perm' advertising injury": Any person or organization with whom you (a) To you, to your partners or agreed, because of a written contract or members (it you are a partnership agreement or permit, to provide insurance or joint venture), to your members such as is afforded under this Business (if you are a limited liability Liability Coverage Form, but only with company), or to a co-"employee" respect to your operations, "your work" or while that co-"employee" is either facilities owned or used by you. in the course of his or her employment or performing duties However, coverage under this provision related to the conduct of your does not apply: business, (1) Unless the written contract or has been executed or a agreement (b) To the spouse, child, parent, permit has been issued prior to the brother or sister of that co- "bodily injury", "property damage" or "employee" as a consequence of "personal and advertising injury". Paragraph (1)(a) above; any person or organization (2) (c) For which there is any obligation included as an insured under provision in to share damages with or repay g_ (Broad Form Vendors). someone else who must pay jury damages because of the in (S) To any other person or organization described in Paragraphs (1)(a) or own in the Cecla:atiorso as an sh Additional insured. (b) above; or Coverage under this provision includes (d) Arising out of his or her prov providing t the following: or failing to provide professional health care services. (1) When an engineer, architect or " surveyor becomes an insured under Property damage" to property: (2) provision 2.f., the following additional (a) Owned, occupied or used by; or exclusion applies: (b) Rented to, in the care, custody or "Bodily injury", "property damage" or control of, or over which physical "personal and advertising injury" control is being exercised for any arising out of the rendering of or the purpose by you, any of your failure to render any professional "employees", any partner or services by or for you including: member (if you are a partnership (a) The preparing, approving, or or joint venture), or any member (if failure to prepare or approve you are a limited liability maps, shop drawings, opinions, company). reports, surveys, field orders, b. Any person (other than your "employee"), change orders. designs or or any organization while acting as your drawings and specifications; and real estate manager. (b) Supervisory, inspection, c. Any person or organization having proper architectural or engineering temporary custody of your property if you activities. die, but only: (2) When a lessor of leased equipment (1) With respect to liability arising out of becomes an insured under provision the maintenance or use of that 2.f., the following additional exclusions property; and apply: Page 10 of 20 Form SS 00 08 04 01