HomeMy WebLinkAbout300 TRUXTUN AVE~,cA oRA ENCROACHMENT PERMIT
CITY OF BAKERSFIELD U fl O
PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
✓``°"ly 1114 BAYERSFIELD CA 93301
1 OR (661) 326-3724
'O THE CITY ENGINEER OF THE CITY OF BAKERSFIELD CALIFORNIA:
ursuant to the provisions of Chapter 12.20 of the Bakersfield Municipal Code, the undersigned applies for a permit to.place, erect, use and.,
iaintain an encroachment on public property or right of way as therein defined.
Application Number . . . 09-30000024 Date 5/29/09
Property Address_ . . . . 300 TRUSTUN AVE
Application type description PW - ENCROACHMENT PERMIT
Owner Contractor
WHITEHEAD BROOKS & DONNA TR OWNER
2514 PARKGATE ST
BAKERSFIELD CA 93311
Permit . . . . . . ENCROACHMENT PERMIT
Additional desc . .
Phone Access Code . 910182
Permit Fee . . . . 208.00
Issue Date . . . . 5/29/09 Valuation . . . . 0
Qty Unit Charge Per Extension
1.00 208.0000 EA PW ENCROACHMENT 208.00
Special Notes and Comments
CAST IN PLACE CONCRETE RAMP WITH STEEL
HANDRAIL. 43' OF RAMP WITH 38' OF
HANDRAIL. CONTACT: JOHN ANDERSON,
327-1436.
Fee summary Charged Paid Credited Due
Permit Fee Total 208.00 208.00 .00 .00
Grand Total 208.00 208.00 .00 .00
~ pplicant
►ermit at
to the Bakersfield Municipal Code Chapter 12.20 to revoke the
Lez~
Print Name
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)
>UBSTANTIALLY INTERFERE WITH THE USE OF THE PLACE WHERE THE SAME IS TO BE LOCATED AND (2)
HILL (NOT) CONSTITUTE A HAZARD TO PERSONS USING SAID PUBLIC PLACE; SAID APPLICATION IS
CHEREFORE (GRANTED) (DENIED). Said permit shall expire on date stated above.
signature of City Engineer
Additional Terms on the Back
0
B 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: July 21, 2009
SUBJECT: Encroachment Permit Application for: 300 Truxtun Ave.
Name of Applicant: Brooks & Donna Whitehead Trust
Description of Encroachment. Install handicap ramp & curb with railing
in front of lot. Ramp is behind sidewalk.
Bldg. is in process of being built.
Engineering and Traffic staff has reviewed the attached encroachment permit to allow the
applicant to install fence as described above.
The applicant has provided proof of appropriate insurance coverage to Risk Management.
Based on their review, staff recommends approval of the permit.
SAPERMITS\ENCROACH\2009 approval letters\300 Truxtun Ave..doc
D _A Iz E R S F I E E
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: John Ussery, Civil Engineer II
FROM: Marian P. Shaw, Civil Engineer 1V, Subdivisions
DATE:. July 14, 2009
SUBJECT: Encroachment Permit Application for: 300 Truxtun Ave.
Name of Applicant: Brooks & Donna Whitehead Trust
Description of Encroachment: Handicap ramp & curb with railing in front
of lot, ramp is behind sidewalk. Building is
in the process of being built.
Please review the attached encroachment permit and return to me at your earliest convenience.
0
4r-
SAPERMIMENCROACHURAFFIM300 TRUXTUN AVE..doc
1 = I~ a S F I E L n
PUBLIC WORKS DEPARTMENT
MEMORANDUM
TO: Ralph Korn, Risk Manager
FROM: Marian P. Shaw, Civil Engineer IV, Subdivisions
DATE: July 8, 2009
SUBJECT: Encroachment Permit Application for: 300 Truxtun Ave.
Name of Applicant. Brooks & Donna Whitehead Trust
Description of Encroachment. Handicap ramp & curb with railing in front
of lot, ramp is behind sidewalk. Building is
in the process of being built.
Please review the insurance certificate with the attached encroachment permit and return to me
at your earliest convenience.
S:\PERMITS\ENCROACH\INSURANC\300 TRUXTUN AVE..doc
ENCROACHMENT PERMIT
APPLICATION FORM
CITY OF BAKERSFIELD
PUBLIC WORKS DEPARTMENT
1501 TRUXTUN AVE
BAKERSFIELD CA 93301
(661) 326-3724 Fax: (661) 852-2012
LOCATION OF ENCROACHMENT(Address required where available):
CA
If there is no address adjacent to work describe limits of work by distances from nearest existing street intersection.
APPLICANT INFORMATION
FULL NAME OF APPLICANT ~~o~• Tom S hVL, , A rM: L ,4 (JrW-E s
COMPLETE ADDRESS: 5100 lae~dtFu~Ml Auz ST.. M5- PHONE: 'Z7-57611
1310 .sr-+su> , CA 0(33 FAX:
ekoo S IbNh . Az V,)f\ %".J -IR t S -f CELL:
600 OU o~ VJ" PROJECT INFORMATION
DESCRIPTION OF ENCROACHMENT (Example: Wood or wrought iron fence, concrete block wall, raised
planter, etc.):
W I
L w "L Ezeg:r dF ?A&-P , t o r rg- 3L?5~ ol= t NpMAu.
PERIOD OF TIME FOR ENCROACHMENT: EINDEFINNITE or OTHER:
fp~ CONTAC'T' PE
RSON Jvj.M ktl M ° Wwu, .F !5y-,T4 PHONE: ?Z7 lgafe
Applicant agrees that if this application is granted, applicant shall indemnify, defend and hold harmless the 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, 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 upon the
revocation thereof by the Cit~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 farther 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.
Applicant acknowledges the right of the City Engineer, pursuant to Bakersfield Municipal Code Chapter 12.20 to revoke
the permit at any time.
Encroachment Permit Fee: $208.00
S:\PERMITS\ENCROACH\ Encroachment Permit Req Form.DOC January 2009
APPLICATION FOR ENCROACEDIENT PERMIT
TO THE CITY ENGINEER OF THE CITY OF IIIAKERSFIELID, 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 th`rda defined
1. Full naive of applicant and complete address including ohone number. -5r c tN~ . fAM
LAIN (c~, ~u I ~x~~ tv tw. 140~ 5M_1Zq' B s~+ izLi> CA- 93309
2. Mature or description of the encroachment for which this application is made: tA( _
3. Locatioa of the proposed encroachment: q5W
4. Period of time for which the encroachment is to be maintained: 19peRr4 R-E - -
Ap ticant agrees that if this application is g-~i~te-d, a}lpiicant shall indemnify, defend and hold harmless City, its
offPeers, agents and eruplov es va3inst. iii ar d al l iiaE l llt Claims, actions, causes of action or demands, whatsoever
~o !ii?s~ tl,ei±g, qr any rift ein, be*cre a~iziliai,str~ti~ , c;uLsi ~udic-d or judicial tribunals ofany kind whatsoever, arisin
G t :1?', t t IlatL taxi k~7itk, rar r 8ll5Cd L~; c~ii It e~"ITplaz if;rt; erection, use (by applicant or any other person or entity
t?E l~sii~teriance ~yt said 'Pi l~~bli t. ' t~ 3}7 Ii~cSiit aTr~13v; ag.-as to maintain the aforesaid encroachment during the
ii JI.53id1 L116.& 7~ei3siie'A 6 &!I` iaa3~Ll Such tIIIIe t t this permit is revoked.
Fpplicant r~,irtlier a~ e~°s +.h~.t u~t~n tEie expii-atiou o;•th erniit for ~rhicli dais appllca.t~t~fi is made, if grailied, or upon
tn~; *t.t~oc=n t?3ere,~f b r the C€.rv eoc~FUeer apolicant wi ! Lt' l~.is r~wr cost end e~e;ts° remove the same frtam else pu lie
,prt);L z r'.,1ti gr* of rI ere t e saii e is Icy ted, and stare said public property ar ri e 4f kvay to the conditit~n
a:= :aH.'•i e~' Sze{~.3 3: T} g'st~:o th~"j7 3~?.T?D* t'rG"i ;~1L~ m ~E '~.]7E;4 {3'r ~ 23C ??f i7 5 'uid ~biL'CQBChs'1i Lilt.
Applicant further agrees to obtain and keep all liability hr stir-anct rerlu =I by the City F.ngineet in full force and effect
for however' long the encroachment remains. Applicant shall furnish the City Risk Manager with a Certificate of
Insurance evide4cing sufficient coverage for bodily injury or property damage liability or both and required
endorsements evidencing the insurance required. The type mss) and amo°wn js) of insurance-coverage is:
Applicant ackaowledges the right of the City Engineer, puirsuant to-Bakers-field Mwiiicipal C9de CW_'_e&12.20 to NY -1
revoke the permit at any time.
Date:
tury'o pP t weer or epresentatavc
PEILMIT G
I I•IEF.EBY" CEXr IF, Y THAT I E1A_V-E.A-,'L D kN friNTST?GATION' OFT FIE FACTS STA'T'ED V4 THE
FCx iEGGt33 G Ai 'LICA7EFt7 i r#°r3 FLND TR. T THE, KkINTENANCE OF SAID ENCROACWMEINT (I) WILL
(NOT) S€ ST.424"i°IALLY 0TERFERE WITH THE USE OF THE PUBLIC: PLACE NVRERE THE S-A-ME Is TO
SAID APPLiCATIN{I9 THEREFORE (GRANTED) i3~A D TO PERSONS US DNG SAID PERMIT SHALL E aPME PUBLIC PLACE;
Date:
Tgnature of City ng-ineer
No. _
Date: 6/17/2009 Time: 11:53 AM TO: 1-661-327-8865 @ 9,1-661-327-8865 James G Parker Page: 003
{ IM
%`::::DATE MM
,fie ee ;
:z:>: ;;:::::.:::::>::::::4: 6/17/09
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
INDICATED
,
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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (M&UDD,YY)
POLICY EXPIRATION
DATE (MMIDONY)
LIMITS
A
GEN
ERAL LIABILITY
GENERAL AGGREGATE
$ 2,000,00
X
COMMERCIAL GENERAL LIABILITY
PRODUCTS - COMP:OPAGG
$ INCLUDE
7
7 CLAIMS MADE X❑ OCCUR
19 0DW12 8 04
10/01/08
10101109
PERSONAL &ADV INJURY
$ 1, 000 , O 0
OWNERS & CONTRACTOR'S PROT
EACH OCCURRENCE
$ 1 , 0 0 0 , 0 D
FIRE DAMAGE (Any one fire)
$ 300,000
MED EXP (Any one person)
$ 1,00c)
AUT
OMOBILE LIABILITY
COMBINED SINGLE LIMIT
$
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
HIRED AUTOS
BODILY INJURY
$
NON-OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
$
GARAGE LIABILITY
AUTO ONLY- EA ACCIDENT
$
ANYAUTO
OTHER THAN AUTO ONLY:
EACH ACCIDENT
$
AGGREGATE
$
EXCESS LIABILITY
EACH OCCURRENCE
$
UMBRELLA FORM
AGGREGATE
$
OTHER THAN UMBRELLA FORM
$
WORKERS COMPENSATION AND
STATUTORY LIMITS
EMPLOYERS' LIABILITY
EACH ACCIDENT
$
THE PROPRIETOR'
INCL
DISEASE- POUCY LIMIT
$
PARTNERS:FXECUTIVE
OFFICERS ARE:
EXCL
DISEASE -EACH EMPLOYEE
$
OTHER
DESCRIPTION OF OPERATIONS,'LOCATIONS,'VEHICLES!SPECIAL ITEMS
ADDITIONAL INSURED PER BLANKET FORM BG-G-305(05/03).
10 DAY NOC FOR NON-PAYMENT OF PREMIUM. RE: TRUXTUN OFFICE
r''nMAT,F.Y - RTTTTMNr A. inn TRUXTUN AVE. BAKERSFIELD, CA 93301.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF 3AKERSFIELD EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
P.O. POX 20S7 a _O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BAKERSFIELD, CA 93303 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR. REPRESENTATIVES.
AUTHORIZED RE ENTATIVE ANGELIOU 12
4WI1.1111- G0 fi_
Date: 6/18/2009 Time: 3:08 PM To: 1-661-327-8865 Q 9,1-661-327-8865 James G Parker Page: 002
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
AUTOMATIC ADDITIONAL INSUREDS. ENDORSEMENT
CONSTRUCTION CONTRACTS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
This endorsement changes the policy effective on the inception date of the policy unless another date is
inrlir±atPri hPlnw
_
Endorsement Effective
_
Attached to and forming a part of Policy
Standard Time
Endorsement Number
Number
mm
dd
12:01
A.M.
190BW 12804
(The above information is required only when this endorsement is issued subsequent to preparation or the policy.)
Authorized Representative
This endorsement is provided in consideration of an additional premium.
Premium:$750 flat - fully Exposure: Only the person or organization named
earned
Date
Classification Code: 49950
Who Is An Insured (Section II) is amended to
include as an insured any person(s) or
organization(s) (hereinafter called "additional
insured") with whom you agree, by virtue of a
written construction contract, written construction
agreement or permit (all of these hereinafter called
"Contract"), that is an "insured contract," to name as
an insured with respect to liability arising out of your
ongoing operations performed on the project
specified in the construction contract, including acts
or omissions of the Additional Insured in connection
with the general supervision of such operations.
Except as provided above, this insurance does not
apply to any "bodily injury," "property damage" or
"personal and advertising injury" arising out of or
resulting from the neglect or negligence of the
Additional Insured described in this endorsement.
The Company will have no duty to defend any "suit"
which alleges neglect or negligence of the
Additional Insured.
Such insurance as is afforded by this endorsement
will only extend as is required by the Contract and
will in no event provide for insurance not afforded
by this policy.
Insurance afforded by this endorsement applies
provided the "bodily injury", "property damage" or
"personal and advertising injury' occurs subsequent
to the execution of the Contract and further
provided that the "bodily injury", "property damage"
or "personal and advertising injury" arises from
"your work" performed during the policy term.
Coverage for liability assumed by the Named
Insured in a Contract shall only be to the extent of
the negligence or fault of the Named Insured
according to applicable principles of comparative
fault.
If other valid and collectible insirance is available to
the additional insured for a Icss we cover under
Coverage A or B of the Coverage Form to which
this endorsement attaches, then the additional
insured must also tender any loss to each such
other insurance. Should such other insurance
apply, then this insurance is excess over any other
such insurance.
This insurance does not apply to any "bodily injury'
to:
a. An "employee" of any insured, or a person
hired to do work for or on behalf of any
130-0-305 0503 Page 1 of 2
Date: 6/18/2009 Time: 3:08 PM To: 1-661-327-8865 @ 9,1-661-327-8865 James G Parker page: uu3
ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (continued)
(1) Employment by any insured; or
b. To any obligation to share damages with or
repay someone else who must pay
damages because of the injury.
(2) Performing duties related to the
conduct of any insured's business; or
b. The spouse, child, parent, brother or sister
of that "employee" as a consequence of
Paragraph a. above.
-This-exclusion-applies=------
a. Whether the insured may be liable as an
employer or in any other capacity; and
These provisions and exclusions apply in addition
to those contained in the Coverage Form. All of the
provisions and exclusions of the policy that apply to
LIABILITY COVERAGES also apply to this
endorsement.
BG-G-305 0503 Page 2 of 2
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