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Home My WebLink AboutTUPActual Event Hours:9:30 am am/pm to 8:00 pm am/pm Setup/assembly/construction Date: Evenings Start time: 7:OOpm Please describe the scope of your setup/assembly work (specific details): Inflate Balloon on roof Type of Event: _ Public Concert _ Fair _ Festival _ Community Event _ Parade _ Demonstration Circus Motion Picture _ Grand Opening X Other Promotion Event Title: T Shirt Balloon Block Party Event Location: 1502 Highland Avenue Event Date(s): From11 to 12/30/11 Total Anticipated Attendance: nA Month/Day/Year ( Participants) ( Spectators) Dismantle Date: Evenings Completion Time: Sundays pm am/pm List any street(s) requiring closure as a result of this event. Include street name(s), day and time of closing and day and time of reopening. Sponsoring Organization: For Profit Not -for -Profit Chief Officer of Organization (Name) Bobby Bosone Applicant (Name): T Shirt Mart Address: 1502 Highland Avenue Daytime Phone: (619) 791-1143 Evening Phone: ( ) Fax: (h19) 791-1146 Contact Person "on site" day of the event: Manager on Duty Pager/Cellular: (619) 850-4545 NOTE: THIS PERSON MUST BE IN ATTENDANCE FOR THE DURATION OF THE EVENT AND IMMEDIATELY AVAILABLE TO CITY OFFICIALS 1 Is your organization a "Tax Exempt, nonprofit" organization? Are admission, entry, vendor or participant fees required? If YES, please explain the purpose and provide amount(s): YES X NO YES X NO $ N/A Estimated Gross Receipts including ticket, product and sponsorship sales from this event. $ N/A Estimated Expenses for this event. $ N/A What is the projected amount of revenue that the Nonprofit Organization will receive as a result of this event? Please provide a DETAILED DESCRIPTION of your event. Include details regarding any components of your event such as the use of vehicles, animals, rides or any other pertinent information about the event. Have large Balloon on roof in the shape of aT Shirt _ YES X NO If the event involves the sale of cars, will the cars come exclusively from National City car dealers? If NO, list any additional dealers involved in the sale: 2 YES X NO V 1/ V 1/ V V 1/ 1/ NI Does the event involve the sale or use of alcoholic beverages? X YES _ NO Will items or services be sold at the event? If yes, please describe: Inside of store YES X NO Does the event involve a moving route of any kind along streets, sidewalks or highways? If YES, attach a detailed map of your proposed route indicate the direction of travel, and provide a written narrative to explain your route. K YES NO Does the event involve a fixed venue site? If YES, attach a detailed site map showing all streets impacted by the event. See address YES X NO Does the event involve the use of tents or canopies? If YES: Number of tent/canopies Sizes NOTE: A separate Fire Department permit is required for tents or canopies. YES X NO Will the event involve the use of the City stage or PA system? n addition to the route map required above, please attach a diagram showing the overall layout ind set-up locations for the following items: > Alcoholic and Nonalcoholic Concession and/or Beer Garden areas > Food Concession and/or Food Preparation areas Please describe how food will be served at the event: N/A If you intend to cook food in the event area please specify the method: N/A GAS ELECTRIC CHARCOAL OTHER (Specify): ➢ Portable and/or Permanent Toilet Facilities Number of portable toilets: N/A (1 for every 250 people is required, unless the applicant can show that there are facilities in the immediate area available to the public during the event) Tables and Chairs Fencing, barriers and/or barricades Generator locations and/or source of electricity Canopies or tent locations (include tent/canopy dimensions) Booths, exhibits, displays or enclosures Scaffolding, bleachers, platforms, stages, grandstands or related structures Vehicles and/or trailers Other related event components not covered above Trash containers and dumpsters (Note: You must properly dispose of waste and garbage throughout the term of your event and immediately upon conclusion of the event the area must be returned to a clean condition.) Number of trash cans: N/A Trash containers with lids: Describe your plan for clean-up and removal of waste and garbage during and after the event: Please describe your procedures for both Crowd Control and Internal Security: N/A _ YES X NO Have you hired any Professional Security organization to handle security arrangements for this event? If YES, please list: Security Organization: Security Organization Address: Security Director (Name): Phone: X YES X NO Is this a night event? If YES, please state how the event and surrounding area will be illuminated to ensure safety of the participants and spectators: Starts at 9:30 and ends at 8:00 PM A few hours will be at night Please indicate what arrangement you have made for providing First Aid Staffing and Equipment. N/A Please describe your Accessibility Plan for access at your event by individuals with disabilities: Special Parking in place Please provide a detailed description of your PARKING plan: On file with city Please describe your plan for DISABLED PARKING: Special parking in place already a Please describe your plans to notify all residents, businesses and churches impacted by the event: N/A NOTE: Neighborhood residents must be notified 72 hours in advance when events are scheduled in the City parks. YES X NO Are there any musical entertainment features related to your event? If YES, please state the number of stages, number of bands and type of music. Number of Stages: Type of Music: YES X NO Will sound amplification be used? If YES, please indicate: Start time: am/pm Finish Time am/pm YES X NO Will sound checks be conducted prior to the event? If YES, please indicate: Start time: am/'pm Finish Time am/pm Please describe the sound equipment that will be used for your event: Number of Bands: YES X NO Fireworks, rockets, or other pyrotechnics? If YES, please describe: YES X NO Any signs, banners, decorations, special lighting? If YES, please describe: Revised 08/10/05 For Office 'Use Only Event: Department Date Approved? Yes No Initial Specific Conditions of Approval Council Meeting Date: Approved: Yes No Vote: Kathleen Trees, Director Building & Safety Department 6 City of National City PUBLIC PROPERTY USE HOLD HARMLESS AND INDEMNIFICATION AGREEMENT Persons requesting use of City property, facilities or personnel are required to provide a minimum of $1,000,000 combined single limit insurance for bodily injury and property damage which includes the City, its officials, agents and employees named as additional insured and to sign the Hold Harmless Agreement. Certificate of insurance must be attached to this permit. Organization T-Shirtmart Person in Charge of Activity Maguel Address 1502 Highland Avenue Telephone (619) 791-1143 Date(s) of Use 3/15/11 -12/30/11 HOLD HARMLESS AGREEMENT As a condition of the issuance of a temporary use permit to conduct its activities on public or private property, the undersigned hereby agree(s) to defend, indemnify and hold harmless the City of National City and the Parking Authority and its officers, employees and agents from and against any and all claims, demands, costs, losses, liability or, for any personal injury, death or property damage, or both, or any litigation and other liability, including attorneys fees and the costs of litigation, arising out of or related to the use of public property or the activity taken under the permit by the permittee or its agents, employees or contractors. Signature ofi"Ap Attorney -In -fact 3/1/11 Official Title Date For Office Use Only Certificate of Insurance Approved Date 7