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Home My WebLink AboutA200• • • Type of Event: _ Public Concert Parade Motion Picture _ Fair _ Festival _ Demonstration _ Circus Grand Opening _ Other b Community Event Block Party Event Title: Atm iC.tt Q. c i _ �r,C-ttT7 RI AY ra. Lit E Event Location: V-•t YV&L1._ 2 PcQ-K. Actual Event Hours: el I ar /pm to` ar /pm Setup/assembly/construction Date: 'L3 Start time: OB • tC Please describe the scope of your setup/assembly work (specific details): ACS STAf L61 41C-S CiAA:a Li. t II C. a-Ik. �,s ? CA10- 5 A tS Sc, ?Nat G010.1A- zRty esar U? i-r - UA4 or Lu E')r Dismantle Date: S/ 2 J251 Completion Time: % 2• DOa 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. Event Date(s): From 81 2) o )I 2S1su3 Total Anticipated Attendance: t) 00 Month/Day/Year ( Participants) Spectators) ( Sponsoring Organization: A VAEI2AQe+t4 (?...etaX42-c2Ctt17 k:A1 - For Profit ®P►J )( Not -for -Profit Chief Officer of Organization (Name) u a a G Zt Ata ` Applicant (Name): I l✓( V Address: QAMlwiv nth t t • '%-kE Ito cAl� �ltkt (1/ Daytime Phone: 4I9) 23 Evening Phone:si�") VPf{ / C24 Fax: (tsIQ) t ..� 7 21 q Lf'1 Contact Person "on site" day of the event: AiE.. SA m Lob • S.....,.•+rs fob tee+ Pager/Cellular: Lelei 2 tog I F !�1 NOTE: THIS PERSON MUST BE IN ATTENDANCE FOR THE DURATION OF THE EVENT AND IMMEDIATELY AVAILABLE TO CITY OFFICIALS 1 .s1 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 _ NO YES %✓ NO $ 101 VW Estimated Gross Receipts including ticket, product and sponsorship sales from this event. $ I r >v Estimated Expenses for this event. $ \o': 000 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. 14h2 E.Qeia rM aini ti2�- e LA•n; C'&r2 l Y\ Qit-ti e4- t 2.0etsa foss►°Jc. rut.. -x-�n , Ann t6c<9_. coL C"rk( • _ YES I 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 NO Does the event involve the sale or use of alcoholic beverages? _ YES A NO Will items or services be sold at the event? If yes, please describe: _ YES 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. YES ' NO Does the event involve a fixed venue site? If YES, attach a detailed site map showing all streets impacted by the event. IC YES _ NO Does the event involve the use of tents or canopies? If YES: Number of tent/canopies ? Sizes t r f O`LIG 2- IbIL tO,-"LCt2.0 i i- W X'1O NOTE: A separate Fire Department permit is required for tents or canopies. YES NO Will the event involve the use of the City stage or PA system? In addition to the route map required above, please attach a diagram showing the overall layout and 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: If you intend to cook food in the event area please specify the method: GAS 4 ELECTRIC i . CHARCOAL OTHER (Specify): D. Portable and/or Permanent Toilet Facilities Number of portable toilets: W (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.) n Number of trash cans: L0 Trash containers with lids: 3 'O+INVP ¶ %l2S Describe your plan for clean-up and removal of waste and garbage during and after the event: ezco ,Vh E (; 0\ u rZ-S w I o i S ` .,e D f fitASH • 3 Please describe your procedures for both Crowd Control and Internal Security: 1_ YES _ NO Have you hired any Professional Security organization to handle security arrangements for this event? If YES, please list: .� Security Organization: _\ r iiM' k c CeS Zc- Security Organization Address: 2.9141 0A041i t ( Rao SO'AIrl tri° CaPcChi ctoC , C eil10I Security Director (Name): Mt \& IA Sth Phone: 12ICi' S? t4. 4 YES _ 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: Pp a.1L L Lo1A-1 A) Co '1 L ► WI"rx� �2-S Please indicate whj.t arrangement tou have made for providing First Aid Staffing anil Eq ui nt. CkC, Please describe your Accessibility Plan for access at your event by individuals with disabilities: Vo.(62_.‘/- r S A-6>i Cum Alt Prey Please provide a detailed description of your PARKING plan: 90‘at VNLV-trot Lek s1I2 1 `PAQk M, Please describe your plan for DISABLED PARKING: (c V ►i L _9-6 11 S Aida 1 I k h 4 • Please describe your plans to notify all residents, businesses and churches impacted by the event: he a-ct klOckC.c —1'2- i 2S ORI ea_ 10 SJEtvi NOTE: Neighborhood residents must be notified 72 hours in advance when events are scheduled in the City parks. YES _ 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: Number of Bands: I S Type of Music: 0 Ma C �l Will sound amplification be used? If YES, please indicate: YES _ NO Start time: •e, /pm Finish Time ' W (arr)pm YES _ NO Will sound checks be conducted prior to the event? If YES, please indicate: Start time: am/'pm Finish Time US r2j° am/pm Please describe the sound equipment that will be used for your event: \; Nal to ¶ (n1 Ru M S ?V VV1.0(Ct ikuS _YES NO Fireworks, rockets, or other pyrotechnics? If YES, please describe: YES _ NO Any signs, banners, decorations, special lighting? If YES, please describe: Li ( 1 'Tot ,%a., 'ktsv` S l v61, &e+'—Or ' 5. Revised 08/10/05 Event: For Office 'Use OnCy 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 (c`l`1\leg-AL'.Pt QPc.CQ0- ef4 C ��v ' NL. Person in Charge of Activity Z..A.d1e__ 5Am \ N 1 e(pt Address 2.1o�S 0..gwAt►ai: OeL Spr. '0)6(0c, CA- `1 Zit' Telephone a'1' Un2- -14 2'3 Date(s) of Use OQJ 23/2001 /25 2'c13 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. 41 SignastG e of Applicant Lip Official Title ii4 r( .)terra. OirlOrr (0utL, Date Oa/ 1-3 For Office Use Only Certificate of Insurance Approved Date 7