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Home My WebLink AboutTUP• • pe of Event: Festival Public Concert — Fair — Parade _ Demonstration — Circus Motion Picture _ Grand Opening _ Other` nex-----s,„LAf‘tov \ k \\ ____' (Ws ) am/Do MC • Event Title: Event Location: Event Date(s): From Actual Event Hours: C1 Total Anticipated Attendance: , ID0tD (P 0 Participants \ \0t Spectators) Setup/assembly/construction Date: Start time: Please describe the scope of our setup/a embly work (specific det it0S1 0 L y_ Community vent — Block Party Dismantle Date: Completion Time: T":b 0 am 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: Chief Officer of Organization (Name) Applicant (Name): \2_—% Address: r)- \ cD \ G r Daytime Phone: ((act) 4[12 ' 34) Fax: (A(- o� a33E-Mail: r w llr�� '(D Contact Person "on site" day of the event: �1 ,(`j�c� a r�C.71-04 Evening Phone: (/ `1) ` t - 30 I l- (b � Gceiiuiartq)/5* NOTE: THIS PERSON MUST BE IN ATTENDANCE FOR THE DURATION OF THE EVENT AND IMMEDIATELY AVAILABLE TO CITY OFFICIALS Is your organization a "Tax Exempt, nonprofit" organization? t YES _ NO Are admission, entry, vendor or participant fees required? ENO If YFS, pleas explain the urpse y=gide amount(s):/Sr` % jilQi C��^�Ur d u�r S -��-dC e�X Jo (e -A^-a ar h41 $ Estimated Gross Receipts including ticket, product and sponsorship sales from this event. $ 10100 0 Estimated Expenses for this event. $ 3 s 00U 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. tSY:A-t Lm0a414 _ YES ✓ NO If the event involves the sale of cars, will the cars come exclusively from National City car dealers? If NO, list any addition I d alers involved in the aaie: YES t7NO Does the event involve the sale or use of alcoholic beverages? YES VN O 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 VYES of travel, and provide a written narrative to explain your route. V YES NO Does the event involve a fixed venue site? If YES, attach a detailed site map showing all streets impacted by the event. BYES �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 _ NO Will the event involve tk use of the City or your stage or PA system? SPECIFY: 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 ELECTRIC CHARCOAL OTHER (Specify): n Portable and/or Permanent Toilet Facilities Number of portable toilets: (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) nTables # and Chairs # n Fencing, barriers and/or barricades nGenerator locations and/or source of electricity nCanopies or tent locations (include tent/canopy dimensions) nBooths, exhibits, displays or enclosures nScaffolding, bleachers, platforms, stages, grandstands or related structures nVehicles and/or trailers n Other related event components not covered above nTrash 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: 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.oth Crowd C•ntrol and Internal Security: ena _ YES 1/60 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: 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: Please indic to what arrangement you have made for providing First Air Staffing a d Equipme; t. eat P fs Ple se de ribeyoour Accessibility PI for access at y ur even y individualsrwi h disabili es: — k 0.c-t I i- e S Go- O.—v ( o a c e-S` �bl e VI Plerse provide a de ailed desc iption of your PhylKlyG plan: de)Aizeie -1'41 4 . C' , 5#tx . -- ; U. b pt AM_ • Plsv desbe your plan PARKING: / -om 1P � �{- Please describe your plaK to notify all resic� s, b sine es an ch rc s impacted by the event: C� ia�'. C��Le ,-s, 1V±c��u-1 Et 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 r Type of Music: saL,„s1 V YES _ NO Will sound amplification be used? If YES, please indicate: Start time: am/ Finish Time am _ YES V 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 ipment that will be u d for your event: q(24344-4 _ YES V NO Fireworks, rockets, or other pyrotechnics? If YES, please describe: 144^c0 isitt61 C YES XO Any signs, banners, decorations, special lighting? If YES, please describe: Revised 02/29/12 I Organization Person in Charge of Activity Address VD \ Gr TelephoneIC(> � 1 �3 o (. ate(s) of Use Mil IV4; cl3 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. tiA LQ Gram►--�- 1� 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. Si Applicant ficial For Office Use Only Certificate of Insurance Approved Date Cafeteria G R A G E R A V E Street Entance Performing Arts Building 8 0 7 Stage Inflatables 700 Building 900 Building Parking Lot 800's PE Building Bathrooms Entrance Tickets GRJ Field Ms. Johnson's Food Court Sumo First Aid/ Lost and Found Inflatables Inflatables Courts