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Home My WebLink AboutTUP APPLICATIONType of Event: _ Public Concert _ Fair _ Festival _ Parade _ Demonstration Circus _ Motion Picture _ Grand Opening Other Event Title 3 1 e t /DO3 Event Location: �,�li� �1 V ittlo r Event Date(s): From 11 )3 to 111 I 113 Actual Event Hours: l,,, i arreto (1; 30 arr pj) Total Anticipated Attendance: ? Cj ( K i5 Participants 1,50 Spectators) Setup/assembly/construction Date: III t l 13 Start time `�M "I CAI" I asSc i i t ./ Please describe the scope of your setup/assembly work (speck details): 5 -- W. 3i -4 4 11v rt wi1t be. 4, I4o►11/1.or nrj `in 441t4t ncvv (i3 3 - i z t-ig I1 ` .' # y i'1 `In Ai, hViacr; k-iinal Ae1CIw,vL smell earriNki %al c‘u`f1 500 you. WiltsAtor wk, i7m-5p tIO b ( 4-'f) pG aid Prcwcru- SWAN Date: ( I ` I 13 Completion Time: i i.� - 30 , a � 5W� 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. ik $� Community vent _ Block Party m�M Sponsoring Organization: Chief Officer of Organization (Name) Fut'fYioi G1 Pe r e .. gtovvian ;OS fO Applicant (Name): Pei f-Yi 6-41 Perez_ Address: 3A op 1 h 14 r t-�1 �'�i I V i C. C` 8 t1 5J' 0 Daytime Phone: thL4, --61IS I Evening Phone: ( -151 J 15 (Lae.) Fax: tll "11\'-Mail: ?ctfn Ua. ` eire_.s1 t/Q�.tuOcft\ (s 0tSContact Person "on site" day of the event: Pa h/ a C' Cellular: (W (1 )15 -0545 NOTE: THIS PERSON MUST BE IN ATTENDANCE FOR THE DURATION OF THE EVENT AND IMMEDIATELY AVAILABLE TO CITY OFFICIALS .�w49, cr Asa Is your organization a "Tax Exempt, nonprofit" organization? YES NO Are admission, entry, vendor or participant fees required? YES NO If YES, lease explain the purpose and provide amo}4nt(s): 1r -151011 Oh t } G�ri�i' SSi �L.S I �� S t (P_S $ ‘57iOOO Estimated Gross Receipts including ticket, product and sponsorship sales from this event. $ 3,5'k Estimated Expenses for this event. $ A t �0-0 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. ji1Q,Cn WI\ 11 15 An Eve Aakbrata olky 6agit vtA Sin-t( -mods c s�pn .i wi') have Cu - r - W 1�in1 u1 '_ Vso/ e"7 !� CLuFs kii4)mct laitt cup pyc/ tm p-ak colt{ 4' V4rz$ J 'be (k AlLyvki a,okckY&, is ► forRtmaMliftel tN q pc A:&v1 & t� •w. \, u-we d tkAitt 7�Yl t lam. 01't' ..Ct'I rt 1 t DeutA t L -G 11 .; kip-, R _ YES,XNO 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: YESXNO Does the event involve the sale or use of alcoholic beverages? )(YES _ NO Will items or services be sold at the event? If yes, please describe: ,Ata k% fik stt tiSi-Vba 1.eAtitcs StiC I 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. I• YES NO Does the event involve the use of tents o canopies? If YES: Number of �J t, tent/canopies Sizes J0 X / NOTE: A separate Fire Department permit is required for tents or canopies. YES$ NO Will the event involve the use of the Cit or your stage or PA system? SPECIFY: .,, c 1 i \ i I` �A . liked In addition to the route map required above, please attach a' diagram showing the overall lay4u�" wi 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): 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) 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: Trash containers with lids: Describe your plan for clean-up and removal of waste and garbage during and after the event: AdAtt4 0U31odiu4ti wrewi �,a� wi I I MLA Please describe your procedures for both Crowd Control and Internal Security: 1 _mod 1 It r� ASS si►b1 uh 9 � -+- can et cc Lioel4A.S t t -2 h IrtI YES NO Have you hired any ProfessionVI Security organization to handle security" rrangements for this event? If YES, please list: 7 5 Security Organization: c/ D� 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 �s fety of the particip t� rand spectators: �� L � � I 5kf1�fl �%Ll in ) 1 & i 1-iw f'tVi'ujt (, �'TS 5=1-ad i 4 hn fi(Attain� -el f3 . J Please indicate what arrangement you have ma NI r,40/2thal e for providing First Aid St.ffing and quipment. • 1)1Ft fiDaL Kati " " PI ase describe your Access'•ility P an for access at your event by individuals with disabilities: r I i i t 1 f l .fi► IL i t ► Il: fL I '5E / l I i (UM. U f PleectMdflol_dett4iled cscri tion of your P KIN an: „t J 4. otteis 541645 1 4. , p aainpus p t f o-(v 1 P 4 s fro-t) Pleas describe your an for DIS LEP D ARKI11Ncc• �1& �i etr,0 bii4 D avk%rh t Ilete i5 � ��d Iho� IUhtt;t'ci � � ) � -��n�— ��— .� Please escri e your pI ns to oti all ressiide�lts, b ine ses an churches impacted by the-B event:1\11 lull.� �L Q��XVb i r CNW 4 (Ai_eibcfte) NOTE: Neighborhood residents must be notified 72 hour in advanevents are scheduled in the City parks. YEL . 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: Type of Music: DI- gic "r 0-al--otihrlittcf (fie TA/16 Yp � �, gOrY .ca i1(1et&r* (i1-iii-hrw' .>(YES _ NO Will sound amplification be used? If YS, please indicate: Start time: r Finish Time "t ' v a S • NO Will sound checks be conducted prior to the event? If YES, please indicate: Start time: Finish Time "J am Please describe the sound equipment that will be used for your event: OLVII eolkApmiiid YES _ NO Fireworks, rockets, or other pyrotechnics? If YES, please de(I; ribe: FI r� �� r�S imt 30 IPA) � I�QI ,,,,ow,, k‘ ?rietithk," YES NO Any signs, banners, decorations, special lighting? If YES, please describe: 0 h Cal I t-C=�.eA i Revised 02/29/12 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. \ytt\ltillt\Ar Sokto-r? Person in Charge of Activity Pad nCi a Pe -1A Do 1-1:11 I (t) r CI\ eif1 5 t Organization Address Telephone 014) k1' 41 t Date(s) of Use 1 i HOLD HARMLESS AGREEMENT 13 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 of Applicant Official Title Date Gl/16/0 /912 € t tehAtii- kb For Office Use Only Certificate of Insurance Approved Date KEY: Vendors; Booths; Canopies over Tables; Ticket Gates; Locked Gates 28th Street Pt t Storage Bins Old Girls PE Visitors Locker Room S31V9 am — sndwej CfQ 0 TI m r v 1 Dance Room 1 30th Street Visitor Ticket Booth