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Home My WebLink AboutTUP APPLICATONType of Event: _ Public Concert _ Fair jFestival _ Community vent _ Parade _ Demonstration _ Circus Block Party Motion Picture _ Grand Opening _ Other Event Title: 'FAA( FE .Ti Event Location: S B CC -- Event Date(s): From t0 I3i, (`? to (6 3t 13 Actual Event Hours: 5 ani to am!r LeSpectators) Anticipated Attendance: UV1tioW �}o Participants ectators (P ) Setup/assembly/construction Date: t0 - 3t - 13 Start time: « Please describe the scope of your setup/assembly work (specific details): 1Nk oos Q ct e. tom 4 se+- UP i b/cs CG «s S-A 4 5 ‹.__ , c> >e cO ( Dismantle Date: tt7. 3t - i Completion Time: tR anita 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. NI Sponsoring Organization: C 6 G G Chief Officer of Organization (Name) D0.J e 5CyA se? 5 Applicant (Name): NA. [e 1 eS U v) Address: -.t (5() GOc if d 4-f/ e Daytime Phone: (6_n) S S00 Evening Phone: ( ) Fax: ( ) E-Mail: (� Contact Person "on site" day of the event: ellulart 26-C(,(}n`Z. NOTE: THIS PERSON MUST BE IN ATTENDANCE FOR THE DURATION OF THE EVENT AND IMMEDIATELY AVAILABLE TO CITY OFFICIALS ,�� - (OH - g2o-5goy 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): iVi h' DYES NO YES ✓ NO $ Estimated Gross Receipts including ticket, product and sponsorship sales from this event. Estimated Expenses for this event. 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. Fall Fediral er-nsis-3 Gfi C.arn1(r/ Cl yle 174t7W o con C sr., sTGiil%s cold a mean s4n9c r prkj/lci It ei-e {. //ye lti',// / t l .„ inpa.raOe Lanes which will at( fNe, an ohs-f-acL , c �urs�r JCusf'il� arei1a ahelTani- s/ide. Mir u1;1f J nuisrG and G'/her per rmances amp) 0 iiarru.,r -c held al- the main s-4-06G a'-. pUrpost. i' 11-tei e ;i fs 1-0 r a Sa 4 and n J►vinaval- •1 r buy 'i2rni Ile S (n ChCtne%l a'?e/ :st:rrounCt('? a1 C rn m tm ► h es a s an Ct I kNneli vt.t sip Iy i c k -o r —tne cckti 1 l rPil e s4-Teets YES _ 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 VNO 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: Cpr1 GPSS; or, le f VY)s YES v O 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. YES k7NO 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 VNO 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: `1"-1 <<f ,1-zhe v \ -Pc c I r / es c'r 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: $H O Trash containers with lids: 6 Describe your plan for clean-up and removal of waste and garbage during and after the event: C% up C'€ws (vse dieduieof 41 rtr4OtAt ett. ri41.9 ' do cp1- checks cI Can &their -ICi -+71 L,uj1( d 0 -fir‘ q C[,'&ii up 4'cv- tiv -we rtit- 3 Please describe your procedures for both Crowd Control and Internal Security: iLk' hG ve-- Q see,u,r; oqu; pp2c+ u yrzte , os s, l7 /y , c4 n /i46d rv;Wi "sEal ki fin d /7 dui,; P/iu, 11-64e,e;~ WItf be tin rife . YES 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: 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: our mrk=in j jof 1r jhJs lvi // Ix can. / U/r odd/ 1,0h at Lav4p5 Please indicate what arrangement you have made for proding First Aid Staffing and,Equipment. Fi`rd-Old wr!1 be a vim, la He 44- pirr ,Yl i.�icit+�Yi boothez� our C,tir,` J -letrm 1s Lees? hared lP ary in,nnr ,r, 4fienc, Please describe your Accessibility Plan for access at your event by individuals with disabilities: %uC ha i^e hero d,'ccL pP parat iyi Al/L and exicireerns wi tI be Q1 grearid(e+ '1. Please provide a detailed description of your PARKING plan: Uae baav1p e part i or Our lob etnd 0/1 slnezt Fa 0 , rpee�sa Please describe your plan for DISABLED PARKING: We h4Pik. dect'rly Yiiarkr s &Aces -6,r di'sa blfc' 4 Please describe your plans to notify all residents, businesses and churches impacted by the event: neic�looreed-F(y-ers NOTE: Neighborhood residents must be notified 72 hours in advance when events are scheduled in the City parks. It 4d'1 "� /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: Type of Music: 6,Nf�-44Pe5/4f2y c� f /Sfilgn/ %ES _ NO Will sound amplification be used? If YES, please indicate: / Start time: �= �b am/ r Finish Time E9.‘UU am/{ ri ✓ YES _ NO Will sound checks be conducted prior to the event? If YES, please indicate: Start time: 440O am/' i Finish Time y. % am{l Please describe the sound equipment that will be used for your event: jc1/79,,e /4/1/PL/ 7 Sp ,e e-g5. YES /NO Fireworks, rockets, or other pyrotechnics? If YES, please describe: YES_ NO Any signs, banners, decorations, special lighting? If YES, please describe: Sma1r s-tagf15h)i 9 Revised 08/10/05 5 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 Person in Charge of Activity Address Telephone Date(s) of Use 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 of Applicant Official Title Date Senjc r fcts For Office Use Only Certificate of Insurance Approved Date THIS D CUMENT HAS A TRUE DOCUCHECK'^" WATERMARK AND VISIBLE FIBERS DISCERNIBLE FROM BOTH SIDES 28481 BUSINESS LICENSE CERTIFICATE CITY OF NATIONAL CITY PURSUANT TO CITY ORDINANCE THIS LICENSE IS HEREBY GRANTED FOR THE TERM & PURPOSE STATED BUS DESCRIPTION BUSINESS ADDRESS 2400 EUCLID AVE BUSINESS N,\ME ATTN: MAILING ADDRESS NON TRANSFERABLE POST IN A CONSPICUOUS PLACE * ;;C A LI F O R N I , Date of Expiration: 12/31/2013 SOUTH BAY COMMUNITY CHURCe RkTED 2400 EUCLID AVE NATIONAL CITY, CA 91950-7715 jam, City Manager IS DOCUMENT IS ALTERATION PROTECTED AND REFLECTS FLUORESCENT FIBERS UNDER UV LIGHT Big Slide Enter&Exit-> Fire Extinguisher Basket- ball Playground Area Football Toss Dart Balloons Shooting Game Ping Pong Bottle Toss Fishing Game Cake Walk Island in Parking Lot t Fire Extinguisher Stage Bean Ring Strength Dunk Bag Toss Test Tank Table Table Cup- cake Corn Table Table Table Fire Extinguisher Nacho Hotdog Other Food Taco Jousting Fire Extinguish • A Exit Obstacle Course Enter Info Booth Coffee A Exit Maze A Entrance a r k n g