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HomeMy WebLinkAboutTUP APPLICATIONType of Event: _ Public Concert _ Fair ?OFestival _ Parade _ Demonstration _ Circus Motion Picture _ Grand Opening _ Other Event Title: 5 / , 14 N% Ho y' O PP--% u < Event Location: I e / 6 rD Ply A /'e u1 U Community vent Block Party %!L Event Date(s): 7 /I/ to 6 /0V �� �� � uu m Actua Event Ho rs: / Z ern to /0 am(�rr j ni - v� Total Anticipated Attendance: (/ (JOParticipants / 5t Spectators) Setup/assembly/construction Date: / Start time: 5 am Please describe the scope of your setup/assembly work (specific details): 5.m -5Tryp C Pops, -7r rn - s7`i�/e $-ep 9A _ "e r u p 7" Ate c / TA13%> U aci✓ ils /C1 rh Ch1Wrc/f (.groups 5 ,e77-/ ccp i3oa774s Dismantle Date: kigl% i Completion Time: ic*i.Cel am/0 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. H r e &.e%i-veoN s�. C105e ,1-T- 5ri(6 77) (P0,'iv ON et /+i ,rpm , ft r 5 L u s , u T-e A-r wed s L'- Sponsoring Organization: 5 %; 71-/i ii y 0 f ID fj to 4 Chief Officer of Organization (Name) Fr, L d ni t t u do 2 0 rc7 (P)" s7 ") Applicant (Name): 5 T. /4- !. i %7Gn/y © F Pct. Jgo Ci/u r cif Address: / lb k4r Li' »' A/i TGN,*/ C'T/, C 4 Daytime Phone: (4 N 117 7 - / S ZG Evening Phone: 4/7 7 - 2 Q 6 a Fax: (W` ¥ 7 7 - e -Mail: VI eeei Te , Contact Person "on site" day of the event: ► _ _ ' _Cellular: (a / 9 3 0O - 0 -76 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? >0 YES NO Are admission, entry, vendor or participant fees required? _ YES )CNO If YES, please explain the purpose and provide amount(s): $ 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. J -e O F Foocif tit re r %/-fly! -e T k 19- FF/-e _ YES N 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: �/ / 7d 7a 70 _ YES NO Does the event involve the sale or use of alcoholic beverages? YES _ NO Fo D YES NO (n1TS X0 YES _ NO YES NO YES XNO Will items or services be sold at the event? If yes, please describe: i NCe5,15ff1N 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. t.t A p uT e - 5 �' e /3-) �� C % ) , r tvn kiva Does the event involve a fixed venue site? If YES, attach a detailed site map showing all streets impacted by the event.( 5 A-7ra e 1-1 j9/ 4. frr»fri Does the event involve the use of tents or canopies? If YES: Number of tent/canopies 30 Sizes / 6 K' /U NOTE: A separate Fire Department permit is required for tents or canopies. Will the event involve the use of the Cy 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: 4-I f P-eraN6 ►y'e tr,t, &-love 7 /-f,3Jia NeTs If you intend to cook food in the event area please specify the method: GAS ) ELECTRIC CHARCOAL OTHER (Specify): Porta and/or Permanent Toilet Facilities umber of portable toilets: ?j (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 # O and Chairs # L/O C) 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: ? .5 Trash containers with lids: -e2 Describe your plan for clean-up and re oval of waste and garbage during and a er the eves t: Ito 1uN % eY'S /-'y'O 1 a'i4r'is /1r epG yrel 13,iv KeNTe4 Fro, VVPI-.57 e Co, Please describe your procedures for both Crowd Control and Internal Security: Cyr i•tp co At C thtrck i;)/ He)p kV, 7-14 (7ro wd Cc Trol 7 iloruk477eer$ _ YES V 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 7NO 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 indicate what arrangement you have made for providing First Aid Staffin and Equ'pm nt. F) r i i-) I) e jT A- r /fin/�Jli c t.1 c e r _T w r Cell PPow.e Please describe your Accessibility Plan for access at your event by individuals with disabilities: PI se provide a detailed description of your PARKING plan: r4r/min J1�� l i c1 I Kt -Lc . P9-Yj-e dir L07 N / 9 ; W 1 i,Scnr i 1m-- w .54/ r rd u Aid Please describe your plan for DISABLED PARKI G: ?4r I-(/VD/cAf9 Pig r/L/n Ll0r"TYI s Please de cribe your plans to notify all residents, j�usinesses and churches impacted by the event: NUT, I1—( A- W€e /G /!0t 7 7-- NOTE: Neighborhood residents must be notified 72 hours in advance when events are scheduled in the City parks. ?0 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: AAfir %ac H f1 o //� lGi/ca, YES _ NO Will sound amplification be used? If YES, please indicate: re: 1 hi i1 -re) IOO 1/pm Pir0e19 Time fin+ _ $ f'l+am/pm 5 i4-7e retify S u ,v r� y YES _ NO Will sound checks be conducted prior to the event? If YES, please indicate: Start time: 7 am pm Finish Time 1 0 am m Please describe the sound equipment that will be used for your event: P 6- 1/57/1,1 DJ eqtto7vieA47- IMNO YES NO Fireworks, rockets, or other pyrotechnics? If YES, please describe: oIYES _ NO Any signs, banners, decorations, special lighting? If YES, please describe: i� 10 n/,tor U N C /-/ rA rG /( ° r o per ,�' ,v �NNGuNc Et, e tit t ,� e c G r,,-T,U N, s /9--rc ct w-®o ► Gip rk 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 atta666-cek--) hed to this permit. Organization S71 A' 4 , � r Person in Charge of Activity 'e✓• \IAS'- Ed 2 bot - L /JCur2Z Address '//O /c * S feet , &) Q ortei a O 9 /9Y) o Telephone (o(9 - y77-c/sa o Date(s) of Use ,TL° ne- 7 S / 3L)/V 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 icial Title Date --,}ey4A—)061, For Office Use Only Certificate of Insurance Approved Date (X) Trots U Cshis :11M ise.x:rifts pita to 'Cr?Jl I il.I zi I I' I II oeris 1 , i zeaTift,, 1 I oc) r t J--400-771N.,,,,7 P9----- 1 rk -04t. 6'6 ( tA r wAs 6ohvsefif cp(1A r kii+L -Cf . *!-V /—/,9-rLt f}l'e WVlN5GN /cr-y E'nl p, f3(4s Ctau e �'c1 N e RMO 2c2 7 57-14 THIS DOC MENT HAS A TRUE DOCUCHECK'' WATERMARK AND VISIBLE FIBERS DISCERNIBLE FROM BOTH SIDES 85724 BUSINESS LICENSE CERTIFICATE PURSUANT TO CIT' ORDINANCE THIS LICENSE IS HEREBY GRANTED FOR THE TERM & PURPOSE STATED CITY OF NATIONAL CITY. BUS DESCRIPTION RELIGIOUS ORGANIZATI BUSINESS ADDA ESS 1816 HARDING AVE BUSINESS NAME ST ANTHONY OF PADUA CHU ATTN: MAILING 410 W 18TH ST ADDRESS NATIONAL CITY, CA 91950-5528 --^- City Manager NON TRANSFER kBLE POST IN A CONSPICUOUS PLACE DOCUMENT IS ALTERATION PROTECTED AND REFLECTS FLUORESCENT FIBERS UNDER UV LIGHT KEEP FOR YOUR RECORDS BUSINESS TAX RECEIPT License No. 85724 TOTAL