Block Party Online Form Occasional Event Permit Application All and any changes, which need to be made must be done through the office of the Special Events and Filming. GENERAL EVENT INFORMATION Public or Private Event:(*) Public: This event will be open to the public. Admission may be charged. Private: This event will not be open to the public. No admission fee allowed. A copy of your invitation MUST be submitted with the application. Invalid Input Name of Event (if part of a City Special Event, list the name of the event with the name of your event if different): Invalid Input Location of Event: Invalid Input Type of Event (Grand Opening, Raffle, Dance, Concert, Fundraiser, or Other): Invalid Input Event Date(s): Invalid Input Event Hours: Invalid Input Type of Entertainment (please be specific; list of bands, entertainers, performers, rides, and vendors. Please list any effects, smoke, pyrotechnics, etc.): Invalid Input Expected Number of Attendees: Invalid Input Admission Fee (if applicable): Invalid Input Has a Promoter Been Contracted? YesNoInvalid Input If Yes, provide Name, Address, & Business License# of Promoter: Invalid Input Will Merchandise be Sold? (Must have a valid city business license.): YesNoInvalid Input Will food be sold? (Must have valid county or city health permit): YesNoInvalid Input Will minors be allowed on premises? YesNoInvalid Input APPLICANT/ORGANIZATION INFORMATION Name: Invalid Input Organization and Business License #: Invalid Input Street Address: Invalid Input City: Invalid Input State: Invalid Input Zip Code: Invalid Input Office Phone #: Invalid Input Cell Phone #: Invalid Input Email Address: Invalid Input Contact Person & Cell Phone # (Day of Event): Invalid Input ALCOHOL INFORMATION (If alcohol will be sold, attach a copy of Department of Alcohol Beverage Control License): Will Alcohol be sold, served, or consumed? Yes, alcohol to be sold, served, or consumed No Alcohol Invalid Input Description of Beer Garden Alcohol Control: Invalid Input Description of Procedure how to identify patrons over 21 years old who wish to purchase alcohol: Invalid Input ALCOHOL CONTROL - CONDITIONS FOR LOCATIONS WITHOUT A LIQUOR LICENSE • All alcohol sales shall cease one (1) hour prior to the scheduled end of the event. Non-alcoholic drinks and food shall remain available for patrons. • If drink tickets are used, drink ticket sales shall cease one and a half (1 1/2) hours prior to the end of the event. • All alcohol shall be served in wide-mouth plastic containers. • A strict limit of two (2) drinks at a time may be purchased. SECURITY INFORMATION Will Private Security be Provided? YesNoInvalid Input Name of Security Company: Invalid Input State of California Private Patrol Operator (PPO) License #: Invalid Input Security Supervisor's name & phone #: Invalid Input Number of Unarmed Security: Invalid Input Number of Armed Security: Invalid Input Method or Plan of Communication (include # of radios/cell phones and which persons will be equipped): Invalid Input Description of Security Uniforms (Include shirt and color, pants and color, AND any badge patch, or log identifying security): Invalid Input Please list on your site plan, a detailed depiction of the locations of where your security will be stationed. Please include perimeter security and roving security personnel if needed. (Note: Off Duty Police Officers working in a "Private Security" capacity, may NOT wear anything identifying them as a peace officer) EVENT MARKETING/TICKETING/ENTRY: How is the event marketed? (Internet, TV, Radio, Flyers, etc.): Invalid Input How are tickets obtained? (Pre-Sale, At Door, etc.) Invalid Input Describe Entry and Search Area (Bag Checks, Wanding, Pat-Down, etc.): Invalid Input List of Prohibited Items (List should be posted in Entry Area and should include a trash can or "Amnesty Box" for discarded items): Invalid Input List of any dress code restrictions: Invalid Input If Event sells out, what procedure is in place? Invalid Input APPLICANT SIGNATURE I, the undersigned, have been provided with a copy of, and am familiar with the requirements and provisions of Section 5.72.130 of the Long Beach Municipal Code (L.B.M.C.). I understand that adult entertainment, as defined in Section 21.15.110 of the Long Beach Municipal Code (L.B.M.C.) is not allowed. Under penalty of perjury, I declare that I am at least 21 years of age, and that all the information listed herein is true and accurate to the best of my knowledge. Permittee Signature: Invalid Input Invalid Input Submit Form: Applications Received less than Ten (10) days prior to the event will NOT be accepted.