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(Revised 9/14) APPLICATION FOR TEMPORARY USE PERMIT (TUP) FOR SALES OF ALCOHOLIC BEVERAGES Planning Division - (661) 267-5200 38250 Sierra Highway Palmdale, CA 93550 [EMAIL REDACTED] Please complete all sections of this form and submit the following information to the Planning Division. Information about how to get a permit and Permit Standards are on the last page of this application. All information must be received before the application can be processed. The application is to be filed with the Planning Division at least sixty (60) days in advance of the event. Important Contacts: State of California Department of Alcoholic Beverage Control Van Nuys Office 6150 Van Nuys Blvd., Room 220 Van Nuys, CA 91401 (818) 901-5017 [EMAIL REDACTED] ALL MAPS MUST BE FOLDED BY APPLICANT TO A MAXIMUM 8½” x 11” SIZE PLANS MAY ALSO BE PROVIDED ON 11” X 17” PAPER TEMPORARY USE PERMIT CHECKLIST The completed Application. 1 copy of the Owner’s Letter of Authorization. 1 copy of the current Health Department permit (if applicable). 1 copy of Fire Department permit. 1 copy of license issued by the State of California Department of Alcoholic Beverage Control (ABC). 1 copy of “Responsible Beverage Service“ training from the ABC. 2 copies of a site plan of the existing development, if applicable, with the location of the event clearly indicated. 1 copy of liability insurance in the amount determined by the City Attorney based on the size and type of the event with an “Alcohol Endorsement” (if applicable). 1 copy of a vicinity map at a scale clearly indicating the subject parcel and showing the existing major street patterns, adjoining projects or businesses, railroads or other significant landmarks within a minimum of one mile of the exterior boundaries of the site on 8½” by 11” paper. Required only if event is not on an existing developed lot. 2 copies of the event Site Plan drawn to scale (see following checklist). Fee of $75 per day plus 5% GIS fee ---PAGE BREAK--- (Revised 9/14) EVENT SITE PLAN CHECKLIST Applicant’s name, address, and telephone number. Address of the event (if applicable) or Assessor’s parcel number. Name of the development (if applicable). Type of event/project. Days/dates the event will be on site. Scale. North arrow. Adjacent streets. Site dimensions. Site plan demonstrating the areas where alcohol is to be sold, dispensed and consumed. Security Plan. Site plan demonstrating areas utilized for live entertainment/amplified music. Proposed fencing (if required, identify type and height). Ingress (show width). Egress (show width). Parking: Dust control method: No. of spaces for this project: Spaces available in the existing development: Any proposed structures or existing structures to be used for the temporary event (show dimensions and use). NOTE: A building permit will be required for tents and other temporary structures. An electrical permit is required for installation of electricity. Sanitary facilities - Type: Fire Department approval stamp. ---PAGE BREAK--- (Revised 4/14) APPLICATION FOR TEMPORARY USE PERMIT (TUP) Permit No.: Activity Location (Address if Available): Approximately Feet N or S of (Circle) (Street Name) Approximately Feet E or W of (Circle) (Street Name) Inclusive dates of activity from: to (Include set-up and strike days) Proposed hours of operation from: to Proposed hours of alcoholic beverage sales from: to Describe proposed activity; please specify all planned activities and structures to be used. Will a tent or other structure be erected on site? Yes No Will electricity be needed on site? Yes No Will a fence be constructed? Yes No Will food or drink be available on site? Yes No Will alcoholic beverages be available on site? Yes No Will a band or amplified sound be on site? Yes No Will portable toilet facilities be on site? Yes No Is this site located at an existing shopping center or other developed parking lot? Yes No Is this site paved? Yes No Is the paving striped for parking? Yes No Does this site have a curb and gutter? Yes No Does this site have an access driveway? Yes No APPLICANT: Name and Email: Contact Person: Address, City, State, Zip: Telephone No.: ( ) ORGANIZATION/REPRESENTATION: Name and Email: Address: City: State: Zip: Telephone No.: ( ) PROPERTY OWNER: Name and Email: Address: City: State: Zip: Telephone No.: ( ) ---PAGE BREAK--- (Revised 4/14) OWNER AUTHORIZATION LETTER (TEMPORARY USE PERMITS ONLY) CASE NUMBER(S): ASSESSOR’S PARCEL NUMBER(S): If the applicant is not the owner of record, then a letter authorizing the applicant to represent the owner(s) must be submitted. Note: All owners must sign as their names appear on the deed to the land. This letter shall serve to notify and verify that I/we am/are the legal owners of the property described and attached hereto and do hereby authorize the applicant to file and represent my/our interest in the above referenced applications(s). I/we have read this Letter of Authorization and know the contents thereof; and so hereby certify (or declare) under penalty of perjury under the laws of the State of California that the information contained in the above referenced application(s) is true and correct. OWNER(S) OF RECORD (Include extra sheets if necessary): Printed Name Signature Date Printed Name Signature Date I certify under penalty of perjury that I am the applicant and that the foregoing statements and answers herein contained and the information herein submitted, are in all respects true and correct. APPLICANT / APPLICANT’S REPRESENTATIVE: Printed Name Signature Date Address Telephone Printed Name Signature Date Address Telephone ---PAGE BREAK--- (Revised 4/14) TEMPORARY USE PERMIT STANDARDS AND APPROVAL PROCESS The following standards shall be adhered to for all Temporary Uses, including Christmas Tree, Pumpkin and Fireworks Sales, Grand Openings, and other Special Events, pursuant to Ordinance No. 892 of the City of Palmdale. 1. All temporary use permits shall be processed in the following order: PLANNING DIVISION: Obtain the temporary use and business license application forms and instructions regarding the requirements. Allow a minimum of one month for processing this application. Final Planning approval should be obtained a minimum of 5 working days before the event. STATE OF CALIFORNIA ABC DEPT.: All uses involving sale of alcoholic beverages will require a license from the State of California Department of Alcoholic Beverage Control. Planning will require 1 copy of a valid ABC license prior to issuing preliminary approval. For information call (818) 901-5017. HEALTH DEPT.: All uses involving sale of food or drink will require a Health Dept. permit. Planning will require 1 copy of a valid health permit prior to issuing preliminary approval. For information call (661) 723-4533. No City inspection necessary. FIRE DEPT.: For any uses requiring Fire Dept. approval, applicant is required to contact the Fire Dept. and obtain an approval stamp on the proposed site plan prior to submittal of the TUP application. Planning will require 3 copies of the stamped site plan prior to issuing preliminary approval. For information call (661) 949-6319. Fire Dept. inspection may be necessary. PLANNING DIVISION: All uses will require preliminary and final Planning Division approval. Submittal shall include a completed Temporary Use Permit application form, 1 copy of required exhibits and permits, and payment of applicable fees as listed in the application checklist. The Planning Division must sign off the Temporary Use Permit Checklist before final approval. For information call (661) 267-5200. BUSINESS LICENSE: All temporary uses will require a Business License and some uses will require a Business Permit. These documents must be displayed on site at all times during the event. Business License must sign off the Temporary Use Permit Checklist before final approval. For information call (661) 267-5434. BUILDING & SAFETY DIVISION: All uses involving electricity will require an electrical permit obtainable from the Building and Safety Division. Tents and amusement rides require building permits. All permits require a field ---PAGE BREAK--- (Revised 9/14) inspection. The Building and Safety Division must sign off the Temporary Use Permit Checklist before final approval. For information call (661) 267-5353. PLANNING DIVISION: All temporary uses require a field inspection by the Planning Division before being initiated. The planner will verify site clearance from all departments and confirms conformance of the use to the approved site plan. For information call (661) 267-5200. NOTE: FOR ANY DEPARTMENT/DIVISION REQUIRING A FIELD INSPECTION, YOU MUST CALL FOR AND REQUEST AN INSPECTION NO LATER THAN 24 HOURS PRIOR TO INITIATING OPERATION OF THE TEMPORARY USE. 2. The site plan shall show all items on the Event Site Plan Check List and be located in a zone permitting the requested activity. 3. All signs shall conform to the Sign Ordinance. A separate permit is required for all signage and may be obtained at the Planning Dept. 4. Sanitary sewer facilities, either portable or permanent, shall be provided. 5. Parking shall be required pursuant to the Parking Ordinance. 6. The parking area used for the temporary event shall be located pursuant to the approved site plan, and clearly delineated for customers. 7. All unimproved parking areas and main walk areas shall be kept damp or shall be covered with a material to prevent the raising of dust. 8. Applicant shall provide safe and adequate roadway access including adequate vehicular sight distance at the driveway entrance/exit 9. In no event shall any portion of the proposed use encroach onto any public rights-of-way, or be located in a way which might cause a hazard. 10. The temporary use shall not adversely affect the surrounding neighborhood by means of odor, noise, dust or other nuisances. 11. Written authorization from the property owner or their agent is required. 12. The lots used for temporary activities shall be completely cleared of all temporary structures and debris which resulted from such operation within five days after the termination of the activity. 13. A $500 bond or cash deposit, or other amount deemed necessary by the City, may be required for temporary uses to assure clean up. The deposit shall be returned upon written request of the applicant following verification of site ---PAGE BREAK--- (Revised 9/14) clean-up, and removal of temporary structures. Any expense incurred by the City for clean up of the subject property shall be deducted from the deposit and the remainder returned to the applicant. 14. If this use will involve animals (circus, carnivals, animal exhibits, etc.), please contact the Department of Animal Care and Control in Lancaster (661/940-4191) at least two weeks before the event so that they can arrange for an inspection upon the animals’ arrival. Fair, rodeo, horse, or school events are exempt from the recently enacted state law (AB 1635). ---PAGE BREAK--- (Revised 4/14) TEMPORARY USE PERMIT APPLICATION AND REVIEW FORM Permit No.: * * * * * * * * * * * * * * * * * * * * * * FOR OFFICE USE ONLY * * * * * * * * * * * * * * * * * * * PLANNING DIVISION REVIEW: Use Permitted? Yes No Deposit Required: Yes No Amount Required: $ Receipt No.: USE APPROVED? Yes No Credit Account No.: 01-2616-0097 Reason for Denial/Comments/Special Conditions: NAME (PRINT) SIGNATURE DATE PLANNING DIVISION: BUSINESS LICENSE Deposit Required? Yes No Amount Required: Receipt No.: Business Permit Required? Yes No Date Issued: Business License Application complete? Yes No Date: Existing Business License No.: Date Issued: Comments: NAME (PRINT) SIGNATURE DATE BUILDING AND SAFETY DIVISION: Electrical Permit Required? Yes No Issued? Yes No Building Permit Required? Yes No Issued? Yes No Field Inspections Approved: Date: Comments: OFFICE APPROVAL - NAME (PRINT) SIGNATURE DATE ---PAGE BREAK--- (Revised 9/14) TEMPORARY USE PERMIT APPLICATION AND REVIEW FORM DEPARTMENT OF ANIMAL CARE AND CONTROL Field Inspection Approved: Date: Comments: NAME (PRINT) SIGNATURE DATE PLANNING DIVISION: PROJECT PLANNER A site inspection completed on at confirmed that the site is in compliance with the Conditions of the Temporary Use Permit referenced above and City codes. All necessary permits and licenses have been posted or otherwise verified. Comments: NAME OF INSPECTOR (PRINT) SIGNATURE DATE CODE ENFORCEMENT: A site inspection completed on at confirmed that the site is in compliance with the Conditions of the Temporary Use Permit referenced above and City codes. All necessary permits and licenses have been posted or otherwise verified. Comments: NAME OF INSPECTOR (PRINT) SIGNATURE DATE