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HomeMy WebLinkAboutTemporary Activity 20150005 - PageCITY OF HUNTINGTONBEACH 2000 Main Street Huntington Beach, CA 92648 Planning Department ..(714) 536-5271 TAP No. I 0 (.6- Application for Temporary Activity Permit Shall not exceed 96 consecutive hours (except agricultural sales) Must display a copy of this permit on premises of activity location A maximum of four events/activities each calendar year are allowed Violation of any of the requirements listed on this permit is subject to immediate issuance of a citation Permitted: outdoor display of goods (banners, pennants, streamers, and flags are allowed as depicted on the diagram below for activity duration only) End Date of Activity:(mm/dd/yyyy)0 %\Start Date of Activity:(rrim/dd/yyyy)31 t•C Description of Activity: Location of Property/Address/Assessor's Parcel Number (APN):01 7— Business Name: Col Applicant or Authorized Agent (Please Print)Property Owner (Please Print) 1.-14- • Mailing Address City 104 11 Telephone Number V" Mailing Address ••••e*S.,%.4 •-› City ci6-VA 116 °.`41.;!-• Telephone Number E-mail Address - LoClo,JA ‘slt.1.5J State Zip E-mail Address ci -2-GS State Zip I havereadandunderstandtherequirementsofthispermit 7.--1 Signature of Applicant Date Signature of Property Owner Date Please provide a diagram in this space, showing location of activity, directional arrow showing north, streets and/or landmarks, i.e. structures, and layout. of sit,.!.and temporary ever.t fixtures. si":rtCrrg7) FOROFFICIALUSEONLY Fee Receipt # Bond Required: NO YES # Distribution: White Yellow (Planning) (Fire) /7 _7 '4"1 Approved: Planning Dept. Initials Thd Date 1 1 Planning Mgr. Initials Date (If Neighborhood Notification is required - See PP-107) Fire Dept. Initials:VAL Date I —2-1-r5 Public Works Dept. Initials Date Police Dept. Initials Date Pink Goldenrod (Applicant) (Code Enforcement) G:\forms\pIng\TempAct_Permit TAP No. r Applicationfor TemporaryActivity Permit Shall not exceed 96 consecutive hours (except agricultural sales) Must display a copy of this permit on premises of activity location A maximum of four events/activities each calendar year are allowed Violation of any of the requirements listed on this permit is subject to immediate issuance of a citation Permitted: outdoor display of goods (banners, pennants, streamers, and flags are allowed as depicted on the diagram below for activity duration only) End Date of Activity:(mm/dd/yyyy)Ca-AC) CITY OF HUNTINGTON BEACH 2000 Main Street Huntington Beach, CA 92648 Planning Department r(714) 536-5271 Start Date of Activity:(mm/dd/yyyy) OD 1 .31 7.011. Description of Activity: Oa0 MSCe? Location of Property/Address/Assessor's Parcel Number (APN): lacVjZ7.-u.IPC.7.-t-)1:X KA Business Name: Fe—C7.0.57.- Applicant or Authorized Agent (Please Print) Mailing Address City 1 t Telephone Number b-)f- • Property Owner (Please Print) 7- t YN uJoi.J ye7_r—,:-JAy -7. Mailing Address ••-••••4..5 C.4-%Cl "2-L.`.:4 City State Zip 4'-';"1 1% ci,Y,t) Telephone Number E-mail Address state Zip E-mail Address I have read and understand the requirementsof this permit vz,7_A I -Vsr- Signature of Applicant Date Signature of Property Owner Date - •Please provide a diagram in this space, showing location of activity, directional arrow showing north, streets and/or landmarks, i.e. structures, and layout of site and temporary event fixtures. S ("Ng n,C0-1:2) FOR OFFICIAL USE ONLY - Fee Receipt # Bond Required: NO YES # Approved: Planning Dept. Initials Date Planning Mgr. Initials Date (If Neighborhood Notification is required - SeePP-107) ,z Fire Dept. Initials - Date ! Public Works Dept.Initials Date Police Dept. Initials Date Distribution: White Yellow Pink Goldenrod (Planning) (Fire)(Applicant) (Code Enforcement) G:\forms\pIng\TempAct_Permit CITYOF HUNTINGTONBEACH 2000 Main Street Huntington Beach, CA 92648 PlanningDepartment ti(714)536-5271 TAP N o . Application.for TemporaryActivity Permit Shall not exceed 96 consecutive hours (except agricultural sales) Must display a copy of this permit on premises of activity location A maximum of four events/activities each calendar year are allowed Violation of any of the requirements listed on this permit is subject to immediate issuance of a citation Permitted: outdoor display of goods (banners, pennants, streamers, and flags are allowed as depicted on the diagram below for activity duration only) Start DateofActivity:(mm/dd/yyyy) 0 ‘S t \. 2-0 End DateofActivity:(mm/dd/yyyy)0,1k‘s DescriptionofActivity:.74741.(44) J.Location of Property/Address/Assessor's Parcel Number (APN):ti)K4-1--) Tia.-^. t'sJtuo c-C7— 1,0 • 4,, Business Name: 44$1 cr. " > s•J Applicantor AuthorizedAgent(Please Print)Property Owner(Please Print) L.of-a MailingAddress MailingAddress V•41, City State Zip City State Zip Mac, TelephoneNumber E-mailAddress TelephoneNumber E-mailAddress I havereadandunderstandtherequirementsofthispermit z SignatureofApplicant Date SignatureofProperty Owner Date Please provide a diagram in this space, showing location of activity, directional arrow showing north, streets and/or landmarks,-i.e.structures, and layout ofsite.' rid.tettiValrary,eventfixtures, Approved:PlanningDept.Initials Date it PlanningMgr. Initials Date (IfNeighborhoodNotificationisrequired—SeePP-107) C Fire Dept. , Initials'.i Irk. Date 1!"..7 PublicWorksDept.Initials Date PoliceDept. Initials Date FOROFFICIALUSEONLY -Receipt# 111,Bond Required:No YES # Distribution: White Yellow (Planning) (Fire) Pink Goldenrod (Applicant) (Code Enforcement) G:\forms\ping\TempAct_Permit Sprouts Farmers Market Layout6942 Warner Ave, Huntington BeachWarner AveGas StationSubwayPizza Hair SalonEmptyParking Lot—1(;-—27- /A°/0'fti,tc,AA/Len (Atoic,rLIQ7Aft0'r-s/tA1A-41L66q4. vet-tWalkwayFitness CenterBBQ AREAEntranceEntranceSprouts Farmers MarketWalkwayNail ShopFan Shop1S@MUapIOD January IS, 2015 To whom it may concern, am the property manager for Sprouts Farmers Market located on 6942 Warner Ave. I understand that the city is requestinil permission by the property manager (myself) for Sprouts Farmers Market to 'receivea city permit for a company promotion. I have approved Sprouts Farmers Market in fluntington Beach to hold their Super Bowl BBQ Sale outside the entrance of their building. The BBQ will be hel.d on Saturday. January 31st and Sunday, 'February ist from 11 a.m. to 6 p.m. The store will be barbequing baby back ribs on a mesquite grill smothered in Polynesian BBQ sauce for customers to purchase. It is the responsibility of Sprouts Farmers Market to abide by all City of Huntington Beach, and shopping center rules and Sprouts Farmers Market assumes the responsibility and liability in the event of any damage that arises from the aforementioned Super Bowl BBQ event. Sincerely, kj b_AAA.,.imt„(A, Laura Tarbutton Property Manager Gallery Real Estate Services, Inc. 23011MoultonParkwayF-2.LagunaHills.CA 92653 Office: 949-71.64888 --- FAX: 949-600-5251. DATE IMMODNYTY)ACORE)CERTIFICATE OF LIABILITY INSURANCE 06,240014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSIITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to he terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER FLYNN COMMERCIAL INS SVCS 5354 EAST 2ND ST., SUITE 279 1,ONG BEACH, ('A. 90803 INSURER F : COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA EL). NO IASII HS I AWING ANY RWUINEMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLtCIES DESCRIBED HEREIN IS SLIR.IFCT TO Al I THE TERMS, EXCLUSIONS AND CONDITtONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR1 A X GENERAL ADDL BRTTPF OF INSIIRANCF uasiLipe commeRCIAL GENERAL LIAoture POLICY EFF POLICY EXPPOUCY NUMBER MMIGG UMfTS EACH OCCURRENCE 318IB0087086/20/14 6120,1c -NI 0PREMISES Eu °Gawp-men $ 1,000 000 100,000 I CLAImS-MADELT\OCCUR MED EXP (Any ono pereom 5,000 PERSONAL & ADV INJURY 3 1.000.000 GENERAL AGGREGATE 3 2.000.000 Galt AGGREGATELIMITAPPUES PER:PROUJOTS - GLIMP/OP AGG S 2.000.000 POLICY PRO-LOC AUTOMOBILE OABILITY COMbIA D SINGLE LIMIT Ea ac.adent) AlY AU1'0 BODILY INJURY (Perperson) ALL OWNED SCHEDULED RODILY INJURY (—Peraccidenll $ AUTOS AUTOS NON-OWN ED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR OCCUR 1_EACHOCCURRENCE EXCESS LIAR I CLAIMS-MADE AGGREGATE DED I RETENTION S WORKERS COMPENSATION WC STATO- OTH- .AND EMPLOYERS UABIUTY Y I N ANY PPOPRIETOPJPARTNERIEXECUTIVE E.L EACH ACCIDENT :OFFICER/V-301ER EXCLUDED"''Mandatory in NI* N / A c.L.DISEASE - EA EMPLOYE If yes, dexribe tender DESCRIPTION OF OPERATIONS bcAuw E.L. DISEASE POLICY LIMIT s A ired Sz.Non Owned Auto 181B008708 6/2014 6/20115 LIMITS INCLUDED DESCRIPTION OF OPERATIONS1 LOCATIONS I VD-OGLES tAttacIt ACORD 101.Auditkied Rumen 31-liedulu, If mull,31.41,1 Is I-equine* CERTIFICATE HOMER IS INCLUDED AS AN ADDITIONAL INSURED AS THEIR INTEREST MAY APPEAR. Location: 4933 Warner Ave. IIuntinulon Beach, CA 92649 _ CERTIFICATE HOLDER CANCELLATION NV:LGRLENS 4935 \VARNER AVE. HUNTINGTON BEACH, CA. 92649 SHOULD ANY OF THE ABOVE DESCRIBED POLICIESBECANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATNE INSURED TI IACKER ENTERPRISES CiO TED THACKER 2124 RIDGEVIEW TERRACE SIGNAL HILL, CA. 90735 CONTACTNAME. PHONE EMAIL D INSURER A : INSURER : INSURER C : INSURER INSURER E : I FAX r (A/C,Nor INSURER 3 AFFORDING COVERAGE NAIC A BURLINGTON INSURANCE CO. ACORD 25 ;2010/05)©1988-2010 ACORD CORPORATION. All rights resorved. The ACORD name and logo are registered marks of ACORD Agreement ThisAgreementismadebetweenTedThacker,ownerofThackerBerryFarmsand Walgreens(4935Warner). TedThackerwillpay$1,000Monthtomonthforthe2015season.(FebruarythruJuly, weatherpermitting)fortheuseofsellingstrawberriesfromhisstrawberrystand.Wewill operatesevendaysa weekfrom9amto 6pm. TedThackerwillprovidea onemilliondollarinsurancepolicynamingtheowneror propertymanagerasadditionalinsured. TedThackeroragentsemployedbyhimwillkeepsaidpropertycleanandfreeof light debrisduringoperation. ThackerBerryFarmswillconducttheirbusinessaccordingtomunicipalcodesandhealth departmentregulations. ThackerBerryFarmswillbefreeofthisagreementinthecasethatthecityforsome reason deniesThackerBerryFarmstheconditionalusepermitneededto conduct business. ThackerBerryFarmsshallbefreeofthiscontractorportionsofrentintheeventofan actofGodshoulddestroyorseverelylimititsstrawberrycropi.e.extremerain,heat, coldordevastatingpestoutbreak. ThackerBerryFarmswillnotoperatetemporarystrawberrystandonsaidproperty -Unlessconfirmedpermissionfromthecity. Propertywillbeleftinthesameconditionasfound. TedTh cke Owner/ propertymanager Date Date I / MgitawinDepurtmcAVAGC46.4/Am.' • .1'•••••Ct.f.•••••/ •••""e•\/