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Home My WebLink AboutTemporary Activity 20150007 - Page0 LiA TAP No.tc-DOT 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 anyof 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) CITY OF HUNTINGTON BEACH 2000 Main Street Huntington Beach, CA 92648 Planning Department (714) 536-5271 Start Date of Activity:(mmiddiyyy)36.1.5' Description of Activity: End D te of Ac ivity:(mm/dd/yyyy) Location of Property/Address/Assessor's Parcel Number (APN): we' Business Name: Applicant or A horized Agfft (Please Print)Property Owner (Please Print) /it 'I ail- _arAnge 0756- Mail ng Address tit '* e2/0071/154,/ 9g0 %t State Zip Oty State Zip V‘ err le-e 4 7/4' 56g41,2le Telephone Number E. ail Address Telephone Number E-mail Address Ajldress City erstand the requiremnts of this permit 5 Date Signature of Property Owner ditcl Signature of Applicant Date Please provide a diagram n this space, showing location of activity, directional arrow showing north, streets and/or landmarks, i.e. structures, and layoutof site and temporary event fixtures. Scc a/latity-d FOR FICIAL USE ONLY 2'3- 20 Bond Required: NO Approved: Planning Dept. Initials Date 1"1 Planning Mgr. Initials Date (If Neighborhood Notification is required -See PP-107; — Fire Dept. Initials SE Date litS.I5 Public Works Dept.Initials PS Date It 2-6115— Police Dept. Initials Date Fee Receipt # YES # Distribution:White Yellow (Planning) (Fire) Pin'<Goldenrod (Applicant) (Code Enforcement) G:\forms\ping\TempAct_Permit • ••,. TelephoneNumber,E-diailAddress e dig TelephoneNumber I have reAdandAderstand the requirements of this permit 474/,,76-ys Ct Ited Signature'ofApplic-ant Date SignatureofProperty Owner Please provide a diagram in this space, showing location of activity, directional arrow showinpiorth, streets t. and/or landmarks, i.e. structures, and layout of site and temporary event fixtures. 7- ,.AppirOed:Planning Dept: Initials -rn.-)' 'Plan'm'figMgr. Initials1 ' Date (IfNieighbOriloUdNotificationisiequired-SeePP-107)- Fire :,Dept. Inilials "fA Date WOrks'.DePt.Initials Dai& *-Police Dept. Initials Date Pink , Goldenrod .(Applicant) (CodeEnforcement) G:\forms\ping\TempActermit TAP No. 1S— Application.for TemporaryActivity Permit CITYOF : HUNTINGTONBEACH 2000MainStreet HuntingtonBeach,CA92648 Planning Department (714) 536-5271 Description of Activity:\-.1e.a 44h..2),ew.L.ag4,4_IV .,. I 0 0 .. . , Location of Property/Address/Assessor's Parcel Number (APN):r o240,Odidied 19,0N-1/1 „ Business Name:dAtf ,JA-AM.,at,rill/4Q) —Ted 4'e gr 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 anyof the requirements listed on this permit is subject to immediate issuance of a citation Termitted:outdoor display of goods (banners, pennants, streamers, and flags are 'allowed as depicted on the diagram beloWfor activity duration only) Start Date of Activity:(mni/dd/yyyy)36-15-End Date of Activity:(mm/dd/yyyy)?/) e" 6t\ • FOR OFFICIIALUSE'q 1L,, I Fee ?>1., • kecdiPt Bond Recittired:4 10::NZYBS Distribution: White Yellow (Planning) (Fire) ••••0.- . • ApplicantOrAuthorizedAgent(Please.Print) Id(AP 17/e0) 77j ra MailingkldresS DI a 11 City 091'16 MailingAddress 7525-,67.1/Neu)ori-ave t(poo NO State Zip City /State Zip e r r 1 54-0 71q-500,101e' Property Owner(PleasePrint) I TAP No. IS Applicationfor TemporaryActivity Permit Start Date of Activity:(mmidd/yyyy)End Date of Activity:(mmidd/yyyy) Description of Activity: \-7( i ! ) :4(C..")1-2-'(.1):611(\/3 ea,'cizeriLocation of Property/Address/Assessor's Parcel Number (APN): NPAA"514 47 Business Name:%/k1/0 V.] A.v. • al. fitt 7/Ark,r E-mail AddressTelephone Number E-Mail Address elt/ Telephone Number I haverealciandAdierstandtherequirementsofthispermit /11/7 /4, 74 /--/5-,(Jfe, Signature of AppliCant Date Signature of Property Owner Date Pink Goldenrod (Applicant) (Code Enforcement) G:\forms\ping\TempAct_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) Applicant or Authorized Agent (Please Print)Property Owner (Please Print) /-.2M1 AII4Vvie Vrraoe.Wig*A/ r ("1 (CI (VIM MailirtgAddress J Mailing Address I(Mid gill •(1(1 7516-M90 NetOrr/LA,' • 0900 - 7(7(j,,,,7.;? Please provide a diagram in this space, showing location of activity, directional arrow showing north, streets and/or landmarks, i.e. structures, and layoutof site and temporary event fixtures. (ig-riekd FOROFFICIALUSEONLY Fee '•Receipt # Bond Required: NO /YES # Distribution: White Yellow (Planning) (Fire) CITY OF HUNTINGTONBEACH 2000 Main Street Huntington Beach, CA 92648 Planning Department (714) 536-5271 Ci•y State Zip City State hernmo5 kr18 ahco. 714-gO'-M'dYe Zip Approved: Planning Dept. Initials - .V.) Date •% Planning Mgr. Initials Date (IfNeighborhoodNotificationis.required-SeePP-107) --Fire Dept. Initials _ Date Public Works Dept.Initials Date Police Dept. Initials Date ; • • • ' ••••••ITI• • ';;;;" • ••••••• I.Araiit,c1 evda*Eilt" 6674.pitiv6;,j 4 6kut)b)uAk.aAA-pd ‘1,4 (574-0144--ok 4- 6-04-0).00' ACCORD CERTIFICATE OF LIABILITY INSURANCE DATE (MWDOCITYY) 06,24/2014 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 POUCIES BELOW. THIS CERTWICATE OF INSURANCE DOES NOT CONSTITUTE 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 the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer r i g h t s t o t h e certificate holder in lieu of such enclorsement(s). PRODUCER FLYNNCOMMERCIALINS SVCS 5354EAST 2ND ST., SUITE 279 LONG BEACH.CA_90803 INSURED TIIACKERENTERPRISES C/0 TED THACKER 2124RIDGEVIEWTERRACE SIGNALhILL. CA. 90733 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 LEL).NU I WI I HS I /WANG ANY HEULPHENIENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TillS PIER A 1 X CERTIFICATE EXCLUSIONS GENERAL MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HFRFIN IS SHR.IFCT T O Al I AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS TYPF OF INSURANCE ADDL SUER! I POLICY NUMB ER POLICY EFF POLICY EXP MINDO M D UNITS LIABILITY EACH OCCURRENCE CoMMERCIAL GsNERAL mow,.Y 18111008708 6/20/14 6'2015 1 -DPREMISES Eu ovaurnoncv) $ TH5 T E R M S , I,000,0(H) 100,000 I CLAIMS-MADE [j OCCUR MED EXP (Any Orle perS0n) 5,000 PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE 3 2.000..000 GEM_AGGREGATE LIMIT APPLIES PER PROUJC TS - COMP/OP AGG S 1000.000 INSURER A INSURER : INSURER C : INSURER 0 : INSURER E : INSURER F : CONTACTNAME: PHONE IFAX1We, No). EMAIL 3: INSURER S AFFORDING COVERAGE BURLINGTONINSURANCE('O. NAIC ft "7- AAIY AdO — ALL OWNED AUTOS HIRED AUTOS poucy pao-Lac AUTOMOBILE UABIUTY UMBRELLA LIAR EXCESS LIAR SCHEDULED BODILY INJURY (-P.e.racddenll 5 AUTOS NON-OWNED RROPERTY DAMAGE AUTOS _Ter nccictent OCCUR kACH OCCURRENCE I CLAIMS-MADE I AGGREGATE COMEIN-D SINGLE LIMIT Ea ac.jdet!l) BODILY INJURY (Per aerSon) 5 DEO I RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY ANY PPOPRIETORMARTNEFUEsECUTIVE :OFFICERTJBWIER EXCLUDED? (MendMo). in NH) LIyer.. de:.cribe isvIer DESCRIPTION OF OPERATIONS below Y / Nri N/A WC STATU- OTH. EACH ACCIDENT EL.DISEASE - EA EMPLOYE E.L. DISEASE POLICY LIMIT A hued & Non Owned Auto 181B008708 620114 6/20'15 ISMTTSINCLUDED DESCRIPTION OF OPERATIONS LOCATIONS 1VEHICLES (Attach ACORD III. tHILIIiionsI 36.110,11,Is,If /Twit: space is rrqisirocl) CERTIFICATEHOLDERIS INCLUDEDAS AN ADDTTIONALINSURED ASTHEIR INTERESTNL1YAPPEAR. Location:7262 GarfieldAvenue Huntin21onBeach,CA 92648 _ CERTIFICATE HOLDER CANCELLATION Y.M270.C.A.OF ORANGECOUNTY 13821NEWPORT AVE.4200 'TUSTIN,CA. 92780 SHOULD ANY Or THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05)1988-2010 ACORD CORPORATION. All rights roserved. The ACORD name and logo are registered marks of ACORD 17.13Severability.If any term,covenantor conditionof thisLeaseorthe applicationthereofto anypersonor circumstanceshall,toanyextent.,beinvalidorunenforceable,theremainderofthisLease,ortheapplicationofsuch term, covenantor condition to personsor circumstancesother than those as to which it is held invalid or unenforceable,shallnotbeaffectedtherebyandeachterm,covenantorconditionofthisLeaseshallbevalidandbe inforcetothefullestextentpermittedbylaw. 17.14FinancialStatements.IfLandlorddesiresto finance,refinanceor selltheProperty,or anyportionthereof, Tenantherebyagreestodelivertoany/enderorpurchaserdesignatedbyLandlord,suchcurrentfinancialstatements oftheTenantasmaybereasonablyavailabletoTenant.AllsuchfmancialstatementsshallbereceivedbyLandlord, suchlenderand/orpurchaserinconfidenceandshallbeusedonlyforthepurposeshereinsetforth. 17.15Authori ofTenant.IntheeventthatTenantisalimitedliabilitycompany,corporationorapartnership, eachindividualexecutingthisLeaseonbehalfofsaidlimitedliabilitycompany,corporationorpartnershiprepresents andwarrantsthatheisdulyauthorizedtoexecuteanddeliverthisLeaseonbehalfofsaidentity,inaccordancewith thegoverningdocumentsofsaidlimitedliabilitycompany,corporation,orsaidpartnership,andthatthisLeaseis bindinguponsaidentity. 17.16Capped Well.Tenantacknowledgesthatthereisa cappedoilwellontheProperty.Suchcappedoil wellisnolongerinuseandisevidencedbyaventontheProperty,nearthecenteroftheProperty.Tenant,and Tenant'semployees,contractors,agentsand invitees,shallnot touch,disturb,manipulate,tamperwith or otherwisehandleanyportionof the cappedoilwell,includingbut not limitedto, the ventpipeor thearea surroundingit. 17.17 Survival.All provisionsdealing with such matters as indemnification,attorney's fees and obligationsandremediesafteradefaultorafterterminationshall survivetheterminationofthisAgreement. IN WITNESS WHEREOF,LandlordandTenanthavecausedthisGroundLeaseAgreementto be executedonthedayandyearfirsthereinabovewritten. "Landlord""Tenant" YMCA OF ORANGE COUNTY TRACKER BERRY BY BY Addr :13821 Newport Avenue, Suite 200 Address:‘—e-) Tustin, California 92780 Ce--•ecD.(7721e/ Attention:Attention: