HomeMy WebLinkAboutDrone Film Photoshoot ApplicationDrone, Film & Photoshoot Permit Application
City of Palm Desert ▪Development Services Department ▪Regulatory Program
73-510 Fred Waring Drive ▪ Palm Desert, CA 92260 ▪ 760.346.0611 ext. 477
Submit completed application and attachments to lritchey@palmdesert.gov ▪ Call 760.346.0611 ext. 477 for more information 1 of 3
PERMIT NUMBER
DFPP -
Approved
Denied
Contact Information
(On Location Point of Contact or Project Manager)
Name: Phone No.:
Title: Mobile No.:
Company: Email:
See Drone, Film, Photoshoot List of Requirements handout for general permit information.
A.Production Details
Photoshoot TV Commercial
Movie Episode
Feature Film Music or Corporate Video
Other: Total Number of days for Permit :
B.Staging Locations
Location(s)
(Address and/or Nearest Intersecting Streets;
Provide owner names and phone numbers for
private property)
Activity
(Prep Area; Film;
Photoshoot; Airspace)
Date(s) & Time
Duration
1. (Primary)
2.
3.
4.
C.Personnel & Equipment Information
No. of Personnel: Vehicles & Equipment:
Equipment Types (Total number of each for production use within city limits)
Generators: Cars: Trucks: RV’s: Other:
D.Drone(s)
i.UAS / AIRSPACE INFORMATON - Class G Airspace Activity Only (400 Ft. AGL)
Make/Model No.: Registration No.:
Make/Model No.: Registration No.:
Total Payload (Weight in LBS):
Drone, Film & Photoshoot Permit Application
City of Palm Desert ▪Development Services Department ▪Regulatory Program
73-510 Fred Waring Drive ▪ Palm Desert, CA 92260 ▪ 760.346.0611 ext. 477
Submit completed application and attachments to lritchey@palmdesert.gov ▪ Call 760.346.0611 ext. 477 for more information 2 of 3
PERMIT NUMBER
DFPP -
Approved
Denied
ii.UAS / AIRSPACE OPERATING AUTHORITY – Remote Pilot in Command (14 CFR Part 107)
Pilot in Command: Phone No.:
Certificate No.: Will Pilot in Command Operate UAS? Y N
UAS Operator(s): 1. 2.
Required Documents: Pilot in Command Certificate and Part 47/Part 48 Registration Certificates (Provide Copies), and
Flight plan operations (include diagrams, charts, and maps). As applicable.
Remote Pilot in Command Acknowledgment:
Pilot in Command, or Authorized Company Representative, accepts responsibility for the safe operation of all UAS activities
and declares that they will follow the entirety of Part 107 standards and requirements.
Signature Date
Print Name Title
E.Stunts & Special Effects
Does production involve stunts and/or special effects? If yes, complete section. Y N
Does projection involve Pyrotechnics? If yes, explain below. Y N
If yes, provide type and details of pyrotechnical effects:
Pyrotechnician Name: License No.:
Use of Hazardous Material? If yes, list below. Y N
List Hazardous Material:
Use of Wild Animals? If yes, list below. Y N
List Wild Animals:
Use of Aerial Stunts and/or Elements? If yes, describe type of stunts in detail below. Y N
Detail of stunts and mechanisms or aircrafts (or similar) used: (Such as hot-air balloons, helicopter landing, etc.)
F.Traffic Control and Road Closures
Does production require Traffic Control? If yes, complete the following. Y N
Plan to Control Traffic:
Does production include road closures? Y N
Plan for restrooms and removal of refuse generated by production:
Drone, Film & Photoshoot Permit Application
City of Palm Desert ▪Development Services Department ▪Regulatory Program
73-510 Fred Waring Drive ▪ Palm Desert, CA 92260 ▪ 760.346.0611 ext. 477
Submit completed application and attachments to lritchey@palmdesert.gov ▪ Call 760.346.0611 ext. 477 for more information 3 of 3
PERMIT NUMBER
DFPP -
Approved
Denied
Filming that includes city/county street(s) and/or county property, or may impact traffic, must attach a Site Plan with all
locations and/or travel route(s) with approximate dates to shoot scene(s).
G.Insurances & City Forms Required
Provide proof of insurance: City Forms (Required as applicable)
Proof of Workman’s Compensation ($5 million per
occurrence for pyrotechnic special effects)
Workman’s’ Compensation
Declaration
General Liability ($1 million per occurrence; $2 million
per occurrence General Aggregate)
Permission to Use Private
Property
Additional Insured
(City named as Additional Insured)
Hold Harmless & Insurance
Coverage Agreement
Required prior to permit issuance. Insurance certificates must be issued by underwriters “admitted” by the California
Commission and rated ‘A’ or ‘B+’ by Best Key Rating Guide.
See Insurance Requirements handout for more information about requirements.
Insurance Company: Expiration Date:
H.Acknowledgment
The permittee agrees to all the terms and conditions of this permit including the provisions listed at the bottom of this form and any attachment.
Permittee waives all claims against City, its offices, agents, and employees, for loss or damage caused by, arising out of or in any way connected with the
exercise of this permit, and permitee agrees to hold harmless, indemnity, and defend City, its offices, agents, and employees, from any and all loss, damage
or liability which may be suffered or incurred by City, its offices, agents and employees caused by , arising out of or in any way connected with exercise by
permitee of the rights hereby permitted, except those arising out of the sole negligence of City. The city shall have the privilege of inspecting the premises
covered by the permit at any or all times. This permit shall not be assigned. The city may terminate this permit at any time if the permittee fails to fulfil any
covenant herein contained at the time and in the manner herein provided. The city agrees it will not unreasonably exercise this right of termination. The
parties hereto agree that the permittee, its offices, agents, and employees, in the performance of this permit shall act in an independent capacity and not
as offices, employees or agents of the City. No alteration or variation of the terms of this permit shall be valid unless made in writing and signed by the parties
hereto. The permittee agrees to comply with the terms and conditions contained in the attached Exhibit(s), which terms and conditions are by this reference
made a part thereof. The permittee hereby agrees to comply with all the rules and regulations of the facility or institution subject to this permit. Permit must
be kept on site at all times. The city made no representation of warranty as to condition of any property of facilities used by permitee, and it is the
responsibility of permittee to fully inspect as such property and facilities to determine their condition prior to their use, and in going forward, assumes all
risks associated with the condition of property or facilities.
Applicant Name / Representative (of) Company Name Application Date
City Staff Use Only
Status of Permit: Approved Approved with Conditions Denied
Conditions of Approval:
Additional Approvals & Permits Required:
Property Owner Permission Yes No Police Dept. Yes No
Encroachment Permit (Traffic Control/Road Closure) Yes No Fire Dept. Yes No
Other Provisions:
Reason for Denial:
Submittal Requirements:
Permit Validity This permit is effective from: to