HomeMy WebLinkAboutFilming and Photography Application OnlyCITY OF PALM DESERT
PHOTOGRAPHY/FILMING/VIDEO PERMIT
APPLICATION
Date:
Company:
Project Title:
Location Manager:
Project Manager:
Phone No.:
Email:
1.Production Type: Still Photography (Complete permit items 1-5 only) TV Commercial TV Movie
. TV Episodic Feature Film Music Video Corporate Video Other:
2.Total Personnel:Total Vehicles/Equipment:
3.Equipment Detail (Supply exact number of each item to be used at filming location(s).): Generators:
Cars: Trucks: RV: Other:
4. Insurance: Before a film permit is issued, a certificate of insurance must be submitted. Insurance certificate must be
issued by insurance underwriters “admitted” by the California Commission and rated ‘A’ or ‘B+’ by Best Key Rating
Guide. Requirements are below and see additional insurance information page.
*Proof of Workman’s Compensation, * $5 million per occurrence for pyrotechnic activities,
*Minimum $1 million per occurrence for General Liability Limit *$2 million per occurrence General Aggregate,
*Appropriate City and/or country Named as Additional Insured.
Insurance Certificate Attached. Insurance Certificate will be submitted by time and date
Insurance Certificate on File. Insurance Certificate Not Available.
Insurance Company: Expiration Date:
5.Location Shoot Specifics: Give specifics about the shoot below. Attach sheets; if more space is needed you must
include the name(s) of property owners(s), nearest cross streets and telephone number (s) of the filming locations(s).
Also, describe all scene(s) to be filmed (including animals, pyrotechnics, and stunts.)
Date Time Location and Activity Prep/Film/Strike
6. Property Owner Permission Required: Yes No 8. Police Required: Yes No
7. Road Encroachment Permit Required: Yes No 9. Fire Required: Yes No
CITY OF PALM DESERT
73-510 Fred Waring Drive
Palm Desert, CA 92260
Tel. (760)346-0611 x 477
10. Traffic: If filming is planned on City/County Street(s)/County property, please submit a site plan showing the
location(s) of the cast, crew, vehicle(s) and the route to be traveled in order to film a scene.
Site Plan Attached. Site plan will be submitted by time and date Site Plan Not available.
Describe your plan for controlling traffic, (i.e. personnel and devices to direct traffic):
If filming is to take place on City streets, please describe planned arrangements for temporary restrooms and
removal of refuse generated by your production:
11. Stunts/Special Effects: If your project involves stunts or special effects, please provide detailed information
about the specifics planned:
Pyrotechnics Specifics:
Pyrotechnician: License No.
Hazardous Materials to be used:
Wild Animals to be used:
12. Aerial Stunts/Elements: Detail any aerial stunts, helicopter landings, hot-air balloons, etc. to be utilized:
Shaded section below to be completed by the City (issuing agency).
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.
Applicant’s Name: Representative of: (Company Name)
Permittee waives all claims against City/County, 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/County, its offices, agents, and employees, from any and all loss, damage or liability which may
be suffered or incurred by City/County, 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/County. *City/Country shall have the privilege of inspecting the premises covered by the permit at any or all
times. *This permit shall not assign. *City/County may terminate this permit at any time if permittee fails to perform any covenant herein contained at the time and in the manner
herein provided. City/County 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 Ci ty/County. * No alteration or variation of the terms of this
permit shall be valid unless made in writing and signed by the parties hereto. * 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 permitee 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. * City/County 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.
City Approved Permit No.
Approved by:
Application Fee: $ Location Fee ( days x $ /day): $ Total Due: $
Conditions of Approval or Special Approvals/Permits Required:
No Special Approvals/Permits Required Road Encroachment Permit
Police Department Approval Fire Department Approval
FAA Approval Property Owner
PM-10 Permit Homeowners Association
Attachments: Yes or No
Other provisions:
This Permit will be effective:
Date Period and Time