HomeMy WebLinkAboutCity of Palm Desert Drone Film Photoshoot Permit Application Drone, Film & Photoshoot Permit Application
City of Palm Desert ▪Development Services Department
73-510 Fred Waring Drive ▪ Palm Desert, CA 92260 ▪ 760.776.6477 ▪ Email filmpermit@palmdesert.gov
Submit completed application and attachments to filmpermit@palmdesert.gov ▪ Call 760.776.6477 for more information 1 of 3
PERMIT NUMBER
DFPP -
Approved
Denied
Contact Information
(On Location Point of Contact or Project Manager)
Name: Phone No.:
Project Title: Mobile No.:
Company: Email:
A. Production Details
Photoshoot TV Commercial
Movie Episode
Feature Film Music or Corporate Video
Drone Other:
B. Staging Locations
Location(s)
Description Activity
Date(s) & Time
Duration
1.
2.
3.
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):
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.
Drone, Film & Photoshoot Permit Application
City of Palm Desert ▪Development Services Department
73-510 Fred Waring Drive ▪ Palm Desert, CA 92260 ▪ 760.776.6477 ▪ Email filmpermit@palmdesert.gov
Submit completed application and attachments to filmpermit@palmdesert.gov ▪ Call 760.776.6477 for more information 2 of 3
PERMIT NUMBER
DFPP -
Approved
Denied
Required Documents: Pilot in Command Certificate and Part 47/Part 48 Registration Certificates (Provide Copies), and Flight p lan
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 a nd
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:
Filming that includes city street(s) and/or city 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).
Drone, Film & Photoshoot Permit Application
City of Palm Desert ▪Development Services Department
73-510 Fred Waring Drive ▪ Palm Desert, CA 92260 ▪ 760.776.6477 ▪ Email filmpermit@palmdesert.gov
Submit completed application and attachments to filmpermit@palmdesert.gov ▪ Call 760.776.6477 for more information 3 of 3
PERMIT NUMBER
DFPP -
Approved
Denied
G. Insurances & City Forms Required
Provide proof of insurance: City Forms (Required as applicable)
General Liability ($1 million per occurrence; $2 million per
occurrence General Aggregate)
Permission to Use Private
Property
Additional Insured Endorsement Hold Harmless & Insurance
Coverage Agreement
Worker’s Compensation (No Employees)
Required prior to permit issuance. Insurance certificates must be issued by underwriters “admitted” by the California Commiss ion
and rated ‘A’ or ‘B+’ by Best Key Rating Guide. See Insurance Requirements handout for more information about requirements.
H. Acknowledgment
The permittee agrees to all the terms and conditions of this permit including the provisions listed at the bottom of this for m 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, i ts
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. 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 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 o f 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. Permit must be always
kept on site.
Applicant Name / Representative (of) Company Name Application Date
City Staff Use Only
Status of Permit: Approved Approved with Conditions Denied
Other Provisions and
Conditions of
Approvals
Property Owner Permission Yes No Police Dept. Yes No
Encroachment Permit (Traffic Control/Road Closure) Yes No Fire Dept. Yes No
Reason for Denial:
Permit Validity This permit is effective from: