HomeMy WebLinkAboutTemporary Event Business License ApplicationPage 1 of 6
CITY OF PALM DESERT
DEPARTMENT OF DEVELOPMENT SERVICES
73510 Fred Waring Drive, Palm Desert, California 92260
Phone (760) 776-6360 ▪ codehotline@palmdesert.gov
TEMPORARY EVENT BUSINESS LICENSE
APPLICATION FEE: $29.00 per booth/stall.
Make check payable to: City of Palm Desert
A Temporary Event Business License application must be submitted at least 14 days prior to the event.
Sections D, E, F and corresponding signatures must be submitted for each vendor.
Once issued, each vendor must post their unique business license at their booth or stall for the duration of the event.
Other:
A.EVENT REPRESENTATIVE CONTACT INFORMATION
Representative Name: Phone:
Mailing Address:
City: State: Zip: Email:
B.EVENT INFORMATION
Event Name: TUP#: N/A
Event Address:
Event Contact #1: Phone:
Event Contact #2: Phone:
City of Palm Desert Business License No. (if applicable):
EVENT START DATE:
From: ____/____/20____
EVENT END DATE:
From: ____/____/20____
EVENT START TIME:
From: _______AM/PM
EVENT END TIME:
To: _______AM/PM
Type of Event: Festival Parade Fair Trade Show Block Party Carnival
C.EVENT REPRESENTATIVE CHECKLIST
Have you provided the following documents with this application? YES NO
A Temporary Use Permit Approval Letter. (if applicable)
A reservation from the Desert Recreation District. (if applicable)
A complete vendors sheet (to be completed by the event representative, page 2).
A complete product sheet for each vendor (page 4 of this packet).
The application fee ($29.00 per booth/stall, excluding nonprofit organizations).
Page 2 of 6
COMPLETE VENDORS SHEET
Please list all vendors to participate in this event. Use another page if needed.
COMPLETE VENDORS LIST
(COMPLETED BY THE EVENT REPRESENTATIVE)
Provide correct information for each vendor. Check the box if YES.
Vendor/Business Name Vendor Representative/Applicant
Are pages 3-5
completed?
Non-Profit
Organization?
Sponsoring Organization and Event Name:
Total vendors (EXCLUDE NON-PROFITS):
CITY OF PALM DESERT
TEMPORARY EVENT BUSINESS LICENSE
Page 3 of 6
3
SECTIONS D, E, F AND SIGNATURES MUST BE SUBMITTED FOR EACH VENDOR.
Is this a nonprofit organization? If yes, provide EIN#.
Briefly describe type of vendor:
Phone: (Day) ________ (Night) _________________ (Cell) __________________
Event Representative Signature: The undersigned states that they are responsible for the event described and herein
give authorization for the filing of the application.
Print Name: Signature: Date:
Applicant (Vendor Representative) Signature: I hereby certify that all information supplied by me is correct and any
licenses required by the County, State or Federal Government issued to me are in full force and effect. I understand that
the City might not approve what I am applying for and/or might require conditions of approval.
Print Name: Signature: Date:
D. VENDOR CONTACT INFORMATION
Organization/Vendor Name:
Applicant (Vendor Representative): Phone:
Mailing Address:
City: State: Zip: Email:
E. VENDOR CHECKLIST
Have you provided the following documents with this application? YES NO
A letter of approval from the sponsor of the event.
A complete product sheet (page 4 of this packet).
Approval from the Riverside County Dept. of Env. Health (food vendors only, page 5).
F. VENDOR INSURANCE INFORMATION
Worker’s Comp. No: Exp:
Insurance Name:
Certificate of Self-Insurance: Insurance Waiver: Yes No
City of Palm Desert Business License No. (if applicable):
Page 4 of 6
COMPLETE PRODUCT SHEET
Please list all foods/products and all equipment to be used in your booth/stall. Use another page if needed.
All foods must be from an approved source and prepared in a licensed food service facility.
No foods may be prepared, cooked, or stored in your home (unless pre-approved by the County of Riverside).
COMPLETE PRODUCT LIST
(COMPLETED BY VENDOR AND VERIFIED BY STAFF AT INSPECTION)
Name of Facility: (if prepared off-site)
Facility Address: (street, city/state, zip)
Name/Description of Item Distributed Prepared Off-Site Equipment to be Used at Stall
YES NO
Vendor Name:
Sponsoring Organization and Event Name:
Booth/Stall Name: (complete only if name is
different than your vendor name)
CITY OF PALM DESERT
TEMPORARY EVENT BUSINESS LICENSE
Page 5 of 6
5
FOOD SERVICE VENDORS ONLY
Prior to submitting this application, you must get approval from the Riverside County Department of
Environmental Health. If approved, the applicant (vendor) must display their license at their booth or stall.
Applications without the health department’s authorized signature CANNOT be considered.
Riverside County Department of Environmental Health
Printed Name Telephone Number
Authorized Signature Date Position
Vendor Name:
Sponsoring Organization and Event Name:
Booth/Stall Name: (complete only if name is
different than your vendor name)
Page 6 of 6
CITY OF PALM DESERT
TEMPORARY EVENT BUSINESS LICENSE
EACH VENDOR MUST POST THEIR UNIQUE BUSINESS LICENSE AT THEIR BOOTH OR STALL FOR THE DURATION
OF THE EVENT.
Approved Denied
Vendor/Booth Name:
License No.:
Exp. Date:
Reason for denial:
By: Date: