Fillable Permit Application / Solicitud De Permiso (City of Gonzales)

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Permit Application / Solicitud De Permiso (City of Gonzales)

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109 Fourth Street • P.O. Box 647 • Gonzales, CA 93926 • Phone 831-675-5010 • Fax 831-675-3205
Gonzales Police Department
APPLICATION FOR PERMIT
Select one:
☐
Public Dance / Party
☐
Private Party
☐
Other
MUSIC CANNOT BE HEARD FROM OVER 200 FEET AWAY
MUSIC SHALL END BY 11:00 PM-NO EXCEPTIONS
NOTE:
A fee of $32.00 dollars must accompany application. A security contract agreement is required at the
time of the application. Minimum of (1) guard required for every 50 Persons in attendance.
Number of Guest:
Date of Event:
Time of Event-
From: To:
Public Event:
☐
Yes
☐
No
Invitation Only:
☐
Yes
☐
No
# of Licensed Security
Guards:
Alcohol Served:
☐
Yes
☐
No
Security Guards:
☐
Yes
☐
No
Alcohol Sold:
☐
Yes
☐
No
Security Guard(s) Arrival Time
From: To:
IF ALCOHOL BEVERAGES ARE SOLD, A.B.C. LICENSE IS REQUIRED
NOTICE TO ALL APPLICANTS:
You must submit sufficient evidence of identity and good character and
business responsibility of the person and/or firm represented to be held financially responsible for any damages
against property or persons as a result of this event.
Applicant certifies that all statements given on this application are true and the event will be conducted in a law
abiding and peaceful manner. Applicants understand that any violations of these permit conditions, the applicable
codes or sections of the Gonzales City Code or any other law governing this activity may be cause for the
IMMEDIATE AND FINAL REVOCATION of this permit issued for the event. Applicant further understands they
assume all responsibility as the contact person, should any damages to property or injuries to persons caused by
any of the guests invited or uninvited, in attendance at the stated event for which this permit was issued.
Signature of Applicant Date
Chief of Police Date
Name of Security Company:
Approved
Denied
KEITH WISE
CHIEF OF POLICE
SERVE • CARE • CONNECT
109 Fourth Street • P.O. Box 647 • Gonzales, CA 93926 • Phone 831-675-5010 • Fax 831-675-3205
Gonzales Police Department
SOLICITUD DE PERMISO
Seleccione Uno:
☐
Baile Publico / Fiesta
☐
Fiesta Privada
☐
Otro
LA MUSICA NO PUEDE SER ESCUCHADA A MAS DE 200 PIES DE DISTANCIA
LA MUSICA TERMINARA A LAS 11:00 PM-SIN EXCEPCIONES
NOTA:
Una cuota de $32.00 dolares debe acompanar la solicitud. Un acuerdo de contrato de seguridad se
requiere en el momento de la solicitud. Se requiere un minimo de un (1) guardia por cada 50 personas
presentes.
Numero de invitados:
Fecha del Evento:
Tiempo de el Evento- De: A:
Nombre de La Agencia de Seguridad:
Evento Publico:
☐
Si
☐
No
Solo con Invitacion:
☐
Si
☐
No
# de Guardias con
licencia:
Alcohol Servido:
☐
Si
☐
No
Guardias de Serguridad:
☐
Si
☐
No
Alcohol Vendido:
☐
Si
☐
No
Hora(s) de Llegada de los Guardias:
De:
A:
SI SE VENDEN BEBIDAS ALCOHOLICAS, A.B.C. SE REQUIERE LICENCIA
AVISO A TODOS LOS SOLICITANTES:
Debe presenter evidencia suficiente de identidad y buen caracter y
responsabilidad comercial de la persona y/o firma representada para ser sostenida financieramente responsable por
cualquier dano contra propiedad o persona como resultado de este evento.
El solicitante certifica que todas las declaraciones dadas en esta solicitud son verdaderas y que el evento se llevará a
cabo de manera respetuosa con la ley y en forma pacífica. Los solicitantes entienden que cualquier violación de estas
condiciones del permiso, los códigos o secciones aplicables del Código de la ciudad de Gonzales o cualquier otra ley
que rija esta actividad puede ser causa de la REVOCACIÓN INMEDIATA Y FINAL de este permiso emitido para el
evento. El solicitante también entiende que asume toda la responsabilidad como persona de contacto, en caso de
daños a la propiedad o lesiones a personas causadas por cualquiera de los invitados invitados o no invitados, en la
asistencia al evento indicado para el cual se emitió este permiso.
Firma Del Solicitante Fecha
Jefe de Policía Fecha
Aprobado
Negado
KEITH WISE
CHIEF OF POLICE
SERVE • CARE • CONNECT
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Permit Application Solicitud De Permiso (City of Gonzales)

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Completed 13 August 2020

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