Film/Photo/UAS Permit Application
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1 Date of Shoot Received Port of San Diego Use Only Company Name Address Issued Film/Photo/UAS Permit Application General Production Information Production Title: Production Type: Commercial Photo Shoot Feature Film TV Series Music Video Documentary Director : Producer: Contact Information Primary Contact On-Site Contact Name : Title: Name : Title: Date, Time and Location Information List all locations on Port District Tidelands, including private and commercial property with a description of activity. #1 Location: #2 Location: Detailed Description: Description: Start Date: End Date: Start Date: End Date: Start Time: End Time: Start Time: End Time: Total People On-Set: Vehicles Used for Prep and Production (Please provide Numbers of each Vehicle) Crew Cars Trucks Trailers Motorhomes Vans Other: Total Number of Vehicles On-Site: Total # Parking Spaces Needed: Total People On-Set: Vehicles Used for Prep and Production (Please provide Numbers of each Vehicle) Crew Cars Motorhomes Trucks Vans Trailers Other: Total Number of Vehicles On-Site: Total # Parking Spaces Needed: Port of San Diego Use Only BP# Trans# Doc# Permit Fee$ Check/M.O. # Credit Card# Cash Receipt# 1/2018 1
2 Special Equipment / Special Effects (Check all that Apply) Driving Shots: In Flow Process Trailer Tow Shots Stunts Pyrotechnics: Sparks Fire Gunfire Explosion Squibs Equipment: Refueler Generator Condor Crane Techno Crane BB Light Other: Additional Information and Documentation Please provide the following: Location of Area Street Closures Parking Diagram Certificate of Insurance(s) Other : Park Permit Certificate of Insurance Requirements Certificate of Insurance Applicant shall, to the fullest extent permitted by law, defend, indemnify, and hold harmless San Diego Unified Port District ( District ) and its officers, employees, and agents for any and all liability, claims, judgments, damages, proceedings, orders, directives, costs, including reasonable attorneys fees, or demands arising directly or indirectly out of the obligations undertaken in connection with this Permit, or Applicant s use, occupancy, possession or activities on the Premises, except claims or litigation arising through the sole negligence or willful misconduct of District. It is the intent of this Paragraph that Applicant indemnify and hold harmless District for any actions of Applicant or District, including duties that may be legally delegated by Applicant to third parties, except for those arising out of the sole negligence or willful misconduct of District. This indemnity obligation shall apply for the entire time that any third party can make a claim against or sue District for liabilities arising out of Applicant s use, occupancy, possession, or activities on the Premises, or arising from any defect in any part of the Premises. Applicant must provide certificate of insurance (COI) coverage naming San Diego Unified Port District as an additional insured and also be listed in the certificate holder box. Insurance coverage must be in force for the duration of the event, including setup through takedown days. The Port of San Diego requires a minimum of$1,000,000 for personal and bodily injury, one person and one occurrence; and a minimum of $2,000,000 coverage for property damage. The same organization named as the insured on the certificate of insurance should also be listed in the applicant blank on this permit application. Port Contact Sofi Bayardo, Special Events and Permitting Film and UAS Coordinator 3165 Pacific Highway, San Diego Ca O C filming@portofsandiego.org 10/2017 NOTE: If you are going to include the use of an Unmanned Aircraft System (UAS) for filming, please read the Guidelines for UAS Operations on page 5. If you are able to meet these Guidelines, then complete the Port of San Diego form on page 2
3 Guidelines for Permit Applicants Permit Holder Responsibilities As the holder of the event permit, you are responsible for the following: Keeping your approved permit and receipt with you on site at your event from setup to departure. It is your only proof of your approval to use the park for your event. Disposal of all trash accumulated by your event. Do not drive their vehicles on the grass areas or walkways at the park and utilize loading zones only when actively loading or unloading. Maintaining a sound- level that is considerate of other park users and surrounding neighborhoods. All amplified sound must cease at 10:00 p.m. in all parks except those in Coronado, where amplified sound must cease at 9:00 p.m. Complying with park hours of operation. Port of San Diego parks are open from 6:00 a.m. to 10:30 p.m. Accessibility Applicant shall ensure that all elements of the event are accessible to all, including persons with disabilities as required by law. Applicants are encouraged to incorporate the principles of Universal Design, which is the design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design, when developing the above required site plan. Specific accessibility to address for events shall include but is not limited to: Parking, including information and notification of alternate parking opportunities and locations; Accessible portable restrooms; Accessible shuttles, buses, and other provided transportation elements as part of the event; Placement of activities in areas for maximum accessibility; Communication and training of event staff, including volunteers, regarding accessibility and disability awareness Compliance with the Americans with Disabilities Act and applicable accessibility laws Alcoholic Beverages Park permits allow you to possess alcoholic beverages in a park, subject to the following exceptions: Keg beer and glass containers are prohibited. Alcoholic beverages are expressly prohibited in the city parks and on the beaches of the City of Coronado. (Coronado Municipal Code, Sec ). This applies to all Port of San Diego parks in Coronado. A designated area for alcohol consumption should be set up at your event to avoid any underage consumption. Smoking Prohibited Smoking is prohibited in any Port of San Diego park or beach. No person shall dispose of any cigarette, cigar, or tobacco in any place where smoking is prohibited, except in a designated waste disposal container. Water and Electricity Water and electricity are not available for public use in any Port of San Diego park. Permit holders must provide their own water and electricity. Generators are allowed, providing they are smaller than 75KWV. Refundable Damage/Security Deposit Depending upon the scope of setup required for the event, the Port may collect a minimum of $ as damage/security deposit and will be assessed upon receipt of your completed application by the permit coordinator. The permit holder will be required to compensate the Port for any incidental costs arising out of failure to meet any of the guidelines above or for damage occurring as a result of a their event Fire Marshal Permit If your event meets any of the following conditions, contact the Fire Marshal in the city in which your event is to be held to determine if a permit in addition to your Port of San Diego park event permit, is required: If your event will utilize any fencing If your event will utilize a tent or set of tents placed together that equal 200 square feet (typically 10 by 20 ) of area or greater; or a canopy or set of canopies placed together that equal 400 square feet (typically 20 by 20 ) of area or greater If your event will have any cooking of food on site including by a caterer(s) or concession vendors - other than a personal barbecue used in open space If Port staff determines from reviewing your application that you need to contact the appropriate City Fire Marshal. The following are contact numbers for the Fire Marshals of the Port cities: City of Chula Vista Fire Prevention Division City of Coronado Fire Services Department City of Imperial Beach Fire Services Department City of National City Fire Department City of San Diego San Diego County or
4 Terms and Conditions for Permit Applicants Use of a San Diego Unified Port District public facility is subject to the following terms and conditions: 1. Applicant shall comply with all applicable laws, rules, regulations and requirements of the San Diego Unified Port District and other governmental entities. 2. All or any portion of the refundable security deposit (if applicable) shall be available unconditionally to the District for the purpose of cleaning or repairing damages to the property post the permitted event. The refund process does not start until 10 days after the event. The refund process may take up to 30 days depending on your form of payment. 3. Either party may cancel this permit by giving twenty-four (24) hours notice to the other party. In the event of an emergency, such cancellation shall be without liability of any nature. Applicant is subject to a processing fee of $35.00 if Applicant provides less than sixty days written notice to the District of cancellation of a scheduled event. 4. This permit shall not be transferred or assigned. 5. Applicant shall, to the fullest extent permitted by law, defend, indemnify, and hold harmless San Diego Unified Port District ( District ) and its officers, employees, and agents for any and all liability, claims, judgments, damages, proceedings, orders, directives, costs, including reasonable attorneys fees, or demands arising directly or indirectly out of the obligations undertaken in connection with this Permit, or Applicant s use, occupancy, possession or activities on the Premises, except claims or litigation arising through the sole negligence or willful misconduct of District. It is the intent of this Paragraph that Applicant indemnifies and holds harmless District for any actions of Applicant or District, including duties that may be legally delegated by Applicant to third parties, except for those arising out of the sole negligence or willful misconduct of District. This indemnity obligation shall apply for the entire time that any third party can make a claim against or sue District for liabilities arising out of Applicant s use, occupancy, possession, or activities on the Premises, or arising from any defect in any part of the Premises. 6. Applicant must provide certificate of insurance coverage naming the San Diego Unified Port District as an additional insured. Insurance coverage must be in force for the duration of the event, including setup through takedown days. The Port of San Diego requires a minimum of $2,000,000 for personal and bodily injury, one person and one occurrence; and a minimum of $1,000,000 coverage for property damage. The same organization named as the insured on the certificate of insurance should also be listed in the applicant blank on this permit application. 7. The rights and privileges extended by this permit are non-exclusive. 8. Applicant shall not engage in any activity on Port District property other than the activity for which this permit is expressly issued. This permit may be terminated immediately by the Port District for misrepresentation of permit information, violation of the law or activities causing an unreasonable risk to public safety (as determined by any public safety agency). 9. Applicant must provide a current business license from the city in which the proposed activity will occur. 10. Permitted special events in Port of San Diego public facilities shall generally take priority over permitted commercial activity. From time to time, a special event may preclude or cause rescheduling or relocation of a permitted commercial activity. The commercial activity permitee will be notified as soon as is practicable if a conflict occurs. I certify that the information contained my permit application is true and correct to the best of my knowledge. I understand and agree to abide by the rules and regulations governing the proposed special event under the San Diego Unified Port District Code Applicant Name (Print) Applicant Signature Date Special Events Associate Date 4
5 Guidelines for Unmanned Aircraft System (UAS) Operations General Requirements for Operators Must be at least 16 years of age. Must have a UAS Remote Pilot certificate. Must have operating authority: o 333-Exemption o 14 CFR Part 107 Must have insurance and the ability to indemnify others as required by the Port of San Diego. Must have Air Traffic Control (ATC) permission/ Tower Flight Plan. UAS requirements: Must weigh less than 55 lbs.* Must undergo pre-flight check by remote pilot in command. Must inspect aircraft before every flight. Location requirements: Must fly for commercial purposes only, unless specifically authorized by the FAA. Must not fly within 5 miles of an airport without an FAA waiver. Note: There is no Class G airspace in Port of San Diego Tidelands. Note: Operations in Class B, C, D and E airspace are allowed with the required ATC permission in the form of a Tower Flight Plan. Must not fly more than 400 feet above ground level (AGL) with elevation determined by location within 400 feet of any structure without a FAA waiver.* Must keep the UAS in sight (i.e. visual line of sight), either by the remote pilot in command or a visual observer.* Must fly during daylight hours* or civil twilight hours (30 minutes before official sunrise to 30 minutes after official sunset, local time) with appropriate anti-collision lighting. Must fly at or below 50 mph.* Must yield right of way to manned aircraft.* Must not fly over people, crowds and stadiums* unless has FAA waiver or authorization Must not operate a UAS from a moving vehicle. *Certificate of Waiver, the FAA will grant waivers if operation can be performed safely but may otherwise not be allowed under Part
6 UAS Company, if applicable: Pilot Name: + Unmanned Aircraft Systems (UAS) Application Pilot in Command Information *If Remote Pilot will not be operating UAS, name of person operating UAS under the direct supervision of Remote Pilot Name: Phone: UAS Operating Authority 333-Exemption Exemption#: Visual Observer: 14 CFR Part 107 Remote Pilot s Certificate#: Class of Airspace UAS Activity Will Occur in: B C D E G Restricted Areas/Temporary Flight Restrictions (TFR) within Proposed/Time/Area of Operation? Yes No REMINDER: if you are flying in Class B, C, D or E airspace, ATC authorization is required for all UAS activity UAS /Airspace Information Make Model Make Model Registration# Registration# Total Payload Weight (incl. UAS/ camera/ additional equipment) Total Payload Weight (incl. UAS/ camera/ additional equipment) UAS Activity Date: UAS Activity Date: Hours of UAS Activity: Hours of UAS Activity: 333 Exemption Requirements Part 107 Requirements Please provide the following: Please provide the following: Copy of COA or Blanket COA Copy of Pilot License Copy of POA w/proof of submission to Local FSDO Copy of Notice to Airman (NOTAM) Certificate of Insurance Copy of Remote Pilot Certificate Copy of Part 47 or 48 Registration Certificate for each UAS Certificate of Insurance Diagram, charts and maps as applicable Attach description of planned flight operations Attach description of planned flight operations WAIVERS: If you are requesting any of the following activities, please check all that apply and furnish proof of waiver from the FAA upon submission of this document. Flight over non-participants ( ) Operating from a moving vehicle ( ) Night flight ( ) Operating multiple small UAS ( ) Flight altitude restrictions ( ) Flight in controlled airspace/or near airports ( ) Remote Pilot in Command or Authorized Company Representative is responsible for the safe operation of all UAS activities and declares that he/she will be in compliance with all Part 27 standards and requirements. Pilot Name (Print) Pilot Signature Date Special Events Associate Date 6
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