Amplified Sound Permit

San Francisco Recreation and Park Department

Amplified Sound Application

Application for event is: *

Initial Application

Amended Application

Event Name: *

Event Website:

Company/Organization Name (If applicable)

CONTACT INFORMATION

Primary Contact:

Contact Person: *

Mailing Address (Street Address, Apt. or Suite#) *

City *

Zip Code *

Day Phone: *

Cell Number: *

Email Address: *

Person in charge at event (if different):

Name

Phone

Cell Number:

Email Address:

EVENT INFORMATION

Location of Event: *

Number of Participants Expected to Attend: *

Proposed Hours of Amplified Sound:

Day *

Date * +

Start Time *

End Time *

If multiple dates and times, use this space to describe (if multiple locations, must file new form): *

Person in direct charge of Sound Equipment and/or Sound Truck:

Name (Include first and last names) *

Day Phone: *

Cell Number: *

Sound Amplifying Equipment: *

Rated power output (watts): *

Types of Sounds to be amplified: (list all types: Human Speech, Music (type of music), etc.): *

Will your activity take place within 450 feet of a hospital, school, church, courthouse, mortuary, public library, or city hall? (250 feet=approximately one city block)

*

No

Yes

If yes, explain:

ACKNOWLEDGEMENT: The above information is complete and correct to the best of my knowledge. I understand that the permit is granted on the basis of the information supplied in the application, and that the permit may be denied or revoked if found to be incorrect and/or incomplete. If my event changes, I must file a new amended application. I further understand that the City may monitor the event, and that failure to comply with any conditions placed on the permit approval or local law my result in the immediate revocation of the permit. *

I Agree To The Above

Print Name of Person Agreeing to Above: *

Date: *

HIT NEXT TO COMPLETE YOUR FORM

**************************** FOR DEPARTMENT USE ONLY ****************************

VALIDATION SECTION

(This application constitutes a permit only if validated)

Location: ______________________________________________

Day ______________ Date _________________Hours ______ am/pm to _______ am/ pm

SF Rec. & Park Approval by:_________________________________________

Print Name: _______________________________________

SFPD Receipt Acknowledged: Permit Officer_________________________ Star # __________

Station: ___________________________________________________

Stipulations and Conditions: ____________________________________________________________

________________________________________________________________________________________________________________________________________________

* Sound Level at 250 Feet from perimeter may not exceed 70 decibels or such other level as set forth in the permit

* Permittee shall reduce sound level to a volume requested by law enforcement personnel.

* This permit shall be void immediately if used in conjunction with any illegal activity, or unlawful assembly.