DEPARTMENT OF FINANCIAL MANAGEMENT
BUSINESS SERVICES BUREAU
Annual Entertainment Permit Application
(Print all information in blue or black ink)
Application Instructions
Complete the application and all accompanying forms legibly in black or dark blue ink. Forms completed in pencil will be returned. All authorized individuals must sign and date the forms, where applicable. Incomplete applications will not be accepted.
Submit your application along with the non-refundable application fee in person to the City of Long Beach Business License Division, W. Ocean Blvd., Floor, Long Beach, CA 90802. Applications will be accepted Monday through Friday from : a.m. to 4:00 p.m.
Type of Entertainment Permit Application Fees (Total)
Entertainment with/without Dancing
Pool/Billiard Hall (3 or more tables)
Entertainment Retail Business
Temporary Entertainment Permit
The application will be reviewed by Business License, Planning, Building, Fire, Health, and PD. After the departments have reviewed, a City Council hearing will be held. For the complete application process, visit www.longbeach.gov/entertainmentpermit. Section A – Entertainment Type Entertainment with Dancing (Bar) Entertainment without Dancing (Bar) Entertainment with Dancing (Restaurant) Entertainment without Dancing (Restaurant) Entertainment (Retail) Social Club
Pool/Billiard Hall Other ______________________________ Section B – Business Information
Corporation Limited Liability Company (LLC) General Partnership Limited Partnership Limited Liability Partnership (LLP) Sole Proprietorship APPLICANT NAME (LEGAL OWNERSHIP STRUCTURE):
BUSINESS NAME (DBA): PLACE AND DATE OF FILING OF DBA:
BUSINESS SITE ADDRESS:
CATION NUMBER:
TYPE: SSN/ITIN EIN NIN
APPLICANT/BUSINESS PHONE: APPLICANT/BUSINESS EMAIL ADDRESS:
MAILING ADDRESS:
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Section – Proposed Entertainment Activities & Schedule
Entertainment - Restaurant Entertainment Tavern (bar) Entertainment - Other Proposed Entertainment Activity:
Outdoor Entertainment? Y N
Dancing by patrons, guests, customers, participants, attendees? Y N Dancing by performers? Y N
Live music by more than two (2) performers? Y N
Amplified music (live)? Y N
Amplified music (recorded)? Y N
Disc Jockey? Y N
Karaoke? Y N
Adult Entertainment as defined by LBMC Section 21.15.110? Y N Adult Entertainment as defined by LBMC Section 5.72.115 (B)? Y N Will the establishment serve as a family pool/billiard hall as provided in Section
5.69.090 of the LBMC? Y N
Any other type of entertainment not listed above? Y N
If yes, briefly describe the entertainment activity: ________________________________________ _______________________________________________________________________________ Describe entertainment by performers: ________________________________________________ Dance Floor? Yes No Stage? Yes No
If yes, provide dimensions of dance floor L _______ x W __________ = _____________ sq ft If yes, provide dimensions of stage L _______ x W __________ = _____________ sq ft Describe floor material and surface type: ______________________________________________ Proposed Entertainment Schedule: Please provide the days and times of the week that you would like to have entertainment at your establishment. Please fill out completely. If you do not wish to have entertainment on a certain day, mark N/A.
Day Monday Tuesday Wednesday Thursday Friday Saturday Sunday Start Time
(AM/PM)
End Time
(AM/PM)
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