The URL can be used to link to this page

Home My WebLink AboutFYPR2025-0002BUILDING PERMIT DESIGN & DEVELOPMENT DEPARTMENT Qa�fra 78-495 CALLE TAMPICO LA QUINTA, CALIFORNIA 92253 ta CALIFORNIA Permit Type: Fire Pyrotechnics & Open Flame Owner: Permit Number: FPYR2025-0002 Applicant: Property Address: 79255 BLACKHAWK WAY APN: 600010003 Contractor: Legal Description Property Zoning: MC Valuation: $0.00 PHONE (760) 777-7125 WWW.LAQUINTACA.GOV APPLIED DATE: 05/13/2025 ISSUED DATE: 05/23/2025 Maria Barajas PO BOX 2329, LA QUINTA, CA 92253 PRIOR TO THE ISSUANCE OF THIS PERMIT FOR CONSTRUCTION, ALTERATION, IMPROVEMENT, DEMOLITION, OR REPAIR THE OWNER, APPLICANT AND/OR CONTRACTOR UNDER PENALTY OF PERJURY HAVE AFFIRMED WHEN APPLICABLE, THROUGH THE SUBMITTAL OF FORMS OR BY OTHER ELECTRONIC MEANS, THE FOLLOWING: LICENSED CONTRACTOR OR OWNER -BUILDER DECLARATION (1 or 2) 1) They are licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and the referenced License is in full force and effect, or; 2) That they are exempt from the Contractors' State License Law for the reason(s) indicated by either (2)(a) and/or (2)(b), or (2)(c) where he or she is exempt from licensure by a valid exemption. [Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code] Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).) a) As owner of the property, or my employees with wages as their sole compensation, will do all of or portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). b) As owner of the property, will be exclusively contracting with licensed c) Are exempt from licensure under the Contractors' State License Law. As an Owner -Builder, they acknowledge that, except for their personal residence in which they must have resided in for at least one year prior to completion of the improvements covered by this permit, they cannot legally sell a structure built as an owner -builder if it has not been constructed in its entirety by licensed contractors. It is understood that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application was submitted at the following Web site: http://www.Ieginfo.ca.gov/calaw.htm1. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY (If applicable) A construction lender will be used for completion of the improvements covered by this permit and the name and information of which is on file for public inspection during the regular business hours of the public entity. Failure of the applicant to indicate the construction lender on the application does not relieve that person of the requirement to give the construction lender preliminary notice from that duty. WORKERS' COMPENSATION DECLARATION (1, 2 or 3) WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. 1) Has and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 2) Has and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 3) Certifies that, in the performance of the work for which this permit is issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, shall forthwith comply with those provisions. NOTICE TO APPLICANT (1, 2 and 3) 1) Each person upon whose behalf this application was made, each person at whose request and for whose benefit work is being performed under or pursuant to any permit issued as a result of this application, the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and employees for any act or omission related to the work being performed under or following issuance of this permit. 2) Any permit issued as a result of this application becomes null and void if work is not commenced within 360 days from date of issuance of such permit, or if cessation of work for 180 days will subject permit to cancellation. On or after January 1, 2019, every permit issued shall become invalid unless the work on the site authorized by such permit is commenced within 12 months after its issuance, or if the work authorized on the site by such permit is suspended or abandoned for a period of 12 months after the time the work is commenced. 3) Certified that they read the application and state that the information provided is correct. Agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above -mentioned property for inspection purposes. IMPORTANT: An Application for Permit was made to the Building Official, subject to the conditions and restrictions set forth at the time of application, which is now hereby an Issued Permit. If any part of the information being supplied on this permit is inaccurate or untrue, please contact the City of La Quinta at (760) 777-7125 immediately for correction. Printed: 5/12/26 3:46 pm Page 1 of 3 BUILDING PERMIT Permit Type: Fire Pyrotechnics & Open Flame Permit Number: FPYR2025-0002 Property Address: 79255 BLACKHAWK WAY FIREWORKS DISPLAY: La Quinta High School graduation event DISPLAY DATE TIME: June 3, 2025 @ approx. 9:00 p.m. DISPLAY LOCATION: La Quinta High School baseball field, 79255 Blackhawk Way, La Quinta, CA Event Name FIREWORKS DISPLAY: La Event Contact Name: Oran Jackson Event Contact Phone: (760) 772-4150 Quinta High School graduation event Type of Event GRADUATION Event Start Date Jun 3 2025 12:OOAM Event End Date Jun 3 2025 12:OOAM FIREWORKS: La Quinta High School Time Start 9:OOPM Time End 9:03PM Total # of People 1 Company Name Pyro Spectaculars, Inc. Company Phone (909) 355-8120 Pyro Product Pyro Spectaculars, Inc. Number Wholesaler Wholesaler State W-0144 Name of Pyro Spectaculars, Inc. Importer/Exporter I/E-0153 License # Importer/Exporter State License Firing Method Electric Location of pyro 3196 N Locust Ave. Departure date from Jun 3 2025 12:OOAM storage PRIOR to storage shipping Route(s) being used safest most direct route Location of storage baseball field, 79255 Provisions for return Returned in DOT approved DURING display Blackhawk Way, La of unused/unfired cartons Quinta, CA product Employee 37-525906-01-04 Public Liability CA000055935-01 Zoning MC Compensation Insurance Policy # Insurance Policy # General Plan MC City Limits Within La Quinta Limits Subdivision Name Lot Number Lot Size 80324.4 Centerlines 83843 Legal Description Type Group Sq Ft Value Invoice No. Fee Fee Amount Amount Paid INV-00014954 Digital Archiving and Records Management Fee - OTC $12.00 $12.00 Fire - Pyrotechnic Permit Review & Standby Charge $1,146.00 $1,146.00 Technology Enhancement Fee $57.30 $57.30 Total for InvoiceINV-00014954 $1,215.30 $1,215.30 Grand Total for Permit $1,215.30 $1,215.30 Workflow Step / Action Name Action Type Start Date End Date Fire Inspections v.1 05/29/2025 15:28 ------------------------- — Pyro Safety Inspection v.1 — ..................- Inspection 05/29/2025 15:28 06/04/2025 7:43 -- -- -- -- -- -- -- -- --......................................................................................................... Fire Permit Final v.1 Inspection Linked Records v.1 ------------------------------------------------- Linked Fire Permit v.1 Create Sub Permit ---------------------------------------------------------------------------------------------------------------------------------------- Linked Permits v.1 Create Sub Permit Printed: 5/12/26 3:46 pm Page 2 of 3 BUILDING PERMIT Permit Type: Fire Pyrotechnics & Open Flame Permit Number: FPYR2025-0002 Property Address: 79255 BLACKHAWK WAY Review v.1 05/13/2025 0:00 05/23/2025 12:36 ---------------------------------------------------------------------------------------------------------------------------------------- Fire Review v.1 Receive Submittal 05/13/2025 0:00 05/23/2025 12:36 Construction or work for which a permit is required shall be subject to inspection by the building official and such construction or work shall remain visible and able to be accessed for inspection purposes until approved. Approval as a result of an inspection shall not be construed to be an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Inspections presuming to give authority to violate or cancel the provisions of the applicable code and other ordinances of the jurisdiction shall not be valid. It shall be the duty of the owner or the owner's authorized agent to cause the work to remain visible and able to be accessed for inspection purposes. Neither the building official nor the jurisdiction shall be liable for expense entailed in the removal or replacement of any material required to allow inspection. It shall be the duty of the holder of the building permit or their duly authorized agent to notify the building official when work is ready for inspection. It shall be the duty of the permit holder to provide access to and means for inspections of such work that are required by this code. A building or structure shall not be used or occupied in whole or in part, and a change of occupancy of a building or structure or portion thereof shall not be made, until the building official has issued a certificate of occupancy therefor as provided herein. Issuance of a certificate of occupancy shall not be construed as an approval of a violation of the provisions of the applicable code and other ordinances of the jurisdiction. Certificates presuming to give authority to violate or cancel the provisions of this code or other ordinances of the jurisdiction shall not be valid. A person shall not make connections from a utility, a source of energy, fuel, or power, or a water system or sewer system to any building or system that is regulated by the applicable code and other ordinances of the jurisdiction for which a permit is required, until approved by the buildinq official. Printed: 5/12/26 3:46 pm Page 3 of 3 OFFICE USE ONLY: I REVIEW DATE: ❑ APPROVED ❑ CORRECTIONS - CALIFORNIA CALLED FOR PICKUP: DESIGN & DEVELOPMENT DEPARTMENT 78-495 Calle Tampico PICKED UP: La Quinta, California 92253 (760) 777-7125 / FAX (760) 777-7011 FIRE REVIEW APPLICATION ❑ SUBMITTA_ L # _ ❑ REVISION # _ _ PERMIT NO. APPLICANT/OWNER INFORMATION Maria w/Pyro Spectaculars on behalf of La Quinta High School Oron Jackson Applicant Name: _ Owner Name: Mailing Address: 79255 Blackhawk Way, La Quinta, CA 92253 Site Address: baseball Field next to stadium, 79255 Blackhawk Way La Quinta, CA Phone Number: (310) 772-4150 Project Fireworks Display: June 3, 2025 @ approx. 9:00 p.m Description: (Include # of sprinkler heads) Email: mbarajas@pyrospec.com Pursuant to a Cooperative Agreement to Provide Fire Services, the Riverside County Fire Department serves as the City's fire department, and the County designee serves as the City's fire chief. Applicant recognizes this contracted arrangement and shall comply with County Fire Department directions. CONTRACTOR INFORMATION Contractor Name: Pyro Spectaculars, Inc. Contractor #: (909) 355-8120 Signature: Contact Person: Maria Barajas Mailing Address: P.O. Box 2329 Print Name: Marla Barajas City, State, Zip: Rialto 92377, CA 92377 Phone Number: (909) 355-8120 ext. 228 Business License #: GPD 672 Email Address: mbarajas@pyrospec.com A. APPLICATION TYPE FIRE SPRINKLER SYSTEM _ _ STORAGE TANKS _ ❑ NEW COMMERCIAL/INDUSTRIAL------------ ❑ DISPENSERS ONLY HOURLY@167/HR ❑ 0-35,000 SQ FT $683 ❑ ABOVE GROUND HOURLY@167/HR SUPRESSION SYSTEM_ ❑ HOOD & DUCT $433 ❑ 35,001-75,000 SQ FT $808 ❑ 75,001-120,000 SQ FT $1017 ❑ 120,001 AND UP $1267 ❑ OTHER SUPRESSION SYSTEM HOURLY@167/HR ❑ TENANT IMPROVEMENTS - FIRE SPRINKLER $516 MASTER PLAN -- ❑ MASTER PLAN HOURLY@167/HR MISC 0 PYRO $1017 El RESIDENTIAL SPRINKLER SYSTEMS ------------ ❑ 1-50 SPRINKLER HEADS $433 ❑ 51-100 SPRINKLER HEADS $516 ❑ OVER 100 SPRINKLER HEADS $599 ❑ HAZMAT HOURLY@167/HR ❑ RESIDENTIAL TRACT HOME (EA.) ADDITIONAL _____----- ❑ HIGH PILE RACK STORAGE HOURLY@167/HR ❑ 1-50 SPRINKLER HEADS $183 ❑ PRIVATE FIRE MAINS $683 ❑ 51-100 SPRINKLER HEADS $267 ❑ TECHNICAL REPORT RESEARCH HOURLY@167/HR ❑ OVER 100 SPRINKLER HEADS $350 ❑ FIRE PUMPS $683 ❑ MULTI -FAMILY Q OR MORE) FIRE ALARM SYSTEM $599 ❑ STANDPIPE SYSTEMS $599 ❑ WATER TANKS $433 ❑ COMMERCIAL - SPRINKLER MONITORING $433 ❑ REVISION $167 ❑ COMMERCIAL - FIRE ALARM SYSTEM $1100 ❑ OTHER HOURLY@167/HR Each application type includes a Technology Enhancement Fee of S5 tx Records management Fee oT>ii or>zi Kt V 13CU lu/11/Lull `For permits billed at on hourly rote, these fees will be added at time of payment. Riverside County Fire Department - Office of the Fire Marshal Riverside Office (West): Palm Desert Office (East): 2300 Market Street, Ste. 150 77933 Las Montanas Road, Ste 201 Riverside, CA 92501 Palm Desert, CA 92211 Phone: (951) 955-4777 - Fax: (951) 955-4886 'b Phone: (760) 863-8886 - Fax: (760) 863-7072 PYROTECHNICS APPLICATION FD Permit # Assessor Parcel#(APN): I/we hereby make application for a permit to utilize pyrotechnic effects as defined by the California State Health & Safety Code, and agree to comply in every particular with the law pertaining thereto as set forth in Part 2 of Division II of the Health & Safety Code, and the rules and regulations adopted by the State Fire Marshal. EVENT INFORMATION Event Name: La Quinta High School Event Contact: Oron Jackson Address: 79255 Blackhawk Way City/ zip: La Quinta 92253 Event Date(s). June 3, 2025 Phone: (760) 772-4150 Type of Event: Graduation fireworks Time Start: APProX. s:" "n" Time End: APPr°X s.oe P m. Total # of people: unknown APPLICANT/SPONSORING ORGANIZATION INFORMATION Company Name: Pyro Spectaculars, Inc. on behalf of La Quinta High School Address: P.O. Box 2329 Applicant Name: Maria Barajas on behalf of Pyro Spectaculars, Inc. Phone: (909) 355-8120 ext. 228 City/ zip: Rialto 92377 Email: PYRO COMPANY INFORMATION mbarajas@pyrospec.com Company Name: Maria Barajas on behalf of Pyro Spectaculars, Inc. Public Display Lic. # GPD-0672 Address: P.O. Box 2329 Phone: (909) 355-8120 ext. 228 City/ zip: Rialto 92377 Email: mbarajas@pyrospec.com PYROTECHNIC OPERATOR INFORMATION Name of CA License Operator Supervising Display: Patrick Mulvihill (714) 493-7648 License Class. Basic License # 3468-02 OFFICE USE ONLY Permit for Transportation Permit for Pyrotechnics Fee Paid: Date: ❑ Granted ❑ Denied ❑ Granted ❑ Denied Payment Method: Signature: Inspected by: Received By: Title: Date: Title: Receipt# Person Assigned: Date: Cell: Foam 21 — Revised 1/2/18 Visit us at www.rvcfire.org PRODUCT INFORMATION Name of wholesaler supplying all devices to be used in display: Wholesale State License #: Pyro Spectaculars, Inc. W-0144 Name of importer/exporter supplying all devices to be used in display: Importer/exporter State License #: Pyro Spectaculars, Inc. I/E-0153 r or Effect Description (type & size) *Attach additional sheets if needed No. of A PProx. Devices Burn Time 75 APProx. Height APProx. Width APProx. Travel Distance Mortar APProx. APP i Drop Diameter Type(s) 3"Single Break Serial Shells 3" Multi -Shot Devices 3 Firing method: ❑ Manual Iii Electric ❑ Both Will reload/ refueling be necessary? ❑ Yes 8 No Will it affect airport traffic? ❑ Yes Iii No F-if"yes", pyrotech is responsible to notify FAA Ceiling Height (if indoors) Fall Out Zone (Distance in feet): 210' LOAD SITE & STORAGE INFORMATION FOR DEVICES & EFFECTS Location of storage PRIOR to shipping to display site: I Departure date from storage location: 3196 N. Locust Ave., Rialto, CA 923761May 23, 2024 Storage Address & City: 3196 N. Locust Ave., Rialto, CA 92376 Route(s) being used: safest most direct rout Location of storage DURING display: I Describe provisions for return of unused/unfired product 79255 Blackhawk Way, La Quinta, CA after display. Returned in DOT approved cartons Location of storage of unused/unfired product (if applicable). 3196 N. Locust Ave., Rialto, CA 92376 INSURANCE INFORMATION Policy number of Employee Compensation Insurance: Policy number of Public Liability Insurance: 37-525906-01-04 (attach copy) CA000002771-38 Application for Permit -- Public Fireworks Display We, Pyro Spectaculars , hereby make application for permit to conduct a display of fireworks by the California State Health and Safety Code, and agree to comply in every particular with the law pertaining thereto as set forth in Part 2 of Division 11, Division 12, and other applicable sections of the Health Safety Code, and the Rules and Regulations adopted by the State Fire Marshal. Sponsoring Organization: La Quinta High School Address:79255 Blackhawk Way. La Quinta, CA 92253 Person in charge of display: Patrick Mulvihill Lic#: 2863-02 (714) 493-7648 Location of display: La Quinta High School - Baseball Field 79255 Blackhawk Way La Quinta, ca Westward Ho & Adams Dates of display: Tuesday, June 03, 2025 Time of display: Approximately 9:00 PM Pyrotechnic Operator in charge (license number): Patrick Mulvihill Lic#: 2863-02 (714) 493-7648 Type of Display ❑d Aerial ❑ Low Level ❑ Set Pieces ❑ Devices ❑ Manual W Electric Description of Product to be Fired I High Level Aerial (Approximately 200 - 1, 000 feet) 75 - 3" Single Break Aerial Shell(s) 3 - 3" Multi -Shot Device(s) Description of storage facilities and location on grounds: Delivered to site on date of display Insurance/License Workers Compensation: Britton -Gallagher Date: 10/01/2024 - 10/01/2025 Public Liability Insurance: $ 5,000,000.00 (Certificate attached) General Public Display License No. 672 issued by State Fire Marshal Wholesale License No. W-144 issued by State Fire Marshal Pyro Spectacul s Applicant's Signatur�i�Q. i� Applicant's Address PO Box 2329, Rialto, CA 92377 AL FOR PERMIT PERMIT FOR PUBLIC DISPLAY OF FIREWORKS to be held (date) is hereby Granted Denied Signature Title cg 72/6/2025 E (MMMD/YYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: Acrisure, LLC dba Britton Gallagher & Associates PHONE AX One Cleveland Center, Floor 30 (A,c, No, Extl: 216-658-7100 (AIC. No) 216-658-7101 E-MAIL 1375 East 9th Street ADDRESS Cleveland OH 44114 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Pyro Spectaculars Inc. San Diego Fireworks P. O. Box 2329 Rialto CA 92377 INSURER A: Everest Denali Insurance Company 16044 INSURER B : Admiral Insurance Company 24856 INSURERC: Arch Specialty Insurance Company 21199 INSURER o : AXIS Specialty Insurance Company 15610 INSURER E : INSURER F : A-MICOwr--mac d%FRTIFIrATF IUIIMRFR• 171'AQA19AQ REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER (MM/DDY/YYYY) (MWDD/YYYY) LIMITS LTR INSR WVD B GENERAL LIABILITY Y CA000055935-01 2/1/2025 2/1/2026 EACH OCCURRENCE $ 1,000.000 X , DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Es occurrence) SCO.000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1.000.000 GENERAL AGGREGATE $ 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X ;60- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY Y S18CA00031-241 1/13/2024 4/2/2025 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED �� SCHEDULED BODILY INJURY (Per accident) $ _ AUTOS AUTOS NON -OWNED PROPERTY DAMAGE $ X HIRED AUTOS X ; AUTOS (Per accident) $ C UMBRELLALIAB X ' OCCUR Y UXP0057894-10 2/1/2025 2/1/2026 EACH OCCURRENCE $4.000.000 X EXCESS LIAB CLAIMS -MADE AGGREGATE $4,000,000 WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE^I I E.L. EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? J N / A (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE'. $ If yes describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ D Excess Liability #2 P-001-000056744-07 2/1/2025 2/1/2026 Aggregate $5,000,000 Total Aggregate Limit $10,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate Holder is named as an additional insured in regards to General Liability and Excess Liability. Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. ADDITIONAL INSURED(S): La Quinta High School, and City of La Quinta, and Desert Sands Unified School District, and County of Riverside, and Riverside County Fire Department, and the State of California, and their officers, agents and employees when acting in their official capacity as such. It is agreed and understood that the State of California shall not be liable for any premiums or assessments on this policy. CERTIFICATE HOLDER GANGELLA11UN DESERT SANDS UNIFIED SCHOOL DISTRICT 47-950 DUNE PALMS RD. LA QUINTA CA 92253 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U 1WOU-LU1U AGUKU GUKYUKAI IUIY. Alt rlgn15 reb"1VVU. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD City of La Quinta s 78-495 Calle Tampico La Quinta, CA 92253 T 760-777-7000 fNuf lit, BUSINESS LICENSE CERTIFICATE NON -TRANSFERABLE Business Name: PYRO SPECTACULARS, INC Business Type(s): 7999 Amusement, Casinos, Fitness, Performing Arts, Promoters, Recreation, Skiing Facilities, and Other Similar Organizations (Except Business, Professional, Labor, and Political Organizations) Business Location: Outside City Limits Mailing Address: 3010 Ingram Ave Springfield, MO 65803 Owner: PYRO SPECTACULARS, INC - MARIA BARAJAS License Number: LIC-765430 Issued Date: 1/8/2025 Expiration Date: 12/31/2025 License Type: Vehicle - Outside City Limits Classification: Vehicle - Outside City Limits Fees Paid: $79.00 Design and Development Director Dear Business Owner: Please be aware that issuance of a business license by the City does not authorize you to conduct business in a building or tenant space that has not been approved for occupancy by the Design and Development Department. If you have any questions regarding this issue, or if you are not sure if a Certificate of Occupancy has been issued for your place of business, please contact Design and Development at (760)777-7000. The Licensee named herein having paid to the City of La Quinta all fees required, license is hereby granted said licensee to transact the business herein set forth, for the period stated, in conformity with the Provisions of Ordinance No. 2 of this City. This license is issued without verification that the licensee is subject to or exempt from licensing by the State of California. TO BE POSTED IN A CONSPICUOUS PLACE - 1. A 2863.02 PATRICK MULVIHILL Ht: 6' Hair:BRN Eyes: BLUE Wt 280 D.O.B.01/24/1962 The bearer whose photo and signature - appear hereon is authorized to perform as a Pyrotechnic Operator within the limity set forth on the reverse. Signature Soe reverse Typia BASIC COMMERCIAL Lic No: 2863-02 `[n5 card Issued by MC California State Fuc Marsha: Is for idenb6Canon purposes only ano Shall NOT be used for advertising. State Fife S13fshal recommendation Is NOT given or irnpned IF F 1UN0 RETURN TO cahfoinia State Fire Marshal ARn F,fc EngineenngfFirewofxs 1 131 S Street Sadramento, CA 35814 01- Y e Entrance Gate - — - - Westward Ho Lai No public access ./ ` No car parking i No public Access Do not drive truck on Gate Baseball Field Park pyro truck here - E Firing Site r Q x No car parking No public Access fl. D 0 ' Graduation '� rid; .- A•. r No car parking PW No public Access G.+ I t ( _ h� j 1',r• i -r L- b y 4. Bart 12°Goggle Application for Permit -- Public Fireworks Display We, Pyro Spectaculars , hereby make application for permit to conduct a display of fireworks by the California State Health and Safety Code, and agree to comply in every particular with the law pertaining thereto as set forth in Part 2 of Division 11, Division 12, and other applicable sections of the Health Safety Code, and the Rules and Regulations adopted by the State Fire Marshal, Sponsoring Organization: La Quinta High School Address:79255 Blackhawk Way, La Quinta, CA 92253 Person in charge of display: Patrick Mulvihill Lic#: 2863-02 (714) 493-7648 Location of display: La Quinta High School - Baseball Field 79255 Blackhawk Way La Quinta, ca Westward Ho & Adams Dates of display: Tuesday, June 03, 2025 Time of display: Approximately 9:00 PM Pyrotechnic Operator in charge (license number): Patrick Mulvihill Lic#: 2863-02 (714) 493-7648 Type of Display: ❑d Aerial ❑ Low Level ❑ Set Pieces ❑ Devices ❑ Manual Electric Description of Product to be Fired High Level Aerial (Approximately 200 - 1, 000 feet) 75 - 3" Single Break Aerial Shell(s) 3 - 3" Multi -Shot Device(s) Description of storage facilities and location on grounds: Delivered to site on date of display Insurance/License Workers Compensation: Britton -Gallagher Date: 10/01/2024 - 10/01/2025 Public Liability Insurance: $ 5,000,000.00 (Certificate attached) General Public Display License No. 672 issued by State Fire Marshal Wholesale License No. W-144 issued by State Fire Marshal Pyro Spectacu Applicant's Signature/ Applicant's Address PO Box 2329, Rialto, CA 9237 APPROVAL FOR PERMIT PERMIT FOR PUBLIC DISPLAY OF FIREWORKS to be held (date) Digitally signed by Chris Cox is hereb Granted Denied DN C=US, Efires�,e,sor@lal,intacagov Sig Chris Cox J ffie be,F° FireDe",CN='t.. gnature aoftbeF,aMaraha ,NN-Chra ox.. Date: 2025.05,23 tosz:oa-woo Title Supervising Fire Marshal CAL FIRE — RIVERSIDE UNIT RIVERSIDE COUNTY FIRE DEPARTMENT �Cci BILL WEISER - FIRE CHIEF OFFICE OF THE FIRE MARSHAL — LA QUINTA-CALIFORNIA - 78495 Calle Tampico, La Quinta, CA 92253 • Phone (760) 777-7000 • www.rvcfire.org May 23, 2025 ATTN: Maria Barajas, Pyro Spectaculars Re: Fireworks Display — June 3, 2025 @ 9pm Permit #: FPYR2025-0002 / Site: La Quinta High School — 79255 Blackhawk Way The pyrotechnics permit application is approved with the following conditions. 1. Provide a minimum of one pressurized water extinguisher readily available on -site, currently serviced within one year. C.C.R. Title 19 § 1004 2. A secured perimeter shall be maintained around the pyrotechnics firing site and fall -out zone as required to maintain audience safety. §982 3. Mortars are to be in good condition. Base plugs in place, with no splits, bulges in tubes or bent or frayed muzzles. §999 4. Operator and assistants located within the fallout area are required to have the proper safety gear/protective clothing on during the firing of the display and immediately after the display. § 1004 5. If mortar racks are used, they shall be stable and secure. § 1001 (f) 6. No smoking in firing or display areas. § 1006 7. During electrical firing, no one is allowed to enter the firing area of the display. § 1001 8. Electrically fired shows require that all technicians shall be positioned a minimum of 100' from any mortar and positioned so as to be protected from the direct line of fire. § 1001 The pyrotechnic operator shall contact the Office of the Fire Marshal at 760-777-7000 or by email at FireBusinessMail(a),LaQuintaCA.gov 72 hours before the date of the fireworks display to coordinate inspection of the mortar set-up prior to loading fireworks material. Chris Cox — Supervising Fire Marshal FireSupervisor(a,LaQuintaCA. Gov (760)777-7078