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2. 
3. Instructions

   Before submitting this application, please review the Special Events Permitting Guide (PDF), which comprehensively summarizes the requirements and processes for hosting an event. If you need assistance, please email specialevents@oakharbor.org or call (360) 279-4754.  
   
   Applications must be submitted at least 60 days before an event. Once received, the application will be reviewed, and if necessary, an event planning meeting with City staff will be scheduled. The application fee will be invoiced separately. An event is not approved until the organizer signs the Conditionals of Approval issued by the City. 

7. Event Name*
8. Is this event a: *

   1. First-Time or One-Time Occurrence
   2. Recurring (weekly, monthly, etc.)
   3. Annual (previously permitted)
10. Event Date Start/End*
    Event Date Start/End Start Date

    Event Date Start/End Start Time

    —

    Event Date Start/End End Date

    Event Date Start/End End Time
11. Event Setup/Tear Down*
    Event Setup/Tear Down Start Date

    Event Setup/Tear Down Start Time

    —

    Event Setup/Tear Down End Date

    Event Setup/Tear Down End Time
12. Event Description*
14. Location:*
    -- Select One --Windjammer Park - PavilionWindjammer Park - Open SpaceWindjammer Park - Kitchen(s)Ft Nugent Park Flintstone ParkSmith ParkCatalina ParkStreet Closure: SE Bayshore DriveStreet Closure: SE Pioneer Way DowntownStreet Closure: Other Other Public Property (please detail in event description above)Private Property
15. Type of Event*
    -- Select One --Community Event (festival, parade, market)Private Event (command picnic, wedding, )Political or Religious Activity (exempt from fee, insurance and indemnification)
16. Estimated Number of Attendees*

    (enter numbers only)

17. Tourism Draw*

    Percentage of all attendees coming from more than 50 miles away. (enter numbers only)

21. Applicant's Name*
22. Company/Organization
23. Sponsor/Beneficiary
25. Mailing Address*
26. City*
27. State*
28. Zip Code*
30. Email Address*
31. Phone Number*
33. Secondary Contact
34. Phone Number
35. Email
37. Day of Event Emergency Contact*
38. Mobile Phone*
42. Event Features:*

    (check all that apply)

    1. Alcohol Consumption/Sales/Service
    2. Amplified Music
    3. Amusement Ride/Inflatable
    4. Animals/Petting Zoo
    5. Dunk Tank/Water Feature
    6. Equipment (fuel-powered)
    7. Fenced Area (beer garden)
    8. Fireworks/Pyrotechnics
    9. Food Consumption (picnic, pot-luck)
    10. Food Truck/Mobile Cart/Stationary
    11. Over 50 Attendees/Command Event
    12. Overnight Security
    13. Parade
    14. Portable Restroom (ADA compliant)
    15. Recreational Games/Sports
    16. Stage
    17. Tent Over 400 square feet
    18. Vendors/Sale of Goods
    19. Vehicle/Equipment Display
43. City Services Requested:*

    (check all that apply)

    Additional charges for city services may apply. Staff will provide a statement of the estimated cost for such services. Please note that the City no longer provides traffic cones/candlesticks, picnic tables, or portable restrooms for events. 

    1. Admin: Electronic Message Sign
    2. Fire: Tent Over 400 SF Permit
    3. Fire: Fireworks Display Permit
    4. Fire: Safety Plan Review
    5. Parks: Water/Electricity (in parks only)
    6. Public Safety: Parade Participation
    7. Streets: Road Closure
    8. Streets: Street Light Electricity
    9. Solid Waste: Dumpster
    10. Solid Waste: Garbage Roll Carts
    11. Stormwater: Street Sweeping
    12. Water: Hydrant Meter
    13. Other Equipment or Staffing
    14. NONE
44. Related Documents/Forms/Links:
    • Alcohol Licensing (WSLCB)
    • Electronic Message Sign Application
    • Food Truck Safety (NFPA)
    • Hydrant Meter Permit & Use Agreement
    • Illicit Discharge Letter (for vendors)
    • Indemnification/Hold Harmless
    • Insurance Worksheet
    • Solid Waste Disposal / Recycling Worksheet 
    • Small Dumpster - City:
      Temporary Dumpster Agreement
    • Large Dumpster - IC Disposal:
      Utility Customer
      Non-Customer
    • Event Recycling
    • Island County Public Health:
      Checklist for a Temporary Food Event
      Mobile Food Establishments
      Temporary Food Establishments
    • Special Event Permit Guide
46. Facility Rental Completed (CivicRec online portal)*

    1. Yes
    2. No
    3. Not Applicable

47. To check availability and reserve a park facility, please visit our online portal. If you do not have an account with CivicRec, you must register. After registering, you may select the facility and date of your rental. You will then pay for your rental through the portal, and will receive a confirmation e-mail. Facility rentals are non-refundable. Submission of this Special Event Permit Application does not guarantee facility availability nor does it constitute a facility reservation.

49. Certificate of Insurance*

    Insurance Worksheet

    Event insurance is availbable through the WCIA at GatherGuard

    
    

50. Indemnification/Hold Harmless*

    Agreement must be notarized prior to uploading. 

51. Event Site Plan/Map*
54. Notice to Neighboring Properties *

    Event organizers must notify neighbors and businesses within 500 ft. of the event, (if applicable) at least two (2) weeks prior to the event. Notification should be in writing (email is acceptable) and include times when traffic/parking and/or noise may be affected in the area.  Signature of your Conditions of Approval indicates you have completed the neighborhood notification and can provide copies of the notification and physical/email addresses where sent if requested. Please check one of the following: 

    1. I will complete the required neighborhood notification at least two (2) weeks prior to my event.
    2. Not applicable to this event.
56. Agreement*

    By checking the "I agree" box below, you agree and acknowledge that: 

    1) (a) your application will not be signed in the sense of a traditional paper document, (b) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and (c) you may still be required to provide a traditional signature at a later date.

    2) you understand and will abide the Special Events Permit Guide, Oak Harbor Municipal Code, and all local, state and federal laws deemed applicable to your event. 

    1. I agree.
58. Electronic Signature*
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit Submit and Print

* indicates a required field