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SAN DIEGO POLICE DEPARTMENT - PERMITS AND LICENSING 1400 'E' STREET, MS-735, SAN DIEGO, CA 92101 (619) 531-2250

ADULT ENTERT AlNER and OUTCALL NUDE ENTERTAINER

San Diego Municipal Code, Section 33.01 01 (e), stales you must have a valid police penni I 10 operate a business designated as pol ice regulated. You are responsible for bei ng fami liar with and complying WIth the ru les and regulations related to Nude Entenainmenl Businesses or Outcall Nude Entertainment. Copies of the Nude Entertainment Business Ordinance, Qutea] ] Nude Entertainment Business Ordinance and General Divisions O rd inances for police regulated activities may be obtai ned from the City Clerk's office located at 202 C Street, 2"d Floor, Telephone # (6 19) 533-4000 or via the City's website: www.sannet.gov/(Department,CityClerk, Documents, Municipal Code), SDMC Chapter 3. Article 3. Divisions 1-5.36 and 28.

Adult Entertainer - means any person who, at a fixed business location, provides nude entertainment or whose perfonnance is distinguished or characterized by an emphasis upon the display of spec ified anatomical areas or specified sex ual activities. It incl udes persons who perfonn da nces, such as: "stage dances," "lap dances," "table dances," and "couch dances," whether or not the entertainer is nude. Outcalf Nude Entertailler - means any person who conducts outcaJl nude entertainment fo r any ind ividual or group at a location other than a fIX ed business establishment that is licensed to provide nude entertainment. It includes strippers for bachelor and bachelorene parties, lingerie models, and other similar entertainers. It includes any person who entertains while nude or whose perfonnance is d istinguished or characterized by an emphasis upon the display o f spec ified anatomical areas and specified sexual activities.

YOU MUST PROVIDE ALL OF THE FOLLOWING WHEN APPLYING FOR TIlE ABOVE MENTIONED POLICE PERMIT. rNCOMPLETE APPLICATION PACKETS WILL NOT BE ACCEPTED:

· · APPLICATION - Po lice Permit Application. F ill out the app lication completely. A thiny (30) day investigation period begins at the time the application is submitted. A criminal records check will be made on each applicant. LIVE SCAN FINGERPRINTS are required for all new applicants. Municipal Code states Fingerprints must be taken by a Governmental Agency. See anached list oflocations. Fill out the anached "Request for Live Scan Service" fonn and bring it with you to a Live Scan agency. Return your completed application to the Police Department so your application can be processed. Tbe completed "Req uest fOr Live Scan Service " form is valid for only thirty (30) days from tbe date your fingerprints were taken. After tbirty (30) days you will be required 10 re-do your Live Scan fingerprints . BUSINESS TAX CERTIFICATE - Adult Entertainers (only) must provide a City or San Diego Business Tax Certificate. This can be obtained from the C ity Treasurer's Office located at 1200 Third Avenue, 1$' floor, San Diego, CA 921 01 Phone: (619) 615·1500. OUTCALL NUDE ENTERTAINER - MUST provide the correct business name, address and Police Pennit num ber o f the business they will be working for. NO EXCEPTIONS. STATEMENT OF UNDERSTANDING - Read , initial each line, sign and date. IDENTLFICA TION - A current U.S. government issued photo iden tification card (i.e. Driver's L icense or Military 1.0., U.S. Passport) is required. INVESTIGATION arid REGULATORY FEES - Cash and checks are accepted. P lease make checks, money orders and cashier's checks payable to C ity Treasurer. NO TH1RD PARTY, OUT OF STATE CHECKS OR CREDIT CARDS WJLL BE ACCEYTED. The investigation fee and photo fee are non-refundable.

·

· · · ·

* Regu latory Pennit Fee * Police Investigation Fee

Photo Fee * Total

ADULT ENTERTAINER FEES:

OUTCALL NUDE ENTERTAINER FEES:

*

$ 245.00 $104.00 $ \ 5.00 $364.00

* Regula tory Permit Fee * Police Investigation Fee * P hoto Fee

*Total

$940.00 $ 104.00 $ 15.00 $1,059.00

ADULT ENTERTAINER AND OUTCALL NUDE ENTERTAINER FEES: Of applying for both at Ihe same lime)

* Adult Entertainer Regulatory Permit Fee * Outca ll Nude Enterta iner Regulatory Pennit Fee * Police Investigation Fee * Photo Fees

* Total

PD-2S83 Rev. 07/0112009

$245.00 $940.00 $104.00 $ 30.00 $1,319.00

G:Perm il5 & Licell$in giAp pliralion Pac kel §{AlE-OINIE

Police Permit Ap.plication San Diego Police .....,.....,u ..u u ..,........

1400 'E' Street

:I

M.S. 735

3

101

OF

DOwner Date of Applicant's Full Other Names Used: (Maiden, Residence Mailing Ph. ( , - - - - - - - Bus. ( Internet Web Site Address/Auction Site User Soc. Sec. ______ Height: Place of Weight:_ _ _ __

(

Employee.

o

Partner

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Corporate

Driver's License/ID

Stage Name: _ _ _ _ _ _ _ __ State,

~--

.......

----------

,_ _ _ _ _ Fax ( )_ _ _~

Where Applicant Expects to be Employed: (MUST HAVE FOR OUTCALL ENTERTAINER)

----------------~

Police Business Permit

----------------------- City, State,

1.

1

2

List

addresses for the past five (5) years: DO NOT LEAVE BLAi~K List Complete Addresses past five vears

re~;lmem!e

Year From

Year To

3

4

f--=

5

i

i

FOR OFFICE USE ONLY

i

App.

"_ _ _ _ _ _ Permit Number:_ _ _ _ _ _ Received

Records Check: _ _ _ _ __ Initials/ID # Approving

Live Scan Received RIOl ok or _ _ _ _ __

o

G:Drive/Permils & Licensing/Internet!Application - Generic

Police Pennit Application Page 2 of3

2.

List previous occupations, places of employment and/or school for the past five (5) years. DO NOT LEAVE BLANK

PLACE OF

~MPLOYMENT

n.

OR SCHOOL

OCCUPATION VAl J!, I'NUM

a.

ADDRESS & PHONE PLACE OF EMPLOYMENT OR SCHOOL

I DATETO

1 DATETO

OCCUPATION VAIl!.l'KUIVI

b.

ADDRESS & PHONE PLACE OF EMPLOYMENT OR SCHOOL

,.

OCCUPATION VAll!. l'KVIVI

C.

ADDRESS & PHONE PLACE OF EMPLOYMENT OR SCHOOL

1

DATETU

OCCUPATION VAIl!.I'KVIVI

d.

ADDRESS & PHONE PLACE OF EMPLOYMENT OR SCHOOL

1

DATETO

OCCuPATION VAl J!, I'KVIVJ

e.

ADDRESS & PHONE

1_

DATE TO

3.

List similar permits or licenses issued by any agency or board, or any city, county, state or federal agency in the past five (5) years. IF NONE, INITIAL HERE: _ _ _ _ _ __

TYPE OF LICENSE LICENSE NUMBER DATES HELD CITY AND STATE

a.

b.

c.

4. Have you ever had any permit or license issued by any agency or board, or any city, county, state or federal agency suspended or revoked? Yes ( ) No ( ) .

If yes, please complete below:

CITY/STATE DATE OF SUSPENSION OR REVOCATION REASON

1

2 3

Rev: 07/15/2008 afs

G:DriveIPennits & Licensing/Application Packets

Police Pennit Application Page 3 of3 5. List all criminal convictions, except traffic convictions. Include pleadings of guilty to a lesser charge in satisfaction of, or as a substitute for, an original charge, and pleadings of nolo contendere. Expunged convictions must be listed per California Penal Code section 1203.4(a).

IF NONE, INITIAL HERE: _ _ _ _ __

CHARGE DATE CONVICTED LOCATrON OF COURT

·

a.

b.

c.

U.

1;; ·

.

.

APPLICANTS: The right of reasonable inspection shall be a condition for issuance of a police pennit. If a pennit is issued, representatives of the police department shaH have access to the business premises during nonnal business hours, which may include entry into the non-public portion of the business.

It is the responsibility of the pennit holder to renew the pennit no later than ten (10) calendar days after the expiration date on the pennit. Failure to renew on time will result in penalty fee of $25.00 plus 10% of the regulatory fee. If a renewal is not completed with all fees and penalties paid within thirty (30) days after the pennit expiration date, the pennit expires and business operations, occupations, or activities allowed by the permit must cease. A pennittee must then begin the application process as a new applicant (Section 33.0308 of the San Diego Municipal Code). I declare under penalty of peIjury that the statements made on this application, including accompanying documents, are true, complete and correct to the best of my know ledge and belief. I understand that any false statements or infonnation are grounds for denial of this application or loss of licensure and that I may be subject to prosecution per section 11.0401(b) of the San Diego Murucipal Code.

I AM AWARE THAT THE INVESTIGATION FEE IS NON-REFUNDABLE. I Al\1l AWARE THAT I AM RESPONSIBLE FOR BEING FAMILIAR WITH AND COMPLYING WITH THE RULES AND REGULATIONS RELATED TO THE POLICE REGIlLATED BUSINESS OR OCCUPATION FOR WHICH I AM APPLYING. I AM AWARE THAT THE GRt\NTING OF A POLICE PERMIT DOES NOT RELIEVE ME FROM OBTAINING PERlVIITS OR APPROVALS REQUIRED BY THE CITY OF SAN DIEGO OR STATE OR FEDERAL LAW. I Ai\f AWARE THAT THE GRA.~TING OF A POLICE PERMIT DOES NOT RELIEVE ME FROM COMPLYING WITH ALL APPLICABLE LOCAL, STATE, AND FEDERAL LAWS, INCLUDING THOSE RELATED TO BUILDING, ZONING, AND FIRE, AND OTHER PUBLIC SAFETY REGULATIONS. I AM AWARE THAT THE GRANTING OF A POLICE PERMIT DOES NOT VEST ANY DEVELOPMENT RIGHTS IN THE PROPERTY OR BUSINESS.

APPLICANT'S SIGNATURE

DATE OF APPLICATION

PLEASE BE ADVISED THE INFORMATION YOU PROVIDE ON YOUR APPLICATION MAY BE SUBJECT TO PUBLIC DISCLOSURE PER THE CALIFORNIA PUBLIC RECORDS ACT.

Rev; 07/1512008 Dfs G:DriveIPermits & Licensing/Application Packets

San Diego Police Department - Permits and Licensing Unit

1400 'E' Street, MS 735

San Diego, CA 92101

Telephone No.: (619) 531-2250

ADULT ENTERTAINER

Statement Of Understanding

Operating Requirements And Regulations

PLEASE READ CAREFULLY: It is unlawful to work as an adult entertainer without a police permit. The adult entertainer permit issued to you is not a license to conduct a nude entertainment business. To legally work as an adult entertainer, you must be employed by someone who possesses a Nude Entertainment Business permit. The permit is valid for a period of one (1) year from the date of issuance. An adult entertainer may perform in a temporary status with a permit during the thirty (30) day investigation period or until the application for a permit is denied. It is your responsibility to renew the permit before the expiration date. No renewal notice will be mailed to you.

Copies of the Nude Entertainment Business Ordinance and General Divisions Ordinances for police regulated activities may be obtained from the City Clerk's office located at 202 C Street, 2nd Floor, San Diego, CA 92101, Telephone No.: (619) 533-4000 or via the City's website: www.sannet.gov/ go to (Department, City Clerk, Documents, Municipal Code, SDMC Chapter 3, Article 3, Divisions 1-5, and 36). The following summarized sections are from the San Diego Municipal Code unless otherwise indicated:

PLEASE INITIAL: 33.3602 - Adult Entertainer means any person who, at a fixed business location, provides nude entertainment or whose performance is distinguished or characterized by an emphasis upon the display of specified anatomical areas or specified sexual activities. It includes persons who perform dances such as stage dances, lap dances, table dances, and couch dances, whether or not the entertainer is nude.

Nude Entertainment Business means any establishment or business operating at a fixed location where (a) any person engages in or operates nude entertainment; or (b) there are live performances which are distinguished or characterized by an emphasis upon the display of specified anatomical areas or specified sexual activities. It includes nightclubs, bars, lingerie modeling studios, and similar commercial establishments commonly known as topless or nude. Nude means being devoid of an opaque covering which covers the genitals, pubic hair, buttocks, perineum, anus or anal region of any person, or any portion of the female breast at or below the areola. Specified anatomical areas means and includes less than completely and opaquely covered human genitals, pubic region, buttocks, anus, female breasts below a point immediately above the top of the areola, or human male genitals in a discernible turgid state, even if completely and opaquely covered. Specified sexual activities means and includes the fondling or other touching of human genitals, pubic region, buttocks, anus or female breasts; sex acts, normal or perverted, actual or simulated, including intercourse, oral copulation, or sodomy; masturbation, actual or simulated; excretory functions as part of, or in connection with, any of the activities set forth above.

PD-2583 Rev: 10/12/07 BSP

Page 2 of2 Adult Entertainer Statement of Understanding Operating Requirements and Regulations 33.3604 - Permits Required: It is unlawful for any person to act as an adult entertainer without a police peffilit. 33.3610(a) - Six-Foot Rule: While nude, an adult enteliainer shall not be within six feet of a patron. 33.3610{b) - No Touching During Performances: An adult entertainer shall not intentionally touch any patron during any perfonnance, or allow any patron to intentionally touch the entertainer whether the entertainer is nude or not. 33.3610(c) - No Touching of Specified Anatomical Areas at any Time: An adult entertainer shall not touch specified anatomical areas of any person, or allow any person to touch the specified anatomical areas of the adult entertainer. 33.3610(d) - Change of Address Requirements: Adult entertainers must notify the Chief of Police of any change in their business or residential address within fIfteen (15) calendar days of the change. 33.3609{b) - Operating Hours: It is unlawful for any nude entertainment establishment to be open for business between the hours of2:00 a.m. and 6:00 a.m. 311.6 - California Penal Code: It is a misdemeanor to knowingly engage in, or participate in, obscene live conduct. 647(b) - California Penal Code: It is a misdemeanor to solicit or agree to engage in any act of prostitution. Prostitution includes any lewd act between persons for money or other consideration. (In addition to agreeing to a sex act, encouraging a patron to masturbate while you perfonn could be considered a violation of this section). I have read and understand the operating requirements and regulations summarized above. I understand it is my responsibility to be familiar with all laws and regulations governing this activity. I understand that my permit to act as an "Adult Entertainer" may be suspended or revoked for violation of the laws and regulations governing nude entertainment. I understand that I may schedule an interview with a Permits and Licensing Police Code Compliance Officer if I have any questions regarding these regulations or my employment in a police regulated occupation.

"

.

Applicants Signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date:

Application Received by: _ __

PD-2583 Rev: 10/)2/07 SSP

San Diego Police Department - Permits and Licensing Unit

1400 'E' Street,MS 735

San Diego, CA 92101

Telephone No.: (619) 531-2250

OUTCALL NUDE ENTERTAINER

Statement Of Understanding

Operating Requirements And Regulations

PLEASE READ CAREFULLY: It is unlawful to work as an outcall nude entertainer without a police

permit. The outcall nude entertainer permit that is being i'ssued to you is not a license to conduct an outcall nude entertainment business. To legally work as an outcall nude entertainer, you must be employed by someone who possesses an outcall nude entertainment business permit. The permit is valid for a period of one (1) year from the date of issuance. An outcall nude entertainer may perform in a temporary status with a permit during the thirty (30) day investigation period or until their application for a permit is denied. It is your responsibility to renew the permit before the expiration date. No renewal notice will be mailed to you. Copies of the Outcall Nude Entertainment Business Ordinance and General Divisions Ordinances for police regulated activities may be obtained from the City Clerk's office located at 202 C Street, 2nd Floor; San Diego, CA, Telephone No.: (619) 533-4000 or via the City's website: www.sannet.gov/ (Department, City Clerk, Documents, Municipal Code), SDMC Chapter 3, Article 3, Divisions 1-5, and 28. The following summarized sections are from the San Diego Municipal Code unless otherwise indicated: PLEASE INITIAL: 33.2802 - Outcall Nude Entertainer: Includes strippers for bachelor and bachelorette parties, lingerie models, and other similar entertainers. It includes any person who entertains while nude or whose performance is distinguished or characterized by an emphasis upon the display of specified anatomical areas or specified sexual activities.

"Outcall nude entertainment business" means any person who, for a fee, commission, hire, reward or profit, furnishes or offers to furnish an out call nude entertainer, as defined in this section, for any individual or group at a location other than a fixed business establishment licensed to provide nude entertainment. It includes businesses that provide outcall nude entertainers such as lingerie models and strippers. "Nude" means being devoid of an opaque covering which covers the genitals, pubic hair, buttocks, perineum, anus or anal region of any person, or any portion of the female breast at or below the areola. "Specified anatomical areas" means and includes less than completely and opaquely covered human genitals, pubic region, buttocks, anus, female breasts below a point immediately above the top of the areola, or human male genitals in a discernible turgid state, even if completely and opaquely covered. "Specified sexual activities" means and includes the fondling or other touching of human genitals, pubic region, buttocks, anus or female breasts; sex acts, normal or perverted, actual or simulated, including intercourse, oral copulation, or sodomy; masturbation, actual or simulated; excretory functions as part of or in connection with any of the activities set forth above.

_ _ 33.2803(a-d) - Permits Required: In addition to their own police permit, every outcall nude entertainer must carry a copy of the outcall nude entertainment business permit with them when working as an outcall nude entertainer.

UutcalJ Nude Entertainer Statement of Understanding Rules and Regulations Page 2

33.2813(a) - Six Foot Rule: While nude, an outcall nude entertainer shall not be within six feet ofa patron. 33.2813(b) - No Touching During Performances: An outcall nude entertainer shall not intentionally touch any patron during any perfonnance, or allow any patron to intentionally touch the outcall nude entertainer whether nude or not. 33.2813(c) - Unlawful To Provide Massage: When acting as an outcall nude entertainer, it is unlawful for any person to provide massage services. If the outcall nude entertainer also holds a police permit as a massage therapist or holistic health practitioner, he or she may not provide massage services to a patron immediately before or after providing outcall nude entertainment services. 33.2811 - Advertising Requirements: Each outcall nude entertainer or outcall nude entertainment business shall include the number of its applicable police permit in any advertisement of services appearing in any newspaper, telephone directory, other printed advertising medium, or electronic media. 33.2808(e) - Operating Hours: It is unlawful for any outcall nude entertainer to provide services between the hours of2:00 a.m. and 6:00 a.m. 33.0312 - Change of Employment: Must notify the Chief of Police (Police Pennits and Licensing) within fifteen (15) calendar days of changing employers. 311.6 -- California Penal Code: It is a misdemeanor to knowingly engage in, or participate in, obscene live conduct. 647(b) -- California Penal Code: It is a misdemeanor to solicit or agree to engage in any act of prostitution. Prostitution includes any lewd act between persons for money or other consideration. (In addition to agreeing to a sex act, encouraging a patron to masturbate while you perform could be considered a violation of this section.) I have read and understand the operating requirements and regulations summarized above. I understand it is my responsibility to be familiar with all laws and regulations governing this activity. I understand that my permit to act as an outcall nude entertainer may be suspended or revoked for violation of the laws and regulations governing outcall nude entertainment. I understand that I may schedule an interview with a Permits and Licensing Police Code Compliance Officer if I have any questions regarding these regulations or my employment in a police regulated occupation.

Applicants Signature: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date:

Application Received by: _ __

PD-2036

Rev. 10/12/07 BSP

Live Scan Fingerprint Information

Municipal Code §33.0304 - Applicant and Employees to Furnish Fingerprints and Photographs For the purpose of investigation and for regu lation oft·he occupation or business during the time it is li censed, applicants, responsible persons, managers, or employees may be required to furnish their fingerprin ts and photographs. Fingerprints must he taken by a govemmental agency. The Chief of Police shall forwa rd the fingerprints to the Id entification Division of the State of California, Department of Justice, or the Federal Bureau of Investigat ion, for identity confirmation and crimi nal histories. The following are acceptable US Governmental Agencies located in San Diego County:

CHULA VlSTA Chula Vista Police Department 315 Fourth Street Chu la Vista, CA 92010 (619) 409-5954 M ~ F (8am-12pm) Appointments Only M - F (lpm-4pm) Appointments Only www.chulavistapd.org LA JOLLA UCSD Police Department 9500 Gilman Dr #0017 La Jolla, CA 92093 (858) 534-4361 Appointments Only M - F 9am-3pm ESCONDIDO Escondido Police Department 700 W Grand Ave Escondido, CA 92025 Contact: (760) 839-4431 M - F (9:00am-3:30pm) Appointments Only

,

LAMESA La Mesa Poli ce Department (Storefron t) 61 19 Lake Murray Blvd La Mesa, CA 91942 (619)667-1342 M, T, W (IOa m-4pm) AppointmentslWalk \n Th, F (9am-3pm) Appointments/Walk In SAN DIEGO San Diego State University 5500 Campanile Dr SSE-14 10 San Diego, CA 92182 (619)594-3193 M - F (8am-4pm) Appointments Only

SAN DIEGO San Diego City Schools Police Services/EOC Bldg 4100 Norma l St San Diego, CA 92103-2682 (619) 725-7015 Appointments (619) 725-7014 (Information) T - F (8:30am-1 pm) Walk In T - F (2pm-4pm) Appointments Only Not open to general publ ic on Monday's Closed School Holidays SAN DIEGO - LSID X54/MLi San Diego Community College Police 1536 Frazee Road, I st Floor San Diego, CA 92108 Con tact (619) 388-6416 M-Th (7:30am-5pm) W1k F (7 :30am-12 noon) Wlk E-mail address: [email protected]

Rev ; 0412012009

State of California

Department of Justice

REQUEST FOR I.IVE SCAN SERVICE

8CII8016 (3107)

A r IppJ/cant Submission

ORI:

CA 0371100

Code assigned by DOJ

Type of Application:

..

Permits & Licensinq

Job Title or Type of License, Certification or Permit:

p.,gency Address Set Contributing Agency:

San Diego Police Department

Agency authorized to receive criminal history information

08228

Marl Code (five-digit code assigned by DOJ)

P.O. Box 121431 - MS 735

Street No. Street or PO Box Contact Name (Mandatory for all school submissions)

San Diego

City

CA

State

92112-1431

Zip Code

( 619 ) 531-2250

Contac! Telephone No.

Name of Applicant:

(Please print) Last First

1'.11

Alias:

Last

Driver's License No: Sex: Weight:

Date of Birth: Height:

o

First

Male

D

Female

Mise. No. BIL Mise. Number: Home Address:

Applicant to Pay

Agency Billing Nunilier

Eye Color: Place of Birtll:

Hair Color:

Street No. Street or PO Box

City, State and Zip Code

Social Security Number: Your Number:

OCA No. (Agency Identifying No.)

Level of Service:

[Z] DOJ

If resubmission, list Original ATI Number: Employer: (Additional response for agencies specified by statute)

,

Not Applicable

Employer Name

..

Street or PO Box Mail Code (five digit code assigned by DOJ)

~

Street No.

(

City

.'

State

Zip Code

Agency Telephone No. (optional)

l

Live Scan Transaction Completed By:

Name of Operator Date

I ransmitting

Agency

ATINo,

....

Amount Collec!edfBilied

ORIGINAL - Live Scan Operator; SECOND COpy - Applicant; THIRD COpy (if needed) - Requesting Agency

Information

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