NAME, (Last, First, MI)
BUSINESS NAME DBA
BUSINESS ADDRESS (Street, City, State, ZIP)
HOME ADDRESS (Street, City, State, ZIP)
CALIFORNIA DRIVER’S LICENSE NUMBER
TYPE OF APPLICATION:
BUSINESS PHONE
CELL PHONE
EMAIL ADDRESS
INITIAL APPLICATION: (RESUME AND FULL FEE REQUIRED) Full fee = $2,274.00 per box
REAPPLICATION: MORE THAN 30 BUT LESS THAN 90 DAYS AFTER FAILURE. (50% FEE REQUIRED)
REAPPLICATION: MORE THAN 90 DAYS AFTER FAILURE. (FULL FEE REQUIRED)
ADDITION TO CERTIFICATE: (FULL FEE REQUIRED)
RENEWALOFCERTIFICATE# PRIORTOEXPIRATION. (50% FEE REQUIRED)*
RENEWALOFCERTIFICATE# AFTEREXPIRATION. (FULL FEE AND COMPLETE TESTING PROCESS)*
ADD/CHANGE/RENEWOFBUSINESSAFFILIATION. (MINIMUM FEE REQUIRED) Minimum fee = $382.00*
*Current copyof Los Angeles CityTax Certificate and State License if applicable)
PER CHAPTER 1 OF THE FIRE CODE, I SUBMIT THIS APPLICATION FOR CERTIFICATE OF FITNESS TO:
PERFORM AS A FIRE SAFETY OFFICER Revenue code: (675) CONDUCT BLASTING OPERATIONS (665)
RECHARGE OR SERVICE PORTABLE EXTINGUISHERS
PERFORM AS A HEALTH CARE FACILITY INSTRUCTOR (680) PERFORM AS A HIGH-RISE LIFE/SAFETY SERVICE (685)
CONDUCT TEST OF FIRE PROTECTION EQUIPMENT AND SYSTEMS (SEE REVERSE FOR CHIEF’S REGULATION 4 CATEGORIES) (670)
REQUIRED RESUME FOR INITIAL APPLICATIONS & ALL ADDITIONS TO CERTIFICATE SHALL INCLUDE:
1.AT LEAST TWO LETTERS OF REFERENCES FOR EXPERIENCE AND PERFORMANCE.
2.EMPLOYMENT RECORD FOR AT LEAST THE PAST FIVE YEARS.
3.EDUCATION BACKGROUND RELATIVE TO FIRE PROTECTION EQUIPMENT.
4. PERSONAL INFORMATION PERTINENT TO CERTIFICATE OF FITNESS.
5.COLOR COPY OF VALID FORM OF IDENTIFICATION.
SIGNATURE OF APPLICANT DATE
SIGNATURE:
CATEGORIES OF FIRE PROTECTION EQUIPMENT OR SYSTEMS:
WATER BASED FIRE PROTECTION SYSTEMS:
AUTOMATIC SPRINKLER SYSTEMS
CLASS I STANDPIPE SYSTEMS
CLASS II STANDPIPE SYSTEMS*
CLASS III STANDPIPE SYSTEMS
COMBINED STANDPIPE AND AUTOMATIC SPRINKLER SYSTEMS FIRE PUMPS
FIRE PROTECTIVE SIGNALING SYSTEMS:
COMPLEX FIRE ALARM SYSTEMS
SUPERVISING STATION ALARM SYSTEMS (Renewal Only)
BASIC FIRE ALARM SYSTEMS (Renewal Only)
GAS DETECTION SYSTEMS: METHANE
ADDITIONAL COMMENTS:
EMERGENCY POWER SYSTEMS:
EMERGENCY GENERATOR AND BATTERY SYSTEMS
BATTERY SYSTEMS ONLY
SMOKE CONTROL SYSTEMS:
PRESSURIZED STAIRSHAFT SYSTEMS
MECHANICAL SMOKE PROOF ENCLOSURES
CBC 905/909 SMOKE CONTROL SYSTEMS
SUBWAY EMERGENCY VENTILATION SYSTEMS (LACMTA Only)
MISCELLANEOUS CATEGORIES:
AUTOMATIC ELEVATORS (PHASE I AND II) (requires a California State Conveyance License)
AUTOMATIC ELEVATORS WITNESS ONLY
AUTOMATIC CLOSING FIRE ASSEMBLIES
FIRE ESCAPE ASSEMBLIES
AS OF 1/5/2026 THE FEE IS $2274.00 PER CATEGORY (per box checked) and THE MINIMUM FEE (Change of Business) IS $382.00.
Every application issued shall become void if the examination authorized by such application has not been completed within one year of the date of issuance. Thereafter, a new application shall be submitted and new application fees shall be required. The Chief may grant extensions of time based upon presentation by the applicant of satisfactory reasons for failure to complete the examination process within the required time period.
It is recommended that an applicant apply for only one system at a time. If multiple systems are on the same application, then ALL systems applied for shall be completed within the one year timeline.
SEC. 57.117.9. CERTIFICATES OF FITNESS – FAILURE OF THE EXAMINATION.
Any applicant who takes the examination and fails may not re-apply within 30 days, and in no event shall the examination be given to the same person more than twice in any one-year period.
SEC. 57.117.10. FEES.
A.(AmendedbyOrd.No.170,954,Eff.4/16/96.)BeforeacceptinganapplicationforaCertificateofFitness requiredbythisDivision,theDepartmentshallcollectthefeesrequiredthereforeassetforthinthemostcurrentcost recoveryschedulepublishedasprovidedbySection57.114andapplicable thereto.
B.Whenever an applicant fails an examination and takes a second examination within 90 days of such failure, the fee for the second examination shall be 50 percent of the fees set forth in subsection A of this section.
* If an applicant applies for and obtains a Certificate of Fitness for “Combined Standpipe and Sprinkler System” and “Class II Standpipe System”, they will be given “Class III Standpipe Systems”at no additional charge.