Public Assemblage: Application for Specific Action Permit

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ANGELES FIRE DEPARTMENT Bureau of Fire Prevention & Public Safety PUBLIC ASSEMBLAGE UNIT 200 N. Main Street, Suite 1700 Los Angeles, CA 90012 (213) 978-3650 6262 Van Nuys Boulevard, Room 451 Los Angeles, CA 91401 (818) 374-1110
FOR SPECIFIC ACTION PERMIT LOCATION INFORMATION Address Date(s) of Use FIRE DEPARTMENT USE ONLY Date Granted Permit # Date Expired Name Phone City State Zip Code CONTRACTOR INFORMATION Name Phone Address City State Zip Code Print Name Signature Title PROPERTY OWNER / SPONSORING ORGANIZATION Name Phone Address City State Zip Code Print Name Signature Title *Do not write below this line* Inspector Signature FIRE MARSHAL Permit will not be valid unless signed by Fire Marshal. Date Unit Public Assemblage EMS & Receipts Unit 200 N. Main, City Hall East 16th Floor, Room #1620 HOURS 7:30AM – 4:30PM Monday through Friday Phone ITEM CODE QTY FEE Fireworks – Ground Display 3888238 $542.00 Fireworks – Aerial Burst (Not over 6”) 3888239 $722.00 Fireworks – Aerial Burst (Over 6”) 3888240 $1,444.00 Exhibit, Shows, Circus or Carnival 3888242 $1,083.00 Tent – 401 to 3,450 Sq Ft (Enclosed) 3888243 $722.00 Tent – 3,501 to 25,000 Sq Ft 3888244 $1,444.00 Tent – Over 25,000 Sq Ft 3888245 $2,888.00 Farmers Market 3888257 $624.00 Operate or Maintain Live Theater < 99 3888253 $722.00 Operate or Maintain Live Theater > 99 3888254 $1,444.00 TOTAL FEES **EFFECTIVE 10-10-23
LOS
APPLICATION

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