Los Angeles Fire Department
FEES
APPLICATION FOR HYDRANTS AND ACCESS (Please print legibly)
Person filling out this form information
(expediter, designer, engineer, architect, contractor, other)
Name of Company:
Phone:
Address: City:
State:
Print Name:
Signature:
Zip Code: Title:
Email Address:
LOCATION INFORMATION Address: Project's Name: Zip Code:
Date SFD PCIS #
APT Tract #
Other
City: LA
Phone:
Parcel Map #
PROPERTY OWNER / SPONSORING ORGANIZATION Name:
Phone:
Address: City:
Print Name:
State:
Signature:
Zip Code:
Title:
201 N. Figueroa St. Suite 300, Los Angeles, CA 90012
03-13-2020