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Public Assemblage: Application for Specific Action Permit

Page 1

F-280

LOS ANGELES FIRE DEPARTMENT Bureau of Fire Prevention & Public Safety 200 N. Main Street, Suite 1710 Los Angeles, CA 90012 (213) 978-3670

Subject line of the email shall be formatted as follows: [ITEM] [1ST Date of Activity] - [Street Address of Activity Location] * EXAMPLE: TENT 10/21/15 - 200 N Main St * Make checks payable to: “City of Los Angeles”

APPLICATION FOR SPECIFIC ACTION OR PROJECT 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 Inspector Signature

this line* Date

Unit Phone

PAU (213) 978-3650

ITEM

CODE

Fireworks – Ground Display

388238

$569.00

Fireworks – Aerial Burst Mortars (Under 6")

388239

$758.00

Fireworks – Aerial Burst Mortars (Over 6")

388240

$1,516.00

Exhibit, Show or Circus

388242

$1,146.00

Tent – 401 to 3,500 Sq Ft

388243

$758.00

Tent – 3,501 to 25,000 Sq Ft

388244

$1,516.00

Tent – Over 25,000 Sq Ft

388245

$3,032.00

Farmers Market 1 Year

388257

$624.00

Live Theater Less Than 30 days < 99 SEATS

388253

$758.00

Live Theater More Than 30 Days > 99 SEATS

388254

$1,516.00

TOTAL FEES

QTY

FEE

FIRE MARSHAL

Permit will not be valid unless signed by Fire Marshal. EMS & Receipts Unit 200 N. Main, City Hall East Suite #1620 (Rev. Code #3882) HOURS 7:30AM – 3:00PM Monday through Thursday

EFFECTIVE Jan 05, 2026


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