* Required Fields |
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Today's Date:* |
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Event Date:* |
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EVENT HOST/ORGANIZATION INFORMATION |
Event Host/Organization Name:* |
Email:* |
Phone:* |
Address:* |
City:* |
State:* |
Zip:* |
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EVENT PLANNER/COORDINATOR |
Name:* |
Title:* |
Email:* |
Phone Number:* |
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BILLING INFORMATION (Provide information for the responsible billing party for this event) Should your event require fire safety officer (FSO), an invoice will be sent after the event to the organization listed below. Current rate for FSO is $175 per hour with a four hour minimum. |
Name of Responsible Billing Party: |
Email |
Address |
Phone |
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EVENT INFORMATION |
Event Name:* |
Venue Name:* |
Venue Address:* |
Venue City:* |
Venue State:* |
Venue Zip:* |
Specific Room Within Venue/Hotel:* |
Hotel Contact/Representative:* |
Posted Occupancy for Room: (If not applicable, type N/A)
Dining*
Reception*
Theater*
Classroom*
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Anticipated Occupancy Load:
Guests*
Event Staff
Hotel/Venue Staff
Technical Staff
Security
Disability Needs
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Description of Event:* (e.g: luncheon, award show, etc.) |
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Start Time:* |
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End Time:* |
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Timeline if available:*
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Gift Bag Giveaway:*
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Greenroom/Backstage:*
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**Hazer/Smoke Effect:*
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Pre/Post Screening Rooms:*
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**Pyrotechnics:*
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Stunt/Special Effect:*
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Valet Parking:*
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**Fire Permit and Fire Safety Officer Required |
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FLOOR PLAN(s) displaying the following:* (Aisles, Seating Arrangements, and Location of Exits are required)
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Please upload the floor plan(s) referenced above (at least one upload required):*
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SECURITY
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Security Needed For:
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FIRE CODE PERMITS |
(Please note that certain items require a Fire Code permit (identified below) with an additional base cost of $85.00) |
Flame retardant required?*
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Candles ($85.00):* Fire Code Permit Required
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Floral Arrangements:
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Displays:
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Vehicle Display ($85.00):* Fire Code Permit Required
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Drapery/Hanging Decorations ($85.00):* Fire Code Permit Required
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BBQ ($85.00):* Fire Code Permit Required
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Special Effects ($85.00):* Fire Code Permit Required
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Other ($85.00):* Fire Code Permit Required
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LPG Gas Appliance/Heaters ($6.00/per):* Fire Code Permit Required
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** If you answered 'Yes' to any items above, please complete a Fire Code Application. If fire code permit required, please provide description (e.g. 5 votives/table, 30 tables total):* (If not applicable, type N/A) |
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TENT/CANOPY PERMITS |
(Please note that the use of tents and canopies requires a Tents/Canopies Permit Application form to be completed; Additional fees will apply.) |
Tents and/or Canopies Installed?* Tents/Canopies Permit Required
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ELECTRICAL NEEDS*
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Generator(s):* *FSO may be required
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Cable(s):*
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Alterations to Electrical Panel:*
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EXITS COMPROMISED*
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Minimum 12 ft. fire lane must be maintained at all times |
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Payment Methods: Cash, Check or Credit Card Payable to "City of Beverly Hills" Check payments shall be made at City Hall cashier Please do not mail checks to the Fire Department |
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I hereby acknowledge submission of Place of Assembly Application in connection with this public assembly event and will obtain and complete all required permits. I also acknowledge that this application must be submitted 10 business days prior to the event. This application must be submitted along with a layout of the event.* |
Name of Applicant:* |
Date:* |