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Community Risk Reduction Online Forms FPB 10 Public Assembly Application


Beverly Hills Fire Department - Fire Prevention Bureau
Telephone: (310) 281-2703; firepermits@beverlyhills.org
FPB 10 - Public Assembly Application

Public Assembly Permit Cost: $68.00

* Required Fields
Today's Date:*
Event Date:*
ORGANIZATION INFORMATION
Organization Name:*
Email:*
Address:*
City:*
State:*
Zip:*
EVENT PLANNER/COORDINATOR
Name:*
Title:*
Email:*
Phone Number:*
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*
Anticipated Occupancy Load:
Guests*

Event Staff

Hotel/Venue Staff

Technical Staff

Security

Disability Needs
Description of Event:*
(e.g: luncheon, award show, etc.)

Start Time:*
End Time:*
Timeline if available:*


Gift Bag Giveaway:*


Greenroom/Backstage:*


**Hazer/Smoke Effect:*


Pre/Post Screening Rooms:*


**Pyrotechnics:*


Stunt/Special Effect:*


Valet Parking:*


**Fire Permit and Fire Safety Officer Required
FLOOR PLAN(s) displaying the following:*
(Aisles, Seating Arrangements, and Location of Exits are required)





















Please upload the floor plan(s) referenced above (at least one upload required):*
SECURITY


Security Needed For:






FIRE CODE PERMITS
(Please note that certain items require a Fire Code permit (identified at right)with an additional base cost of $68, plus $33 for each item)
Flame retardant required?*


Candles ($33.00):*
Fire Code Permit Required


Floral Arrangements:


Displays:


Vehicle Display ($33.00):*
Fire Code Permit Required


Decorations/Drapery ($33.00):*
Fire Code Permit Required


BBQ ($33.00):*
Fire Code Permit Required


Special Effects ($33.00):*
Fire Code Permit Required


Other ($33.00):*
Fire Code Permit Required


LPG Gas Appliance/Heaters ($6.00/per):*
Fire Code Permit Required


If fire code permit required, please provide description(e.g. 5 votives/table, 30 tables total):*
(If not applicable, type N/A)
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


ELECTRICAL NEEDS*


Generator(s):*
*FSO may be required


Cable(s):*







Alterations to Electrical Panel:*


EXITS COMPROMISED*


Minimum 12 ft. fire lane must be maintained at all times
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
I hereby acknowledge receipt of Fire Prevention Bureau Form #10 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 form must be submitted along with a layout of the event.*

Name of Applicant:*
Date:*