| * Required Fields |
| |
Today's Date:*
|
| |
Event Date:*
|
|
| |
| EVENT HOST/ORGANIZATION INFORMATION |
Event Host/Organization Name:*
|
Email:*
|
Phone:*
|
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 below) with an additional base cost of $85.00) |
| Flame retardant required?*
|
Candles ($85.00):*
Fire Code Permit Required
|
| Floral Arrangements:
|
| Displays:
|
Vehicle Display ($85.00):*
Fire Code Permit Required
|
Drapery/Hanging Decorations ($85.00):*
Fire Code Permit Required
|
BBQ ($85.00):*
Fire Code Permit Required
|
Special Effects ($85.00):*
Fire Code Permit Required
|
Other ($85.00):*
Fire Code Permit Required
|
LPG Gas Appliance/Heaters ($6.00/per):*
Fire Code Permit Required
|
** 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)
|
| |
| 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 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:*
|
