Los Angeles Fire Department
FEES
APPLICATION FOR HYDRANTS AND ACCESS
(Please print legibly)
Applicant Information (expediter, designer, engineer, architect, contractor, other) Name of Company:
Phone:
Address: City:
State:
Print Name:
Signature:
Zip Code: Title:
Email Address: Email Address For Billing:
Project Information
Address: Project's Name: Zip Code:
SFD
APT
Other
City: LA
Date Phone:
PCIS #
Property Owner Information
Name:
Phone:
Address: City:
State:
Print Name:
Signature:
Zip Code: Title:
Email address for billing is the email that the invoice will be sent to for credit card payment processing It may be different than the email for the individual who is dropping off and picking up plans
PLEASE CHECK THIS BOX IF THIS PROJECT IS BEING SUBMITTED FOR A RE-STAMP.
201 N. Figueroa St. Suite 300, Los Angeles, CA 90012
03-13-2020