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: SFD
Project's Name: Zip Code:
APT
Other
City: LA
Date Phone:
PCIS #
Property Owner Information
Name:
Phone:
Address: City:
State:
Print Name:
Signature:
Zip Code: Title:
Please Select One of the Following Options if Applicable to your Project Accessory Dwelling Unit (ADU)/Accessory Living Quarters (ALQ) Single Family Dwelling Remodel Oil Well Clearance Only - CalGEM (D.O.G.G.R.) CSWR Letter Attached Affordable Housing
Re-Stamp If the project is being resubmitted due to corrections issued by an Inspector or you have a prearranged drop off, please indicate the name of the Inspector to whom these are being submitted to. Inspector ____________ 201 N. Figueroa St. Suite 300, Los Angeles, CA 90012