Los Angeles Fire Department
FEES
APPLICATION FOR HYDRANTS AND ACCESS
(Please print legibly)
Person filling out this form 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:
LOCATION INFORMATION Address: Project's Name: Zip Code:
Date SFD PCIS #
APT Tract #
Other
City: LA
Phone:
Parcel Map #
PROPERTY OWNER / SPONSORING ORGANIZATION Name:
Phone:
Address: City: Print Name:
State: 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
201 N. Figueroa St. Suite 300, Los Angeles, CA 90012
03-13-2020