Fillable Fire-marshal-special-event-application-and-permit RELATED TO TEMPORARY PUBLIC ASSEMBLY

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Fire-marshal-special-event-application-and-permit RELATED TO TEMPORARY PUBLIC ASSEMBLY

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File type: PDF

U.S.A. forms for California State University Channel Islands

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Instructions to the Applicant
1. The Facility Representative shall complete a “Special Event Application &
Permit”.
A site and floor plan must be submitted to the Office of the State Fire
Marshal for approval 10 days prior to the event. If application is not
received 10 days prior to the event the application may be denied.
At a minimum the items listed below shall be shown and identified on the plans:
1. Emergency access for fire equipment must be provided
2. Location of all grandstands, stages, tents, temporary fencing, cooking
areas, generators, vendors, etc.
3. Location of all exits, path of travel to exits, and specify all exit and exit
aisle widths
4. Location of tables and chairs and/or chair rows
5. Location of fire extinguishers and electrical panels
This event shall be conducted in accordance with the Fire and Life Safety requirements
of Title 19, Title 24, and the conditions noted on this permit. Non-compliance with
either the code requirements or the noted conditions shall be cause for denying
the application.
2. The Facility Representative shall transmit the “Special Event Application &
Permit” to the Office of the State Fire Marshal to the address listed on the
application. This may be done in any of the following methods:
a. Mailed or faxed to Sacramento Headquarters or Monrovia Regional office
or
b. E-mailed to the area Supervising DSFM as listed on the website.
Final approval of the permit may be subject to a field inspection. Stand-by personnel
may be required for the event at the discretion of the Office of the State Fire Marshal.
DEPARTMENT OF FORESTRY AND FIRE PROTECTION
Fire & Life Safety Division – South
602 E. Huntington Dr. Ste A
Monrovia, CA 91016
(626) 305-1908
(626) 305-5173 - fax
Website: www.fire.ca.gov
SPECIAL EVENT APPLICATION AND PERMIT
Facility Name ________________________________________________________________________________________
Facility Address __________________________________________________________Fax (_____) __________________
City_________________________________ Zip Code______________ County ___________________________________
Facility Representative_________________________________________________ Phone (_____) ___________________
E-Mail ______________________________________________________________________________________________
TYPE OF ACTIVITY
FESTIVAL CONCERT TRADE SHOW OTHER_______________________________________________
Event Sponsor _______ ______________________________________________________________________________
Event Location/Building _______________________________________________________________________________
Event Date(s) ________________________________________________Estimated Daily Attendance ________________
Event Time(s) Start_____________ am/pm Finish_____________ am/pm
Event Description ____________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
A site and floor plan must be submitted to the Office of the State Fire Marshal for approval 10 days prior to the event.
At a minimum the items listed below shall be shown and identified on the plans;
1. Emergency access for fire equipment must be provided
2. Location of all grandstands, stages, tents, temporary fencing, cooking areas, generators, vendors, etc.
3. Location of all exits, path of travel to exits, and specify all exit and exit aisle widths
4. Location of tables and chairs and/or chair rows
5. Location of fire extinguishers and electrical panels
Final approval of the permit may be subject to a field inspection. Stand-by personnel may be required for the
event at the discretion of the Office of the State Fire Marshal.
This event shall be conducted in accordance with the Fire and Life Safety requirements of Title 19, Title 24, and the
conditions noted on this permit. Non-compliance with either the code requirements or the noted conditions shall
validate this permit. in
********************************************************************************************************************************************
For Dept. Use Only
Comments/Conditions:_______________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
PERMIT NOT VALID UNTIL SIGNED BY DEPUTY STATE FIRE MARSHAL
DSFM Signature _______________________________Print Name______________________________ Date __________
Application
Approved Denied SFM File # _____________________________
CSU Channel Islands
1 University Dr.
Camarillo
93012
Ventura
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Fire-marshal-special-event-application-and-permit RELATED TO TEMPORARY PUBLIC ASSEMBLY

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Completed 10 February 2020

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