PHOTOGRAPHY FILMING APPLICATION
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COUNTY OF PLACER PHOTOGRAPHY/FILMING PERMIT APPLICATION
OFFICE OF ECONOMIC DEVELOPMENT
175 FULWEILER AVENUE, AUBURN, CA 95603-4543
TEL: (530) 889-4091 FAX: (530) 889-4095 |
General Information
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| Date |
Permit No. |
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Production Company |
Location Manager |
| Address |
Production Manager |
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Producer |
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Phone |
Director |
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Fax |
Production Title |
| Specific Filming Information Prep, Film. & Strike* |
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Date (s) |
Times |
Location Address & Activity Be specific: ie, stunts,
dialog, stills, int or exteriors, base camp, etc.
Must specify if stunts or pyrotechnics are planned.
Attach additional pages if necessary. |
P/F/S* |
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Vehicles/Equipment |
Generators |
Cars |
Trucks |
RVs |
Aircraft |
Other |
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Total # |
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PYROTECHNICS: Special Effects Permit #:
Pyrotechnician: License No:
CHILDREN: ANIMALS:
THIS PERMIT IS VALID: From: To:
(Film Office will complete dates)
Permit must be on site at time of activity.
SIGNATURES: Hard Copy (please fax) or Electronic (please mail):
Production Company Representative:_________________________________________________
Original signature required and will be on file at ECD Office Date
County Representative:_________________________________________________________
David C. Snyder, Director of Economic Development Date
Placer Co. Film Permit No.
APPROVALS:
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AGENCY |
TITLE/NAME |
FAX NUMBER |
DATE |
REQUIRED (Film Office will contact) |
Film Office will determine |
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Insurance Company |
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X |
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County Sheriff |
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X |
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Fire Dept(s): |
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X |
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County Facilities |
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X |
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County Public Works |
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X |
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County Planning |
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X |
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Film Safety Officer |
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X |
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CHP |
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X |
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Other |
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X |
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Other Permits: |
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X |
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GENERAL PROVISIONS:
1. The Permittee shall indemnify and hold harmless the County, its officers, officials, agents, employees and volunteers, from and against any and all claims, suits, proceedings, costs, expenses (including reasonable attorney’s fees), damages and liabilities claimed by any person, organization, association or otherwise arising out of or relating to any act or omission of the Permittee, its agents, contractors or employees under this Agreement. Such indemnification shall not be effective to the extent that the damage or injury results from the sole negligence of the County. The indemnification provided for in this permit shall survive any termination of this Agreement.
2. The Permittee has read, understood and agrees to comply with all County Regulations and Procedures (including Bridge Regulations if applicable) as regards filming production activity under this permit.
3. Permit is not valid without signatures, approvals.
4. Permittee is responsible for obtaining all pertinent permissions and permits for production activities in Placer County.
5. Permit must be physically on location during production activity.
6. Certificate of Insurance must be on file with County prior to permit approval.
SPECIAL PROVISIONS (County will make this determination):
Yes _____ (if "yes" see attached pages for details)
No _____