COUNTY OF PLACER
PHOTOGRAPHY/FILMING PERMIT
OFFICE OF ECONOMIC DEVELOPMENT
175 FULWEILER AVENUE, AUBURN, CA 95603-4543
TEL: (530) 889-4091 FAX: (530) 889-4095
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General Information
Date |
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Permit No. |
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Production Company |
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Location Manager |
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Address |
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Production Manager |
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Producer |
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Phone |
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Director |
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Fax |
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Production Title |
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Specific Filming Information Prep, Film. & Strike*
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Date (s) |
Times |
Location Address & Activity (be specific: ie, stunt fall from roof, still, house interiors) Attach additional pages if necessary. Must specify if stunts or pyrotechnics are planned. |
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:
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. 07-0
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 |