F-15 PRE-INSPECTION/CONSULTATION REQUEST
LOS ANGELES FIRE DEPARTMENT Valley Public Safety Unit: lafdvpsu@lacity.org or (818) 374-1110 Schools Churches & Institutions: lafdsci@lacity.org or (213) 978-3664 TYPE OF REQUEST (New or Existing): _____________________________ TYPE OF FACILITY (ex: RCFE, ARF, Drug/Alcohol): ________________ STATUS OF CLIENTS (ex: Ambulatory, Non-Ambulatory, or Bedridden): ________________________________________________________________ TOTAL # OF CAPACITY REQUESTED: ________ 25 OR LESS CLIENTS - $1083.00 FEE
25 OR MORE CLIENTS - $1,444.00 FEE
FACILITY ADDRESS: __________________________________________________ FACILITY NAME: _____________________________________________________ FACILITY OWNER: ___________________________________________________ CONTACT PHONE NUMER: ____________________________________________ CONTACT EMAIL: ____________________________________________________ L.A.M.C. 57.4703.7.1 Preinspection. As provided by the California Health and Safety Code Section 13235, a prospective State licensee of a community care facility, as defined in Section 1502 of the California Health and Safety Code, or of a residential care facility for the elderly, as defined in Section 1569.2 of the California Health and Safety Code, may request a preinspection of the facility prior to final clearance approval in connection with the issuance of such State license. A fee equal to, but not exceeding, the actual cost of the preinspection services shall be charged for the preinspection of these facilities. Such fee shall be paid to the Department prior to the preinspection by the Department. The fee shall be established in the same manner as provided for the establishment of fees under Section 106.7.1.1. L.A.M.C. 57.4703.7.2 Final Clearance. The Department shall charge and collect a fee for the final clearance approval inspection in connection with the issuance of a State license to operate a residential care facility housing nonambulatory elderly persons. The fee shall be established in the same manner as provided for the establishment of fees under Section 106.7.1.1, but shall not exceed any fee for such inspection established by the State Fire Marshal pursuant to Section 13131.5(f) of the California Health and Safety Code
All LADBS Permits shall be approved prior to Final Inspection or Fire Clearance WILL be denied.
FOR FIRE DEPARTMENT USE ONLY
RECIEPT NUMBER #______________
Fee Received by:______________________________ Date: ______________________