City of Moorpark
Application Submittal Requirements
For Film Permit
The following list, as identified by City Staff, specifies information that is required in order
to submit a film permit application. For more information, please call (805) 517-6224.
Submittal Requirements by: ______ Date: _____ Application Reviewed by: ______ Date: _____
Community Development Department
Film Permit Requirements
Submitted
1.
Film Permit Application
Application
Insurance Requirements
Indemnification Agreement
2.
Fee (established by Resolution No. 2016-3505)
3.
Insurance Naming the City of Moorpark and its
officers, employees, servants, and agentsin the
following:
Certificate of Insurance
Endorsement
Worker Compensation (if applicable)
4.
“Permission to Use Property” Letter or Contract Lease
Agreement
5.
Site Plan showing the following:
Filming location
Base camp (if applicable)
Crew parking (if applicable)
*Submitting an incomplete application with missing information may result in delays or the denial
of processing your permit.
06/02/17
City of Moorpark Film Permit #: _________
Film Permit Application Date Submitted: ___________
(Application must be submitted at least four (4) weeks in advance for public property and/or city
right-of-away filming, and two (2) weeks in advance for private property prior to filming activity)
Production Information
Company Name: ______________________________________________________________________
Address: ____________________________________________________________________________
Unit Production Manager: _______________________ or Production Manager: ____________________
Cell Phone: _______________________________________ Office: ____________________________
Fax: ______________________________ Email: ____________________________________________
Contact Person: ________________________________ Title: _________________________________
Cell Phone: _______________________________________ Office: ____________________________
Fax: ______________________________ Email: ____________________________________________
*Please note: At least one contact person must be on site and available to City staff during the filming period.
Location Information
Production Title: ______________________________________________________________________
Type of film:
Feature
Commercial
Photo
Pilot
Movie
Indie
Webisode
Music Video
TV
Other:
___________
Filming Date(s)
Filming Time(s)
Location(s)
Prep Date(s) and Time(s): ______________________________________________________________
Filming Date(s) and Time(s): ____________________________________________________________
Hold Date(s) and Time(s): ______________________________________________________________
Strike Date(s) and Time(s): _____________________________________________________________
Street Closure
Animals
Traffic Control
Catering Truck
Sidewalk Closure
Encroachment Permit
Open Flame
Pyrotechnics
Wet down
Drones
Generators
Pedestrian Control
If YES on any of the above questions, please explain _________________________________________
___________________________________________________________________________________
Number of Vehicles/Equipment: Cars _______ Vans _______ Trucks ________ Camera Cars________
Motor Homes / Trailers ______ other (specify) ______________________________
Number of Personnel: Cast _______ Crew _______ Extras _______ Total _______
___________________ ________________________________ ___________
Print Name Signature Date
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
QUESTIONNAIRE FOR FILMING
PRODUCTION COMPANY: __________________________________
NAME OF PRODUCTION: ___________________________________
LOCATION OF FILMING: ______________________________________
DATE/S OF FILMING: _______________________________________
Fire Department Film Review Fee for Filming: $222.00
Still Photography Review Fee: $148.00
If any of the following will be present at the production site or base camp area a
Fire Code Permit and a Fire Safety Officer may be required.
Tents 401 to 1600 sq. ft. $185.00
Tents greater than 1600 sq ft $333.00
Pyrotechnics (explosives, squibs, open flame) $259.00
Additional activities:
Interior Set Construction No Yes
Construction of structures No Yes
Operation or landing of aircraft or helicopters No Yes
Stunts No Yes
The Fire Safety Officer is on production company time card and paid by the production
company.
Current rate is $48.00 an hour with an 8-hour min. Time and a half after 8 hrs and
double time after 12 hrs.
Contact Lori Ross, Filming Fire Safety Coordinator, with any questions
805-947-8535 / Lori.ross@ventura.org
Company Representative / Location Contact Name: ______________________
Contact Number: __________________________________
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