City of Victoria Film Permit Application Location Sheet
Template application form from the City of Victoria used as an example for View Royal's proposed permit.
FILM PERMIT APPLICATION LOCATION SHEET
This application form must be completed for any filming on City streets, in parks or in any other public space. Applicants are required to read the Permit Application guidelines and sign the statement on page 2 of this form prior to submitting the application. Completed application forms may be returned by mail, fax or email to: City of Victoria, Arts Culture & Events, #1 Centennial Square, Victoria BC, V8W 1P6 Office Location: Victoria Conference Centre, 720 Douglas St, Victoria, BC V8W 3M7 Inquiries: Phone: (250) 361-0580 Fax: (250) 361-0385 Email: dmcconachie@victoria.ca
Please fill in a separate Location Sheet for each film location applied for, or if the location is the same but has different requirements for subsequent dates. Please specify the street names involved, and attach a marked map of the location, together with a detailed layout plan showing placement of production vehicles, etc. This application form becomes an approved permit when it is returned to you signed and dated (see over page).
Applicant Organization: __________________________________________________
Contact Person: ___________________________________ Phone: _________________________
Mailing Address: ___________________________________ Cell Phone: _____________________
Fax: ________________________________________
Film Name or Client: ____________________________________________________________________
Location: ______________________________________________________________________________
Shooting Date / s: ______________________________________________________________________
Time of Shooting: a) start and finish of shoot: ___________________________________________________________ b) including set-up and clean-up: _______________________________________________________
Approximate Number of Crew and Cast: ___________________________________________________
Number of Production Vehicles and Type (eg. Cars, pick-up trucks, commercial vehicles):
Name of main liaison person and how to contact before the shoot and on-site (eg. Pager # or cell phone #). This person must have the authority to shut down the shoot in case of emergency or contravention of the permit conditions, and must carry a copy of the approved permit on his / her person throughout the filming.
City of Victoria Electrical Permit Number: ___________________________________________________ (An electrical “Entertainment Permit” is required for all filming in the City of Victoria. Please phone City of Victoria Permits and Inspections Division, 1-250-361-0343 (fax 1-250-385-1128) for electrical permit information.) PLEASE COMPLETE AND SIGN PAGE 2
REQUEST FOR SPECIFIC REQUIREMENTS / CITY SERVICES
Please detail specific production requirements, e.g. requests for site amendments, parking, City services, etc., and sign and date application below.
On behalf of the applicant organization, I acknowledge that I have read and understood the conditions contained in the Filming Permit General Conditions, and agree to comply with them and any additional conditions noted hereunder.
Signature: ___________________________________ Date: ______________________________
OFFICE USE:
- Police/Transp. Approval: ___________________________
- Proof of Insurance: _______________________________
- Deposit Received: _________________________________
- Electrical Permit: _________________________________
APPROVAL IS GRANTED SUBJECT TO THE FILMING PERMIT GENERAL CONDITIONS, AND TO THE FOLLOWING ADDITIONAL CONDITIONS AND COMMENTS.
City of Victoria: _______________________________ Date: ______________________________