Fireworks & Explosives (Pyrotechnics) Retail Sale Permit Application

First Name *

Last Name *

Phone *

Email *

Business Name *

Business Address *

City *

State *
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Zip *

Location of Stand *

Date/Time of Setup *

Name of Pyrotechnics Company *

Name of Insurance Company *

 

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List of all Safety Equipment that will be present at time of activity: *

Please provide a diagram of where the merchandise will be sold in the business as well as what merchandise will be located near the display(s). All flame producing devices such as lighters, matches etc. shall be separate from pyrotechnics displays.
Upon approval of the pyrotechnics permit application, a placard will be issued and MUST be displayed in plain view to the public at the stand. A site inspection will be performed by the Fire Prevention Division.
I hereby certify that I am the owner or authorized agent for the above-mentioned property listed for a pyrotechnics event. All pyrotechnics will be in accordance with Chapter 33, Explosives and Fireworks, exclusively sections 3301.2.3 and 3301.2.4.2 of the International Fire Code.
Applicant Signature: