fv West Windsor Township Fire & Emergency Services · OFU'fv West Windsor Township Fire & Emergency...
Transcript of fv West Windsor Township Fire & Emergency Services · OFU'fv West Windsor Township Fire & Emergency...
OFU'fv West Windsor TownshipFire & Emergency Services
I, P. O. Box 38
West Windsor, NJ 08550
Phone 609-799- 8735 Fax 609- 799- 8926
FIRE SAFETY PERMIT APPLICATION
APPLICANT INFORMATION (INCLUDE BUSINESS NAME AND ADDRESS):
PHONE NUMBER:
ACTIVITY BEING CONDUCTED (IF cooking— include type(s) of appliance cooking with)
EXACT LOCATION OF ACTIVITY( INCLUDE NAME OF EVENT OR FESTIVAL IF APPLICABLE):
DATES AND TIME DURATION ACTIVITY WILL OCCUR:
RESPONSIBLE PARTY NAME & CONTACT INFORMATION:
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATIONPROVIDED IS CORRECT, AND THAT I AM THE OWNER OR DULY AUTHORIZED TO ACT IN THE
OWNER' S BEHALF AND AS SUCH HEREBY AGREE TO COMPLY WITH THE APPLICABLE
REQUIREMENTS OF THE FIRE CODE AS WELL AS ANY SPECIFIC CONDITIONS, LIMITATIONSAND/OR SPECIAL INSTRUCTIONS IMPOSED BY WEST WINDSOR TOWNSHIP OR THE FIRE
OFFICIAL.
SIGNATURE TITLE DATE
Any permit application that is received late (seven ( 7) days or less prior to the event), thePERM/TFEEW/LL DOUBLE
THIS SECTION FOR DIVISION USE ONLY
FIRE SAFETY PERMIT 0:
DEP PERMIT FIRE RETARDANT CERTIFICATION
UCC APPROVAL CERTIFICATE OF INSURANCE
FEE CHECK NUMBER
Permit Fees: Type I=$65.00 Type II=$250.00 Type III=$475.00 Type IV=$625.00