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HA WAIL FIRE DEPARTMENT Ulte <br /> FIRE PRE VENTION B UREA U P2iunent Amount <br /> HILO:25Aiipiini St.Suite 2501,Hilo,HI96.20 (808)932-2913 or(808)932-2914 RecenetlB% <br /> KO\-,4: _4 5044Ane Keohokalole Hig%Bldg E.Kaihia-Kona,HI 96-40(808)323-4-60 PennitNmnbei <br /> TENT FAIR MARKET PERMIT APPLICATION <br /> Completed application shall be submitted with payment to the Hilo or Kona fire prevention office. Payment may be <br /> cash or check. Checks shall be made out to `County Director of Finance'. <br /> (To be completed by applicant) <br /> Permit Type: ❑ Carnival or Fair nFarnrer's Market.Open Market.or Flea Market ElTent/Temporaiv Structure <br /> Tent/Temporary Structure Permit <br /> Carnival or Fair Permit$200.00 Farmer's Market,Open Market, $50.00 per tent>700sgft,tents<10' <br /> from or Flea Market$100.00 apart shall be counted as one tent. <br /> April 1 to September 30 <br /> to October 1 to March 31 from <br /> (Dates) Year to <br /> (Dates) <br /> Business/Event Name: <br /> TMK: <br /> Address/Location: <br /> Citv/State: Zip Code: <br /> Applicant: Phone: <br /> Fay: E-Mail Address: <br /> Mailing Address for Permit: <br /> *A Site Map shall be attached. Site map shall depict all structures,temporary or permanent,with dimensions. Distances to <br /> fire department eater supplies,emergency access routes,and location of fire extinguishers shall also be depicted. Nearest <br /> sheet or public way shall be included and labeled as a frame of reference. A ®symbol shall be used to depict fire <br /> extinguishers,and a label shall be included with its size and classification. <br /> (To be completed by HFD) <br /> INSPECTION <br /> Detailed Site Map Submitted ❑Yes ❑No LPG> 10'from general public ❑Yes ❑ No ❑N/A <br /> Fire Protection Equipment Satisfactory ❑Yes ❑No LPG Tanks Secured ❑Yes ❑ No ❑N/A <br /> Emergency Lighting Satisfactory ❑ Yes ❑No ❑N/A Tents Secured ❑Yes ❑ No ❑N/A <br /> Staff Proficient in Evacuation Training ❑Yes ❑No Tents>25'from Vehicles ❑Yes ❑ No ❑N/A <br /> Open flame cooking producing grease laden vapors under noncombustible roof ❑Yes ❑ No ❑N/A <br /> K Extinguisher for Deep Fat Frying<30' ❑Yes ❑No ❑N/A <br /> Emergency Exits,Egress&Access Satisfactory ❑Yes ❑No <br /> Date Extinguishers Inspected: Inspected by: <br /> Comments: <br /> APPLICANT SIGNATURE: DATE: <br /> INSPECTOR SIGNATURE: DATE: <br /> Revised 4/13/2012 <br />