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HA WAIL FIRE DEPARTMENT Dltz <br /> FIRE PREVENTIONBUREAU P2iunmirAi��°�uir $290.00 <br /> HILO:25Aitpitni St Suite 2501,Hilo,HI9h720 (808)932-2913 or(808)932-2914 <br /> KOl:4: -4 5044Ane Keohokalole Hig%Bldg E.Kafhta-Kona,HI 96-40(808)323-4-00 Permit Ntunber <br /> For Fire D"J"rt]nt U <br /> FLAMMABLE FINTWES 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 /> Business Name: TMK: <br /> Address: <br /> City/State: Zip Code: <br /> Applicant: Phone: <br /> Fax: E-Mail Address: <br /> Mailing Address for Permit: <br /> (To be completed by HFD) <br /> INSPECTION <br /> Inspection Type: ❑Initial ❑Annual Over spray confined to Booth/Room ❑Yes ❑ No <br /> Spray Booth/Room separated by 3' clearance or partitions of lhr construction(Sec. 43.1.3.3) ❑ Yes ❑ No <br /> Open flame or spark producing devices are not in use within 20' of spray areas(Sec. 43.1.4.1.5) ❑ Yes ❑ No <br /> Smoking is prohibited and`No Smoking" signs are conspicuously posted. ❑ Yes ❑ No <br /> Approved waste collection cans are supplied for spray impregnated rags ❑ Yes ❑ No ❑N/A <br /> Mechanical ventilation satisfactoq ❑ Yes ❑ No Filters Clean ❑ Yes ❑ No <br /> Exhaust ducts vent to exterior ❑ Yes ❑ No <br /> Electrical wiring approved for spray finishing applications ❑ Yes ❑ No <br /> Exit(s) Satisfactory ❑ Yes ❑No Emergency Lighting Satisfactory ❑ Yes ❑ No ❑N/A <br /> Minimum 4A:40BC Extinguisher Within 30'of spray finishing application ❑ Yes ❑ No <br /> Date portable fire extinguishers inspected: Inspected by: <br /> Spray Booth/Room protected by an approved automatic fire extinguishing system ❑ Yes ❑ No <br /> Automatic sprinkler heads are protected from overspray ❑ Yes ❑ No ❑N/A <br /> Fire Sprinkler System Satisfactoq ❑ Yes ❑ No Date Fire Sprinklers Inspected: <br /> Inspected by: Documentation maintained on site ❑ Yes ❑No <br /> Comments: <br /> APPLICANT SIGNATURE: DATE: <br /> INSPECTOR SIGNATURE: DATE: <br /> Revised 4/13/2012 <br />