Fillable 10486 SAMPLE FORM: INSPECTION RECORD MEMORANDUM—IBC 109

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10486 SAMPLE FORM: INSPECTION RECORD MEMORANDUM—IBC 109

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Town of Fort Myers Beach
T
EMPORARY USE APPLICATION
LDC Sec. 34-3050
Revised 1/6/2017 Town of Fort Myers Beach Page 1 of 3
2525 Estero Blvd., Fort Myers Beach, Florida 33931
Phone: 239-765-0202 Permits@FortMyersBeachFL.gov Fax: 239-765-0909
Property Address:
Property Owner’s Name: Strap Number:
Applicant: Contact Person:
Phone Number: Email:
Description of Temporary Use (please be specific):
Date(s) Requested: thru Hours to
Number of Tents: Sq. Ft. Per Tent: Tent Side Walls: Yes No
Temporary Lighting: Yes No Temporary Electric: Yes No Amps
ADDITIONAL INFORMATION / SUBMITTAL REQUIREMENTS
A. Application fee $150.
B. Notarized letter from property owner giving permission for use of property (not required for construction
Office/Shed).
C. Two site plans indicating available parking, loading space, existing structures and location of equipment,
restroom facilities, etc.
D. Evidence that adequate sanitary facilities meeting the requirements of Lee County Health Department are
provided (Port-o-let contract or letter from neighboring business stating that restroom facilities are for their use
and that hours of operation are compatible).
E. Evidence that sounds emanating from the temporary use shall not adversely affect any surrounding property,
per Noise Control Ordinance No. 15-01.
F. Evidence of public liability insurance and property damage insurance.
G. Where applicable, evidence that the applicant for a proposed use has complied with Town ordinances pertaining
to Special Events LDC Section 22, Ordinance No.12-04.
H. Evidence that the appropriate law enforcement and fire agencies that will be coordinating traffic control or
emergency services have been advised of the plans for the temporary use and are satisfied with all aspects
under their jurisdiction.
I. If tent is 2,500 sq. ft. and over, plans will need to be reviewed by Plan Review ($50 review fee).
J. Two copies of the flame retardant certificates are required for each tent (if applicable).
K. Temporary use applications for events between May 1
st
and October 31
st
will need to be reviewed by
Environmental Sciences for compliance with LDC Section 14-11. ($25 review fee).
L. Temporary electric and lighting requires separate electrical trade permit application and inspection. ($104 fee)
The undersigned applicant agrees to comply with the Town of Fort Myers Beach Land Development Code and any
other applicable codes and certifies that to the best of his/her knowledge, the information submitted for the
temporary permit is true and correct.
Signature (owner/authorized agent)
Typed or printed name Date
Official Use Only:
Permit # TMP
Zone
click to sign
signature
click to edit
Town of Fort Myers Beach
T
EMPORARY USE APPLICATION
Town of Fort Myers Beach
2525 Estero Blvd Fort Myers Beach, Florida 33931
Phone: 239-765-0202 Fax: 239-765-0909
permits@fortmyersbeachfl.gov
AFFIDAVIT FOR OVER THE COUNTER TENT PERMITS
I hereby affirm that the following criteria will be met for the tents to be erected at:
(Address)
For for the purpose of
(Business Name) (Event)
• Tent is under 2,500 square feet and does not have side walls
• Tents will not be used for a place of assembly (more than fifty people), kitchen or mess hall
• Tents will not block any driveway, fire hydrant or fire access to any building
• Tents will be at least twelve feet from all property lines and have an unobstructed passage-way or fire
road not less than twelve feet wide and free from guy ropes or other obstructions on all sides of tent
• “NO SMOKING” signs will be placed approximately every twenty feet around perimeter of tent
• One classification type 2A fire extinguisher will be provided in every tent having a floor area of more
than five hundred square feet but less than one thousand square feet, and also one in each auxiliary
tent adjacent thereto. Two classification type 2A fire extinguishers will be provided for each tent from
1,000 to 2,500 square feet.
• NOTE: At a minimum, all tents displaying or selling any sparklers shall have at least on 10 LB 4A-60BC
Fire Extinguisher per NFPA-a Chapter 16.
• Tents that will be occupied after sunset will have lights and emergency lighting.
• Flame resistance certificates will be on the job site for inspection.
• All other applicable requirements of N.F.P.A. 102 will be complied with.
I understand that it is the responsibility of the permit holder to call the Inspections Office for inspection
request and the Fort Myers Fire Prevention Department to receive final fire inspection prior to using the tent.
Under penalties of perjury, I declare that I have read the foregoing Affidavit and that the facts stated in it
are true.
Signature (owner/authorized agent)
Typed or printed name Date
Official Use Only:
Permit #
Zone
click to sign
signature
click to edit
Town of Fort Myers Beach
2525 Estero Boulevard Fort Myers Beach, Florida 33931
Telephone: 239-765-0202 Fax 239-765-0909
Permits@FortMyersBeachFL.gov
BUILDING AND FIRE MARSHALL CODES FOR TEMPORARY PERMIT
Permit Required
No person may erect, operate, or maintain a tent or air supported structure covering an area in excess of one hundred
twenty (120) square feet without a permit. Tents used exclusively for camping are exempt from the above requirement.
Place of Assemblage
A place of assemblage includes any circus, carnival, tent show, theater, skating rink, dance hall or other place of
assemblage in or under which persons may gather for any purpose.
Location of Tents and Air Supported Structures
1. A tent or air supported structure must be located from any property line or permanent structure so as to be
readily accessible by fire equipment.
2. Tents or air supported structures having an area of fifteen thousand (15,000) sq. ft. or more must be located not
less than fifty (50) feet from any other tent or structure as measured from the side wall of the tent unless joined
together by a corridor.
3. Tents and air supported structures may be joined together by means of corridors, but such corridors must be
open to the sky. On each side of such corridor and approximately opposite each other, there must be provided
openings not less than twelve (12) feet in width. These openings must be equipped with sliding curtains.
4. An unobstructed passageway or fire road not less than twelve (12) feet in width and free from guy ropes or
other obstructions must be maintained on all sides of all tents or air supported structures unless otherwise
approved by the fire authority having jurisdiction.
Structural Stability
Tents or air supported structures and their appurtenances must be adequately roped, braced and anchored to withstand
the elements of weather against collapsing.
Flame-Retardant Treatment
The side wall, drops and top of all tents and air supported structures and all decorations must be of flame-retardant
material or must be made fire retardant.
An affidavit or affirmation must be retained on the premises at which the tent or air supported structure is located,
attesting to the following information relative to the flame retardant treatment of the fabrics:
1. Date the fabric was last treated with flame-retardant solution.
2. Trade name or kind of chemical used in treatment.
3. The name or person or firm treating the material.
4. The name and address of the owners of the tent.
Fire-Safety Standards
1. Smoking must not be permitted in any tent or air supported structure. Approved “NO SMOKING” signs must be
conspicuously posted.
2. No fireworks, open flame or other device emitting flame or fire may be used in or immediately adjacent to any
tent or air supported structure while open to the public.
Fire Extinguishers and Other Fire Protection Equipment
Fire extinguishers and other fire protection equipment must be provided in every tent or air supported structure as
follows:
1. One 2-A type extinguisher must be provided in every tent or air supported structure having a floor area of more
than five hundred (500) square feet but less than one thousand (1000) square feet and also one in each auxiliary
tent or air supported structure adjacent thereto.
2. One additional 2-A type extinguisher must be provided for each additional two thousand (2000) square feet or
fraction thereof.
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10486 SAMPLE FORM: INSPECTION RECORD MEMORANDUMIBC 109

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Completed 12 July 2020

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