Fillable City of La Porte Fire Marshals Office FIREWORKS (City of La Porte)

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City of La Porte Fire Marshals Office FIREWORKS (City of La Porte)

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BROWSE CITY OF LA PORTE (TX) FORMS

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City of La Porte
Fire Marshal’s Office
FIREWORKS– SINGULAR OR MULTIPLE DISPLAY PERMIT
General Information
Type of Work (select one): SINGULAR MULTIPLE Other __________________
Facility Name:
Facility Address:
Specific location of display:
Date: Duration of display:
Person Submitting Plans:
Contact Information
Pyrotechnic operator who will supervise the display:
License number: 24-hour Emergency Contact Number:
Company performing the launching operations:
License number: 24-hour Emergency Contact Number:
Requirements
Yes No Fire watch required
Yes No Financial responsibility provided
Yes No Fall-out area clear of combustibles
Yes No List of fireworks to be displayed (number, size, division)
Yes No Fire extinguishers and fire hoses (where provided) are operable and available
Yes No Statement of maximum weight of fireworks to be on site at anytime
Yes No Site plan showing location and distance to vehicle parking, street, audience, lot lines,
buildings overhead obstructions and site security.
Yes No Copy of DOT transportation license, if applicable.
Yes No Copy of ATF license, if applicable.
Yes No Other -
Yes No Other -
Yes No Other -
THE AUTHORITY HAVING JURISDICTION MAY REQUIRE STANDBY FIREMEN OR
EQUIPMENT DURING ANY OR ALL OF THE ABOVE FUNCTIONS. ALL REQUIRED FEES
SHALL BE PAID PRIOR TO THE COMMENCEMENT OF THE FUNCTIONS
Certification
This document is a governmental record. Individuals who knowingly make a false entry in, or false alteration
of, a governmental record are subject to criminal prosecution under Section 37.10 of the Penal Code, Vernon’s
Texas Code Annotated.
I hereby certify that I have read and examined this application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work will be complied with whether specified or not.
The granting of a permit does not presume to violate or cancel the provisions of any other state of local law
regulating constitution or the performance of construction. I also understand that the installation of any of the
work related to this permit application shall not proceed until approved plans are issued from the City of La
Porte.
Signature: Date:
Print Name:
FIRE MARSHAL’S OFFICE USE ONLY
Date of Review: ____________________ Reviewed By: ______________________________________
Approved: Yes No
Require Follow-up: Yes No Explain:__________________________________________________
Fee’s Due: Yes No
Amount Paid: ___________________
Date Paid: ____________________
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City of La Porte Fire Marshals Office FIREWORKS (City of La Porte)

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Completed 23 January 2021

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