Maricopa County Environmental Services Department
Environmental Health Division
Phone: (602)506-6824
Esplanreview@mail.maricopa.gov
FOOD ESTABLISHMENT PERMIT APPLICATION
Follow all instructions below to avoid delays in the application review process.
For office locations please visit: http://www.maricopa.gov/2505/Locations-Hours
If you are visiting one of our regional offices, we recommend that you call the office first to ensure the office is open so as to better serve your needs.
Checklist for construction/review
Complete Application (please indicate n/a, if not applicable rather than leaving empty boxes on the application)
Plan Review application fees (see table on page 6)
Proposed menu(s) with consumer advisory (if applicable)
Complete set of plans (refer to Construction Guide for guidance)
Plumbing and Finish schedule (if not already indicated in the plan otherwise, see plumbing schedule on page 4)
Plans are to be full size, printed to scale as indicated on plan/drawing, and legible. Plans shall be a minimum of 8.5"x11".
All equipment is clearly labeled
Plans contain all lighting, ventilation, plumbing layout, and locations of sinks and equipment.
Cut sheets/schematics of all equipment to be installed. This includes any custom built equipment.
Application Steps
1. Fill out and submit your application
2. Our office will review, assess the required application fees, and send you your confirmation
3. Pay application fees (via online, in person, over the phone, fax, or by mail)
***Note: Annual permit fees are assessed once the establishment qualifies for a permit.
For fee schedule, visit: http://www.maricopa.gov/DocumentCenter/Home/View/5500
Make checks payable to MCESD. We also accept Visa, Mastercard, American Express and Discover.
If submitting application electronically, payment can be made via online service once the application is accepted
and reviewed .
Fees are non-refundable.
Complete Application (please indicate n/a, if not applicable rather than leaving empty boxes on the application)
Application fees (see table below)
Proposed Menu(s) with consumer advisory (if applicable)
Checklist for no new construction (new owner of permitted establishment)
Shared Restroom/Mop sink agreement (if applicable)
Shared Restroom/Mop sink agreement (if applicable)
Pg. 1
Site plan showing restrooms, mop basin, alleys, streets, vacant lots, adjacent buildings, and outside equipment (dumpsters,
well, septic, etc.)
Food Establishment Permit Application
Business Fax:Business Phone:
City: State: Zip:
Business Address:
Business Name:
BUSINESS INFORMATION (Name on Establishment)
BUSINESS OWNERSHIP INFORMATION (Responsible Party)
Entity Type:
Sole proprietor (Must Show Lawful Presence) Corporation Association Other
Owner/Corporation:
Owner Address:
City: State: Zip:
Owner Phone: Owner Fax: Email:
MAILING/BILLING INFORMATION
Owner/Corporation:
Owner Address:
City: State: Zip:
Owner Phone: Owner Fax: Email:
City:
INSPECTION or PLAN REVIEW RESPONSE CONTACT
Name:
Address:
Pg. 2
Email:Phone: Fax:
Email
Best Method of Contact:
U.S Mail Fax
Zip:State:
Pg. 3
Menu/Operation information
General Information
Hours of Operation:
Type of Sewer Provider: Name of Sewer Provider:
Water Heater Capacity (ga.):
Name of Water Provider:Type of Water Service:
Taking ownership of an existing/previously permitted establishment or sharing
space/adding an additional permit in an existing permitted establishment.
Ownership change/occupancy date:
Major Construction/Major Remodel
Start Date: End Date:
Minor Review (e.g. outdoor food service, new hood install, restroom
remodel, new beverage station w/ counters, new custom equipment, etc.)
Start Date: End Date:
Permit Questionnaire (Check all that apply)
Name:
Email:
Phone:
Operation Categories (please check all that apply)
Restaurant Full Service Restaurant Quick Service Convenience Store Hotel/Resort Food Serivce Retail - Grocery Store/Market School Food Service Institutional Food Service other
CONTRACTOR CONTACT INFORMATION (IF APPLICABLE)
ARCHITECT CONTACT INFORMATION (IF APPLICABLE)
Name:
Email:
Phone:
Recovery Rate (ga./hr):
Menu/Cuisine Type
Seating Capacity
Type of Service
For information on demolition or removing/altering of a load bearing wall: https://www.maricopa.gov/1701/Asbestos
Note: Depending on extent of minor review/remodel (e.g. multiple areas impacted or phased installation, etc.), then you may be assessed a fee for a major
remodel.
Total Square Footage of Facility
Finish/ Plumbing Schedule
Check where
appropriate
Indirect
Drain
Direct
Drain
Hand Wash Sink
3-Compartment Sink
Food Prep Sink
Automatic Dishwasher
Ice Machine(s)
Condensation Line(s)
Steam Table(s)
Dipper Well(s)
Beverage Station(s)
Garbage Disposal(s)
Indicate type of finish (e.g
tile, drywall etc...)
Floors Walls Ceiling Cove Base
Kitchen/Bar/Food
Storage
Restrooms
Mop Sink/Can Wash
Area
Walk-in Freezer/
Refrigerator
Area Under Vent
Hood(s)
Outdoor Dumpster/
Grease
Ware Washing
Other:
Write "n/a" if not applicable.
Pg. 4
Are you planning on having continuous openings/garage/roller doors off the dining room or bar area to the exterior?
Yes
Number of floors on which operations are conducted?
Are you also applying for a Dog Friendly Patio?
Yes
*Any construction or minor review will require a set of plans to be submitted with this application (See checklist for details).
No
No
If yes, please submit a dog friendly patio application.
Are you also planning on conducting Outdoor Food Operations?
Yes No
An additional review/remodel charge may also apply.
Permit Questionnaire (continued)
NoYes
Drive thru window?
Brief Description
of Project
(please be as
detailed as
possible to
convey to the
reviewer what
will be taking
place at the
establishment)
Pg. 5
No persons shall commence construction unless the required plans have been approved. It shall be the full responsibility of
said person that construction is done in conformance with the approved plans and specifications.
The approval of plans and specifications shall lapse and become invalid one year from the date of approval unless a substantial portion of the work
described in the plans and specifications has commenced by such anniversary date. An approval of plans and specifications can be renewed for one
year if an application for renewal is submitted within 180 days prior to expiration and a fee equal to one-half (1/2) of the flat fee or initial plan
review fee is paid. The approval will be effective for one year from the date of expiration.
Should it be necessary or desirable to make any material change in the approved plans and specifications, revised plans and specifications shall be
submitted to the department for review, and approval shall be obtained before the work affected by the change is undertaken. Once submitted, the
plans will be review for compliance with the Maricopa County Environmental Health code (MCEHC). A response letter will be drafted and delivered
to the applicant using the method indicated on the application. The letter will indicate items of noncompliance that need to be addressed during the
construction of the establishment
Approval of these plans and specifications by this Regulatory Authority does not indicate compliance with any other code, law or regulation that may
be required--federal, state, or local. It further does not constitute endorsement or acceptance of the completed establishment (structure or
equipment). A pre-opening inspection and final inspection of the establishment with equipment in place and operating will be necessary to
determine if it complies with the Maricopa County Environmental Health Code governing establishments.
Approval of a permit by this Department does not indicate compliance with any other code, law, or regulation that may be required - federal, state, or
local. In order to ensure compliance with local mechanical and building codes, obtain a Certificate-of- Occupancy “C-of-O” from the local municipality
or “Green Tag” from the local fire department, if required.
A “grandfather” clause or provision is not provided for in Maricopa County Environmental Health Code. All establishments under new ownership,
newly built, or remodeled shall meet current construction, equipment, facility, and operational regulations as adopted and provided for in the
Maricopa County Environmental Health Code, guidelines, and procedures, and policy statements. A permit shall not be issued to a facility for which a
permit is required, and shall not be allowed to operate until the applicant demonstrates to the Department full compliance with applicable provisions
of the Maricopa County Environmental Health Code. Any construction, alteration, or addition shall be made in accordance with specifications
approved by the Department. The owner, operator, or authorized agent shall certify in writing that the establishment will comply with these
regulations. On-site inspections of the facilities and premises with equipment in place and operating will be necessary to determine compliance with
the Maricopa County Environmental Health Code.
Delivery of Inspection Reports
Pursuant to A.R.S. § 41-1009, the Department may enter your establishment to conduct inspections. You have the right to receive a copy of the
Department's inspection report at the time of the inspection, within thirty (30) days after the inspection, or as otherwise provided by federal law. I
agree that the Department may send me a copy of its inspection report by e-mail or by facsimile transmission to the e-mail or fax number provided
under the Business Ownership Information provided above. It is the responsibility of the permit holder to update the Department if there is a change
in contact information.
I hereby certify that the above information is correct, agree to comply with the Maricopa County Environmental Health Code, agree to allow the
regulatory authority access to the establishment as specified under § 8-402.11 and to the records specified under §§ 3-203.12 and 5-205.13 and
Subparagraph 8-201.14(D)(6), and I fully understand that any deviation from the above without prior permission from the Maricopa County
Environmental Services Department may nullify final approval.
Disclaimer
Information entered on this form will be retained by Maricopa Environmental Services Department and is a record as defined by Arizona law.
This form will be provided without redaction in response to a public record request unless any of the information is exempt from release under
Arizona law.
By checking the check box and typing your name you have digitally signed this application.
I agree to the 50 percent extension.
Signature: Date:
I agree the application is true and correct.
Signature: Date:
Arizona law, A.R.S. § 11-1605(I), allows Maricopa County Environmental Services Department (MCESD) and the applicant for a license to mutually
agree to extend the plan review time frame by 50 percent of the substantive time frame and overall time frame. MCESD will agree to any applicant's
request for an 50 percent extension of the substantive review time frame and overall time frame when box is checked and signed below.
Submit by E-mail
Application Type Fee Expedite? Quantity Total
New Business (taking ownership with no new construction) $315.00 per permit
New Business + Minor Review (taking ownership with minor
review/modification/addition/construction)
$315.00 + $245.00 per permit
Plan Review 0-9 Seating (New Construction or Major Remodel) $545.00 per permit 2x the fees
Plan Review All Other (New Construction or Major Remodel) $615.00 per permit 2x the fees
Minor Review (to an existing permit) $245.00 per permit involved 2x the fees
School Facilities (New Construction or Major Remodel) $480.00 per permit involved 2x the fees
Fees
Pg. 6
Business Name
Business Address:
Submittal Date: Site Location:
District: Expedite (Yes/No):
Permit # Permit Type Classification
For Office Use Only
Maricopa County Environmental Services Department
Environmental Health Division
Phone: (602)506-6824
Esplanreview@mail.maricopa.gov
Notice
ARS § 11-1604. Prohibited acts by county and employees; enforcement; notice
A county shall not base a licensing decision on whole or in part on a licensing requirement or condition that
is not specifically authorized by statute, rule, ordinance or delegation agreement. A general grant of authority does
not constitute a basis for imposing a licensing requirement or condition unless the authority specifically authorizes
the requirement or condition.
Unless specifically authorized, a county shall avoid duplication of other laws that do not enhance regulatory clarity
and shall avoid dual permitting to the maximum extent practicable.
This section does not prohibit county flexibility to issue licenses or adopt ordinances or codes.
A county shall not request or initiate discussions with a person about waiving that person's rights.
THIS SECTION MAY BE ENFORCED IN A PRIVATE CIVIL ACTION AND RELIEF MAY BE AWARDED AGAINST A COUNTY.
THE COURT MAY AWARD REASONABLE ATTORNEY FEES, DAMAGES AND ALL FEES ASSOCIATED WITH THE LICENSE
APPLICATION TO A PARTY THAT PREVAILS IN AN ACTION AGAINST A COUNTY FOR A VIOLATION OF THIS SECTION.
A COUNTY EMPLOYEE MAY NOT INTENTIONALLY OR KNOWINGLY VIOLATE THIS SECTION. A VIOLATION OF THIS
SECTION IS CAUSE FOR DISCIPINARY ACTION OR DISMISSAL PURSUANT TO THE COUNTY'S ADOPTED PERSONNEL
POLICY.
THIS SECTION DOES NOT ABROGATE THE IMMUNITY PROVIDED BY SECTION 12-820.1 OR 12-820.02.
Pg. 7