NATURE OF PERMIT:
TENT EVENT FIREWORKS OTHER: ________________________________
PERMIT FEE PAID? YES NO NOT REQUIRED EVENT DATE(S): __________________________
SIZE OF TENT(S): ___________________________________ SETUP DATE/TIME: ________________________
RAIN DATE (IF APPLICABLE): __________________________________ TIME: ________________________
PHYSICAL ADDRESS FOR EVENT: _________________________________________________________________
BUSINESS/PROPERTY OWNER: ____________________________________________________________________
EVENT COMPANY NAME: _________________________________________________________________________
EVENT COMPANY ADDRESS: _____________________________________________________________________
CITY: _____________________________ STATE: ________ ZIP CODE: ______________
EVENT CONTACT PERSON: _______________________________ PHONE: ________________________________
E-MAIL ADDRESS: _______________________________________________________________________________
THIS SECTION FOR FIREWORKS/PYROTECHNICS ONLY*
FIREWORK/PYROTECHNIC MATERIALS STORAGE AREA:
WHOLESALER NAME (FIREWORKS ONLY):
*COMPLETE DETAILS (INCLUDING SAFETY SITE PLANS) MUST BE SUBMITTED WITH THIS
APPLICATION TO THE PERMTTING OFFICE. A SITE INSPECTION MUST BE ARRANGED.
*NOTE: THE PERMIT WILL BE REVOKED WHEN CONDITIONS CHANGE, AS OUTLINED PURSUANT
TO THE NORTH CAROLINA FIRE CODE, OR WHEN ANY PROVISIONS OF THE CODE ARE NOT MET.
By signing this application, I certify I am aware of the requirement(s) for which the permit is issued and all conditions of
the permit will be met in accordance with the Jackson County Prevention and Protection Ordinance along with the NC
Fire Prevention Code.
SIGNATURE OF APPLICANT: _________________________________________ DATE: _________________
THIS SECTION TO BE COMPLETED BY FIRE INSPECTOR
Inspections will be regulated by the current version of the NC Fire Prevention Code.
APPROVED
DENIED (REASON):
EXPIRATION DATE:
_________________________________________________________________ _______________________
JACKSON COUNTY FIRE INSPECTOR APPROVAL SIGNATURE APPROVAL DATE
You may submit a completed, signed copy of this application to our office in person, by fax, or e-mail to
jcpermitcenter@jacksonnc.org. Fees may be required.
JACKSON COUNTY PERMITTING & CODE ENFORCEMENT
Fire Prevention Permit Application
Sylva Office: 401 Grindstaff Cove Road, Suite 145, Phone: 828-586-7560 / Fax: 828-586-7563
Cashiers Office: 357 Frank Allen Road, Phone: 828-745-6850 / Fax: 828-745-6867
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