Fillable PEChanga Fire Department (Pechanga Tribal Government)

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PEChanga Fire Department (Pechanga Tribal Government)

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PEChanga Fire Department
Application for Fire Department Operational Permit
(Submit Application at least 14 days prior to work / event.)
APPLICANT INFORMATION (PERMITTEE)
Name: Title:
Company: License Type & #:
Phone: Email:
I certify that all of the information I have provided is correct, and I agree to comply with any CONDITIONS OF APPROVAL and all laws
pertaining to this permit adopted by the Pechanga Indian Reservation. I understand that any false or misrepresented information
provided or any violation of the conditions or laws may result in the immediate revocation of this permit. I understand that approval
of this permit is valid only for the permittee, work, location, and dates specified on this application.
Signature: Date:
PERMIT INFORMATION
Name of Project/Event: PFD Project #:
Address: Bldg. Permit #
Location: Date(s) of work/event:
OPERATIONAL PERMIT TYPE (check all that apply)
OPERATIONAL PERMITS
- Allows the applicant to conduct an operation or a business for which a permit is required by applicable Pechanga
Building & Fire Code Ordinance for either a prescribed period or until renewed or revoked. PRC PDC PTG Private
Description
Description
Carnivals and fairs
*Open flames, torches, and fire performance
Combustible dust-producing operations
Open flames and candles
Compressed gases
Outdoor assembly event
Cryogenic fluids
Places of
assembly, special event
Exhibits and trade shows
Private fire hydrants
*Explosives / Fireworks (Engine Company Standby Required)
*Pyrotechnic special effects material, fire performances
Fire hydrants and valves
Refrigeration equipment
Flammable and combustible liquids
Repair garages and motor fuel dispensing facilities
Floor finishing
Spraying or dipping
Fumigation and thermal insecticidal fogging
Temporary membrane structures and tents
Hazardous materials
Wood products
High-piled storage
Production facilities used for a live audience, or for wrap
parties
Hot work operations (welding, cutting, torching, etc.)
Pyrotechnics and special effects used for the purpose of
motion picture, television, and commercial production
Liquid or gas fueled vehicles or equipment in assembly
buildings
Live audiences in approved production facilities, production
studios and sound stages
Liquid Petroleum Gas (LPG/propane)
Other:
Mobile fueling of hydrogen-fueled vehicles
Other:
Mobile food preparation vehicles
Other:
Motor fuel dispensing facilities
Other:
Open burning
Standby Service $300 per hour: #engines____ #hours____
*Additional PFD forms required (complete list of permits available at https://tinyurl.com/PechangaFD)
PFD P-005B (12/12/19 rev) OPERATIONAL PERMIT APPLICATION Page 1 of 2
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signature
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ADDITIONAL INFORMATION (Required)
Provide detailed description of operation. For operations / events, include details such as size, scope, number of occupants /
participants, special effects, timeframe (load-in / out), start / end time), vendor list and contact information, and any other
pertinent information. Attach plans, diagrams, flame certificates, and other applicable documentation.
FEES
Operational permits are $150 each. Permit/Inspection Fees include inspections noted in conditions and (1) reinspection – additional
reinspections will be charged $75. **Some operational permits require plan review per fee schedule or the miscellaneous hourly rate.
Total # of permits:
Total Permit Fee: $
Plans/Submittals Included:
YES
NO
N/A
Total Plan Review Fee: $
Submit permit applications, and (3) sets of plans, when required, with payment: In person, or by appointment to: Pechanga Fire
Department, Office of the Fire Marshal, 45421 Pechanga Resort Dr., Ste. 217 (Pechanga Resort & Casino Career Center) Tuesday-
Friday, 7am to 6pm. By mail send to: 48240 Pechanga Rd., Temecula, CA 92592. We accept Checks and Cashier Checks. Sorry we do
not accept cash or credit cards. Make checks payable to “Pechanga Fire Department”.
OFFICE USE ONLY
Date Received: Received by:
Permit Paid in Full: YES NO
N/A
Permit Fees Paid: $
Balance Due: $
Plan Review Paid in Full:
YES
NO
Review Fees Paid: $
Balance Due: $
Plan Review Required:
YE
S
NO
Check #
Credit Card
Permit #: Effective Date:
Issued by: Expiration Date:
Approved Approved with Conditions Denied
Approval of this permit shall not be construed to be approval of any violation of any provision of federal, tribal, or applicable laws.
CONDITIONS:
951-770-6010 permit tech | 951-770-6045 office | 951-694-0449 fax | PFD-FMO@pechanga-nsn.gov | https://tinyurl.com/PechangaFD
PFD P-005B (12/12/19 rev) OPERATIONAL PERMIT APPLICATION
Page 2 of 2
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PEChanga Fire Department (Pechanga Tribal Government)

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Completed 11 August 2020

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