TEMPORARY STRUCTURES APPLICATION
BUILDING STANDARDS ׀ 5800 Shier Rings Road, Dublin OH 43016 ׀ 614.410.4600 ׀ DublinOhioUSA.gov
PROPERTY OWNER / REPRESENTATIVE / CONTACT (PRINT)
I, the owner of this building and the undersigned, do hereby convenant and agree to comply with all the laws of the State of Ohio and the Ordinances of this jurisdiction,
pertaining to the building and the buildings, and to construct the proposed buidling or structure or make the proposed change or alteration in accordance with the plans
and specications submitted herewith, and certify that the information and statements given on this application, drawings and specications are to the best of their
knowledge, true and correct.
I, the Project Representative and Contact, acknowledge and make this application as, or on behalf of, the owner and further assert that I am the agent / representative
to be contacted concerning matters relating to this application.
Contractor Name
Signature
Corporate / Company Name
Address
City, State, Zip Code
Telephone
Email
Fax
Date
Title
Property Owner Name
Signature
Corporate / Company Name
Address
City, State, Zip Code
Telephone
Email
Fax
Date
Title
BASIC PROJECT INFORMATION (PRINT)
Structure Location / Address
Duration of Structure(s)
Bleachers
Grandstands
Modular Buildings
Tents
STRUCTURE TYPE
Platform
Stage
Project Name
APPLICATION NO.
TEMPORARY EVENT STRUCTURES CHECKLIST
TEMPORARY EVENT STRUCTURES CHECKLIST
BUILDING STANDARDS ׀ 5800 Shier Rings Road, Dublin OH 43016 ׀ 614.410.4600 ׀ DublinOhioUSA.gov
APPLICATION NO.
CHECK ALL THAT APPLY
SITE PLAN TO SCALE LOCATING RELEVANT STRUCTURES
Property Line
Dimensions between structures and between structures and property lines
Toilet Fixtures complying with OBC 2902.2 and OBC Chapter 11
Generators located, sized and grounded
FOUNDATION PLAN TO AN APPROPRIATE SCALE
Baseplate and cribbing details
Lateral Stability (Main Wind Force resisting) system
Guy Wire and ballasting requirements
TEMPORARY STRUCTURE PLAN TO AN APPROPRIATE SCALE
Structure manufacturer’s design assumptions and loading data
Building Code Data
Structure manufacturer’s design assumptions and loading data
Building Code Data
Applicable Code(s)
Construction Type
Occupancy
Occumpant Load
Applicable Design Criteria
Specic Live Load Information
Compliance with OBC Chapter 11 and ICC A117.1-2009 demonstrated
Means of Egress dened
Seating Illustrated
Egress Illumination
Exit Signs Located
Maximum Capacity Signs
Portable Fire Extinguishers located and identied
Membrane structure or Tent Afxed Label
Membrane structure or Tent Afdavit
Location and type of heating and electrical equipment
Special Inspections (Major Events)
Special Inspectors Credentials (Major Events)
TEMPORARY STRUCTURES PERMIT
Temporary Structures Permit Application (SIGNED)
Name of Applicant
Business Location
Type of Permit Requested
**
**
To: WASHINGTON TOWNSHIP FIRE DEPARTMENT For Department Use Only:
FIRE PREVENTION BUREAU
6200 Eiterman Road
P.O. Box 3248
Dublin, Ohio 43016 (614-652-3920)
Code
Dublin Fire
Code Section
105
Article No.
105.6.43 and 105.7.12
Description:
To install and operate
temporary membrane structures,
tents/bounce houses and air
supported structures.
Property Use:
Inspection By:
Approved:
Disapproved:
Remarks:
See permit
Date Received:
Permit Number:
Permit issued by:
Date issued:
Permit Fee:
Return 1 copy with the required fees
WASHINGTON TOWNSHIP
FIRE DEPARTMENT
Date:
**
Application is hereby made by the undersigned for a permit to:
Install
Operate
In or on the premises located at:
**
The following materials, processes or equipment will be used:
** Number of tents/bounce houses:
** Size of tents/bounce houses:
** Date installed:
** Date removed:
**** Flame retardant certificate required ****
I hereby agree to:
Conditions, surroundings and arrangements, to be in accordance with the Fire Codes adopted by the
City of Dublin, Washington Township and the Fire Marshal, State of Ohio.
Complete plans and constructions details must be submitted on all projects when requested.
REQUESTED:
NOT REQUESTED:
RESUBMIT:
SIGNATURES:
Person Responsible
Address
Telephone
click to sign
signature
click to edit
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