Fillable Vendor Permit Application - ( Food, Merchandise Or Service) (City of Burlington)

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Vendor Permit Application - ( Food, Merchandise Or Service) (City of Burlington)

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Burlington Parks and Recreation Vendor Permit Application for Special Events & Tournaments
(360) 755-9649 | BParks@burlingtonwa.gov Page 1
EVENT NAME
EVENT LOCATION
EVENT DATE(S)
VENDOR
APPLICANT
INFORMATION
BUSINESS NAME:
BUSINESS OWNER:
MAILING ADDRESS:
CITY/STATE/ZIP:
AUTHORIZED REP:
EMAIL ADDRESS:
PHONE 1:
PHONE 2:
DESCRIPTION
OF MOBILE
OPERATION
MY OPERATION
INCLUDES SALES OF
☐Food ☐Merchandise ☐ Services
DESCRIBE
PRIMARY
MOBILE UNIT(s):
(Check all that apply)
MOBILE UNIT IS:
LENGTH
x
WIDTH
☐Tent with side(s)
x
☐Canopy without sides
x
☐Food Cart/Kiosk
x
☐Food Truck
x
☐Food Trailer
x
☐Other, Describe:
x
DESCRIPTION:
DIMENSIONS (Length X Width)
DESCRIBE OTHER
STRUCTURES or
VEHICLES THAT
WILL BE SETUP
WITHIN YOUR
BOOTH SPACE:
BRIEFLY DESCRIBE
OPERATION’S
ITEMS/PRODUCTS:
OTHER REQUESTS
OR INFORMATION:
VENDOR PERMIT APPLICATION
Special Events/Tournaments
BURLINGTON PARKS and RECREATION
900 E. Fairhaven Avenue
Burlington, WA 98233
(360) 755-9649 | BParks@burlingtonWA.gov
Burlington Parks and Recreation Vendor Permit Application for Special Events & Tournaments
(360) 755-9649 | BParks@burlingtonwa.gov Page 2
FOOD
PREPARATION
DESCRIBE APPLIANCES
USED FOR FOOD PREP:
CHECK ALL THAT APPLY:
☐All Items are pre-packaged and not prepared onsite.
☐A generator will be used. Make/Model:
☐A propane/LPG tank will be used. Size:
☐A BBQ Grill will be used. Make/Model:
☐A Coleman-style cook stove will be used. Describe:
☐My operation includes cooking with grease or oil. Type:
☐Hookup to City electricity is needed. Max watts needed?
☐Hookup to City water is needed. Purpose:
☐A current fire extinguisher with a minimum size/rating of 2A10BC (or Type K if cooking
with grease/oil) will be easily accessible in my mobile unit.
PERMITS &
CERTIFICATES
CHECK ALL THAT APPLY:
☐My Skagit County Health Permit is current for mobile food operations.
(Food Vendors)
☐Application for my Skagit County Health Permit was submitted on:
☐My mobile operation does not require a Health Permit from Skagit County.
☐My Labor & Industries certification tag for mobile food operations is current.
☐Application for my Labor & Industries certification was submitted on:
☐My mobile operation does not require Labor & Industries inspection certification.
☐My mobile operation has passed a Region 3 Inspection in the current calendar year and I
will provide copy of the inspection report with my Vendor Permit Application.
AGREEMENT and INDEMNIFICATION
I, the applicant, agree and understand that it is my responsibility to oversee all contractors, vendors or parties affiliated
with my vending operation and to insure compliance with all policies, rules, regulations, guidelines and ordinances of the
State of Washington and the City of Burlington. I understand that any violations may result in immediate revocation of
the permit. I understand that the permit is non-transferable and, if approved, must be displayed throughout the event
duration.
I further agree to defend, to indemnify and to hold and save the City of Burlington, its elected officials, appointed
officers, employees, and agents harmless from and against all liability, claims, suits, damages, costs, losses and
expenses, including expenses of litigation which includes attorney fees, in any manner resulting from, arising out of or
connected with any loss or damage to any act or omission of the user or any officer, agent, employee, guest or visitor in
or about the facilities during the event to be held. By hereby affixing my signature, I certify that I am the owner of the
above named business or an authorized representative of the owner.
Signature of Applicant: Date:
FOR CITY USE ONLY
Received by:
Date:
Date sent to Fire Marshal:
☐Payment Received:
☐ APPROVED by Fire Marshal
☐Bill Event Organizer
☐ NOT Approved by Fire Marshal
Remarks:
Burlington Parks and Recreation Vendor Permit Application for Special Events & Tournaments
(360) 755-9649 | BParks@burlingtonwa.gov Page 3
SUBMITTAL OF VENDOR PERMIT APPLICATION
Return your completed permit application TO YOUR EVENT ORGANIZER. The City of Burlington will
accept applications from the Event Organizer only. The organizer is required to submit all applications from
their invited vendors to the City at least 30 days prior to event’s start date. Be sure to return your
application to the Event Organizer with enough advance in order for the organizer to meet that deadline.
Food Vendors must submit a diagram reflecting their mobile operation’s layout when setup. The diagram
must reflect the minimum setbacks for the following, where applicable:
Mobile Operations cooking from Food Trucks or Trailers Minimum Setback
Between food truck/trailer with cooking appliances and canopy/tent………. 20’
Between food trucks/trailers with cooking appliances and their storage
units or vehicles………………………………………………………………………………. 15’
Between food truck/trailer and LPG tank……………………………………………… 0’ if under 500gal
Between food truck/trailer and generators…………………………………………… 0’
Mobile Operations cooking from a Canopy or Tent
Between canopies/tents using cooking appliances………………………………… 20’
Between canopies/tents’ cooking appliances and utility storage units……… 20’
10’ from LPG tank
Between canopies/tents and LPG tanks………………………………………………… 10’ if under 500gal
Between canopies/tents and generators………………………………………………. 20’
(Generator must be fenced/cordoned from public access)
SAMPLE DIAGRAM
Burlington Parks and Recreation Vendor Permit Application for Special Events & Tournaments
(360) 755-9649 | BParks@burlingtonwa.gov Page 4
FIRE MARSHAL REVIEW and INSPECTION
All applications will be reviewed by the
Burlington Fire Marshal. Your permit
application to participate in the event is not
considered approved until confirmed by the Fire
Marshal.
It is imperative that your communications with
the fire marshal be timely and prompt if you are
contacted for inspection of your operation.
Vendors in possession of a current Region 3
Inspection Certificate should be sure to submit a
copy with their application as this may save you
the time of re-inspection. Please see the
adjacent sample certificate.
LABOR AND INDUSTRIES INSPECTION
All food vendors operating from a unit built
on a permanent chassis which includes electrical,
plumbing or gas piping must have a current
inspection permit issued by Washington State
Labor & Industries posted on their mobile unit.
For more information, contact Labor & Industries
at 360-902-5218 or visit
www.lni.wa.gov/TradesLicensing/FAS/FoodTruck
Trailer/.
RECYCLING
Washington State law requires a recycling
program at any “…official gathering and sports
facility in communities where recycling services
are available.” The law states that vendors who
sell beverages in single-use aluminum, glass, or
plastic bottles or cans are responsible for
providing the recycling program at events.
Please visit the Washington State Department of
Ecology’s website for complete information
regarding the law, www.ecy.wa.gov (RCW
70.93.093) or phone 1-800-RECYCLE.
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Vendor Permit Application - ( Food, Merchandise Or Service) (City of Burlington)

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Completed 2 August 2020

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