Burlington Parks and Recreation Vendor Permit Application for Special Events & Tournaments
(360) 755-9649 | BParks@burlingtonwa.gov Page 2
USED FOR FOOD PREP:
☐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.
☐My Skagit County Health Permit is current for mobile food operations.
☐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
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:
Date sent to Fire Marshal:
☐ APPROVED by Fire Marshal
☐ NOT Approved by Fire Marshal