DeLand Fire Department

Public Fireworks Display Permit Application

Application shall be turned in 45 days in advance of event. Any permit issued after this time must receive permission from the City Manager’s Office. A separate application shall be filed for each and every operation and location at which Public Fireworks Display Event is proposed.

Only the operator, authorized persons, and inspector(s) representing the AHJ shall be permitted in the display site while the display is in progress.

Personal protective equipment, as necessary, shall be worn by the operator and authorized persons during the setup and cleanup of the display.

Smoking materials, matches, lighters, or open flame devices shall not be permitted within 50 ft of any area where fireworks or other pyrotechnic materials are present.

If high winds, precipitation, or other adverse weather conditions prevail or begin such that a hazard exists in the opinion of the operator or the AHJ, the fireworks display shall be postponed or discontinued until weather conditions improve.

Wherever, in the opinion of the AHJ or operator, any hazardous condition exists, the fireworks display shall be stopped until the condition has been corrected.

I certify that I have read and understand the above information and will abide by the requirements set forth herein.

Date of Event:

Time of Event:

Event Rain Date:

Time of Event:

Location of Proposed Display:

Sponsor Name:

Primary Phone Number:

Secondary Phone Number:

Applicant Name:

Applicant Mailing Address:

Applicant Email Address:

Business Name:

Business Mailing Address:

Business Email Address:

Name of Registered Operator:

Federal Explosives License/Permit #:

Operator’s Mailing Address:

Operator’s Physical Address:

Operator’s Email Address:

Authorized Persons to be On-Site:

Additional Actions/Attachments Required:

$150.00 Permit Fee – Required to be Paid Prior to Issuance

$1,000,000 Minimum Liability Insurance Certificate – City of DeLand Must be Listed as Additionally Insured

Copy of Driver’s License for Applicant, Operator, and Authorized Persons to be On-Site

Copy of Federal Explosives License/Permit

Complete Shell Count/Show Description

A statement, on letterhead, signed by the operator stating the following: I understand that I, the operator, shall be responsible to abide by all rules set forth by the applicable Fire Protection Codes, Statutes, Local Codes, and Fire Marshal’s Office. The statement must reference this specific application.

Site Plan Diagram

Site Plan Must Illustrate:

Location, Type, and Dimensions of Short-Term Storage Container(s)
Location of Public Fireworks Display
Dimensions of the Discharge Site, Spectator Viewing Area, Parking Areas, and the Fallout Area and the Associated Separation Distances

I hereby certify that the provided information is true and correct to the best of my ability. I understand that failure to comply with any provisions of applicable Law or Code including, but not limited to, the provisions of this application can result in the denial and/or revocation of this permit.

Signature:

Date:

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Fireworks Application

Public Fireworks Display Permit Application