OPEN FLAME PERMIT

Sponsoring Group:

 

Event Coordinator:

 

Event:

 

Date(s):

 

Time(s):

 

Location:

 

Type of Open Flame (Check appropriate box(es)

 Candle       Lantern      Lamp         Sterno

 

 Propane     Potpourri   Other

If Other, Specify:

 

Name(s) of Fire Watch:

 

 

 

Issue Date of Permit:

 

Permit Issued By:

 

 

(Building Coordinator)

Permit Received By:

 

 

(Event Coordinator