Application for Pyrotechnics
Please select the pyrotechnics certification you are applying for:
*
Pyrotechnics: Special Effects
Pyrotechnics: Aerial Display
Other
Please select based on the certificate you are applying for. Venue Capacity (SPECIAL EFFECTS PERMIT) or Aerial Projection Distance (AERIAL DISPLAY PERMIT). You will receive an invoice for the total:
*
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( X )
SPECIAL EFFECTS PERMIT: 1-500 people
$
192.00
SPECIAL EFFECTS PERMIT: 501-1000 people
$
244.00
SPECIAL EFFECTS PERMIT: 1,0001-5,000 people
$
278.00
SPECIAL EFFECTS PERMIT: Each additional 5,000 people
$
51.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
AERIAL DISPLAY PERMIT: 0-20 feet
$
249.00
AERIAL DISPLAY PERMIT: 21-50 feet
$
322.00
AERIAL DISPLAY PERMIT: Greater than 50 feet
$
396.00
Event Information
Applicant Name
*
First Name
Last Name
Email
*
example@example.com
Business Name (if applicable)
Event Date
*
-
Month
-
Day
Year
Date
Name of Event
*
Event Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pyrotechnic Company Information
Please fill out the following information for the pyrotechnic company providing your display. You will also be prompted to upload necessary insurance and event information.
Pyrotechnic Company Name
*
Pyrotechnic Company Contact Phone
*
Please enter a valid phone number.
Lead Pyrotechnician Name
*
First Name
Last Name
Name of Pyrotechnic Company's Insurance/Bond Carrier
*
Insurance/Bond Carrier Policy Number
*
Insurance/Bond Carrier Policy Expiration Date
*
Insurance/Bond Policy Value
*
Please upload Insurance Carrier documentation, event plans (if applicable) and any other documentation relevant to your application:
*
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Acknowledgement
By signing this application, I/we acknowledge that we comply with the provisions of Section 8.52 of the Missoula Municipal Code, International Fire Code, and the requirements of the Missoula Fire Department pertaining to a pyrotechnics certification. I hereby understand that individual fire artists performing in the venue listed above must possess a City business license or business license exemption affidavit from the City Development Services Office and artists must notify the Fire Marshal's Office at (406) 552-6210, at least 7 days prior to any planned performance.
Signature
*
Date
*
-
Month
-
Day
Year
Date
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