Application For License To Sell Fireworks At Wholesale - Department Of Public Safety Division Of Fire Prevention

ADVERTISEMENT

OFFICIAL USE ONLY
DEPARTMENT OF PUBLIC SAFETY
PERMIT # _________________
DIVISION OF FIRE PREVENTION
Issue Date _________________
5700 East Tudor Road
Receipt # _________________
Anchorage, Alaska 99507-1225
APPLICATION FOR LICENSE TO SELL FIREWORKS AT WHOLESALE
(Authority AS 18.72.030, 13 AAC 51.010)
Please print the following information
:
Last Name
First
M.I.
Social Security Number
Company Name
Location of Business
Mailing Address
City
State
Zip
Phone Number
040 and
hereby make application for a license to sell fireworks at wholesale under the provisions of AS 18.72.020-
13 AAC 50.025 (24) through (36), and state that such fireworks will be offered for sale at
_____________________________
If applicable, physical address of wholesaler’s facility(s)
_______________________________.
__________________________
_______________. Indicate whether the facility(s) have been inspected and approved by State and/or local fire authorities.
Date of last inspection
: ____________________________.
13 AAC 50.025, STORAGE OF DANGEROUS AND SALABLE FIREWORKS BY A WHOLESALER.
Article 77 & 78 of the 1997 edition of the Uniform Fire Code are adopted for regulating the storage and use of
salable fireworks by a wholesaler.
Signature of Applicant
Date
Subscribed and sworn to before me on this day ________ of _____________ , 19___
(SEAL)
Notary Public in and for
My Commission Expires
PERMITS ARE ISSUED TO THE PERSON LISTED ON THE APPLICATION.
THE STATE FIRE
MARSHAL’S OFFICE DOES NOT ISSUE PERMITS IN THE NAME OF THE COMPANY.
The fee for these permits is $50.00 and are ONLY valid until the last day of calendar year. Please make checks
payable to the State of Alaska.
IF YOU NEED FURTHER INFORMATION, CONTACT MARIE COLLINS AT (907) 269-5625.

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go