HomeMy WebLinkAboutSPFX Application.pdfCORPORATION OF THE DISTRICT OF MAPLE RIDGE
CITY OF MAPLE RIDGE 11995 HANEY PLACE, MAPLE RIDGE, B.C. V2X 6A9 Application is to be received 10 calendar days prior to the date scheduled for the special effect. SPECIAL EFFECTS APPLICATION
Name (print) ___________________________________________________________________ Mailing Address: _______________________________________________________________ Telephone/fax/email:
____________________________________________________________ Pyrotechnician’s Certificate number: _______________________________________________ Class: _________________________________
Expiry Date: ____________________________ Company (if applicable) __________________________________________________________ Address: ________________________________________________________________
______ Telephone/fax/email: ____________________________________________________________ Production Name: ______________________________________________________________ Contact Person:
________________________________________________________________ Location Manager: _____________________________________________________________ Telephone/fax/email: ________________________________
___________________________ Event Location: _______________________________________________________________ Dates and Times of event: _______________________________________________________
Fire Alarm system Present: Yes No Insuring Agency: ______________________________________________________________ Telephone/fax/email: ___________________________________________________________
Place and Method of Onsite Storage: _______________________________________________ _____________________________________________________________________________ Signature of Pyrotechnician:________
______________________________ Maple Ridge Fire Department (office use only) Name of Fire Officer: ______________________________________________________ Pyro Effects Site Plan and Letter
of Intent Yes No Approval Granted to Modify Smoke Detectors Yes No Fire Watch and Fire Safety Plan Yes No Signature of Fire Officer: ______________________________________________________
Permit Fee: ___________________ GL# 22000 4220 Validated by Cash Register
The Fire Chief may issue a permit under the following conditions and any additional conditions noted on completed permit: 1. Permit will not be transferable and any change in use or
operation requires a new permit. 2. Permit will be posted on site in a conspicuous place to the satisfaction of the Fire Chief. 3. Portable fire extinguishers are required to be on
site at all times. 4. If a fire hydrant is required for use during the special effect, a Fire Hydrant Use Permit must be completed and approved by the Engineering Department (fee is
$50 per day). 5. All water run off from the filming site shall be contained to the site and if contaminated it shall be disposed of in an acceptable manner. 6. Any soil contaminated
by the use of combustible or flammable liquids or the use of other products, solid, liquid or gas, shall be removed and replaced with clean fill to an acceptable degree. The contaminated
soil shall be disposed of by an acceptable method. 7. A pyrotechnic remediation damage deposit of $5,000.00 shall be deposited with the City of Maple Ridge. The City of Maple Ridge
Fire Department will determine the fire suppression and/or fire prevention personnel required. The film company will be responsible for the costs involved as per the Fees outlined in
the permit. INDEMNITY The applicant will, if approval is granted for the services of facilities requested in the application, indemnify and save harmless the City of Maple Ridge from
and against any and all claims, including without limiting the foregoing all claims for bodily injury or property damage caused by, arising from or connected with any act or omission
of the applicant or the agent, employee, customer, licensee or invites of the applicant, and against and from all liabilities, expenses, costs and legal or other fees incurred in respect
of any such claims or any actions or proceedings brought thereon arising directly or indirectly from or in connection with the property facilities or services of the City of Maple Ridge.
. SPECIAL EFFECTS CONDITIONS
1. Written sequence of each effect 2. Site plan submitted showing; red, yellow and green safety zones distance calculations location of safety personnel location of fire equipment
3. Personnel with fire extinguishers and trained in their use. Additional fire suppression measures may be imposed by Fire Officer. Minimum two (2) – 3A-60BC fire extinguishers Yes
No Located within 15 metres of special effects Yes No Located within 15 metres of special effects storage 4. Fire Evacuation Plan All personnel knows the location and availability
of all exits Fire watch established (ADDENDUM -A) If a fire alarm or sprinkler system has been impaired (under fire department approval) procedures and personnel are trained and
in place. (ADDENDUM -B) SPECIAL EFFECTS CHECKLIST Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No Yes No