Mobile Food Vehicle Permit Woodburn Fire District Fire Prevention 1776 Newberg Highway, Woodburn, OR 97071 Mobile Food Vehicle Fire Safety Operational Permit Application Business Name Business Address Date City, State, Zip Owner DL# State Owner Address City, State, Zip Telephone # Cell Phone # Mobile Unit License Plate # Month/Year Marion County Environmental Health Permit/Classification Date Service Location/s (Need Map Attached) Mobile Unit Fire Protection Information Fire Extinguisher/s Mfg., Type, Size, Location/s Last Inspection Dates Fire Suppression System Type Original Reviewed/Approved Date Last Inspection/Test Date Any Changes, modifications to Mobile Unit requiring new inspection or additional fire protection systems installed Permit Application Instructions This permit application can be filled out prior to or during a vehicle inspection, however, any violations of vehicle inspection must be resolved prior to issuing a permit to operate. This includes the permit and licensing through the Marion County Environmental Health “Food Licensing Program.” Plans of vehicle design and installation must be provided for review and all information about the vehicle on page one and all additional pages must be complete. Fill out the following: Number of Propane Tanks, Sizes and Location: Detail of appliances/equipment utilizing propane: Detail of appliances/equipment utilizing electrical: Details of Generator, make/model, fuel tank size, location, etc.: Details of Ventilation System, make/model, cfm output, etc.: Make/Model, Vin# of Mobile Unit: Fee Payment: Please enclose a check/money order for $50 payable to Woodburn Fire District for the issuance of a Mobile Unit fire safety operational permit. Print and sign name below. By signing and submitting this application packet, you confirm that all information is valid, complete, and correct. Applicant Name (print): Signature Date There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
