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Temporary / Seasonal Permit Application (Web Form)
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Temporary / Seasonal Food Establishment Permit Application
Maricopa County Environmental Services Department
Environmental Health Permitting Services Program
Phone: (602)506-6978
specialevents@maricopa.gov
If you need assistance, please visit one of our locations.
Office Locations
If you are visiting one of our regional offices, we recommend that you call the office first to ensure the office is open so as to better serve your needs.
Temporary Permit Fees: For events lasting 14 days or less
$85 more than 7 days before event / $135 less than 7 days before event
Seasonal Permit Fees: For events lasting 15 to 120 days
$180 more than 7 days before event / $230 less than 7 days before event
Make checks payable to MCESD or payment can be made online once the application is accepted and reviewed.
Reviewing the following information is required for submitting and obtaining this permit.
Requirements
Permit Requirements for Special Events (PDF)
Resources, Guidance and Documents
Special Events
Please visit our Special Events page.
Regulatory Bill of Rights
Regulatory Bill of Rights (PDF)
Notice of Inspection
Notice of Inspection Rights (PDF)
Sampling of Non-Time/Temperature for Safety Foods
Promotional Sampling
By checking the boxes below, you are acknowledging that you have received and reviewed the following:
*
Special Events Permit Requirements
Regulatory Bill of Rights
Notice of Inspection Rights
Event Information
Do you currently hold a Food Catering or Mobile Food permit with our Department?
Yes
No
Provide Permit Number
If operating above the limited guidelines of the issued permit, a temporary/seasonal food establishment permit is required.
Event Start Date/Time
*
Event Start Date/Time
Event Start Date/Time
Event End Date/Time
*
Event End Date/Time
Event End Date/Time
Food Service Start Date and Time
*
Food Service Start Date and Time
Food Service Start Date and Time
Event Name
*
Please provide complete, unabbreviated event name.
Event Address
*
City
*
State
*
Zip Code
*
Coordinator Name
*
Coordinator Phone
*
Coordinator Email
*
Business - Name on Booth
Entity Type
*
Corporation
Association
Sole Proprietor (must show lawful presence)
Other
Owner/Corporation Name
*
Owner Address
*
City
*
State
*
Zip Code
*
Owner Phone Number
*
Owner Contact Number During Event
*
Owner EMail Address
*
Commissary - Where Food is Prepared
Will food be prepared off site prior to the event?
*
Yes
No
Commissary Business Name
Commissary Contact Name
Commissary Phone
List Foods Prepared at Commissary
Commissary Permit Number
Date and Time Food Prepared
*
Date and Time Food Prepared
Date and Time Food Prepared
If advanced preparation is taking place at commissary, please provide date/time when you will be at commissary. If all preparation is taking place at the event, please indicate what date/time you will be at event site.
Commissary Visits Log
Commissary Visits Log
Please be prepared to provide inspector with commissary visits log upon request during inspection at event.
Food/Beverage Booth Information
Will you be operating more than one food / beverage booth?
*
Yes
No
Enter Number of Booths
*
Booth and Type of Food / Beverage
Booth Name
*
Menu
*
Booth Name
Menu
Booth Name
Menu
Booth Name
Menu
Booth Name
Menu
Booth Name
Menu
Booth Name
Menu
Booth Name
Menu
Booth Name
Menu
Booth Name
Menu
Delivery of Inspection Reports
Pursuant to A.R.S. § 41-1009, the Department may enter your establishment to conduct inspections. You have the right to receive a copy of the Department's inspection report at the time of the inspection, within thirty (30) days after the inspection, or as otherwise provided by federal law. I agree that the Department may send me a copy of its inspection report by e-mail or by facsimile transmission to the e-mail or fax number provided under the Business Ownership Information provided above. It is the responsibility of the permit holder to update the Department if there is a change in contact information.
I hereby certify that the above information is correct, agree to comply with the Maricopa County Environmental Health Code, agree to allow the regulatory authority access to the establishment as specified under 8-402.11 and to the records specified under 3-203.12 and 5-205.13 and Subparagraph 8-201.14(D)(6), and I fully understand that any deviation from the above without prior permission from the Maricopa County Environmental Services Department may nullify final approval. By checking the check box and typing your name you have digitally signed this application.
I agree the application is true and correct.
I agree
Disclaimer
Information entered on this form will be retained by Maricopa Environmental Services Department and is a record as defined by Arizona law. This form will be provided without redaction in response to a public record request unless any of the information is exempt from release under Arizona law.
Signature
Date
Date
Once the application has been submitted, you should receive a confirmation email from the Special Events Program.
Then once our staff has received your application you will receive a follow-up email to provide details on permit fees.
Leave This Blank:
Receive an email copy of this form.
Email address
This field is not part of the form submission.
Submit
Submit and Print
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