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1. Public liability insurance naming City of Centerville and other public agencies <br />additionally insured is required. <br />2. Hold harmless forms executed and failed. <br />3. List and approve/disapprove other insurance coverage as may be required. <br />5. FIRE DEPARTMENT <br />Approved by: <br />Date: <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />Signature <br />Title <br />Emergency vehicle access. <br />Use of fireworks, pyrotechnics, vehicle fuel, open flame. <br />Cooking facilities. <br />Occupancy and spacing of tables, enclosures. <br />Parade, floats. <br />Tents, air supported structures, canopies. <br />Other provisions as my be required by this department: _ <br />6. BUILDING DEPARTMENT <br />Approved by: <br />Signature <br />Date: <br />Electrical: <br />Title <br />1. Plan check/inspection of any wiring installed on a temporary or permit basis. <br />2. Permit(s) attached. <br />Structural Plan: <br />I . Plan check/inspection of any temporary or permanent structures, including <br />bleachers, scaffolding, grandstand, reviewing stands, stages, or platforms. <br />2. Permit(s) attached. <br />3. Other provisions as may be required by this department: <br />Page 8 of 10 <br />22 <br />