The Indiana Entertainment Permit form is a document required for individuals or organizations seeking to host events in various entertainment facilities within the state. This application must be completed and submitted to the Department of Homeland Security's Division of Fire Safety, along with necessary documentation such as a floor plan and, if applicable, a 501c letter. To ensure compliance with state regulations, it is important to accurately fill out the form and submit it as directed.
To begin the process of obtaining your permit, please fill out the form by clicking the button below.
When applying for an Indiana Entertainment Permit, several other forms and documents may be necessary to ensure compliance with local regulations. Understanding these additional requirements can help streamline the application process and facilitate a successful event.
Gathering these documents in advance can help avoid delays in the permitting process. By ensuring all necessary paperwork is complete and accurate, applicants can focus on making their event a success.
Neglecting to Include a Floor Plan: One common mistake is failing to attach an updated floor plan with the application. This is a crucial requirement that helps authorities understand the layout of the facility.
Omitting the 501c Letter: If claiming exempt status, applicants often forget to include a valid 501c letter. This documentation is necessary to verify the exemption.
Incorrect Facility Type Selection: Choosing the wrong type of facility can lead to complications. Ensure the selected type accurately reflects the nature of the venue.
Incomplete Contact Information: Providing incomplete or incorrect contact information for the applicant can delay the processing of the permit. It is essential to double-check phone numbers and addresses.
Failing to Specify the Event Date: Some applicants forget to include the date of the event. This detail is vital for scheduling inspections and approvals.
Not Indicating Intended Occupant Load: Leaving the intended occupant load blank can cause issues. This information helps determine the appropriate fees and safety measures.
Missing Signatures: An application without the required signatures is invalid. Ensure that all necessary parties have signed and dated the application.
Ignoring Permit Fees: Some applicants overlook the fee structure based on occupancy load. It is important to calculate and include the correct fee with the application.
When it comes to filling out the Indiana Entertainment Permit form, understanding the requirements and processes is essential for a smooth application experience. Here are some key takeaways to keep in mind:
By keeping these points in mind, applicants can navigate the process more effectively and ensure compliance with Indiana’s entertainment regulations.
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Indiana 53421 - Applicants must provide information about all adult family members living in the household.
APPLICATION FOR AMUSEMENT
Return this completed form to:
ENTERTAINMENT PERMIT
State Form 42235 (R6 / 2-10)
DEPARTMENT OF HOMELAND SECURITY
DIVISION OF FIRE SAFETY - PERMIT DIVISION
Approved by State Board of Accounts, 2010
302 West Washington Street, Room E241
Indianapolis, Indiana 46204
INSTRUCTIONS: 1. Include an updated floor plan with this application.
2. If claiming exempt status, include a valid 501c letter with this application.
FOR OFFICE USE ONLY
Permit number
Receipt number
FACILITY INFORMATION
Type of facility
Theater
Dance Hall
Night Club
Cabaret
Special Event
Other (specify)
Assembly Hall
Roller Rink
Lodge Hall
Carnival Fair
Gymnasium
__________________
Name of facility
City
County
Address of facility (number and street, city, state, and ZIP code)
Specific room or floor number
Description of facility
Closest intersecting street or road
Direction from intersection
North
South
East
West
APPLICANT INFORMATION
Type of applicant
Owner
Operator
Lessee
Name of applicant
Telephone number
()
Address of applicant (number and street, city, state, and ZIP code)
If incorporated, name of principal officer of corporation
Name of person to contact for inspection
E-mail address
Address of contact person (number and street, city, state, and ZIP code)
(
)
Responding fire department
Address of fire department (number and street, city, state, and ZIP code)
PERMIT REQUEST INFORMATION
Type of permit request
Special Event Endorsement
Annual Event
Name of event
Date of event (month, day, year)
Hours of event
Intended occupant load
If Special Event Endorsement, existing operating permit number
APPLICATION CERTIFICATION
I, or we, ________________________________________________, hereby certify, under penalty of perjury, that the information contained in this
application is true and accurate to the best of my knowledge and belief and that the operation of the place of amusement or entertainment or events described above will conform in every respect and at all times with the laws, rules, and regulations of the Fire Prevention and Building Safety Commission and will not be used for other purposes except as herein stated.
Signature
Date (month, day, year)
PERMIT FEES
Fees are based on occupancy load, effective September 30, 2006.
1 - 99 persons
$99.00
100 - 499 persons
$134.00
500 - 999 persons
$168.00
1,000 - 4,999 persons
$203.00
5,000 - 9,999 persons
$237.00
10,000 persons or more
$272.00
Date permit issued (month, day, year) Date of reinspection (month, day, year) Date of inspection (month, day, year) Type of permit
Fee amount / year of permit
$
20 _____