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2. A Mobile Food Vendor (MFV) hired to cater a private event on private property within the City of Portland is different from a MFV operating at an event that requires a full access or special event permit. If you have questions regarding which permit or form is required, please contact the Business Office for assistance.

   IMPORTANT: All catered-event MFVs must submit this fire safety form. Vendors are subject to an in-person fire safety inspection at any time during the event. An MFV may be required to cease operations if it fails an on-site fire safety inspection. By providing your electronic signature, you certify that all information submitted is true and accurate to the best of your knowledge.

3. 
7. Mobile Food Vendor Business Name*
8. Email Address*
10. First Name*
11. Last Name*
13. Address*
15. City*
16. State*
17. Zip Code*
19. Owner Phone*
20. Operator Phone
22. Event Date*
    Event Date
23. Event Location*
25. Do you have a State of Tennessee Mobile Food Vendor Fire Inspection Permit? (state permit not required)*
    -- Select One --YesNo
26. If YES, enter your State of Tennessee Mobile Food Vender Fire Inspection Permit number.
28. Does your unit contain a cooking appliance that produces grease-laden vapors? (grills, stoves, or deep fryers)*
    -- Select One --YesNo
29. If YES, the appliances must be protected by appropriate fire-extinguishing equipment. Please, note below what fire-extinguishing equipment is present in your unit and the date of last inspection. (Inspection date should be on the sticker/tag)*

    If you answered NO or have a State of Tennessee MFV Fire Inspection permit, enter NA.

31. All hood & exhaust systems are to be periodically inspected and cleaned to the manufacturer’s specifications. All MFV's must have an ABC fire extinguisher present. A type K extinguisher of sufficient size shall be installed in vehicles with grills, stoves and deep fryers that produce grease-laden vapors. MFV's with gas systems will ensure that portable gas containers are in the upright position and secured to prevent tipping over. The operator will inspect gas systems prior to each use. The operator will ensure that on gas system piping, a flexible connector is installed between the regulator outlet and the fixed piping system.*
    -- Select One --Yes, I agree.No, I am unable or unwilling to follow the requirements.
33. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
35. Electronic Signature
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit Submit and Print

* indicates a required field