Fireworks Display Application

Fireworks Display Application

Fireworks permit application submittal for Clackamas Fire District #1 for public and private displays. OAR 837-012 and ORS 480.111 to 480.165.
Please fill out form below and submit the OSFM application in pdf format. Application must be complete to be accepted. OSFM form, site diagram, responsible person's ID, and certificate of liability of insurance must be included.
Date submitted*

MonthDayYear
Date
Person/company submitting permit application*

First NameLast Name
Email of person submitting permit application*
example@example.com
Responsible Person on Permit*

First NameLast Name
Email of Responsible Person on Permit*
example@example.com
24 hour Phone Number*
Please enter a valid phone number.
Display location*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Upload the following: 1) OSFM application in pdf format 2) Site diagram 3) Photo ID 4) insurance certification. All four items must be included or the permit application approval will be delayed. *

Cancelof

Public Fireworks Display Fee

$160.00

Total

$0.00

* Any revisions to this application may require an additional $25.00 fee *
This application will be submitted to the Clackamas Fire's Fire Marshal Office for review. Once approved, a final copy will be returned to you for submission to the State Fire Marshal's Office.

Business Services - FMO - (12/2022)
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