Health Permit

Please enable JavaScript in your browser to complete this form.

Company Name

Day-of event contact name

Day-of event contact phone

Applicant's Driver's State & License Number

Food Items to be served (only listed foods & beverages may be served)

Place of Preparation & Storage

Texas Sales and Use Certificate

Health Permit (permanent) and/or Manufacturer's Permit

Latest Health Inspection Report

Certificate of Insurance - AI (Brewvolution, LLC)

Certificate of Insurance - AI (B-Weiss Entertainment)

Certificate of Insurance - AI (Weiss Enterprises)

Terms and Conditions

I have read and agree to the terms and conditions

I acknowledge receipt of a copy of City of Dallas Guidelines for Temporary Food Establishments and understand that failure to meet provisions for a Temporary Food Establishment described in the City of Dallas Food Establishment Code, Chapter 17, can result in citations for violations and penalties to be assessed in court. I certify that all facts stated in this application are true and correct to the best of my knowledge and belief.

Special Conditions Comply with all TEMPORARY FOOD GUIDELINES as required by the City of Dallas Restaurant and Bar Inspection Division. Home preparation of food is not allowed. You must have MECHANICAL HEATING OR REFRIGERATION for all potentially hazardous foods. Provide hand and utensil wash set up, stem type dial thermometers for measuring internal food temperature. NO CUTTING OF ANY FOOD ON-‐SITE. NO STERNO FOR OUTSIDE USE; NO ICE CHEST FOR FOOD STORAGE. Submit a copy of the State, County, City permit and current inspection report for foods prepared or manufactured beyond Dallas City limits.

Signature

Comment