VANCOUVER FIRK & RESCUE SERVICES
CITY OF VANCOUVER, B.C.
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Phone:
Fax:

PERMIT NO.

FIRE PREVENTION DIVISION

(604) 873-7595
(604) 873-7872

//20I - 456 West Broadway
Vancouver, B.C.

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RECEIPT NO. O &

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**for office use only**

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PURSUANT TO ARTICLE 2.4.5. BYLAW NO. #/?/
Permission is hereby granted to:

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SUBJECT TO THE FOLLOWING CONDITIONS:

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IN CONSIDERATION OF THE GRANTING OF THIS PERMIT I AGREE TO COMPLY WITH ALL CONDITIONS
OUTLINED IN THIS PERMIT, REQUIREMENTS OF THE FIRE BY-LAW AND ALL OTHER ACTS,
REGULATIONS AND BY-LAWS IN FORCE IN THE CITY OF VANCOUVER AND TO INDEMNIFY AND SAVE
HARMLESS THE CITY OF VANCOUVER AGAINST ALL CLAIMS, LIABILITIES, JUDGEMENTS, COSTS AND
EXPENSES WH3CH4AAY ACCRUE AGAINST THE CITJY IN CONSEQUENCE OF, AND INCIDENTAL TO, THE
GRANTING OF THIS F*ERMIT.
Authorized by
Signature of Applicant
Date

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Name of Applicant

Address of Applicant

ACCOUNT NO. Y y & % & 0

THE PERMIT FEE OF $100.00 IS PAYABLE TO THE CITY OF VANCOUVER
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