Candle Permit Application

This form is required for use of candles at any FIU campus or satellite location. This form must be submitted by the user AND approved by FIU EH&S Fire Safety team prior to the use of any candle at FIU locations.

Name of Applicant Name of Applicant First Last
Phone Number Phone Number - ### - ### ####

Provide a reliable number where we can contact you as needed.
Email Address

Confirm Email Address
CANDLE USE DETAILS
Candle(s) Will Be Used For:
Will the Candle(s) Be Used Indoors or Outdoors?
Building Name
Room Number
Describe the Location(s) Where Candle(s) Will Be Used

Whether you selected outdoor or both, please provide details of the building(s) and room (if applicable), and descriptions of common areas, pavilions, breezeways, lawns, etc.
Permit Status

Permit Status TEMPORARY PERMIT PERMANENT PERMIT
Use of Candle(s) Will COMMENCE On: Use of Candle(s) Will COMMENCE On: / MM / DD YYYY
At: At: : HH MM AM/PM
Use of Candle(s) Will TERMINATE On: Use of Candle(s) Will TERMINATE On: / MM / DD YYYY
At: At: : HH MM AM/PM
Draw your signature into the box below.

Draw or Type

I attest this is a legal representation of my signature. Clear

Full Name

I attest this is a legal representation of my signature.
Date of Signature Date of Signature / MM / DD YYYY

Candle Permit Application

Candle Permit Application

CANDLE USE DETAILS