EVENT APPLICATION FORM
ATTACHMENTS
Please complete the forms necessary for your application and forward through with your
completed event application form.
Contents:
Advice of Structures Form
 For each structure greater than 9m2
 To be completed on the day of the event
Certificate of Structures Form
 For each structure greater than 55m2
 To be completed prior to the event and submitted with Public Liability of stage
owner, structure certification and specifications and Public Liability of the stage
installer
Form 5 - Certificate of Electrical Compliance


To be completed by a Licensed Electrician on the day of the event
Check with Health and Compliance whether you need this to be completed
Application to Sell Food at an Event

Should be submitted along with accompanying information at least 4 weeks
prior to the event
For Medium and High Risk Events (for submission prior to your event)
Form 1 - Application to Construct, Extend or Alter a Public Building
Form 2 - Application for Certificate of Approval
Other Information
Waste Function Bin Price List
Temporary Signage on Verges Approval Conditions – available for non-for-profit groups only.
For Traders Permits
Application for a Permit - Stallholders and Trading in Thoroughfares and Public places
ADVICE OF STRUCTURES FORM
For structures greater than 9m2
To be completed on the day of the event
This form must be completed by whoever is erecting the structure, on the day of erecting and delivered to the
Environmental Health Officer attending this event. In the absence of the Environmental Health Officer this
form must be given to the Event Organiser who then has the responsibility of delivering the form to the
Environmental Health Officer within 1 working day from receiving this form.
Any temporary structures greater than 9m2 that have not been certified must not be occupied.
EVENT DETAILS
Name of Event:
Location of Event:
Event Date:
Structures:
Event Contact:
Signature:
Date:
INSTALLER'S DETAILS
Business Name:
Registration Number:
Address:
Phone:
Phone (M):
Fax:
DECLARATION
I hereby certify that the structures listed below have been erected and/or constructed in accordance with their
respective engineering details and/or manufacturer’s instructions.
Signature of Installer:
Date:
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
CERTIFICATE OF STRUCTURES FORM
For any structure equal to or greater than 55m 2
To be completed prior to the event
This form must be completed in full and submitted with Structure Certificate or design specifications, the
Public Liability insurance of whoever owns the structure and the Public Liability of whoever is erecting the
structure.
This form must be submitted prior to the event.
EVENT DETAILS
Name of Event:
Date of Event:
Location of Event:
FACILITY DETAILS
The purpose for which the facility is to be used:
Maximum number of people to use the facility:
Integrity of design and manufacturer of the component parts:
Environmental factors (weather and ground conditions):
Erector’s competence to erect the facility correctly:
MANUFACTURER'S DETAILS
Name:
Address:
Phone:
Phone (M):
Fax:
Description of the structure:
Dimensions:
Type of material:
Intended use:
Code to which it must comply:

A practicing structural engineer should certify the designs;

It is recommended that Certification be no more than 3 years old;

Structural design calculations should be available;

Detail the safe operating parameters (i.e. Wind limitations and Fire Indices);

Details of the flammability of materials used to construct and decorate the facility;

Ground density details (For structures that will be erected for greater than 24 hours actual “holding down”
tests should be performed using a tension gauge or other approved method to ascertain the actual ground
holding capacity); and

Correct erection methods.
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
CERTIFICATE OF STRUCTURES FORM – CONTINUED
INSTALLER'S DETAILS
Business Name:
Registration Number:
Address:
Phone:
Phone (M):
Fax:
Signature of Installer:
Name of Installer:
Date:
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
CERTIFICATE OF ELECTRICAL COMPLIANCE
FORM 5
Health Act 1911
Health (Public Buildings) Regulations 1992
To be completed by a Licensed Electrician on the day of the event for all temporary power or power.
PREMISES DETAILS
Name & Initial of Occupier:
Details of Building:
Name:
Location Number:
Street:
Town/Suburb:
PARTICULARS OF INSTALLATION
Is there any electrical work for which you are not responsible in these premises? Yes
No
CONTRACTOR'S DETAILS
Business Name:
Registration Number:
Address:
Phone:
Phone (M):
Fax:
DECLARATION
I hereby certify that the electric light and/or power – installation, alteration, addition- at the undermentioned
premises has been carried out in accordance with Part 4 of the Health (Public Buildings) Regulations 1992.
Signature of Licensed Electrical Contractor:
Date:
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
APPLICATION TO SELL FOOD AT AN EVENT
 Support documents must be attached and the form must be completed in full and received by the City at
least 4 weeks prior to the event or the application will be declined.
 This form is for ALL food stalls or catering including Charity/Community fundraising and registered food
businesses, selling or supplying/giving away food free of charge, either prepared on-site or prepacked food.
 Refer to the Minimum Standards for Use of Temporary Food Premises for One or Two Day Events
EVENT DETAILS
Name of Event:
Date of Event:
Location of Event:
APPLICANT'S DETAILS
Name:
Trading Name (if applicable):
Address:
Email:
Phone:
Mobile:
Details of Public Liability Insurance (Insurer and Expiry Date. Please supply a copy of your current PLI):
Are you a fundraising organisation for charity or a community group? Yes
Are you a registered food business?
Yes
No
No
If yes, please attach a copy of your Certificate of Registration. All food businesses (unless exempted) must be
registered by the relevant enforcement agency.
SITE PLAN
You must provide a site plan with your application, is this attached?
Yes
No
Please show the following details on your site plan:

Benches, preparation area and equipment

Cooking area (barricades, fire extinguishers)

Refrigeration

Bin area

Hand-wash facility
Hot water and wash-up facility
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
APPLICATION TO SELL FOOD AT AN EVENT – CONTINUED
OPERATIONS
Please list all food types to be sold (i.e. drinks, jams, hot dogs etc.):
Please provide details of all places where food is prepared/packaged/cooked. Please list the particular food
associated with each place AND the time of preparation (i.e. Salads prepared on site on day of the event):
Please provide details of how you will keep hot food hot and cold food cold:
Number of staff at your stall:
Do all staff have the skills and knowledge for the tasks they perform?
Yes
No
Please provide details of how foods will be stored on the day of the event (Note all food must be stored at least
150mm off the floor):
Please provide details of how food will be transported to the site on the day of the event:
Have you previously been approved to sell food by the City of Stirling or another local authority?
Yes
No
If yes, please provide details:
DECLARATION
Signed:
Date:
ATTACHMENTS TO BE SUBMITTED WITH THIS APPLICATION
Site Plan
Public Liability Insurance Certificate
Food Business Registration
HEALTH AND COMPLIANCE USE ONLY
Inspection Required prior to event?
If Yes, date conducted:
No
Yes
No
Time:
Recommend Approval to trade at event?
SEH signed:
Yes
Date:
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
ENVIRONMENTAL HEALTH INFORMATION GUIDE
Minimum Standards for Use of Temporary Food Premises for One or Two Day Events
This guide is to be used only for temporary food stalls at events that last for either one or two days.
1. GENERAL
 Food stalls are to consist of a roof and three sides with a floor (or shall consist of an open food stall which
must comply with Point 8).
 The stall and components are to be kept in a clean, sound condition and constructed of readily cleanable
materials such as plastic sheeting, vinyl or other approved material.
 The floor surfacing is to extend beneath any tables or large appliances and be an easily cleanable surface
such as concrete, brick paving, duckboard, tarpaulins, vinyl or heavy duty plastic.
 The location and layout must be appropriate for the intended activity and provide adequate space for
fixtures, fittings and equipment.
 Smoking, small children and animals are not permitted in areas where food is prepared, stored or cooked.
 All heating and cooking equipment must be well separated from public contact and adjoining flammable
surfaces.
 There must be access to a fire extinguisher if cooking is involved.
2. PROTECTION OF FOOD
 All food is to be adequately protected from dust, pest, sunlight, rain, human contact and other foreign
matter.
 Food is to be stored above the ground and stored in sealed, impervious food grade containers or other
suitable covering e.g. cling wrap, plastic containers.
 Raw and cooked food must always be stored and handled separately to prevent cross contamination.
Separate utensils for raw and cooked foods should be used. Food handlers must also wash hands or change
gloves in between the handling of cooked and raw food.
 Disposable eating and drinking utensils only shall be used. The utensils are to be wrapped in paper napkins,
cellophane bags or similar prior to distribution to the public and stored so as to prevent any contamination.
 All condiments and sauce are to be contained in squeeze type dispensers or in commercially sealed packs.
 Tea, coffee, cordial and other beverages are to be dispensed from an enclosed or lidded receptacle
equipped with a tap or spout.
 Food must be transported in approved/registered food transport vehicles or containers to prevent
contamination.
3. FOOD TEMPERATURE CONTROL
 All hot food must be kept above 60°C. All cold food must be kept below 5°C.
 Takeaway food prepared at the food stall must be sold immediately unless there is a suitable food warmer
or display cabinet which can keep food hot (above 60°C) or cold (below 5°C).
 Pre-prepared food products or pre-cooked food which contains fresh cream, custard, trifle, or any similar
food which promotes bacterial growth must be stored and displayed in a refrigerated unit at a temperature
below 5°C.
 All raw and perishable foods such as steaks, hamburger patties, seafood and other meat products must be
stored under refrigeration. Small amounts of these foods can be stored in an esky with an adequate supply
of ice or a cooling medium for less than 4 hours.
 The sale of pre-cooked chicken or pre-cooked chicken pieces or pre-cooked rice from a one or two day food
stall is not permitted. Where specific approval has been granted for food to be prepared at an approved
premises prior to the event, the food is to be reheated on a stove or in a microwave oven to a temperature
in excess of 60ºC, and kept above 60ºC during display.
 All food stalls are to have an accurate probe thermometer onsite to monitor the temperature of cold and
hot foods.
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
4. HAND WASHING FACILITIES
 A potable supply of water (ie. Reticulated or a 20L container) must be provided for dishwashing and hand
washing purposes.
 Separate basins/containers must be available for hand washing,
 Each food stall is to provide warm running water, liquid soap and disposal paper towels for hand washing
and detergent for washing up.
 All wastewater must be disposed of to an approved sewage disposal system or to the City of Stirling’s
satisfaction.
 Disposable hand towels, liquid soap and detergent shall be provided in each food stall where washing
facilities are required by this Standard.
 Where hot water cannot be provided other options may be approved in certain low food risk activity
circumstances, for example; use of disposable gloves, hand sanitisers, cold water and liquid hand soap.
5. UTENSIL WASHING FACILITIES
 Separate utensil washing facilities shall be provided within the stall for washing and rinsing (eg, A
plastic/suitable bowl/container of sufficient capacity for adequate cleaning of utensils and a supply of hot
and cold water shall be immediately available to the food stall. (Disposal of wastes to the City of Stirling’s
satisfaction). The water in the containers should be changed frequently so as to maintain wash water that is
as clean as can be achieved under the conditions
 Dish washing facilities should be of a sufficient capacity for washing utensils.
 All wastewater must be disposed of to an approved sewage disposal system or to the City of Stirling’s
satisfaction.
6. HYGIENE
 Food handlers to wear clean clothing, protective aprons and head coverings.
 Food handlers must be clean and free from infectious disease.
 Food handlers are to ensure that any boils, infected wounds or sores are covered using a coloured,
waterproof bandage or dressing and disposable gloves.
 Food handlers must have access to approved sanitary (toilet) facilities.
 Money handlers must wash hands or change gloves before handling food.
 Food handlers should have adequate food safety skill and knowledge in relation to the tasks they are
undertaking. The City strongly recommends the I’M ALERT Training Course. To complete this free online
course just logon to: www.stirling.imalert.com.au
7. RUBBISH DISPOSAL
 Provide a suitable waste disposal receptacle with a tight fitting lid for all rubbish generated inside and
outside the food stall. Provisions must also be made for patrons to dispose of their litter.
8.
OPEN FOOD STALLS
 Open food stalls consisting of tables only or tables and trestles, where permitted by these standards, shall
be used only for the sale of factory pre-packaged food in hermetically sealed containers (eg, canned or
bottled soft drinks, canned foodstuffs).
 No perishable food shall be sold from an open food stall except packaged milk, packaged milk products and
pre-wrapped ice cream which must be displayed in a refrigerated unit at a temperature below 5°C or other
approved means.
9. LABELLING PACKAGED FOODS
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
 All pre-packaged food sold for commercial purposes shall be labelled in accordance with the provisions of
the Food Standards Code. Food labels must include the following information:
 A description of the food, for example “strawberry jam” or “chocolate cake”
 The name and address of the person or company who made the food, so that the maker can be traced if
there is any problem with the food. A street address is needed, as a post office box cannot be traced;
 A list of ingredients
 A ‘best before’ date to indicate how long the food will keep; and
 Any special storage conditions, for example ‘keep refrigerated’
Except where –
i.
ii.
iii.
iv.
v.
vi.
vii.
viii.
the food is not in a package; or
the food is in an inner package not designed for individual sale. Despite this, individual portion
packs in a container or wrapper with a surface area of 30 cm² or greater must bear a label
containing information in accordance with clauses 3 and 4 of Standard 1.2.3; or
the food is made and packaged on the premises from which it is sold; or
the food is packaged in the presence of the purchaser; or
the food is whole or cut fresh fruit and vegetables, except sprouting seeds or similar products, in
packages that do not obscure the nature or quality of the fruit or vegetables; or
the food is delivered packaged, and ready for consumption, at the express order of the
purchaser; or
the food is sold at a fund raising event; or
the food is packaged and displayed in an assisted service display cabinet.
 Where the above exemptions apply; All food stalls including charities and community organisations must
advise prospective purchasers on request verbally or in writing (displayed next to the food or on the
packaging) that food contains any ingredients listed below which are known to cause allergic reactions:
 gluten (found in wheat, rye, barley, oats and spelt)
 fish, fish products, shellfish or shellfish products;
 milk and milk products;
 egg and egg products;
 soya beans and products;
 peanuts and peanut products;
 sesame seeds and sesame products;
 other nuts and their products; sulphites (a preservative);
 royal jelly, bee pollen or propolis
A guide for food labelling (including community or charity organisations) can be viewed at:
www.foodstandards.gov.au.
For further information please contact the City’s Health Services on 9205 8555
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
APPLICATION TO CONSTRUCT, EXTEND OR ALTER A PUBLIC BUILDING
Form 1
Health Act 1911
Health (Public Buildings) Regulations 1992
I being the owner/agent hereby apply under section 176 of the Health Act to construct, alter or extend a public
building.
PREMISES DETAILS:
Name:
Location Number:
Street:
Town/Suburb:
Nearest Cross Street:
Intention for Use:
Signed:
Owner:
Address:
Phone:
Phone (M):
Fax:
Note: Any of the following may sign this notice: The owner, occupier, Manager, Trustee or other person by
whose authority such Public Building is intended to be built, created or converted thereto.
APPLICATION FOR CERTIFICATE OF APPROVAL
FORM 2
Health Act 1911
Health (Public Buildings) Regulations 1992
I being the owner/agent hereby apply for certificate of approval in respect of:
PREMISES DETAILS:
Name:
Location Number:
Street:
Town/Suburb:
Nearest Cross Street:
Intention for Use:
Construction/extension/alteration of which was completed on:
in accordance with your approval given on:
Signed:
Owner/Agent:
Address:
Phone:
Phone (M):
Fax:
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
FUNCTION BINS PRICE LIST 2014-15
DELIVERY
COLLECTION
TOTAL
MGB 240L Bins
1
$12.02
$28.72
$40.74
2
$24.04
$57.44
$81.48
3
$36.06
$86.16
$122.22
4
$48.08
$114.88
$162.96
5
$60.10
$143.60
$203.70
6
$72.12
$172.32
$244.44
7
$84.14
$201.04
$285.18
8
$96.16
$229.76
$325.92
9
$108.18
$258.48
$366.66
10
$120.20
$287.20
$407.40
11 to 25
$132.22
$268.88
$401.10
26 to 50
$312.52
$448.28
$760.80
Deposit*
$154.52
BULK BIN
1.5m std
$154.52
$60.88
$215.40
3m std
$154.52
$86.80
$241.32
4.5m std
$154.52
$123.21
$277.73
*Deposit required for all bin requests on application or 28 days prior to event.
14 days notice of cancelation required or deposit is forfeited.
Skip/Bulk Bin Sizes:
1.5m3 (equivalent to 6 MGB’s)
3m3 (equivalent to 12 MGB’s)
4.5m3 (equivalent to 18 MGB’s)
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
COMMUNITY SAFETY
TEMPORARY SIGNAGE ON VERGES APPROVAL CONDITIONS
Permission must be sought from the Community Safety Business Unit prior to the erection of
any temporary signage on public spaces in the City of Stirling.
















Maximum of ten signs
Available to not-for-profit groups only
Must not exceed 1.5m in height and do not exceed an area of 1m2 on any side
unless otherwise approved by the City;
Must relate only to the community event described on the permit, and may not include
any name, brand, logo or identifying mark of a profit or commercial body, unless
otherwise approved by the City;
Contain letters not less than 200mm in height;
Are secured in position in accordance with any requirements of the City;
Are placed so as not to obstruct or impede the reasonable use of a thoroughfare or
access to a place by any person;
Are placed so as not to obstruct lines of sight along a thoroughfare or cause danger
to any person using the thoroughfare;
May not be attached to another sign, traffic control device or sign, power pole, bus
seat or shelter, pole or local government property or other item placed under a written
law in a thoroughfare or verge;
May not be nailed or attached to a street tree or plant, or on any bridge or the
structural approaches to a bridge;
Must be maintained in good condition;
May not be placed on or does not overhang a footpath or parking bay;
May not be placed on a verge in a residential area without the permission of the
adjoining owner or occupier;
May not be erected more than 14 days prior to the event, unless otherwise approved
by the City;
Must be removed within 48 hours after completion of the event; and
Must comply with other conditions specified in the permit.
Permission must be granted from the Main Roads Department prior to the erection of any
signs on a main road or highway. Failure to do so can result in infringements being issued
and the signs being impounded. These roads include –
West Coast Highway
Marmion Avenue
Mitchell Freeway
Wanneroo Road
Karrinyup Road - Marmion Avenue to Morley Drive
Morley Drive
Reid Highway
In the interest of public safety it is now a requirement when using star pickets for advertising
signs to attach plastic protector caps. If these caps are not used, the City’s Rangers will
remove the signs from their location.
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
Application for a Permit
Stallholders and Trading in Thoroughfares and Public places




This application form must be completed for all applications for a Permit to conduct a stall or trade,
(including Street Entertainers) in any Thoroughfare and or Public Place within the City of Stirling.
Local Law and City of Stirling Policy requirements are set out in the following documents and are
available for viewing at www.stirling.wa.gov.au :
o The Thoroughfares and Public Places Local Law 2009 (Sections 5 and 6); and
o Stallholders and Traders Permits in Thoroughfares Policy.
Applicants are encouraged to read and understand the requirements contained within prior to
submitting applications.
This form is not required for private events on residential properties.
This form should be submitted a minimum of 4 weeks (28 days) prior to the date that the stall is to be
operated or the trader intends to trade.
Note: in some cases, depending on the nature and size of the operation/ structure a Development
Application may be required and if so a processing period of a minimum of 12 weeks (84 days) prior to the
commencement will be required. It is the stall holders/ Traders responsibility to ensure that they submit
the required application in compliance with these timelines.


Permit fees maybe applicable depending on the period and type of stall or trading being proposed.
Not for profit groups may be exempt from fees and changes.
Notes:
1. A Separate form is required for booking venues under the care of the City
2. This form is not to be used for any trading or stall holders who are intending to sell any food
products.
Completed forms and enquiries
should be directed to:
Mail: City of Stirling – Community Safety, 25 Cedric St, Stirling WA
6021
Phone: (08) 9205 8538 Fax: (08) 9205 8822 Email:
stirling@stirling.wa.gov.au
CONTACT DETAILS
Name of Organisation/ Trader or Stall Holder:
Is the Organisation/ Business a not-for-profit?
Yes
Business Street Address:
Postcode:
Business Postal Address:
Postcode:
No
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
Contact Person (Must be over 18 years)
Title:
Given Name:
Surname:
Position:
Phone (W):
Phone (H):
Phone (M):
Email:
STALL / TRADER DETAILS – WHERE AN ORGANISATION OR OPERATOR ACCEPTS RESPOSIBILITY AND LIABILITY FOR ALL STALL
HOLDERS AND TRADERS ONE APPLICATION CAN BE SUBMITTED BY THAT PERSON/ ORGANISATION HOWEVER INFORMATION WILL
NEED TO BE PROVIDED IN RELATION TO EACH SPECIFIC STALL OR TRADER.
Description of Event/ Trading to be conducted :
Location of Operation:
Date to be Operated:
Start Time:
Finish Time:
Set-up Date/Time:
Duration:
Pack Down Date/Time :
Is the trading or stall to be open to the general public?
INSURANCE
Yes
No
HEALTH AND COMPLIANCE 9205 8444
Please ensure you attach a current copy of your Public Liability Insurance.
Attached
Yes
No
PUBLIC LIABILITY INSURANCE
A copy of the applicant’s Public Liability Insurance (Certificate of Currency) with a cover of not less than $10
million must be provided with the application form. Your event will not be allowed to go ahead without a copy
of this being provided. Please contact your insurance company to check that your event is covered.
ELECTRICAL LEADS & INSTALLATIONS
HEALTH AND COMPLIANCE
9205 8444
Detail the type of electrical equipment to be used. (I.e. generators, electrical leads, sound system, lighting
etc.)
PLEASE NOTE: If your event contains electrical installations such as lighting, electrical equipment etc. a Licensed
Electrician (Electrical Contractor) will be required to check all installations on the day of your event and complete a Form
5 Certificate of Electrical Compliance.
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
TEMPORARY STRUCTURES
HEALTH AND COMPLIANCE
(Refer to attachments)
Will you be having any structures erected? Eg.marquees, stage, tents etc?
9205 8444
Yes
No
If yes, please provide details for each structure including the proposed use and size:
PLEASE NOTE:
For structures greater than 9m2 the “Certification of Structures Form” (see attachments) needs to be
completed on the day of the event by the person who erects the structure.
SIGNAGE
Are you requesting approval to erect / display signage?
Yes
No
If yes, please details:
ATTACHMENTS Please tick attachments submitted with this application. (Note: all are required)
Site Map showing location of stall or trading
Public Liability Insurance Certificate of Currency
Certificate of Incorporation
NOTE: If you are a not- for –profit incorporated group, please provide a copy of your Certificate
of Incorporation or any identifying documentation with your application. If you have supplied
this previously you will not need to provide this again unless requested
Advice of Structures Form and Public liability Insurance Certificate of Currency for business
erecting the 9m2 structure
Where requested a Parking Plan
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014
APPLICANTS DECLARATION
As the stallholder/trader, or event organiser
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I certify that the information provided in this application is true and correct to the best of my
knowledge.
I agree to notify the City of Stirling of any changes to the information provided in this application.
I will ensure that appropriate liability and other insurances are in place for the activities to be
conducted.
I agree to Indemnify the City, the Council and its employees harmless from and against all
damages, sums of money, costs, charges, expenses, actions, claims and demands, which
may be sustained or suffered or recovered or made against the Council by any person for
any loss of life or injury or damage any person may sustain as a result of and during the
conduct of business.
I have read and understand the Terms and Conditions of approval for a Stallholder and Trader and
agree to abide by these at all times when involved in or conducting business associated with this
application.
I acknowledge that the City will assess this Application and may issue a Permit allowing me to trade.
I acknowledge and understand that I cannot conduct a stall or trade without a Permit issued by the
City.
I acknowledge and agree to comply with all statutory legislation in force through the conduct of the
business.
Not to damage, break, dig up or alter any infrastructure;
To clean up and remove any rubbish, litter and materials including any spills made at the
site.
Name:
Position
Signature:
Date:
OFFICE USE ONLY DETERMINATION
Permit request approved
Yes
No
Delegated Officer Name:
Notes:
City of Stirling Administration Centre | 25 Cedric Street Stirling WA 6021
Telephone (08) 9205 8555 | Facsimile (08) 9205 8822| E-mail stirling@stirling.wa.gov.au | Website www.stirling.wa.gov.au
Revised November 2014