Formular Mobile Food Establishment Permit | Maricopa

Follow all instructions below to avoid delays in the application review process.

Information regarding State Licensure:

Application Steps

Make checks payable to MCESD. We also accept Visa, Mastercard, American Express and Discover.

Checklist for no new construction (new owner of permitted establishment or those with current permit issued in another Arizona county)

Complete Application (please indicate n/a, if not applicable rather than leaving empty boxes on the application)

Application fees (see below)

Proposed Menu(s) with consumer advisory (if applicable)

Commissary Agreement

Toilet Use Agreement (if applicable)

Route Sheet/Location of operation

Photos of interior and exterior of unit

Copy of current permit card in other Arizona county, if permitted under state licensing requirements, if applicable

Copy of Food Processor/Production permit or equivalent, if applicable

Checklist for construction/review

Complete Application (please indicate n/a, if not applicable rather than leaving empty boxes on the application)

Plan Review fees

Proposed menu(s) with consumer advisory (if applicable)

Commissary Agreement (must be submitted prior to permit issuance)

Complete set of plans

Plumbing and Finish schedule (if not already indicated in the plan)

Cut sheets/schematics of all equipment to be installed. This includes any custom built equipment.*

Toilet Use Agreement (if applicable, must be provided prior to permit issuance)

Route Sheet/Location(s) of operation (must be provided prior to permit issuance)

Photos of interior and exterior of unit

Copy of Food Processor/Production permit or equivalent, if applicable

Checklist for submitting plans/layout

Plans are full size, printed to scale as indicated on plan/drawing, and legible.

Plans include top view and side view(s) of unit/booth layout

Plans are a minimum of 8.5"x11".

Plans contain all lighting, ventilation, plumbing layout, and locations of sinks and equipment.

Visit one of our offices to deliver your application

• “Annual Event Food Establishment” means a food establishment that operates in conjunction with one event that operates for not more than one-hundred twenty (120) consecutive days. • “Mobile Food Type I” means a food establishment that dispenses commercially processed, individually packaged foods and/or non-time/temperature control for safety (non-TCS) beverages. • “Mobile Food Type II” means a food establishment that dispenses food that requires limited handling and preparation. • “Mobile Food Type III” means an enclosed vehicle-mounted food establishment that prepares, cooks, holds and serves food.

If expedited plan review is being requested, the plan review fees per permit are doubled.

***Note: Annual permit fees are assessed once the establishment qualifies for a permit.

Business Name *

Vehicle/Unit #

License Plate

Vin #

Address *

City *

Zip *

State *

Phone # *

Email Address *

Alternate Phone Number

Alternate Email

Owner/Corporation *

Address *

Email *

Phone *

FAX #

City *

State *

Zip Code *

Owner Name

Address

City

State

Zip Code *

FAX #

Phone *

Email *

Check all that apply

Currently permitted in another Arizona County and operating in accordance with state licensing requirements.

Taking Ownership of an existing/previously permitted establishment.

Construction/Review of an existing/previously permitted establishment

Construction/Review of a new/never permitted establishment

Any construction or review will require a set of plans to be submitted with this application.

Copy of current permit from other Arizona county

Drag and drop a file here or click to select a file

Permit # *If currently permitted in another county, please provide permit number.

Layout Provide layout for all projects involving construction/review. Please be advised that the documents must be legible to avoid delays in the review process.

Drag and drop a file here or click to select a file

Equipment Cut Sheets/Schematics Please provide equipment cut sheets for any projects involving construction/review. Please be advised that the documents must be legible to avoid delays in the review process.

Plumbing/Finish Schedule Either complete the plumbing/finish schedule on this page or provide information on separate sheet for review.

Menu Combine multiple files into one PDF or JPG.

Commissary Agreement

Copy of Food Processor/Production permit or equivalent, if applicable

If operating at multiple markets, please provide detailed calendar/event list

Menu *

Provide brief list of menu items. Please ensure you attach complete menu.

Drag and drop a file here or click to select a file

Hours of Operation (indicate AM/PM)

Months plan to operate

Days plan to operate

List of the location/events/farmers' markets you plan to operate at

Fresh water tank size (gallons) *

Inner diameter of fresh water inlet (inches) *

Waste water tank size (gallons) *

Inner diameter of waste water outlet (inches) *

Water heater tank size (gallons) *

Flow rate at sinks ( gallons/minute) *

Handsink basin (LXWXD) *

3 Comp sink basin (LXWXD) *

Generators

ARS § 11-1604. Prohibited acts by county and employees; enforcement; notice A county shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not specifically authorized by statute, rule, ordinance or delegation agreement. A general grant of authority does not constitute a basis for imposing a licensing requirement or condition unless the authority specifically authorizes the requirement or condition. Unless specifically authorized, a county shall avoid duplication of other laws that do not enhance regulatory clarity and shall avoid dual permitting to the maximum extent practicable. This section does not prohibit county flexibility to issue licenses or adopt ordinances or codes. A county shall not request or initiate discussions with a person about waiving that person's rights. THIS SECTION MAY BE ENFORCED IN A PRIVATE CIVIL ACTION AND RELIEF MAY BE AWARDED AGAINST A COUNTY. THE COURT MAY AWARD REASONABLE ATTORNEY FEES, DAMAGES AND ALL FEES ASSOCIATED WITH THE LICENSE APPLICATION TO A PARTY THAT PREVAILS IN AN ACTION AGAINST A COUNTY FOR A VIOLATION OF THIS SECTION. A COUNTY EMPLOYEE MAY NOT INTENTIONALLY OR KNOWINGLY VIOLATE THIS SECTION. A VIOLATION OF THIS SECTION IS CAUSE FOR DISCIPINARY ACTION OR DISMISSAL PURSUANT TO THE COUNTY'S ADOPTED PERSONNEL POLICY. THIS SECTION DOES NOT ABROGATE THE IMMUNITY PROVIDED BY SECTION 12-820.1 OR 12-820.02.

Delivery of Inspection Reports

Disclosure Acknowledgement*

I hereby certify that the above information is correct, agree to comply with the Maricopa County Environmental Health Code, agree to allow the regulatory authority access to the establishment as specified under § 8-402.11 and to the records specified under §§ 3-203.12 and 5-205.13 and Subparagraph 8-201.14(D)(6), and I fully understand that any deviation from the above without prior permission from the Maricopa County Environmental Services Department may nullify final approval. By checking the check box and typing your name you have digitally signed this application.

Application Acknowledgement*

Arizona law, A.R.S. § 11-1605(I), allows Maricopa County Environmental Services Department (MCESD) and the applicant for a license to mutually agree to extend the plan review time frame by 50 percent of the substantive time frame and overall time frame. MCESD will agree to any applicant's request for an 50 percent extension of the substantive review time frame and overall time frame when box is checked and signed below.

Licensing Time Frame Extension Acknowledgement

Electronic Signature Agreement

I agree.

Disclaimer

Maricopa

Mobile Food Establishment Permit

Instructions for Submission

Business Information

Business Owner Information

Mailing/Billing Information

Permit Questionnaire

Menu, Operation, Plumbing & Generators

Review Notice

Review Disclosures

Review and Sign