Exhaust Hood Cleaning Permit Application

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An application for a Commercial Kitchen Exhaust Hood Cleaning Permit must be paid for and submitted to the City of Edina Fire Prevention Bureau five (5) days prior to the start of cleaning. If it is submitted in less than the required five (5) days, arrangements must be made with the Prevention Bureau at 952-826-0378 or 952-826-0393 (FAX). Cleanings performed without a permit will be charged an additional $25.00.

When the cleaning is complete, call the Edina Fire Department at 952-826-0378 for an inspection. For the inspection, cleaning crews should have all their work completed, and all access panels must be open.

The permit fee is $85.00.

Permit Information: Please provide the following information. The red asterisk (*) indicates a required field.

*	Site Name:
*	Site Contact Name:
*	Contact Phone Number:
*	Site Address:
	Suite/Unit Number:
	If job site has multiple hoods, please list those to be cleaned
	Hood #1
	Hood #2
	Hood #3
	Hood #4

Contractor Information: Please provide the following information. The red asterisk (*) indicates a required field.

*	Contractor Name:
*	Contractor Address:
*	City:
*	State:
*	Zip:
*	Phone Number:
	Fax Number:

Cleaning Schedule: Please provide the following information. The red asterisk (*) indicates a required field.
*	Start Date: (mm/dd/yyyy) * Time: (hh:mm)
*	Estimated Completion Date: (mm/dd/yyyy)
*	Estimated Completion Time: (hh:mm)

I understand that some of the information provided on this form will be public data. Public data is available to anyone who makes a request for such information. My credit card number is not considered public data.