BTR Checklist for Amusement Arcades

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BTR Checklist for Amusement Arcades Sec. 22-3 - Amusement arcade: That portion of an interior premises consisting of three (3) or more amusement devices, but no more than forty-nine (49) amusement devices. Sec. 22-3 - Arcade amusement center: That portion of an interior premises consisting of fifty (50) or more amusement devices. Arcade amusement centers shall operate in accordance with the provisions outlined in F.S. 849.161(1)(a)(1) as amended from time to time. Sec. 22-3 - Amusement device: An amusement device shall mean any table, platform, mechanical or electronic device or apparatus operated or intended to be operated indoors for amusement, pleasure, test of a skill, competition or sport, where the use or operation of which is conditioned upon payment of a consideration either by insertion of a coin, electronic card, or token in a slot or otherwise so long as the person playing does not receive anything of value or any prize in violation of state or federal law. The definition of an "amusement device" shall include, but not be limited to, devices commonly known or simulated baseball, simulated football, simulated basketball, simulated hockey, simulated boxing, pinball, shuffleboard, ray guns, bowling games, bumper games, skiball, electronic video games, and shall also include billiard tables and pool tables (whether coin or not). Such definition does not include a bowling alley, juke box, or other coin-operated music machine, or a mechanical children's amusement riding device. BTR FEES ARCADES a. Amusement Arcade - consisting of 3-49 devices - $210.58 b. Arcade Amusement Center - consisting of 50 or more devices - $578.81 How to apply: An applicant for a permit to operate an amusement arcade or arcade amusement center shall submit the following information: a. MUST MEET ALL CONDITIONS OF CODE OF ORDINANCES 22-71 (ATTACHED) b. All applications shall include a list of all current owners and employees of the arcade. c. For each owner and employee, a criminal history certification shall be ordered through Florida Department of Law Enforcement which includes a fee of $24.00 per history and mailed directly to the City Clerk s office. Forms are provided for your convenience.

d. Each owner and employee must complete a City of Fort Pierce Criminal History Affidavit and meet the requirements of a Level 2 screening standards as outlined in F.S. 435.04. e. Provide an operating plan consisting of an interior layout plan drawn to scale showing the location of all machines, devices, equipment and access ways, and such other information as may be reasonably requested. f. Amusement arcades or arcade amusement centers that serve food or provide catering services on premises must be licensed by the Department of Health, Department of Business Professional Regulation, or Department of Agriculture and Consumer Services. g. A complete inventory, including serial numbers or equivalent identification, common name, and type or description of the game played on the machine, of all amusement devices in operation on the premises of the amusement arcade at all times. h. A certificate of inspection by the planning department of the inventory. i. City of Fort Pierce Building Inspection - $75.00. j. Application fee of $15.00 k. BTR Application for Amusement Arcade (Sec. 9a or 9b) with appropriate fee l. Additional Fee - $50.00 per machine pursuant to Resolution 15-R11, as amended. m. Fictitious Name or Corporate Document Registration. n. Other state licenses as required. At BTR Renewal: a. Current list of all owners and employees. (Background checks for any new employees) b. Certificate of inspection of updated inventory, along with serial numbers or equivalent identification, of the amusement device that the permittee intends to put into operation when the amusement arcade begins its business activities under the renewal license. c. BTR Renewal Fee of $5.00 d. Annual Business Tax for Amusement Arcade Category 9a or 9b as amended from time to time. e. Annual Fee of $50.00 per machine as required by 22-71(c)(1) and established pursuant to Resolution 15-R11, as amended.

Florida Department of Law Enforcement Criminal Justice Information Services (850) 410-8109 Florida Criminal History Information Request Pursuant to provisions of Chapter 119 and Section 943.053, Florida Statutes I am requesting Florida criminal history information on the following individual: Last Name*: Last Names should not include spaces (ex. De la Rosa, DelaRosa). Please use hyphens when applicable (ex. Jones- Smith) First Name*: Middle Name: Other Names Used: Last, First, Middle (Please omit spaces and include hyphens when necessary) Last) First) Middle) Last) First) Middle) * Required Fields NOTE: PLEASE INDICATE HISPANIC PERSONS AS EITHER WHITE OR BLACK BASED ON THEIR ACTUAL SKIN COLOR *Race (pick one): W - White/Caucasian B - Black U - Unknown A- Asian/Pac. Islander I - Alaskan/Native American Race*: Sex*: Date of Birth*: Social Security Number: Optional Information: Social Security Number Middle Name Other Names Used Please provide as much information as possible. The accuracy of the information provided is critical as all searches are based on this information. We accept the following payment methods: Personal or business check imprinted with name of account holder and address or money orders. Checks or money orders should be made payable to FDLE and be in U.S. Currency. Submit completed form along with the required $24 fee (per inquiry) to: Florida Department of Law Enforcement User Services Bureau / Criminal History Services Post Office Box 1489, Tallahassee, FL 32302-1489 Certified Results Notary letters certifying the results are available at no additional charge I am requesting certification of criminal history information request results I am requesting certification of criminal history information request results in Spanish **Please note that only results that have no criminal history record will be translated and certified in Spanish. Results that contain a Florida criminal history cannot be translated into Spanish, but will be certified. Mail Criminal History Information Request Results To: Contact Person: Contact Telephone: ORI Number: (If applicable) Date Submitted: Street: City: State: ZIP: USB-007 (Rev 08-2015)

CITY OF FORT PIERCE OFFICE OF THE CITY CLERK 100 N. US HWY 1 FORT PIERCE, FL 34950 772-467-3065 CRIMINAL HISTORY AFFIDAVIT Name of Business Name of Applicant Arcade location address Have you ever been convicted of any crime, misdemeanor or felony? If yes, please answer all of the following: What was the nature of the offense? When did the offense occur? What was the punishment or penalty assessed? Is the punishment or penalty still in effect? Signature of Applicant STATE OF FLORIDA ST. LUCIE COUNTY Before me, the subscriber, personally appeared who being duly sworn, deposes and says that the above statement is true and correct without any deduction for or on account of any indebtedness or liability of any nature whatsoever. Sworn and subscribed before me, this day of, 20. Notary Public Rev 4/16