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Fire Prevention Permit Request

2. Fire Prevention Permit Request
4. You will be contacted to once the information has been processed to arrange for payment of permit fees and issuance of permit.
6. Organization/Individual Requesting Permit Information
8. First Name*
9. Last Name*
11. Business Name (If Applicable)
13. Business Address*
15. City*
16. State*
17. Zip*
19. Phone Number*
20. Date of Request
    Date of Request

    Date of Request
22. E-Mail Address
23. Preferred Method of Contact
    -- Select One --PhoneE-Mail
27. Information for Location of Permit Utilization
29. Name of Individual/Organization*
31. Location for Permit Utilization
33. City
34. State
35. Zip
37. Type of Permit Requested

    1. Hot Work Operations ($50)
    2. Open Burning ($50)
    3. Temporary Tent/Canopy ($50)
    4. Automatic Fire Extinguishing System/Fire Pump Installation ($100 + $2 per device)*
    5. Fire Alarm/Detection System ($100 + $2 per device)*
    6. Other (Please describe in Additional Comments/Information Section)
38. Additional Comments/Information
40. Account Number 5310-435299
42. * Please List Number of Devices in Comments Section
Leave This Blank:


44. 1. Receive an email copy of this form.
45. Email address

    This field is not part of the form submission.

46. Submit

* indicates a required field