Form Center

2. Fire Prevention

   Fire Prevention Registration and Payment

4. Date and Time*
   Date and Time

   Date and Time
8. Business Contact

   The business contact should be a person that either owns the business or makes business decisions on behalf of the owner.  All correspondence from this office will be sent to the business owner.

10. Business Contact Name*
11. Email Address*
13. Address*
15. City*
16. State*
17. Zip Code*
19. Phone Number*
20. Additional Phone Number
22. Building Owner
24. Building Owner Name*
25. Email Address*
27. Address*
29. City*
30. State*
31. Zip Code*
33. Phone Number*
34. Fax Number
36. Emergency Contact Information

    An emergency contact should be a person that is able to make decisions related to your property on your behalf in the event of an emergency. An emergency contact should have full access to your property and live within 30 minutes of your property.

38. First Name*
39. Last Name*
41. Phone Number*
42. Fax Number
44. Email Address*
48. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
50. Electronic Signature*
51. Date
    Date
55. Online Invoice Payment
    Pay your registration fee below. Select only the fee amount detailed on your invoice.
57. Invoice Number*
59. Invoice Amount(s)

    1. Less than 500sq/ft - $75
    2. 500 to 1,000sq/ft - $100
    3. 1,001 to 3,000sq/ft - $150
    4. 3,001 to 5,000sq/ft - $200

    1. 5,001 to 10,000sq/ft - $250
    2. 10,001 to 20,000sq/ft - $300
    3. 20,001 to 50,000sq/ft - $500
    4. 50,001 to 100,000sq/ft - $750

    1. Type 1 Permit - $54
    2. Type 2 Permit - $214
    3. Type 3 Permit - $427
    4. Type 4 Permit - $641
61. Shipping Cost
62. Taxable
63. Quantity
Leave This Blank:


65. Calculate Totals Proceed to Checkout

* indicates a required field