Fire and EMS Department

Application for Permits and Inspections (* = Required field)

Application Type:
Permit/Inspection Type:
Base Price:

DCRA #:
Quantity (lbs):

Literal1: Vehicle Tag:

Customer Information:

Contact: Name:
Phone:
Email:

Company: Name:
Address:
City:
State:
Zip:
Phone:
Email:

Service Location: Business Name:
Service Location:
Ward:
Quadrant:

Event Information: Name:
Location:
Floor:
Exhibit Area:
Start:
End:

Permitholder Name:
Permitholder Address:
Supporting Documents:
Comments:

Payment Information: Payment Amount:
Expedite: The Permit Fee is doubled for Expedited Requests
Credit Card Type:
Credit Card Number:
Expiration Date: /
Security Code:
Cardholder Name:

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