Form Center

2. 
   FIRE PREVENTION
   PERMIT APPLICATION

3. 

5. FIRE PREVENTION BUREAU
   Administrative / Inspections: (810) 694-7211 Fax: (810) 424-2787

7. BUILDING INFORMATION

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9. Building/Occupant Name:*
10. Manager/Contact:*
12. Building Location:*
13. Phone Number:*
15. Additional Mailing / Corporate Address (If Applicable)
16. Email Address:

    If you would prefer email communications, please provide email address.

18. BUILDING OWNER'S INFORMATION

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20. Building Owner's Name:*
21. Phone Number*
23. Address:*
24. Email Address:
26. EMERGENCY CONTACTS:
28. Contact #1:*

      Name

29.  *

      Phone

31. Contact #2

      Name

32.  

      Phone

34. DESCRIPTION OF WORK:

36. Permit includes initital inspection and (1) re-inspection. There will be a $50.00 fee for each additional re-inspection required.

    Please Return Application and Payment to: P.O. Box 1833., Grand Blanc, MI 48507

38. 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.
40. Electronic Signature*

42. This department will not discriminate against any individual or group because of race, sex, region, age, national origin, color, marital status, handicap or political beliefs.

    AUTHORITY -- Public Act 207 of 1941, As Amended   COMPLETION -- Mandatory to obtain permit.   PENALTY -- Permit cannot be issued.

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