Phoenix

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Alarm Permits

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Name of Residence or Name of Business (Should be Same Name Alarm Company Uses for Dispatch) *

Telephone Number At Location *

Address of Alarmed Location: (One Address Only) *

City *

Zip Code *

Email *

Please Check One

Residence

Business

Name *

Address *

City *

State *

Zip Code *

Name of Owner if Different than Subscriber / Proprietor *

Alternate Telephone Number For Owner *

Check One Control Panel: A separate permit is required for each control panel.

1 Control Panel (Burglar Only) $17

1 Control Panel (Fire Only) $17

1 Control Panel (Burglar & Fire) $17

Installed/Serviced by (Name of Company) *

Phone *

Monitored by (Name of Company) *

Phone *

List at least two responsible representatives (other than the applicant) who will respond to an alarm activation within 30 minutes to assist the Police or Fire Department in determining the cause of the alarm activation and to secure the premises.

1. Name *

Daytime Telephone Number Ext. *

Nighttime Telephone Number Ext. *

Relationship *

Pager Number *

Cell Phone Number *

2. Name *

Daytime Telephone Number Ext. *

Nighttime Telephone Number Ext. *

Relationship *

Pager Number *

Cell Phone Number *

3. Name

Daytime Telephone Number Ext.

Nighttime Telephone Number Ext.

Relationship

Pager Number

Cell Phone Number

4. Name

Daytime Telephone Number Ext.

Nighttime Telephone Number Ext.

Relationship

Pager Number

Cell Phone Number

The application fee of $17 MUST be included with the application. Please make check or money order payable to the CITY OF PHOENIX. To pay by credit card over the phone, first email the completed application to [email protected], wait for an emailed response, and then call 602-534-0322 (or fax the completed application, wait 60 minutes, and then call 602-534-0322).

Created by AIPSS

Phoenix

Alarm Permits

SUBSCRIBER / PROPRIETOR INFORMATION

SUBSCRIBER / PROPRIETOR MAILING ADDRESS

BURGLAR & FIRE ALARM COMPANY AND / OR MONITORING COMPANY

RESPONSIBLE REPRESENTATIVES