CITY OF HEATH
EMERGENCY ALARM PERMIT
PERMIT HOLDER:
ADDRESS:
PHONE:
ALARM LOCATION:
ALARM CLASS:
RESIDENTIAL
APARTMENT SINGLE
COMMERCIAL
APARTMENT MULTIPLE
ALARM TYPE:
BURGLARY
ROBBERY
PANIC
FIRE
SQUAD
OTHER
INSTALLATION DATE:
ALARM COMPANY:
PHONE:
ALARM COMPANY STATE LICENSE NUMBER:
KEY HOLDERS (Person to Contact in Case of Emergency)
In Sequence to be Called:
MUST BE NOT
Name
Phone
1)
2)
3)
This Alarm Permit Is Non-Transferable. HEATH POLICE DEPARTMENT
IMMEDIATELY OF ANY CHANGES IN THIS PERMIT.
This Includes: Key Holder Information, Changes
in Alarm Company, Business/Residential Information, etc. A New Permit
Must
be Obtained Within
Two
(2)
Business Days Should Changes be Necessary.
PERMIT FEES:
RESIDENTIAL / SINGLE APARTMENTS
COMMERCIAL/MULTIPLE APARTMENTS
$ 25.00
$100.00
RENEWAL FEES: RESIDENTIAL / SINGLE APARTMENTS
COMMERCIAL/MULTIPLE APARTMENTS
$ 25.00
$ 50.00
This Permit Expires Three (3) Years from the Date of Issuance. An Updated Application Must be Filed for
Renewal.
I
ISSUED BY:
DATE ISSUED: