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Phone: 409-643-5700 FAX: 409-643-5719
General Permit
Type of Permit Requested:
Fire Alarm System, Alarm Re-Test, Above Ground Storage Tank, Dry Cleaning plant, Flammable
finishes booth, Day Care, Suppression system, Sprinkler System, Open Burn, Trench Burn,
Explosive or Fireworks use/transport/storage, Tent, Compressed gas, Fuel Disp., Flammable and
Combustible liquid storage. Alarm systems, Underground Supply for Sprinkler systems,
Venthood systems, and Paint booth suppression system Plans must be submitted with a flash
drive containing a PDF formatted copy of the submittal, and 2 hard copies.
Date Issued: ________________
ID #: ____________________ Fire Official_______________________
Date Expires: _______________ Permit #: _______________________
Name of Occupancy: ____________________________________________________
Address of Occupancy: ___________________________________________________
Business / Applicant Name: ____________________________________________
Business Address: ______________________________________________________
Phone: _____________________ Cell Phone: ____________________
Fee Required: $___________ Applicable fees must be paid prior to permit issuance.
Cash [ ] Check [ ] Fee Received By: _________________________________
Details regarding the above request must be filed when application is made and whenever requested by
the Fire Official. It is the applicant’s responsibility to ensure that conditions are in accordance with
applicable State and Local fire regulations. I understand that it is the sole discretion of the Fire
Official making inspection to approve or disapprove this request for any reason.
I understand that the Fire Official may revoke this permit at any time for non-compliance.
Note: Operating with no permit or an expired permit may result in a municipal citation, and double
permit fees.
Applicant may not proceed without the approved permit by Fire Official.
__________________________ ________________________ _____________
Applicant Signature Print Name Date
Email Address:_________________________________
**For Fire Department Use Only**
Notes regarding Inspection (If disapproved, state reasons)
Approved: [ ] Yes [ ] No
** Permit must be kept at site at all times **
Date Application Rcvd ______________