APPLICATION FOR ALARM PERMIT
CITY OF HELENA/LEWIS & CLARK COUNTY FIRE AND INTRUSION ALARM SERVICE
TYPE OF ALARM:
Business Name/Resident Owner’s Name (Check all that Apply)
Commercial Residential
Intrusion Fire
Alarm Address Phone Number Silent Audible
Other (Specify)
Owner/Mailing Address Phone Number Alarm Manufacturer
Business/Person responsible for alarm maintenance:
Name Phone Number
Street Address/PO Box City, State, Zip
List contact person for deactivating alarm when owner or subscriber is unavailable:
Name Phone Number
Street Address/PO Box City, State, Zip
Name Phone Number
Street Address/PO Box City, State, Zip
Name Phone Number
Street Address/PO Box City, State, Zip
List ammunition, explosives, flammable liquids, poisonous or hazardous materials on
property:
List animals left in building protected by alarm:
Monitoring company’s address:
Name Phone Number
Street Address/PO Box City, State, Zip
Dated this Day of , 20 .
Subscriber/Representative Signature Phone
APPLICATION APPROVED
Support Services Division Approval/Date Alarm Permit Number
Amount
Cash OR Check #
