Lebanon Fire Department
12 South Park Street
Lebanon, NH 03766
Phone: 603-448-8810
Fax: 603-448-8811
Email: fire@lebanonnh.gov
Application for Fire Code Permit
(Please Print or Type)
Phone:
Phone :
Fax: :
Address:
Property Owner:
Contact Person for Project:
Submitting Contractor:
Email Address:
Project Location:
Tax Map:
Tax Lot:
Tax Plot:
Mailing Address:
Location (Physical Address):
Permit Code(s) (From following pages):
(Example: 105.6.28 LP-gas Operational Permit)
Signature of Applicant:
Date:
FOR OFFICE USE ONLY
APPROVED - FIRE PREVENTION:
INSPECTED - FIRE PREVENTION:
DATE:
DATE:
Description of Activity:
Received: File #: Permit #: Issued:
Date Paid:Voucher #Statement Mailed:Fire Dept Fee(s)
$:
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