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Fire System
Permit Application
Fire Services
Innovative - Responsive - Professional
TYPE OF PERMIT REQUESTED
This permit is for (select one):
Alarm System Radio System
Sprinkler/Suppression System
This permit involves (select one):
A New System
Alteration to an Existing System
Provide Scope and Description of Work:
PROPERTY INFORMATION
Address:
Parcel Number:
Property Owner:
Tenant (Commercial):
CONTRACTOR INFORMATION
Contractor Business Name:
Contractor Address:
Contact Name: Contact Phone:
Contractor's L&I License No.
L&I License Expiration Contractor's Kirkland Business License No. Business License Expiration
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge and further that I am authorized by the owner of the
above premises to perform the work for which permit application is made. I further agree to save harmless the City of Kirkland as to any claim (including costs, expenses,
and attorney's fees incurred in investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of
Kirkland, but only where such claim arises out of the reliance of the City, including its officers and employees, upon the accuracy of the information supplied to the City as
a part of this application.
Applicant (Signature):
Date:
