Rev. 03-19 Subject to Change
Inspection Request Form
Date: Email to: fire.inspections@prosperfire.com
Inspection Type: Annual Inspection Re-Inspection Fee After-Hours Inspection
Description: _______________________________________________________________________________
__________________________________________________________________________________________
To be filled out by business/person applying for inspection. Please print clearly.
Name of Company: ___________________________________________________________________________
Company Address: ___________________________________________________________________________
City: ____________________________ State: __________________ Zip Code: ______________________
Company Phone: _____________________________ Company Fax: _________________________________
Company Email: ___________________________________________
Name of Applicant: ______________________________________________________
Permit #: _________________________
(if applicable)
Applicant’s Address: _________________________________________________________________________
City: ____________________________ State: __________________ Zip Code: ______________________
INSPECTION FEES:
Inspection Fee - $150.00 Re-inspection Fee - $150.00 After-Hours Inspection - $150.00
(Per hour one-hour minimum)
I hereby certify that the above application is complete and correct to the best of my knowledge. The undersigned applicant
certifies that the project described herein will be built in accordance with plans and specifications submitted. All provisions of
laws and ordinances governing this type of work will be complied with whether specified or not. The granting of a permit does
not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or performance
of construction.
CANCELLATIONS
Notice of cancellations must be made 24 hours in advance or re-inspection fees will be accessed. Please note; in
the event of inclement weather underground inspections will be cancelled.
Print Name Date
Signature
click to sign
signature
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