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2. 
4. Name of Business:*
5. Phone #:*
6. Type of Business:*
8. Occupancy Load:*
9. Business Square Footage:*
10. Number of Employees on Site at Once:*
12. Address of Business/Building:*
13. Mailing Address (If Different):
15. Is there cooking at the establishment?*

    1. Yes
    2. No
17. Is alcohol served at the establishment?*

    1. Yes
    2. No
18. If no, can they bring their own?*

    1. Yes
    2. No
    3. N/A
20. Are there classes at the establishment?*

    1. Yes
    2. No
22. Are there any Hazardous/Biohazard materials on site?*

    1. Yes
    2. No
24. Number of apartments within building:*
26. Business Owner Name:*
27. Business Owner Address:*
28. Business Owner Phone:*
29. Business Owner Email:*
31. Building Owner Name:*
32. Building Owner Address:*
33. Building Owner Phone:*
34. Building Owner Email:*
36. Mail noticies to:*

    1. Building Owner
    2. Business Owner
38. Business Emergency Contact #1:*
39. Emergency Contact #1 Phone #:*
40. Emergency Contact #1 Email:*
42. Business Emergency Contact #2:
43. Emergency Contact #2 Phone #:
44. Emergency Contact #2 Email:
46. Is there a fire alarm system in the building?*

    Required to be inspected annually and copies of inspection reports sent to Fire Prevention office

    1. Yes
    2. No
48. Is it centrally monitored by an alarm company?*

    1. Yes
    2. No
50. Is there a sprinkler system in the building?*

    Required to be inspected annually and copies of inspection reports sent to Fire Prevention office

    1. Yes
    2. No
52. Is there a Kitchen Suppression System in the building?*

    Required to be inspected every 6 months and copies of inspection reports sent to Fire Prevention office

    1. Yes
    2. No
54. Is there a key Knox box located on the building?*

    1. Yes
    2. No
55. If yes, are the keys up to date in the key box?*

    1. Yes
    2. No
Leave This Blank:


57. 1. Receive an email copy of this form.
58. Email address

    This field is not part of the form submission.

59. Submit

* indicates a required field