Application For Fire System Design, Installation Or Maintenance Permit - Alaska Department Of Public Safety

ADVERTISEMENT

OFFICIAL USE ONLY
DEPARTMENT OF PUBLIC SAFETY
PERMIT # _________________
DIVISION OF FIRE PREVENTION
Issue Date _________________
5700 East Tudor Road
Verification _________________
Anchorage, Alaska 99507-1225
APPLICATION FOR FIRE SYSTEM DESIGN, INSTALLATION OR MAINTENANCE PERMIT
(Authority 13 AAC 50.035)
Please print the following information:
Last Name
First
M.I.
Social Security Number
Date of Birth
Home Phone Number
Resident Mailing Address
City
State
Zip
Business Name
Work Phone Number
Business Address
City
State
Zip
This application is for:
New Permit
Renewal Permit
Addition/change of level
CLASS LEVELS OF PERMIT REQUESTED:
IA
IIA
IIIA
IV
IB
IIB
IIIB
IC
IIC
IIIC
I certify that the information supplied on this application is true and accurate. I agree to perform only those
functions on fire systems allowed by this permit. (See 13 AAC 50.035)
Signature
Date
There are no fees for these permits. Please attach the following information:
1. Proof of required work experience from a current/former employer. The individual must be a manager or owner,
and he/she can verify dates of employment and specific duties.
2. Copy of NICET “Certification”, “Conditional Decision” letters, Exam results, or the NICET certificate. NICET
certification cards will NOT be accepted.
IF YOU NEED FURTHER INFORMATION, CONTACT MARIE COLLINS AT (907) 269-5625.

ADVERTISEMENT

00 votes

Related Articles

Top 20 Happy Easter Cards And Gift Tags To Download For Free
Top Ten Easter Arts And Crafts Activities For Your Kids
Free Easter Coloring Pages And Easter Printables For Your Kids

Related forms

Application For Fire System Renewal Permit - Alaska Department Of Public Safety Application For Fire System Renewal Permit - Alaska Department Of Public Safety Legal
Application For Permit To Sell Salable Fireworks At Retail Form - Alaska Department Of Public Safety Division Of Fire Prevention Application For Permit To Sell Salable Fireworks At Retail Form - Alaska Department Of Public Safety Division Of Fire Prevention Legal
Notice Of Intent To Sell Or Change Ownership - Missouri Department Of Public Safety Notice Of Intent To Sell Or Change Ownership - Missouri Department Of Public Safety Legal
Application Form For Permit To Use Dangerous Fireworks And Class Application Form For Permit To Use Dangerous Fireworks And Class "c" Fireworks In Excess Of 250 Pounds - Department Of Public Safety Division Of Fire Prevention Of Alaska Legal
Application For License To Sell Fireworks At Wholesale - Department Of Public Safety Division Of Fire Prevention Application For License To Sell Fireworks At Wholesale - Department Of Public Safety Division Of Fire Prevention Legal
Application For Concealed Firearm Permit - State Of Utah Department Of Public Safety Application For Concealed Firearm Permit - State Of Utah Department Of Public Safety Business
Applications Form For Weapons Identification Card - Commonwealth Of The Northern Mariana Islands, Department Of Public Safety Applications Form For Weapons Identification Card - Commonwealth Of The Northern Mariana Islands, Department Of Public Safety Legal
Applicant Reference Form - Westchester County Taxi & Limousine Commission, Department Of Public Safety Applicant Reference Form - Westchester County Taxi & Limousine Commission, Department Of Public Safety Business
Application For Non-resident Ri Landing License Form - Rhode Island Department Of Environmental Management Application For Non-resident Ri Landing License Form - Rhode Island Department Of Environmental Management Legal
Application For Participation In The Underserved Areas Credit Program - Chicago Department Of Revenue Application For Participation In The Underserved Areas Credit Program - Chicago Department Of Revenue Financial

Related Categories

Parent category: Legal
Download
Go