Fire Protection Contractor Application

Part One

Company Name *

DBA *

Responsible Person *

First

Last

Responsible Person Certification

Business Address *

Address Line 1

Address Line 2

City

State

Zip Code

Same as Business Address

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Business Phone *

Cell Phone

Email *

Website / URL

Part Two

Business Certification

License Class *

License Number *

Exp. Date *

License Class

Part Three

Services and Systems

Alternative Fire Suppression System (i.e. Foam, Wet & Dry Chem, Halon, CO2, etc.

Yes
No

Emergency Responder Radio Coverage System/BDA

Yes
No

Carbon Dioxide (CO2) System Detection and Monitoring

Yes
No

Fire Alarm Monitoring – Central Station

Yes
No

Fire Alarm Systems

Yes
No

Fire Sprinklers – Commercial

Yes
No

Fire Sprinklers – Residential

Yes
No

Fire Extinguishers

Yes
No

Underground Fire Lines

Yes
No

Part Four

Certifications and Licenses

Does your organization perform work in buildings owned and/or operated by Sun City Fire Department or Youngtown?

Yes
No

Part Four

I (we) hereby make application for a permit to provide the products and/services described above, pursuant to The International Fire and Building Code, (IFC and IBC). I (we) agree to service, install and/or repair fire protection equipment in accordance with the applicable provisions of the International Fire Code and the appropriate standards of the National Fire Protection Association. I (we) further understand that issuance of approval does not constitute recommendation of my (our) company by the Sun City Fire and Medical Department and I (we) agree not to use such permit in said manner.

Name *

First

Last

Title *

Date / Time *

Email *

Provide email address for invoice to be sent.