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3. Safety Inspection Request*

   1. Residential
   2. Commercial
5. Date*
6. Time Received

   For office use only

8. Point of Contact*
10. Phone Number*
12. Email Address
14. Address*
16. City*
17. State
18. Zip Code
20. Lock Box
22. Special Instructions

24. Residential Inspection Fee: $25.00

    001-342500-004-000

    Commercial Inspection Fee: $40.00

    001-342500-004-000

26. Once this form is submitted, a customer service representative will contact you for payment. After payment is made, our Building Department will contact you to schedule the inspection.
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

* indicates a required field