Private Fire Service Mains and Appurtenance Permit Application Property InformationProject Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific Installing ContractorCompany Name(Required) Company Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Contact Name(Required) First Last The person listed will receive all correspondences in reference to the permit application.Primary Contact Phone(Required)Primary Contact Email(Required) Project InformationTotal linear feet of pipe to be installed(Required)Number of fire hydrants to be installed(Required)Private fire main supplying (check all that apply) Fire Sprinkler System Standpipes Private Hydrant(s) Hose House SubmittalSubmittal(Required) Drop files here or Select files Max. file size: 256 MB. Attach plans with enough detail to illustrate a code compliant installation.AffirmationAffirmation(Required) I agree to the followingI hereby affirm that I have read and completed this application and know the same to be true and correct. All provisions of the law & ordinances of the City of Salisbury governing the proposed work will be complied with whether specified or not. No work will be performed on the above property not specifically described herein. I understand that all work is subject to field inspection and/or testing. No work shall start prior to the issuance of a permit. The permit, once issued, is valid for work commenced within a period not to exceed 180 days after issuance. Otherwise, it is void and of no effect. The permit shall be for periods as the Fire Marshal determines, not to exceed one year. Any application for, or acceptance of, any permit requested or issued pursuant to the Fire Prevention Code shall constitute agreement and consent by the person making the application or accepting the permit to allow representatives from the Office of the City of Salisbury Fire Marshal's Office to enter the premises at any reasonable time to conduct such inspections as required by the Fire Prevention Code.Submitting Party's Name(Required) First Last Submitting Party's Email(Required)
