Fire Prevention Application Permit

MUNICIPALITY OF PENN HILLS
CODE ENFORCEMENT DEPARTMENT
12245 FRANKSTOWN ROAD
PENN HILLS , PA 15235
OFFICE # (412)798-2132 / FAX # (412)798-2160

Fee: $50.00

Applicant (required)

Application Date (required)

Email Address (required)

Phone No. (required)

Address (required)

Owner
if different then applicant

Phone No.

Owner's Address

THE ABOVE NAMED APPLICANT HEREBY MAKES APPLICATION TO CONDUCT THE FOLLOWING ACTIVITY AT THE LOCATION DESCRIBED BELOW

Activity (required)

Location (required)

I hereby acknowledge that I have read this application, that the information given is correct, and that I am the owner, or duly authorized to act in the owner's behalf, and, as such, hereby agree to comply with the applicable requirements of the fire prevention code.

Date (required)

Applicant/Agent signature (required)

Comments