Fire and Life Safety Program

These designated hot works areas must be maintained

Info iconThis preview shows page 1. Sign up to view the full content.

View Full Document Right Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: iling Address: __________________________________________________________________________________ (P.O. Box or Street Number and Name, City, State, Zip Code) Business Telephone: ________________________________ Business FAX: _________________________________ Business E-mail address: ___________________________ Website Address: _________________________________ Is building owned by applicant? (circle one) YES NO If not, Owner’s name: __________________________________ Address: ________________________________________________ Phone Number: __________________________ Contact person for Inspection: _______________________________ Phone Number: _________________________ << FIRE AND LIFE SAFETY PROGRAM Proposed Start Date:____________________________ Sales Activity (circle one): NONE WHOLESALE Sales Tax License Number: ___________________________ RETAIL Do you dispense or sell:liquor _____ food _____ yes/no yes/no Manager or person principally in charge of operation of business Name & Title: _____________________________________________________________________________________ Home Address: ____________________________________________________________________________________ (Street Number and Name, City, State, and Zip Code) Fax: __________________ Home/Cell Phone:________________ Driver’s License #: _________________________ E-mail: _______________________________ Last 4 digits of S.S. #: ________ Date of Birth: ___________________ Building Owner Information Owner’s Name: ____________________________________________________________________________________ Home Address: ____________________________________________________________________________________ (Street Number and Name, City, State, and Zip Code) Fax: __________________ Home/Cell Phone:________________ Driver’s License #: _________________________ E-mail: _______________________________ Last 4 digits of S.S. #: _______ Date of Birth: ___________________ Official Corporate Name: Corporate Address: (Street Number and Name, City, State, and Zip Code) Telephone: _________________________ Fax: _______________________ E-mail: _________________________ Michigan C...
View Full Document

Ask a homework question - tutors are online