Alarm Permit Application – Fill Out and Use This PDF

PLEASE READ BEFORE FILLING OUT APPLICATION:

1.PERMIT HOLDER-We must have the name, address and telephone numbers (home and business) of the PERSON who will be responsible for the alarm system. A COMPANY NAME IS NOT ACCEPTABLE.

2.Signature of applicant/permit holder must be the signature of the person listed as permit holder.

3.Please list all zip codes, and all area codes other than 817.

4.Application must include check or money order made out to City of Fort Worth, Texas. Also, Visa and MasterCard accepted.

5.No permit fee shall be required for a permit obtained for an alarm system at a one-family dwelling when the alarm site is determined by the Chief or authorized designee to be occupied by a low income family. Proof of low income and number in household required.

The Administration and enforcement of this ordinance, including but not limited to the insurance of permits, collection of applicants fees, and the revocation of permits is the sole responsibility of the City of Fort Worth and is no way relective of the acts or intentions of any alarm company.

ALARM LOCATION INFORMATION:

NAME (Business Name OR Resident Name)____________________________________________________________________

ALARM LOCATION ADDRESS_______________________________________________________________ Zip____________

MAILING ADDRESS (If Different)_____________________________________________________________ Zip____________

DATE OF OCCUPANCY _____________________________

PERMIT HOLDER INFORMATION (PERSON/USER RESPONSIBLE FOR ALARM SYSTEM):

NAME__________________________________________________________________ DRIVER’S LICENSE #_____________

RESIDENCE ADDRESS________________________________________ CITY____________ STATE________ ZIP__________

TITLE ( Owner, Tenant, Manager, etc.)_________________________________________________________________________

PHONE # HOME_____________________________________________ PHONE # WORK ______________________________

GOVERNMENT (City/County) (no Permit Fee required) LOW INCOME ( no permit fee required; See #5 above))

INDIVIDUAL APARTMENT ($50 Permit Fee) Complex Name________________________________________Apt.#_______________

ALARM COMPANY NAME AND PHONE NO:______________________________________________________________________________

SUBMIT A SEPARATE PERMIT APPLICATION (AND FEE) FOR EACH SYSTEM. PERMIT IS VALID FOR ONE YEAR FROM DATE OF ISSUE.

I have carefully read the completed application and know the same is true and correct and hereby agree that if a permit is issued, I will comply with all provisions of

Chapter 12 of the Code of the City of Fort Worth and applicable state laws. I accept responsibility for payment of all fees and ines that may result from the operation of the alarm system described above.

DATE_________________ __________________________________________________________________

Signature of Applicant/Permit Holder

PERMIT HOLDER’S RESPONSIBILITIES

On November 18, 2003, the Fort Worth City Council amended Chapter 12, concerning the regulation of alarm systems. The ordinance will be in full force and effect from and after January 1, 2004.

1.The ordinance applies to a person who operates, or causes to be operated, an alarm system at an alarm site. No permit shall be required of state and federal governmental entities. City and county political subdivisions that op- erate alarm systems are required to obtain a permit, however, permit fees and service fees shall not be required.

2.The Chief or authorized designee shall refuse police response to any alarm notiication from an alarm site that does not have a valid alarm permit unless the alarm notiication is a duress alarm, a hold-up alarm, a panic alarm or a report to 911 emergency telephone or to the police department by a person other than an alarm company.

3.ASEPARATE PERMIT IS REQUIRED FOR EACH ALARM SYSTEM AND EACH SEPARATE ADDRESS and cannot be transferred to

another person or to alarm system except by authorization of the Chief or authorized designee. Additional permit applications for multiple alarm systems at one alarm site may be obtained simply by photocopying the alarm permit application on the reverse side. Each permit application must show for each alarm system located at the alarm site the purpose of the alarm system, i.e., burglary, robbery, hostage, etc.

4.The fee for annual permit, an annual permit renewal or a permit reinstatement for all alarm permits is ifty dol- lars ($50.00). Each permit issued pursuant to this chapter shall be valid for a twelve (12) month period from the date of issuance as indicated on the permit. No refunds of a permit fee, permit renewal fee, or permit reinstatement fee will be made. A permit will not be renewed if the applicant has past due outstanding service fees at the alarm site or at another alarm site for which he is the permit holder, unless the service fees are under review in an appeal.

5.Apermit expires one year from the date of issuance and must be renewed annually by submitting an updated application and a permit renewal fee. It is the responsibility of the permit holder to submit an application and the required permit fee prior to the permit expiration date. A permit shall not be renewed if the applicant has past due outstanding service fees at the alarm site or at another alarm site for which he is the permit holder, unless the service fees are under review in an appeal.

6.No permit fee shall be required for a permit obtained for an alarm system at a one-family or two-family dwelling when the alarm site is determined by the Chief or authorized designee to be occupied by a low-income family.

7.Within thirty (30) days of receipt of a completed application form and the required fee, the Chief or authorized designee shall issue an alarm permit to an applicant unless the applicant has failed to pay a service fee or has had an alarm permit revoked, and the violation causing the revocation has not been corrected.

8.To obtain a permit, complete the permit application on the reverse side and return the application with a check or

money order to the:

CITY OF FORT WORTH

PLANNING AND DEVELOPMENT DEPARTMENT, ALARM UNIT

1000 THROCKMORTON STREET

FORT WORTH, TEXAS 76102

If you have any questions, call the Planning and Development Department, Alarm Unit at 817-392-1300.

Rev. 03/09