Harris County Alarm Permit – Fill Out and Use This PDF

ALARM SYSTEM PERMIT APPLICATION

LOCATION INFORMATION:

NAME*: __________________________________________________________________________________________________________________

(PERSON OR BUSINESS)

*If the intended permit holder is a business, please attach a copy of the applicable document to this application form: (A) assumed name registration, (B) partnership registration, if any, and the names and addresses of the general managing partner, and all other general partners if the permit holder is to be apartnership,(C)corporate charter with the names and addresses of all officers and the registered agent, or (D) certificate of authorization to do business from the Secretary of State of Texas if the permit holder is to be an out-of-state corporation.

ADDRESS: ________________________________________________________________________________________________________________

(Where alarm system will be operated) Street AddressApt/Condo/Suite # City/State Zip Code

TELEPHONE NUMBER: (____)______________________________________

MAILING/BILLING ADDRESS: _____________________________________________________________________________________________

(If different than above Address) Street Address/P O BoxApt/Condo/Suite # City/State Zip Code

TYPE OF LOCATION: _____HOUSE _____APT _____BUSINESS _____(OTHER) ___________________________________

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PERMIT APPLICANT: (Individual Making Application)

NAME: _______________________________________________________TELEPHONE NUMBER: (_____)______________________________

MAILING ADDRESS: ______________________________________________________________________________________________________

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CONTACTS: Please list below two (2) two LOCAL emergency contacts, other than the INTENDED PERMIT HOLDER OR ALARM COMPANYthatarewilling and able to respond WITHIN (1) ONE HOUR to grant access or secure the property, or deactivate the alarm system in the event the owner/occupant cannot be contacted.

NAME OF CONTACT #1: _______________________________________________ TELEPHONE #: (____)_____________________

NAME OF CONTACT #2: _______________________________________________ TELEPHONE #: (____)_____________________

STATEMENT OF HAZARDOUS CONDITIONS AT ALARM SITE: (Check the Statement that applies)

_____ THE APPLICANT/INTENDED PERMIT HOLDER ACKNOWLEDGES AND REPRESENTS THAT THERE ARE NO DANGEROUS OR SPECIAL

CONDITIONS PRESENT AT THE ALARM SITE.

_____ DANGEROUS OR SPECIAL CONDITIONS DO EXIST AT THE ALARM SITE. You are requested to attach to this Application a DETAILED statement of the

nature of the dangerous or special conditions for the safety of County Law Enforcement Officials that respond to activated alarms.

The Applicant/Intended Permit Holder acknowledges and represents that all outstanding fees, fines, charges, costs and/or court judgments relating to the Revised Rules Governing the Regulation of Alarm Systems within Harris County, Texas and owed to Harris County have been paid or satisfied.The Applicant/Intended Permit Holder acknowledges receiving a copy of the Revised Rules Governing the Regulation of Alarm Systems within Harris County, Texas, which are incorporated herein by reference. Please note that the Harris County has rules, policies and procedures that are not specified on this application.

The Applicant/Intended Permit Holder acknowledges and authorizes that information contained in the alarm records of the Alarm Detail may be given to applicant’s alarm company (for the purpose of the reduction of false alarms).

The Applicant/Intended Permit Holder affirms that he/she has read this application, and that all information herein is true and correct to the best of his/her knowledge. This application may be denied, or permit revoked, for false or misleading information, and that the Applicant, if other than the intended permit holder, certifies herein that he/she is authorized to act for the intended permit holder.

THE APPLICANT/INTENDED PERMIT HOLDER FURTHER ACKNOWLEDGES THAT HE/SHE HAS READ AND UNDERSTANDS THE INFORMATION CONTAINED IN THIS APPLICATION.