Per Ordinance No. 2004.12
All questions pertaining to the completion of this form should be directed to:
City Hall 760-839-4956 / FAX 760-746-0612


Do not send payment at this time. An invoice will be mailed to you.


NOTE: Required fields are marked with a red asterisk.




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BUSINESS OWNER(S):

Business Owner 1:







Business Owner 2:








EMERGENCY INFORMATION:

Please list 3 responsible parties who will respond to the alarm location within 30 minutes of an alarm activation, if requested to do so. (For both commercial and residential applicants) The applicant understands that it may be necessary, in the event of a break-in, for the affected building to be boarded up at the applicant's expense in those instances where a responsible party fails to respond to the location when requested to do so within 30 minutes of said request.

Emergency Contact 1:


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Emergency Contact 2:








Emergency Contact 3:









ALARM MONITORING INFORMATION:


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The following questions are voluntary and will assist in the appropriate response to your alarm:














To avoid false alarm charges, please ensure that your alarm is properly maintained and that your family or employees are properly trained.



 
  • Alarm User Name: is required.
  • Alarm Address (exclude City): is required.
  • Zip Code: is required.
  • Alarm User Home Phone Number (include area code): is required.
  • Name: is required.
  • Address: is required.
  • City: is required.
  • State: is required.
  • Zip Code: is required.
  • Home Phone Number (include area code): is required.
  • Monitoring Company Name: is required.
  • Phone Number 1 (include area code): is required.