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Application for Alarm

There is a $25.00 alarm system permit application fee. A service charge of $100.00 for eachfalse alarm in excess of three (3) false alarms per fiscal year (October 1 to September 30) will be charged. Please direct all inquiries and correspondence to the False Alarm Coordinator, ElSegundo Police Department, 348 Main Street, El Segundo, CA 90245, (310) 524-2246.

APPLICATION FOR ALARM SYSTEM PERMIT

DATE OF APPLICATION:
NAME OF BUSINESS/RESIDENCE:

APPLICANT:

First Name, Last Name, Middle & Title:
Address, City & Zip Code:
Home phone:Date of Birth:CA Driver Lic. #

EMEGENCY INFORMATION (PERSON WHO MAY SECURE PRMISES ON 24 HR BASIS)

NameAddressTelephones(s)
NameAddressTelephones(s)
NameAddressTelephones(s)

PURPOSE OF ALARM (ARMED ROBBERY, BURGLARY,ETC.)
TYPE OF ALARM (SILENT, AUDIBLE,ETC.)
AREA PROTECTED (PERIMETER, DOORS, SAFE,ETC.)

ALARM COMPANY

Name:
Address:
Telephone:

FOR OFFICE USE ONLY

CURRENT PERMIT NO.:DATE:
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