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2. 
4. Applicant Information
6. Applicant Company
8. Applicant First Name*
9. Applicant Last Name*
11. Phone Number
12. Email Address*
16. On-Site Information

    Please list the name, email address, and contact phone number of the person that will meet our inspector on-site.

18. Site Contact Name*
19. Site Contact Phone Number*
21. Site Contact Email Address
25. Billing Information
27. Billing Contact First Name*
28. Billing Contact Last Name*
30. Billing Contact Address
32. Billing Contact City
33. Billing Contact State
34. Billing Contact Zip Code
36. Billing Contact Phone Number
37. Billing Contact Email Address*
41. Vehicle Information

    Please mark all applicable items

    1. A type I hood is installed above commercial cooking appliances
    2. (if applicable) The kitchen hood inspected and tested in past 6 months (must provide documentation of cleaning and suppression system inspection)
    3. A 2-A:20-B:C extinguisher is provided
    4. (if cooking) A type K extinguisher is provided
    5. No more than 2 LP-gas containers (100 lbs. each)
    6. All LP-gas containers are secured and upright
    7. If LP-gas is stored in a compartment, the compartment is vented to the exterior
    8. If LP-gas containers are on the rear of a vehicle, adequate impact protection is provided
    9. Any extension cords are classified as heavy-duty (12–14 gauge wire)
    10. Any extension cords are classified for outdoor use
43. Vehicle License Plate Number*
47. Inspection Information

    Requested date and time for inspection. Inspections may be conducted at Redmond City Hall (15670 NE 85th St, Redmond) or at a specified location within Redmond's city limits.

    
    

    Inspections may start on the hour from 7 a.m. to 2 p.m. A staff member from Redmond Fire Prevention will send an email confirmation once a time has been determined or if alternate times need to be discussed.

49. First Choice Date & Time*
    First Choice Date & Time

    First Choice Date & Time
50. Second Choice Date & Time:
    Second Choice Date & Time:

    Second Choice Date & Time:
52. Additional Comments
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field