coiLogo IRVINE POLICE DEPARTMENT ipdLogo
Regulatory Affairs Unit
ALARM SYSTEM PERMIT APPLICATION
  David L. Maggard, Jr.
Chief of Police
INSTRUCTIONS: A separate application must be completed for each alarm system installed at each location. Permits cannot be transferred to another person or entity. The Responsible Party is required to notify the Alarm Coordinator of any changes on this application within 10 business days. Applications must be complete in order to process. If you have any questions, please contact the Alarm Coordinator at (949) 724-6467.  
ALARM USER INFORMATION
Check pertinent box(s):
Residence Last Name
(or Business Name)		  
Name of Responsible Party  
Address  
 Suite  State     Zip   
E-Mail Address Premise Phone#   
Alternate Phone#  
 Alternate Phone#  
BILLING INFORMATION (if different from above)
Address Suite 
City State   Zip    
EMERGENCY CONTACT INFORMATION
In an emergency response, the Responsible Party listed above will be the first person contacted. If the Responsible Party cannot be reached, we will contact the person(s) listed below. You must list two other responsible parties who will respond to the alarm location within 45 minutes of alarm activation, if requested to do so. The two listed contacts must have the ability to reset or deactivate the alarm system. (NOTE: Both commercial and residential applicants must complete this section.)
Name   Home#   Business#   Cell#  
Name   Home#   Business#   Cell#  
ALARM COMPANY INFORMATION
Name  
Address  
 City  
State  
 Zip  
 Phone  
OFFICER SAFETY INFORMATION
Are there any weapons at the alarm location?  
Are there any hazardous materials stored or maintained at this location?  
Are there any dogs at this location?                      
E-SIGNATURE
By completing and submitting this form electronically, I agree to "conduct the transaction by electronic means" in accordance with the terms of the California Uniform Electronic Transactions Act (Civic Code § 1633.1 et seq.). I understand and affirm that my signature has the same legal effect as if written, and that it is fully enforceable in a court of law. After agreeing to submit this form by electronic means, I understand and affirm that I cannot repudiate my signature's legal effect. I acknowledge that I may choose not to conduct this transaction by electronic means, and in that instance, I should not complete this transaction online.
Date  
FOR OFFICE USE ONLY
Permit Number  PEID Number  Anniversary Date 


The verification words are incorrect.