Fire - Smoke Cert Application - Create · DCA Service Portal

PROPERTY INFORMATION

Reason for Certification

Date of Closing/Change in Occupancy

*

Application Date

*

Submit Request

NoYes

Application Fee Total

*

PROPERTY LOCATION

Block

*

Lot

*

Address Line 1

*

Address Line 2

*

Address Line 3

*

County

Municipality

Fire District

State Property?

NoYes

Basement?

NoYes

Number of Stories

**

FORWARDING ADDRESS

Name

*

Phone #

*

Email

**

Current Address

*

Forwarding Address Line 1

*

Forwarding Address Line 2

*

Forwarding Address Line 3

*

City

*

State

*

Zip

*

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