Alarm Permit Application

In case of emergency Dial 911

Non-emergency calls: (913) 596-3000

Contact Information

Name/Business Name: *

Alarm Street Address: *

Zip Code: *

Home Phone (Include area code): *

Work Phone (Include area code):

Mailing Address (if different than above)

Name/Business Name:

Street Address:

City:

State:

Zip Code:

Phone (Include area code):

If alarm system is for a residence, please provide your Drivers License/State ID #

State of Issuance:

DL# or State ID#:

If alarm is for a business, please check what type:

Financial

Government

Other

If other, describe type of business:

Not-for-Profit: *

Yes

Emergency Contacts

Primary Contacts

Name: *

Street Address: *

City: *

State: *

Zip Code: *

Phone (Include area code): *

Secondary Contacts

Name:

Street Address:

City:

State:

Zip Code:

Phone (Include area code):

Alarm Information

Monitoring Company: *

Installation Company: *

Installation Date: *

My Alarm Business has furnished me with written and verbal directions regarding the proper use and maintenance of fire, intrusion, and other emergency alarms. I have received a summary of the Kansas City, Kansas Alarm Ordinance, #65971, and understand that it is my responsibility to follow the provisions found within it. I understand that I must notify the Alarm Coordinator to update any information contained on this permit within 10 days of a change.

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Alarm Permit Application