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City of Irvine PUBLIC SAFETY
Regulatory Affairs
ALARM SYSTEM PERMIT APPLICATION

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 ten (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.
NOTE: All fields are required.
(Session will expire in 20 minutes)
TYPE OF ALARM
COMMERCIAL  (Nature of Business)  RESIDENCE CHANGE OF INFORMATION
A L A R M   U S E R   I N F O R M A T I O N
NAME OF RESPONSIBLE PARTY FOR ALARM SYSTEM
LAST FIRST MIDDLE
RESIDENCE LAST NAME OR BUSINESS NAME E-MAIL
STREET ADDRESS (P.O. Box NOT acceptable) SUITE ZIP
PREMISES PHONE ALTERNATE PHONE ALTERNATE PHONE
BILLING ADDRESS (Complete if different from above) SUITE
CITY STATE ZIP
E M E R G E N C Y   C O N T A C T   I N F O R M A T I O N

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 (2) other responsible parties who will respond to the alarm location within 45 minutes of alarm activation, if requested to do so. The two individuals must have the ability to reset or deactivate the alarm system. (FOR BOTH COMMERCIAL AND RESIDENTIAL APPLICANTS)
1. EMERGENCY CONTACT NAME HOME PHONE BUSINESS PHONE CELL PHONE
2. EMERGENCY CONTACT NAME HOME PHONE BUSINESS PHONE CELL PHONE
A L A R M   C O M P A N Y 
NAME OF ALARM COMPANY
STREET ADDRESS PHONE NUMBER
CITY STATE ZIP
Any weapons at the alarm location?  NO  YES  
Any hazardous materials stored or maintained at this location? NO YES   
Any dogs at this location? Are they located inside or outside?    NO YES    Location: INSIDE OUTSIDE
E - S I G N A T U R E

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 (Civil 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.
I AGREE           DATE

Please enter the word above in the text box below.

The City of Irvine takes your privacy seriously. This form asks you to provide the City with certain personal information. Such information is being requested and will be utilized by the City for the specifc and limited purpose of future City correspondence regarding the subject-matter of this form. Pursuant to Measure S, an initiative ordinance passed by City voters in 2008, all information provided on this form will be kept confidential. Unless you expressly indicate to us otherwise or unless compelled by a court order, it will not be shared with other agencies, businesses or individuals.