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2. Contact Name
4. Type of Structure

   1. Residential
   2. Commercial
5. Ownership

   1. I own the structure
   2. I rent the structure
6. Age of Structure
8. Number of Working Smoke Detectors
10. Business Name
    If Applicable
12. Address
14. City
15. State
16. Zip Code
18. Phone Number
19. Fax Number
21. Email Address
23. Best Time to Call
24. Best Time to Visit
    Inspections are conducted Monday through Friday, between 9 a.m. and 4 p.m.
26. Type of Inspection

    1. Residential
    2. Commercial
28. Comments
    Please indicate why you would like an inspection, as well as any additional comments, questions, or suggestions you may have.
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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field