Oxygen System Permit Applications

Allow 14 days for review after full submittal

Installing Contractor

Name (required)

Phone (required)

Email (required)

Mailing Address (required)

City/State/Zip (required)

Project Location

Address (required)

City/State/Zip (required)

Building Owner

Name (required)

Phone (required)

Email (required)

Mailing Address (required)

City/State/Zip (required)

Occupant/Business Owner

Name (required)

Phone (required)

Email (required)

Mailing Address (required)

City/State/Zip (required)

General Contractor

Name (required)

Phone (required)

Email (required)

Mailing Address (required)

City/State/Zip (required)

File Uploads

File (PDF set of scaled plans submitted - hard copy when required by DFR), Specifications (PDF only), Other Info. (If sharing files through a shared links, please do that in the box below)

Additional File

Scope of Work

How many oxygen generator/concentrator units will be installed? (required)

Describe the scope of work (required)

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