Get OR Residential Alarm User Permit Application - City Of Portland 2023-2024

RESIDENTIAL ALARM USER PERMIT APPLICATION OFFICIAL USE ONLY Date Received Amount Received Portland Police Alarm Administration PO Box 1867 Portland OR 97207 Phone 503 823-0031 Fax 503 823-0507 Alarm Permit Date Issued ALARM USER INFORMATION NOTE The City of Portland requires an alarm user s permit for each burglary or robbery alarm system. Name of 1st Alarm User nd Name of 2 Date of Birth senior discount Alarm User Street Address City State Zip Residence Phone Mailing Address if different Signature Type of Location House Rental House Condominium Apartment Other Date CAN YOU MANUALLY ACTIVATE A ROBBERY/ SILENT SIGNAL A Robbery or Silent feature signals the alarm monitoring company by a button Police shield button on alarm pad or a number code that you are in danger and need police assistance. CHECK ONE BOX ONLY AND ENCLOSE THAT ALARM PERMIT FEE 25 - Burglary Alarm ONLY Audible system-activated signal of entry/ attempted entry. 25 - Robbery/ Silent Alarm ONLY Silent user-activated robbery silent signal. 50 - BOTH a Burglary AND a Robbery/ Silent Alarm. Acceptable forms of payment Check/Cash/Money Order/VISA/MasterCard Credit Card Expiration / ALARM COMPANY INFORMATION Alarm Installer 24-Hour Phone Monitoring Company EMERGENCY CONTACT INFORMATION List up to three 3 people that possess a key and/or have permission to access the premises and deactivate the alarm. Primary Phone Alternate Phone Name Contact / Alarm User 1 SPECIAL INSTRUCTIONS FOR OFFICER RESPONSE Special directions Guard dog Security guards etc. Persons with sight hearing or speech disabilities Other Instructions DESCRIPTION OF FEES AND HOW TO FILE YOUR APPLICATION Burglar Alarm Permit Robbery Alarm Permit 25 Billed annually Systems with both robbery/silent and burglary alarm capabilities require separate permits for each function. Fee is waived for residents who are age 62 or over. RESIDENTIAL ALARM USER PERMIT APPLICATION OFFICIAL USE ONLY Date Received Amount Received Portland Police Alarm Administration PO Box 1867 Portland OR 97207 Phone 503 823-0031 Fax 503 823-0507 Alarm Permit Date Issued ALARM USER INFORMATION NOTE The City of Portland requires an alarm user s permit for each burglary or robbery alarm system* Name of 1st Alarm User nd Name of 2 Date of Birth senior discount Alarm User Street Address City State Zip Residence Phone Mailing Address if different Signature Type of Location House Rental House Condominium Apartment Other Date CAN YOU MANUALLY ACTIVATE A ROBBERY/ SILENT SIGNAL A Robbery or Silent feature signals the alarm monitoring company by a button Police shield button on alarm pad or a number code that you are in danger and need police assistance. CHECK ONE BOX ONLY AND ENCLOSE THAT ALARM PERMIT FEE 25 - Burglary Alarm ONLY Audible system-activated signal of entry/ attempted entry. 25 - Robbery/ Silent Alarm ONLY Silent user-activated robbery silent signal. 50 - BOTH a Burglary AND a Robbery/ Silent Alarm* Acceptable forms of payment Check/Cash/Money Order/VISA/MasterCard Credit Card Expiration / ALARM COMPANY INFORMATION Alarm Installer 24-Hour Phone Monitoring Company EMERGENCY CONTACT INFORMATION List up to three 3 people that possess a key and/or have permission to access the premises and deactivate the alarm* Primary Phone Alternate Phone Name Contact / Alarm User 1 SPECIAL INSTRUCTIONS FOR OFFICER RESPONSE Special directions Guard dog Security guards etc* Persons with sight hearing or speech disabilities Other Instructions DESCRIPTION OF FEES AND HOW TO FILE YOUR APPLICATION Burglar Alarm Permit Robbery Alarm Permit 25 Billed annually Systems with both robbery/silent and burglary alarm capabilities require separate permits for each function* Fee is waived for residents who are age 62 or over.