Location Information
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
www.uprov-montco.org/
Lot
Block
Type and select the address of the property
Address
{[PNAME]} Application
Address 2
  • Building Information
  • Contacts
  • Attachments/Certification
Gross Sqft of building
Proposed # of Employees/occupants
Tenant Space (Sqft)
Does the building currently have an operational Fire Alarm System?
Does the building currently have a Fire Department key box?

Note: Additional permits, reviews and approvals may be required for alterations.

Please describe any proposed changes to the interior/exterior as well as signage
Is the Sqft of tenant space different?
Building Information
Does the building currently have an operational Fire Sprinkler System?
Previous Use Description
Current Use Description
Are there any Interior/exterior construction changes proposed?
Will the occupancy have storage above 12 ft?
Are there any signage changes proposed?
Address
Name
Phone #
Primary Emergency Contact Information
Email
Phone #
Phone #
Business/Occupant Name
Type of Business
Current Business/Occupant Information
Email
Type of Business
Secondary Emergency Contact Information
City, State, ZIP
Fax #
Name
Applicant Information
Phone #
Business/Occupant Name
(Last known business/tenant)
Proposed Business/Occupant Information
Fax #
Email
Address
City, State, ZIP
Phone #
Email
City, State, ZIP
Contact Name
Name
Email
Contact Name
Address
Type Full Name :
Sign With Hand
Applicant Signature
I, the undersigned, do hereby acknowledge that I am aware of the Township of Upper Providence Code relating to property maintenance, fire safety and signage.

I understand that if I, or my tenant violate any part of the Township Code, I may be subject to prosecution by the Township of Upper Providence including possible fines and court costs associated with any violations.

I further acknowledge that an inspection by the Fire Marshal’s Office will need to be conducted. Information identified in this application will be used during the inspection to identify compliance with the Township of Upper Providence Code.

Attachments
Fees
Certification
Amount Due
Attach any supporting documents (if applicable).