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2. 
3. 
   Franklin County Department of Public Safety
   50 Claiborne Ave.
   Rocky Mount, VA 24151
   
   Fire Inspection Request
5. Choose type of inspection needed:*
   -- Select One --Routine Fire InspectionShort Term Rental InspectionMobile Food Preparation Vehicle
7. Name of Requestor:*
8. Business Name*
10. Street Address*
12. City*
13. State*
14. Zip Code*
16. Phone Number*
17. E-Mail Adress:*
19. Inspection Time Preferred (regular business hours)
    Inspection Time Preferred (regular business hours)

    Inspection Time Preferred (regular business hours)
20. If you would rather us contact you for an appointment time, please tell us if you would rather be contacted by phone or e-mail?

    1. Phone
    2. E-Mail
Leave This Blank:


22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field