Online Forms

2. Business/Company Name:*
3. Person Making Request*
5. Inspection Site Address*
6. City*
   -- Select One --EugeneSpringfield
7. Zip Code*
9. On-Site Contact Name*
10. On-Site Contact Number*
11. On-Site Contact E-mail Address*
13. Types of Services*

    1. Occupancy Type B or E Inspection - $208.00
    2. Occupancy Type I, SR, or R-4 Inspection - $425.00

    
    

    
    

    ^{B         Business occupancy (includes colleges and universities}

    ^{E         Educational occupancy up to the 12th grade}

    ^{I          Institutional}

    ^{SR      Special Residency}

    ^{R-4    A residential occupancy where more than 5 but less than 16 persons are cared for}

15. Types of Services*

    1. Adult Care Inspection
    2. Child Care Inspection
    3. Special Request/Other
17. Special Request/Other:
19. Billing Address*
20. City*
21. State*
22. Zip Code*
24. Billing Contact Number*
25. Billing Contact Fax Number
27. Scheduling Inspection:

    Next steps: Your application will be received by the Fire Marshal’s Office when you select the "Submit" button below. An invoice will be created and e-mailed to you when the application has been processed. The e-mailed invoice will be sent from FMOAdmin@ci.eugene.or.us and will contain the appropriate fee/s for inspection as well as details on where to send the payment. It is recommended that you keep track of the date you submit this application for your records. Please allow 10 business days for us to process this application. 

    If you do not receive communication from FMOAdmin@ci.eugene.or.us, you are welcome to e-mail us (after 10 business days) with the address of the inspection location along with the business name and the date you submitted the application. 

29. I understand that:*

    Fees for an occupancy Type B or E inspection are $208.00.

    Fees for an occupancy Type I, SR, or R-4 inspection are $425.00

    
    

    For every hour after the initial two-hour inspection, there is an additional fee of $110.00 per hour.

    A re-inspection is included in the original fee, but there will be an additional $110.00 charge for the second non-compliance re-inspection. 

    
    

    *Please do not send any money or checks until you have received an invoice. Invoices will be issued from our Finance Department upon application review.

    
    

    By providing the information on this form and electronic signature, the undersigned certifies that they have read and understood the submittal requirements outlined and that they understand that omission of any listed item may cause a delay in processing the inspection request. I, the undersigned, acknowledge that the information supplied in this request is complete and accurate to the best of my knowledge.

    By checking this box, I am providing an electronic signature.

    
    

    1. Sign
31. I understand that:*

    Fees for an inspection are $179.00.

    
    

    There will be an additional $94 per hour charge for non-compliance re-inspections with 1-hour minimum or if inspections require an excessive amount of time. 

    
    

    *Please do not send any money or checks until you have received an invoice. Invoices will be issued from our Finance Department upon application review.

    
    

    By providing the information on this form and electronic signature, the undersigned certifies that they have read and understood the submittal requirements outlined and that they understand that omission of any listed item may cause a delay in processing the inspection request. I, the undersigned, acknowledge that the information supplied in this request is complete and accurate to the best of my knowledge.

    By checking this box, I am providing an electronic signature.

    1. Sign
Leave This Blank:


33. Submit

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