Application for Permit to Operate Electronic and Mechanical Devices

License and Inspection

Application Information

To complete the paper form, click here 

Machine Information

  DeviceSerial Number (MFG)Inspection TypeFee  
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Sign the Form Using the Drawing Tool in the Box Below

Payment Information

Payment of fees for this application will be requested via email once your submission has been reviewed.  Please verify that emails from are not sent to your spam/junk mail folder.  The email will contain a link to this form allowing you to make a secure payment by credit card.  The amount shown below is an estimated amount and may be adjusted once your submission is reviewed.