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STATE OF TENNESSEE
DEPARTMENT OF COMMERCE AND INSURANCE
STATE FIRE MARSHAL’S OFFICE
ADMINISTRATIVE SERVICES SECTION
500 JAMES ROBERTSON PARKWAY
NASHVILLE, TN 372430577
APPLICATION FOR CODE INSPECTOR
RECERTIFICATION
Applicant Name: ___ SS#: ___
Home Address: ___ Home Phone #: ( ) ___
City: ___ State: ___ Zip: ___
Employer Name: ___ Position: ___
Address: ___City: ___State: ___ Zip: ___
Work Phone #: ( ) ___ Fax #: ( )
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