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Submit by Email Print Form Home Safety Visit Request Owner/Occupant Name Address Unit # Postal Code Home phone number Cell phone number Name of person making request (if different) Name of residence owner (if different) Preferred inspection date Preferred day of week Preferred time of day How many people are living at this residence Are there any children in the household Y N Ages? Are there any seniors in the household Y N ID WITH CONFIRMATION OF ADDRESS WILL BE REQUIRED PRIOR TO INSPECTION BEING CONDUCTED Questions please call (714) 765-4040 Upon completion E-mail Click on e-mail button Fax Fax to (714) 765-4068 Mail or drop off Anaheim Fire & Rescue 201 S. Anaheim Blvd #300 Anaheim, CA 92805