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1323 58th Street Lubbock, Texas 79412
Call Us : (806) 762-8721
P.O. Box 3730, Lubbock, Texas 79452
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About Spag
Employment Opportunities
Programs & Services
Area Agency on Aging
Information & Assistance
Benefits Counseling
Ombudsman Program
Family Caregiver Support Program
Care Coordination Program
Resources
Senior Citizen Centers
Economic Development
Revolving Loan Fund
SPAG CORE
SPEDD
SPHFC
Regional Services
Census Data
Community Development
Criminal Justice Planning
Homeland Security
Regional Solid Waste Management Program
Transportation
SPAG Regional Safe Room Rebate Program
Upper Brazos Regional Flood Planning Group
Safe Room Rebate Program
Region O Regional Water Planning Group
Section 3
Affordable Connectivity Program (Broadband)
Regional 911
9-1-1 Links
911 Public Education
911 Training
Physical Address Assignment
Regional 9-1-1 Maps
2-1-1 Texas
Law Enforcement
General Info
News
South Plains ADRC
Directory
Calendar
Transparency & Reports
Public Notices
Agenda
Minutes
Contact Us
About Spag
Employment Opportunities
Programs & Services
Area Agency on Aging
Information & Assistance
Benefits Counseling
Ombudsman Program
Family Caregiver Support Program
Care Coordination Program
Resources
Senior Citizen Centers
Economic Development
Revolving Loan Fund
SPAG CORE
SPEDD
SPHFC
Regional Services
Census Data
Community Development
Criminal Justice Planning
Homeland Security
Regional Solid Waste Management Program
Transportation
SPAG Regional Safe Room Rebate Program
Upper Brazos Regional Flood Planning Group
Safe Room Rebate Program
Region O Regional Water Planning Group
Section 3
Affordable Connectivity Program (Broadband)
Regional 911
9-1-1 Links
911 Public Education
911 Training
Physical Address Assignment
Regional 9-1-1 Maps
2-1-1 Texas
Law Enforcement
General Info
News
South Plains ADRC
Directory
Calendar
Transparency & Reports
Public Notices
Agenda
Minutes
Menu
About Spag
Employment Opportunities
Programs & Services
Area Agency on Aging
Information & Assistance
Benefits Counseling
Ombudsman Program
Family Caregiver Support Program
Care Coordination Program
Resources
Senior Citizen Centers
Economic Development
Revolving Loan Fund
SPAG CORE
SPEDD
SPHFC
Regional Services
Census Data
Community Development
Criminal Justice Planning
Homeland Security
Regional Solid Waste Management Program
Transportation
SPAG Regional Safe Room Rebate Program
Upper Brazos Regional Flood Planning Group
Safe Room Rebate Program
Region O Regional Water Planning Group
Section 3
Affordable Connectivity Program (Broadband)
Regional 911
9-1-1 Links
911 Public Education
911 Training
Physical Address Assignment
Regional 9-1-1 Maps
2-1-1 Texas
Law Enforcement
General Info
News
South Plains ADRC
Directory
Calendar
Transparency & Reports
Public Notices
Agenda
Minutes
Contact Us
Certificate of Installation/Inspection for Residential Safe Rooms
Texas Division of Emergency Management Recovery, Mitigation and Standards Texas Residential Safe Room Rebate Program Certificate of Installation/Inspection for Residential Safe Rooms
Citizen Participant Information
Name
First
Last
Address of Safe Room
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Type of Safe Room:
Above Ground
Underground
Manufacturer Name
Model
Installation Company Name
Telephone #
Date of Installation
MM slash DD slash YYYY
Longitude
Latitude
(GPS coordinates, five degrees decimal)
Compliance Statement
The undersigned attests that this safe room's design, construction, and installation comply with FEMA P-320, Fourth Edition (Taking Shelter from the Storm), FEMA P- 361, Third Edition (Safe Rooms for Tornadoes and Hurricanes), and ICC 500-2014. The undersigned certifies (1) door assemblies of this product have passed ICC 500 testing to meet or exceed FEMA safe room criteria (2) above ground safe room foundation meets ICC 500, Section 308.1.1.1 and post-installed anchors comply with ICC 500 and Chapter 17 of the American Concrete Institute standard ACT 318- 14 (3) underground safe rooms meet ICC 500 Section 303.3 design to resist buoyancy and hydrostatic loads.
Name of Installer:
Title
Installer Signature:
Date
MM slash DD slash YYYY
Notary Republic Signature:
Notary Seal:
Max. file size: 512 MB.
Date
MM slash DD slash YYYY
Must upload photo of saferoom
Max. file size: 512 MB.