SF035 | 0121 FML-009A
Fire alarm installation certificate
After completing an installation, modification, or addition of a system or single-station detector (excluding a one- or
two-family residence), the licensee must complete and present this certificate to the owner or owner’s representative
or post the certificate near the main control panel (Fire Alarm Rules, 28 Texas Administrative Code, 34.617.
Original to owner or posted on site at control panel. Copy 1 to main authority having jurisdiction. Copy 2 for certifying alarm company to keep in its office for access by SFMO.
Property name:
Type of Installation:
The system complies with the following codes and standards.
Building/floor:
New
Code
Year/edition
Code
Street:
Modification
NFPA 72
IBC / IFC
City / Zip:
Addition
NFPA 70
Certifying alarm company:
NFPA 101
City / State / Zip:
Name of nearest fire department:
Phone:
Fire department (non-emergency) phone:
Alarm certificate registration:
Emergency phone:
System information
Control panel manufacturer:
Model #
Other:
Check all the applicable system types below that were installed by the above certifying company or the system type(s) in which the company made modifications or additions.
Fire alarm/Evacuation
Fire detection
Smoke damper control
Sprinkler system supervision
Voice notification
Elevator control
HVAC
Magnetic door
Initiating devices
Initiating devices
Notification appliances
Supervisory devices
Circuit style
Circuit style/class
Type
Quantity
Type
Quantity
Type
Quantity
Type
Quantity
Quantity
Quantity
Smoke detectors
UV/IR
Bell, horn, or chime
Valve tamper switches
SLC 4
NAC Y or B
Heat detectors
Isolation modules
Strobe
High / low air pressure
SLC 6
NAC Z or A
Duct smoke detectors
Kitchen suppression
Speaker
Fire pump
SLC 7
Beam smoke detectors
Sprinkler flow switch
Horn/chime/strobe
IDC A
Fire alarm boxes
Gas fire protection syst.
Speaker strobe
IDC B
Fire phones
Annunciation panel
Record drawings
Record drawings (one with original planner’s signature)
Company:
Instructions describing, operation, test, and maintenance
City / State:
Information to aid in establishing an Emergency Evacuation Plan
Planner's name:
The above required documents were supplied to:
License num. PE or APS:
Person's name:
Date on plan:
Company’s name:
Revision number/date:
Date:
I certify, on behalf of the registered certifying company, that this fire alarm system has been tested and complies with the requirements of Texas Insurance Code, Chapter 6002, and Texas
Administrative Code, Section 34.600, the Fire Alarm Rules; the applicable codes and standards; and the manufacturer's installation requirements.
Signature of licensee:
License number:
Printed name of licensee:
Date signed:
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signature
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