Fillable FIRE PROTECTION SYSTEM APPLICATION FOR FIRE PROTECTION PLAN (City of Newark)

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FIRE PROTECTION SYSTEM APPLICATION FOR FIRE PROTECTION PLAN (City of Newark)

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APPLICATION FOR FIRE PROTECTION PLAN REVIEW
FIRE PROTECTION SYSTEM
1. Project Name:
Building
Unit
Phase
Subdivison/Complex / Address:
City:
Zip Code
County (NC, K, S):
Number of Stories:
Complete Tax Parcel Number:
Square Footage:
Fire Alarm Sprinkler Hood Exhaust Hood Suppression Special Hazard
New Installation Addition to an Installation Upgrade to an Installation Other
3. Date of Edition:
NFPA 12 NFPA 13 NFPA 13D NFPA 13R NFPA 14
NFPA 15 NFPA 16 NFPA 17A NFPA 72 NFPA 96 NFPA 2000 NFPA 2001 Other
4.
Fee Calculation: Installation Cost:
Fee:
Check #:
Deposit/Rtn Date:
Exempt Status:
State
County
Federal
DSHA
Fire Company/Amb
Municipality
5
. Fire Alarm Only: Type of System
:
Local Remote Central Proprietary
Number of Risers
Wet
Dry
Deluge
Single-Interlock Preaction
Double-Interlock
Most Demanding System:
Wet Dry Deluge Preaction:
Fire Pump: Yes No Rating:
GPM
7. Hood Suppression System Only: Type of System:
Wet Chem Dry Chem Sprinkler Other:
System Description:
Number of Flows Required:
Number of Flows Available:
8. Special Hazard System Only:
Description:
9. Applicant
Phone
:
10. Property Owner
Phone:
Cell Phone: Cell Phone:
Fax:
Fax:
FMO LIC #:
**FMO CERT #
Name:
Name:
Address:
Address:
City:
State:
ZipCode:
City:
State:
ZipCode:
Email:
Email:
Any approval of the submitted project documents does not relieve the owner, designer, contractor, or designated representative from
their responsibility to comply with applicable provisions of the Delaware State Fire Prevention Regulation.
11. CERTIFICATE HOLDER Signature:
**Signature required
Date:
FOR OFFICE USE ONLY:
_________________________________________________________ ______________________________
FIRE MARSHAL
DATE
I.D. # _______________ Plan Review # _____________________________________
Rolled plans
Fire Protection Systems Plan Submittals
Is your fire protection plan drawn to scale; unique and exclusive of all other plans (including electrical,
mechanical, and plumbing plans); and does it include the following information?
Name and address of building
Plan date
Owner of the building
Name and address of applicant submitting plans
Licensed company’s name
Licensed company’s address
Licensed company’s phone number
Licensed company’s SFMO license number
Certificate Holder’s name
Certificat
e Holder’s signature
Certificate Holder’s SFMO Certificate Number
Reflected ceiling plan indicating device locations
Cross section plan of building including concealed spaces (attics, crawl spaces, etc.)
Technical Documents and Manufacturer’s Specifications
All other information as required by the applicable IFC documents, as adopted and/or modified by the
Delaware State Fire Prevention Regulations.
Do you have the following items ready for submittal?
Two (2) copies (for each system) of your fire protection system plans, calculations, and
specifications
Application for Fire Protection Plan Review
✔
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FIRE PROTECTION SYSTEM APPLICATION FOR FIRE PROTECTION PLAN (City of Newark)

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Completed 4 August 2020

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