FIRE PROTECTION SUBCODE
TECHNICAL SECTION
A. IDENTIFICATION - APPLICANT: COMPLETE ALL APPLICABLE INFORMATION. WHEN CHANGING
CONTRACTORS, NOTIFY THIS OFFICE. CALL PA ONE CALL 8-1-1 OR 1-800-242-1776 BEFORE DIGGING.
Work Site Location ______________________________________________________________________________
______________________________________________________________________________________________
Owner in Fee: __________________________________________________________________________________
Tel. _______ ________________________ Email ________________________________________________
Address _______________________________________________________________________________________
street municipality zip code
Contractor: _______________________________________________ Tel. _______ ______________________
Address _________________________________________________ Email ______________________________
______________________________________________________________________________________________
Fire Alarm Contractor No. ____________________________________ Exp. Date _____________________
Home Improvement Contractor Registration No. Exemption Reason (if applicable): ____________________________
CIty of Allentown Business License No. ______________________ Exp. Date ____________________
B. FIRE PROTECTION CHARACTERISTICS
Use Group: Present _________ Proposed _________ Fire Alarm System: [ ] New OR [ ] Existing
Constr. Class: Present _________ Proposed _________ Location of Panel: ________________________
Heating System: [ ] New OR [ ] Existing [ ] HVAC Fire Suppression/Standpipe System:
Type: [ ] Gas [ ] Oil [ ] Electric [ ] Solar [ ] New OR [ ] Existing
[ ] Other ___________________________________ Location of Mail Control Valve: ______________
Location: ____________________________________________ _______________________________________
Fuel Storage Tank:
Fuel Type: [ ] Flammable OR [ ] Combustible Capacity ___________________
Total Cost of Fire Protection Work $ ______________________
JOB SUMMARY (Office Use Only)
PLAN REVIEW INSPECTIONS DATES (Month/Day)
[ ] No Plans Required _____________ Type: Failure Failure Approval Initial
INITIAL
Joint Plan Review Required:
[ ] Building [ ] Plumbing
[ ] Electric [ ] Elevator
[ ] Fire Plans Approved
Date: ____________________________
Approved by: ______________________
SUBCODE APPROVAL
[ ] CO [ ] CCO [ ] CA
Date: _____________________________
Approved by: _______________________
Alarm System ______ ______ ______ ______
Suppression Sys. ______ ______ ______ ______
Standpipe ______ ______ ______ ______
Fire Pump ______ ______ ______ ______
Pre-Eng. System ______ ______ ______ ______
Mechanical ______ ______ ______ ______
Smoke Control ______ ______ ______ ______
TCO ______ ______ ______ ______
Flam/Combust Tanks ______ ______ ______ ______
Fireplace Venting ______ ______ ______ ______
Final ______ ______ ______ ______
Other __________ ______ ______ ______ ______
C. CERTIFICATION IN LIEU OF OATH
I hereby certify that I am the (agent of) owner of record and am authorized to make this
application.
_________________________________________________________
Applicant’s /Contractor’s Signature
[ ] Certified Contractor [ ] Exempt Applicant
D. TECHNICAL SITE DATA
DESCRIPTION OF WORK:
Water Supply Source ___________________________________________________
Method of Alarm/Suppression System Supervision __________________________
NUMBER FEE (Office Use Only)
Flammable / Combustible Tanks _____ _________________
Alarm Systems
[ ] System
[ ] 110v Interconnected
[ ] CO Detectors/110v
Alarm Devices (i.e., smoke, heat, pulls, waterflow) _____ _________________
Supervisory Devices (i.e., tampers, low/high air) _____ _________________
Signaling Devices (i.e., horn/strobes, bells) _____ _________________
Other Devices ________________________ _____ _________________
TOTAL _____ _________________
Suppression Systems
Fire Pump _____ GPM Type _____ _____ _________________
Dry Pipe / Alarm Valves _____ _________________
Pre-Action Valves _____ _________________
Sprinkler Heads (Dry and Wet) _____ _________________
Standpipes _____ _________________
Pre-engineered Systems
Wet Chemical _____ _________________
Dry Chemical _____ _________________
CO
2
Suppression _____ _________________
Foam Suppression _____ _________________
FM200 Suppression _____ _________________
Other ________________________________ _____ _________________
Other Systems
Kitchen Hood Exhaust System _____ _________________
Smoke Control System _____ _________________
Fired Appliances [ ] Gas or [ ] Oil _____ _________________
Fireplace Venting / Metal Chimney _____ _________________
Other ________________________________ _____ _________________
Archive Fee $ _________________
Certificate of Occupancy $ _________________
State Permit Surcharge Fee $ _________________
TOTAL FEE $ _________________
Master Permit #
Permit #
click to sign
signature
click to edit
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