Fillable FireProtectionSystem PermitApplication PLEASE SUBMIT TWO (2) SETS OF (Lewis County)

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FireProtectionSystem PermitApplication PLEASE SUBMIT TWO (2) SETS OF (Lewis County)

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2025 NE Kresky Avenue
Chehalis, WA. 98532
(360) 740-1146
FireProtectionSystem
PermitApplication
PermitNumber:______________________
Please check permit(s) applied for: Fire Alarm Fire Sprinkler Other: ____________________
Please check the Occ
upa
ncy
Type: Single Family
Multi-Family Commercial / Non-Residential
For Fire S
p
rinkl
er please check the type of system(s): NFPA 13D
NFPA 13R NFPA 13 Underground
PLEASE SUBMIT TWO (2) SETS OF DRAWINGS AND CUT SHEETS PER NFPA STANDARDS
MAXIMUM PLAN SHEET SIZE: 24” X 36”
PROJECT DESCRIPTION
PROPERTY INFORMATION
Site Address: Parcel Number:
Name of Business or Tenant: Phone:
PROPERTY OWNER INFORMATION
Property Owner Name: Daytime Phone: Cell Phone:
Mailing Address:
E-Mail:
APPLICANT INFORMATION
Name: Daytime Phone: Cell Phone:
Mailing Address: E-Mail:
CONTRACTOR
Name:
Company:
Daytime Phone:
Mailing Address: Cell Phone:
Contact person (if different):
E-Mail:
WA. St. Business License Number:
Contractor’s License #: (card must be presented) Expiration Date: Verified:
Yes □ No □
STATEFIREMARSHALCERTIFICATIONLEVEL:________ Certificate#: ExpirationDate:
SPRINKLER DESIGN CONTRACTOR (IF DIFFERENT FROM ABOVE)
Name:
Company:
Daytime Phone:
Mailing Address: Cell Phone:
Contact person (if different): E-Mail:
WA. St. Business License Number:
Contractor’s License #: (card must be presented) Expiration Date: Verified:
Yes □ No □
STATEFIREMARSHALCERTIFICATIONLEVEL:_________ Certificate#: ExpirationDate:
VALUATION:
(BasedonFairMarketValueforthecostofmaterialsandinstallation.)
$_____________________________
S:\COMMUNITY DEVELOPMENT\Applications & Forms\Currently on Website
Updated January 2019
Fire Sprinkl
e
r:
Plans require the following stamps depending on the type of work. Please select the project type that is being
submitted under this application.
Select Plans Type Stamp Requirements
Single family residential systems utilizing NFPA 13D design criteria Level 1, 2 or 3 Stamp
Multi-family or similar occupancy utilizing NFPA 13R design Level 2 or 3 Stamp
All other systems (retail, business, storage, health care, industrial
or multi-
family) utilizing NFPA 13 design criteria
Level 3 Stamp
Underground supplies includ
ing Fire Department Connections for NFPA
13R systems installed by Level 2 contractor
Level 2 Stamp
Underground supplies includ
ing Fire Department Connections for NFPA 13
systems installed by Level 3 contractor
Level 3 Stamp
Underground supplies includ
ing Fire Department Connections for NFPA
13R systems installed by Level U contractor
Level U Stamp and also stamped by Level
2 contractor or licensed professional
engineer registered in the state of
Washington (two stamps required).
Underground supplies includ
ing Fire Department Connections for NFPA 13
systems installed by Level U contractor
Level U Stamp and also stamped by Level
3 contractor or licensed professional
engineer registered in the state of
Washington (two stamps required).
Fire Alarms:
BMC 15.20.190 IFC Section 907 amended – Fire alarm and detection.
(2) IFC Section 907.2, System installation, is amended by addition of the following section:
907.2.24 System installation. Fire alarm systems shall be installed and maintained in accordance with this code by persons
under the direct supervision of individuals that have factory training and certification on the system being installed. Plans
submitted for Fire Alarm System permits shall be prepared under the supervision of individuals possessing a NICET
(National Institute for Certification in Engineering Technologies) Level III certification in Fire Alarm Systems; or shall
be licensed by the State of Washington as a Professional Fire Protection or Electrical Engineer or certified by the
State of Washington. Plans shall identify certification and/or licensing information.
Expiration of Plan Review: Applications for which no permit has been issued may be canceled for inactivity, if an applicant fails to respond to
the department’s written request for revisions, corrections, actions or additional information within 90 days of the date of the request. Applications
for which no permit is issued within 18 months following the date of application shall expire and all fees paid shall be forfeited.
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I am the
owner of this property or am authorized by the owner above to perform the work for which permit application is made. I further agree to save
harmless the County of Lewis as to any claim (including costs, expenses, and attorney incurred in investigation and defense of such claim),
which may be made by any person, including the undersigned, and filed against the County of Lewis, but only where such claim is out of the
reliance of the County, including its officers and employees, upon the accuracy of the information supplied to the County as part of this
application.
Owner / Agent Signature: ______________________________________________________________ Date: _________________________
Print Name: _____________________________________________________________________
S:\COMMUNITY DEVELOPMENT\Applications & Forms\Currently on Website
Updated January 2019
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FireProtectionSystem PermitApplication PLEASE SUBMIT TWO (2) SETS OF (Lewis County)

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Completed 21 January 2021

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