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Phone: 409-643-5700 FAX: 409-643-5719
Underground Fire Sprinkler Supply Line Permit
Minimum Requirements Listed on Page 2 of Permit
Name of Occupancy: ____________________________________________________
Address of Occupancy: ___________________________________________________
Project RME Name: ____________________________________________
Project RME Number: ____________________________________________
Project RME Business Name: _____________________________________________
RME Business
Installation Contractor Business Name:_______________________________________
RME Phone: ________________Installation Contractor Cell Phone: _______________
Fee Required: $__50.00_______ Applicable fees must be paid prior to permit issuance.
Cash [ ] Check [ ] Fee Received By: _________________________________
Details regarding the above request must be filed when application is made and
whenever requested by the Fire Official. It is the applicant’s responsibility to ensure that
conditions are in accordance with applicable State and Local fire regulations. I
understand that it is the sole discretion of the Fire Official making inspection to
approve or disapprove this request for any reason.
I understand that the Fire Official may revoke this permit at any time for non-
Note: Operating with no permit or an expired permit may result in Municipal
Citations, as well as stop work orders, and double permit fees.
Applicant may not proceed without the approved permit by Fire Official.
__________________________ ________________________ _____________
Applicant Signature Print Name Date
Applicant Email Address:_________________________________
** Permit must be kept at site at all times **
Date Issued: ________________
ID #: ____________________ Fire Official_______________________
Date Expires: _______________ Permit #: _______________________
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Phone: 409-643-5700 FAX: 409-643-5719
Page 2 Minimum Requirements
Underground Fire Sprinkler Supply Line Permit & Installation
Underground Fire Sprinkler Line Minimum Plans Requirements
Plans must have a signed & dated RME stamp
Plans must list pipe type & size of all lines being installed
Plans must show overall sight, and routing of all lines to be installed on-sight
Plans must convey that they comply with NFPA 13 & NFPA 24
Plans must convey Pipe Lengths
Plans must show all couplings, elbows, Ts , and risers
Plans must show City water line routing, size, and tie in location
Plans must show backflow preventer detail and location
Plans must show Thrust block details and location of all Thrust blocks or specify the
means of restraint as detailed by NFPA 24
Thrust blocks shall be in place and dry prior to an inspection
Location of all valves. Specify the type for each (e.g., post indicator valve (PIV), key gate
valve, system control valve, double detector check (DDC) assembly, outside stem and
yoke (OS&Y), etc.).
Location of the fire department connection (FDC); FDC’s shall be no more than 150 feet
from a fire hydrant
Provide a fire riser detail
Backfill Detail shall include: A 6-inch bed of clean fill sand shall be provided below the
pipe and 12-inches above the pipe
Burry depth and trench detail shall be conveyed: Pipe shall be buried at least 36” where
subject to loading (e.g., driveways, parking lots) and at least 30” elsewhere.
Pipe shall be center-loaded with clean sand to prevent uplift, but all joints shall remain
exposed. The system shall be hydrostatically tested at 200 psi for a duration of at least
two hours
All ductile iron, retaining rods, and other non-plastic components shall be externally
coated for corrosion and poly-wrapped
All underground piping shall be thoroughly flushed PRIOR TO connecting to the system
A Completed Contractors Material and Test Certificate for Underground Piping Shall be
provided upon completion of Hydrostatic Test. (Form SFO42 state fire marshals office)
**For Fire Department Use Only**
Notes regarding Inspection (If disapproved, state reasons)
Approved: [ ] Yes [ ] No
** Permit must be kept at site at all times **
Date Application Rcvd ______________