FIRE PROTECTION SUBCODE TECHNICAL SECTION

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Date Received Control #. fire PROTECTION SUBCODE . TECHNICAL SECTION Date Issued Permit #. A. IDENTIFICATION APPLICANT: COMPLETE ALL APPLICABLE INFORMATION. WHEN CHANGING C. CERTIFICATION IN LIEU OF OATH. CONTRACTORS, NOTIFY THIS OFFICE. CALL UTILITY DIG NO: 1-800-272-1000. I hereby certify that I am the (agent of) owner of record and am authorized to make this Block Lot Qualification Code application. Work Site Location Applicant/Contractor sign here: Owner in Fee: Print name here: Tel. e-mail [ ] Certified Contractor [ ] Exempt Applicant D. TECHNICAL SITE DATA. Address DESCRIPTION OF WORK: street municipality zip code Contractor: Tel. Water Supply Source Address e-mail Method of Alarm/Suppression System Supervision _____________________. NUMBER 1234567890123456. FEE (Office Use Only).

Fire Alarm System: [ ] New OR [ ] Existing Location of Panel: Total Cost of Fire Protection Work $ Type: Failure Failure Approval Initial INSPECTIONS Dates (Month/Day) Other Fireplace Venting Flam/Combust Tanks Final TCO Smoke Control Mechanical Pre-Eng. System Fire Pump Standpipe Suppression Sys. Alarm System JOB SUMMARY (Office Use Only) PLAN ...

  Fire, Failure, Failure failure