FIRE PROTECTION SUBCODE TECHNICAL SECTION

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2 IDENTIFICATION APPLICANT: COMPLETE ALL APPLICABLE INFORMATION. WHEN CHANGINGCONTRACTORS, NOTIFY THIS OFFICE. CALL UTILITY DIG NO: Control SystemKitchen Hood Exhaust SystemOtherFM200 SuppressionFoam SuppressionCO2 SuppressionDry ChemicalWet ChemicalStandpipesSprinkler Heads (Dry and Wet)Pre-action ValvesDry Pipe/Alarm ValvesGPM TypeFire PumpTOTALO ther DevicesSignaling Devices ( , horn/strobes, bells)Supervisory Devices ( , tampers, low/high air)Alarm Devices ( , smoke, heat, pulls,water/flow)System[ ][ ]110v InterconnectedFlammable/Combustible TanksFireplace Venting/Metal ChimneyAdministrative Surcharge$Minimum Fee$State Permit Surcharge Fee$TOTAL FEE$[ ]CO Detectors/110vBlockLotQualification CodeWork Site Locationzip codemunicipalitystreetAddresse-mailTel.

3 Owner in Fee:Contractor:Tel. Addresse-mailFire PROTECTION Equipment, NJ Div of Fire Safety Permit PROTECTION Equipment, NJ Div of Fire Safety Installer Alarm Contractor DateFederal Emp. ID : Home Improvement Contractor Registration No. or Exemption Reason Applicant: When submitting this form to your Local Construction Code Enforcement Office, please provide oneoriginal plus three F140 (rev. 02/11)Internet version123456789012345678901234567890121 2345678901234567890123456789012123456789 0123456789012345678901234567890121234567 8901234567890123456789012123456789012345 6789012345678901234567890121234567890123 4567890123456789012123456789012345678901 2345678901234567890121234567890123456789 0123456789012123456789012345678901234567 8901234567890121234567890123456789012345 6789012123456789012345678901234567890123 4567890121234567890123456789012345678901 2123456789012345678901234567890123456789 0121234567890123456789012345678901212345 6789012345678901234567890123456789012123 4567890123456789012345678901212345678901 2345678901234567890123456789012123456789 0123456789012345678901212345678901234567 8901234567890123456789012123456789012345 6789012345678901212345678901234567890123 4567890123456789012123456789012345678901 2345678901212345678901234567890123456789 0123456789012123456789012345678901234567 8901212345678901234567890123456789012345 6789012123456789012345678901234567890121 2345678901234567890123456789012345678901 2123456789012345678901234567890121234567 8901234567890123456789012345678901212345 6789012345678901234567890121234567890123 4567890123456789012345678901212345678901 2345678901234567890121234567890123456789 0123456789012345678901212345678901234567 8901234567890121234567890123456789012345 6789012345678901212345678901234567890123 4567890121234567890123456789012345678901 2345678901212345678901234567890123456789 0121234567890123456789012345678901234567 8901212345678901234567890123456789012123 4567890123456789012345678901234567890121 2345678901234567890123456789012123456789 0123456789012345678901234567890121234567 8901234567890123456789012123456789012345 6789012345678901234567890121234567890123 4567890123456789012123456789012345678901 2345678901234567890121234567890123456789 0123456789012123456789012345678901234567 8901234567890121234567890123456789012345 6789012123456789012345678901234567890123 4567890121234567890123456789012345678901 2123456789012345678901234567890123456789 0121234567890123456789012345678901212345 6789012345678901234567890123456789012123 4567890123456789012345678901212345678901 2345678901234567890123456789012123456789 0123456789012345678901212345678901234567 8901234567890123456789012123456789012345 6789012345678901212345678901234567890123 4567890123456789012123456789012345678901 2345678901212345678901234567890123456789 0123456789012123456789012345678901234567 8901212345678901234567890123456789012345 6789012123456789012345678901234567890121 2345678901234567890123456789012345678901 2123456789012345678901234567890121234567 8901234567890123456789012345678901212345 6789012345678901234567890121234567890 Fuel-Fired Appliances[ ] Oil[ ] Gas[ ] SolidB.

4 FIRE PROTECTION CHARACTERISTICSP roposedPresentUse Group:ProposedPresentConstr. Class:Fuel Storage Tank:Fuel Type: [ ] Flammable OR [ ] CombustibleCapacityNew ORExistingFire Alarm System:[ ][ ]Location of Panel:Total Cost of Fire PROTECTION Work $InitialApprovalFailureFailureType:Dates (Month/Day)INSPECTIONSO therFireplace VentingFlam/Combust TanksFinalTCOS moke ControlMechanicalPre-Eng. SystemFire PumpStandpipeSuppression SystemJOB SUMMARY (Office Use Only)PLAN REVIEWNo Plans Required[ ]Approved by:Date: SUBCODE APPROVAL for CERTIFICATECA[ ]CO[ ][ ]CCOJ oint Plan Review Required:[ ] Bldg. [ ] Elec. [ ] Plumb. [ ] APPROVAL for PERMITDate:Approved by:Approved by:Date:Fire PROTECTION Plans Approved[ ]Partial -Underslab Utilities Approved[ ]Approved by:Date:Fuel Type:OtherLocation:[ ]Solar[ ]Electric[ ]Oil[ ]Gas[ ]New ORLocation of Main Control Valve:ExistingFire Suppression/ standpipe System:[ ][ ]Heating System:Modification to ExistingOR[ ]New[ ][ ] ReplacementOR[ ] ConversionORC.

5 CERTIFICATION IN LIEU OF OATHI hereby certify that I am the (agent of) owner of record and am authorized to make Supply SourceMethod of Alarm/Suppression System Supervision _____[ ] Certified Contractor [ ] Exempt ApplicantD. TECHNICAL SITE DATAA pplicant/Contractorsign here:DESCRIPTION OF WORK:$Print name here.