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Fire Station Application Form With Claim Stub

This document is an application for a fire safety evaluation clearance or fire safety inspection certificate from a fire station. It requires information about the applicant, building details like address and floors, and various documents needed for assessment like building plans, fire safety plans, and proof of fire insurance. Once submitted, the application will be processed and either approved or denied within a specified timeframe to allow for occupancy or business permits. The key purpose is to evaluate buildings for fire safety compliance before allowing occupancy.

Uploaded by

Jim Bryan Raz
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
242 views1 page

Fire Station Application Form With Claim Stub

This document is an application for a fire safety evaluation clearance or fire safety inspection certificate from a fire station. It requires information about the applicant, building details like address and floors, and various documents needed for assessment like building plans, fire safety plans, and proof of fire insurance. Once submitted, the application will be processed and either approved or denied within a specified timeframe to allow for occupancy or business permits. The key purpose is to evaluate buildings for fire safety compliance before allowing occupancy.

Uploaded by

Jim Bryan Raz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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(FIRE STATION LETTER HEAD)

APPLICATION __________________
NO. ______________ Date

(To be filled up by applicant/owner)


Name of Applicant/Owner _________________________________________________
Type of Building/Occupancy ________________________________________________
Total Number of Floors ____________________________________________________
Total Floor Area __________________________________________________________
Location/Address of Building/Establishment/Construction ________________________

Requirements Submitted: (To be checked/filled up by the Customer Relations Officer)

FIRE SAFETY EVALUATION CLEARANCE FIRE SAFETY INSPECTION


(FSEC) CERTIFICATE (FSIC) FOR OCCUPANCY
PERMIT OR BUSINESS PERMIT
Endorsement from the Building Official (BO) Endorsement from Building Official
(BO)/Business Permit Licensing Office (BPLO)
Three (3) Sets of Building Plans and
Specifications Photocopy of Building Permit and
Assessment of Occupancy Permit Fee/
One (1) Set of Bills of Materials and Cost Assessment of Business Permit Fee/BPLO
Estimate Assessment/Tax Bill for Business Permit as the
case maybe
Three (3) Sets of Detailed Fire Safety Plans
and Specification or Fire And Life Safety Copy of Fire Insurance Policy (If Any)
Assessment Report-1 (FALAR-1) for Occupancy
of at least 50 persons Copy of Latest Fire Safety Inspection
Certificate Immediately Preceding this
Application (If Any)

Three (3) sets of Fire and Life Safety


Assessment Report-2 (FALAR-2) for
Occupancy permit or FALAR 3 for Business
Permit (For Occupancy of at least 50 Persons)

________________________________________
SIGNATURE OF APPLICANT/OWNER

Time and Date Received: _____________________________________


Due for Release (FSEC with FS Checklist): ________________________
(FSIC/NTC): _____________________________
Certified By:

__________________________
Customer Relations Officer
Note: Only application with complete requirements shall be processed.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _

CLAIM STUB
__________________
APPLICATION NO. ______________ Date

NAME OF APPLICANT/OWNER: _______________________________


Time and Date Received: _____________________________________
Due for Release (FSEC with FS Checklist): _______________________
(FSIC/NTC): __________________________________ Certified By:

__________________________________________________

Customer Relations Officer

“FIRE SAFETY IS OUR MAIN CONCERN”

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