14-1041-004Miami -Dade Fire Rescue
Fire Alarm Pre - Submittal Checklist MI®
Based On NFPA 72 2007' Ed. & NFPA 1 and 1012009' Ed.
Date:
Buildi De Process Number is ` ins wilt C M = is vided in title block of tans. YES NO N/A
1 Pro'ed Name: d a ication. If address contains
? Address in title block shall match address in °Building Dept. Computer System" and attached perm ppl'
2 a s buildi ,floor. suite, or unit number or letter, it shall be ro ' ed in title block, to match Building Dept. Corn er S tern.
3 The total cost of the installation to the customer is $
and a copy of the contract or a notarized affidavit V
from the owner showing this amount is attached.
4 Fire Alarm S terns costi more than $5,000 are sealed or stain b a Florida R istered Pro fessional En ineer.
�ptnhnt�hlG• . R„ f N 1
i
5 The total number of DEVICES and COMPONENTS bei installed is 0� 21 and a co is attached to tans.
6 The alarm ual'fiers state license number is EF EH EY #
Complete, current manufacturers Specfication and Installation Sheets are attached for all control units, components, devices,
7 modules and rela listed on L end. Miam'rDade Fire Rescue? if yes, a v
Is this permit application for fire alarm work a result of a Notice Of Violation (NOV) issued by
{ 8 cu of the Notice of Violation is attached.
Ir (fill in the Occupancy Chapter & Section from NFPA 101 v
9 This fire alarm: ( ) is required render � red system or component
OR, ( is a rife safety equivalency OR, I is a non-required of prior
This is an "EXISTING (Locaq Fire Alarm System and is stated as such on the plans. Al prol� airs docxxn t of fire nalarm plans or
10 approval of system s a (Local) Fi� arm System `n the fo of o�ipal Flre Deft pP r b c- ,4`p7i �•
j certified microfilm co of same. Gh t'a`i' �A G �4
I 11 This is a'NEW Local Fire Alarm S ten" and is stated as such on tans. of the exsting
This is an'EXISTING Central Station Service Fire Alarm System' and i�,s protected " yladdress and uniquely identdying
12 BUILDING UL or ETL certificate, or FM Placard,
specifically g
this buildi 's fire alarms stem, is attached.
If the company that issued the existing certificate or placard for this building's fire alarm system is d'rfferent than the company t i
13 applying for this permit; is the required Affidavit to Work on another Company's Certificated or Placarded Fire Alarm System
Provided?
14 This is a NEW Certificated of Placarded "Central Station of the ULior ETL cercate of FM placard from the contractor,
j 15 If this i as NEW "Central Station Service Fire Alarm System; a copy
or from the Central Station Service Comnan�ssu Fire AlamtdS a and is stated s such own the plans. AHJ will require Ap
This is an "EXISTING Remote Supervi g Yd
16 documentation of prior approval of system as a Remote Supervising Station Fire Alarm System in the form of the original Fire Dept
a roved 'ob co set of fire alarm laps or certified microfilm co of same. V
17 This is ar "EXISTING °S rinkier Waterflow and Su rviso em" on and is stated s such on laps.
'! This is a NEW "Sprinkler Waterflow and Supervisory System" only and is stated rd such on�ns� S,Sttatit Service Fre monitored mt° and V
18 and provides emergency forces notification through a Certificated (� or Placarded U
is stated as such on the plan s.
A complete detailed M-1-M... ceomthe NFP is tied and NF F1011 (2009 }, or prio a Its of these tenant
s if applicable. V
19` entirety, will be inspected for
Also outline I- of work with bolded dashed iirres n floor lam and riser for ebsti systems.
20 The buildi is "New" or'Existi and is indicated as such on the 31ans.
A description of the building is provided, inducing fire sprinkler systems, fire suppression systems, number of stories, square V
21 foota a floor, and elevation of the last 00C11, ied floor if over 5 stores.
A location lGey provided showing the area of proposed work within the building. Also provided is a site key for projects with v
multiple buildi s showing locations of all buildings with addresses
23 All interconnected Fire Alarm ConVoi Panels are 1 111 ed to Ti ction as a si le s ten and monitored for int ri r NFPA 72. d 11
24 The class /s is shown for ail Initiati Device Circuits IDC . S' nal Line Circuits SLC and Notification lance Circuits NAC . f1
25 The ma)dmum number of each device type is Provided for each IDC based on device load or each SLC, based on loss and style,
r NFPA 72 and the manufacturers lions.
_j I 26 A specific "Sequer�e of Operation" inducing all alarm, supervisory. trouble and wntrol functions such s fire sprinkler, door
release smoke control elevator recall, s ression s tems, and transmission of s nals otisite, etc. are s m onthe }lavyn11ero Station
The type of monRoring station, (Listed Central Station, Remote Supervising Station, Listed Pro prietary Supervis g
A to is dea and concise stated in the "Sequence of 0 rations'
27 alarm, trouble, and su i s nals are transm fitte
28 T
,
If this building contains elevators that are not capable of recall, k
elevator contractors letterhead tii LItThag "Elevators are not ca
If this building does not contain a fire alarm system, and the fire
30 I
dead de ' nated nel as "Elevator Recall Control and Su rvi
Manufacturer, model number and unique symbol for each model
31 M
ower su and fire alarm control anel is s in the_sym
32 E
Each device, module, appliance and component is identified w
Floor plans are drawn to 1/8" scale or, if using another scale, all
dimensions are included.
its oven unique number and indicated on the floor plans and riser.
device coverage is diagrammed on the floor plan and all room V
s
Designed by:
OS (► ✓e_ 000, Phone t s.4
j Signature: _ Created by: MDFR 081 2012
A REQUIRED DOCUMENT ON ALL FIRE ALARM PLAN SUBMITTALS
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