12-1288R-004Miami -Dade Fire Rescue
Fire Alarm Pre - Submittal Checklist
Based On NFPA 72 200T Ed. & NFPA 1 and 101 20W Ed.
• r•s
COuNTY
ijuaa Process NumDer is ifs wrm L. or M rJai6: f r
1 Pm Nam Scut 3RD FLOOR OBSTETRICAL NICO OR Is provided in title block of plans. YES NO N!A
2 Address in We block shay match address in'Buiidi g Dept. Computer System' and attached permit application. If address contains x
a buildiria, floor, suite or unit numberor letter, ff shall be ed in filter M2E& to match Boft Dept. Computer
3 The total cast of the Installation to the customer Is $ - _ _ - - _ - _ _ _ and a copy of the contract or a notartzed of idavft x
fmrn the kroner showing this amount is attached.
5 The total number of DEVICES and COMPONENTS beky Installed Is 14 x
6 The alarm qu~s state license number Is EF Eli # and a copy is attached to plans. x
7 Complete, current manufacturer's Specification and Installation sheets are akfached for all control units, components, devices, x
modules and EdW lsted our Legend.
8 is this permit application for fire alarm work a result of a Notice Of Violation (NON} issued by Mlaml -Dade Fire Rescue? If yes, a x
copy of the Notice of Violation Is ate.
g This fire alarm: x is reautred under CH# 19 (119 In the Occupancy Chapter A Section from NFPA 101, or x
Is a IIfe safety equivalency, or_, is a non4equlred system or cnmponenL
- This is an'EXISTiNG Local Fire Alarm System' and Is stated as such on the plans. AHJ W2 require documentation of prior
10 approval of system as a Local Fire Alarm System In the form of the original Fire Dept approved job copy set of fire alarm plans or
0
This Is an'EXISTiNG Central Station Service Fire Alarm System' and is stated as such on the Plans. A copy of the exlstlng
12 BUILDING UL or ETL carlificate, or FM Placard, specifically Wer& irrg this protected prernia by address, and uniquely Werffying Ix this building's fire alarm is attached. _ -
if the company that issued the existing certificate or placard for this building's fire alarm system Is dfffere d than the company
13 applying for this permit* Is the required Affidavit fo Wok on another Company's Certificated or Placarded Fue Alarm System x
15
it this is a NEW "Central Station Service FIND Alain System,` a copy of tine UL or EfL certificate of FM placard from the contractor, x
or from the Central Station Service Company, Issuing the building certIficatelplacard, Is attached.
This Is an `DUSTiNG Remote Supervising Station Fire Alarm System' and Is stated as such on the plan. AHJ will require x III
1 e documentation of prior approval of system as a Remote Supervising Station Fire Alarm System In the form of the original Fire Dept.
ME2nW job copy set of fire alarm pWj3 or certified microfikn copy of same.
17 This is an 'EXISTING `5 rinider Waterflow and S M S and is stated as such on plans. x
This is a NEW `Spdnlder Waterflow and Supervisory System' only and Is stated as such on plans. The system Is monitored off -site
18 and provides emergency forces notification through a Certiftated (_j or Placarded ((. �j'Cantraf Station Service Fins Alarm" and x
is stated as such an the plans.
A complete detailed statement of the `SCOPE OF WORK' Is stated on the plan. Please note that the complete tenant space, in its
19` entirety, will be Inspected for compliance with NFPA 72 (2007) and NFPA 101(2009), or prior edition's of these codes If applicable. x
21
A descaipfion of the building Is provided, Inclucflrg fire sprinlde systems, fire suppression systems, number of stories, square
x
footage per floor and elevation of the last occup124 floor if over 5 stories.
22
A location Key Is provided showing the area of proposed wok wtthhn the building. Also provided is a site key for project with
x
mu le builds s sheLAM locationapf-all-buildingis with addresses
23
All interconnected Fire Alarm Cord Panels are arranged to function as a sirde m and monitored far integrity Eff NFPA 72:.
x
24
The clasaJa a is shown for all I Device Circuits DC SIgnal Una Circuits LS LC and Notttication Appliance Circuits
x
25
The maudrnun; number of each device type is provided far each IDC based an device load or each SLC, based on class and stale.
x
Per NFPA 72 and the manufacturer's specifications.
28
A specific `Sequence of Openx5W including al. alarm, supervisory, trouble and control functions such as fire spr 'snider. door
x
release smoke control elevator recall, suppression systems, and traramissfon of signals offstte eta are specified on the plan.
27
The type of monitoring station, (Listed Central Station, Remote Supervising Station, Listed Proprietary Supervising Station). where
x
alarm trouble and supervisory s cis are transmitted to, is dearly and c D stated In the ` of erations'
28
The method of communication to the monftpft station is included an the riser.
x
29
tf this building contains elevates that are not capable of recall, It shall be stated as such on plans and written documentation on
elevator c ontractDes letterhead staft that `Elevators are not of df man function, paMed,
30
If this building does not contain a foe alarm system, and the fire alarm panel is used exclusively for elevator recall; plans shall
cis designated panel as `Elevator Recall Control and Panel'
31
Manufard�, model number and unique symbol for each model number is WwAded for each device, module, relay, component,
x
owe and tire alarm contrdpanel Is specified In the symbol legend.
32
Each device, module, appliance and component Is identified with Its won unique number and indicated on the floor plans and riser.
x
33
Floor plans are drawn to 1/8` scale or, If using wxnthar scale, ail device coverage is diagrammed on the &uor plan and all room
x
dirnensions are included.
Designed by: CALVIN C. REYNOLDS JR. Phone#: 1- 954 -862 -5223
Signature - z_. __ Created by: MDFR0812012
THIS IS A REQUIRED DOCUMENT ON ALL FIRE ALARM PLAN SUBMITTALS
1 OF 2