12-354-001Miami -Dade Fire Rescue MIAMht�ADt:
Fire Alarm Pre - Submittal Checklist _
Based On NFPA 72 2002 edition & NFPA 1 and 1012006 edition
954- 862 -5223
CALVIN C. REYNOLDS JR.
Designed by: Phone #:
Signature: Created by. MDFR 11 / 2009
THIS IS A DOCUMENT ON ALL FIRE ALARM PLAN SUBMITTALS
Building Department Process Number is ........... (begins with C or
Date:
Project Name: and Is provided in title block of
plans SMH ELEVATOR RENOVATIONS
YES
NO
WA
LOCATION I COMMENTS
Address in title block to match address found in Building Department Computer
System ". If address contains a building, suite, or specific unit number or letter,
same to be provided in title block — to match Building Department Computer
7300 SW 62nd
X
Stem. AVENUE, MIAMI, FLORIDA 33143
A copy of the contract or a notarized affidavit from the owner showing the total cost
X
1
of the equipment and Installation is provided. Cost $
2
Systems costing more than =5,000 are sealed or approved by a Florida Registered
X
Engineer.
3
The total number of devices and components being installed Is 48
X
4
A copy of alarm ualifiers state license Is attached. EC EF EH EY #
X
Complete, current manufacturer's specification and installation sheets are provided
5
for all devices, modules, control units and components. All additions to existing
X
fire alarm systems shall Include manufacturers specification sheets for FACP.
6
Manufacturers documentation of device compatibility has been provided.
--"'
X
7
Is this permit application for fire alarm work a result of a Notice Of Violation issued
by Miami -Dade Fire Rescue? If a co of the Notice of Violation is ovldad.
retire alarm: X Is required under NFPA 101 CH 19
3
X;
(Ex; Occupancy chapterisectlon from NFPA 101) or Indicate if It is a fife safety
equivalency, or is a non — required Wtorn or component.
This fire alarm system is not required, but owner 1 tenant elects to have the
occupancy protected by a fire alarm system. Fire alarm system shall be Installed
NFPA 101 &
'I r
--�
9
per
NFPA 72 standard.i
X
i
This fire alarm system is not required to have emergency forces notification, but
owner I tenant elects to have system monitored. if this Is a new system, monitoring
10
shall be through a listed central station or a listed proprietary supervising station.
X
This fire alarm system is for sprinkler system supervision only. Sprinkler
11
supervisory only fire alarm systems, new or existing, shall also monitor duct
X
detectors if an and suppression systems if an as Per NFPA 72 and NFPA 90.
This Is an EXISTING sprinkler supervision only fire alarm that is monitored off-site
and provided emergency forces notification through an Existing Remote
Supervising Station, and is stated as an Existing Remote Supervising Station Fire
Alarm System on the plans. ANJ may require documentation of prior approval of
X
12
system as a Remota Supervising Station Fire Alarm System In the form of the
original Fire Dept. approved job copy set of plans or certified microfilm copy of
same.
This is a NEW sprinkler supervision only fire alarm that is monitored off-site and
13
provided emergency forces notification through a Certificated L,) or Placarded
X
Central station Service Fire Alarm and is stated as such on the plans.
This system will be a NEW Certificated L) or Placarded U "Central Station
14
Service Fire Alarm System" land is stated as such on the plans. (24 hoUrs
X
seconds power)
If this Is a NEW "Central Station Service Fire Alarm System," a copy of the UL or
ETL certificate or FM placard for the contractor pulling permit or, from the Central
15
Station Service Company responsible for the installation, servicing and monitoring
X
of the s stem. Is attached.
Is Is an EXISTING "Central Station Service Fire Alarm System.." A copy of the
existing UL or ETL certificate, or FM Placard, specifically Identifying this protected
16
premise by address, and uniquely identifying this building's fire alarm system, is
X
attached.
( the contractor that Issued the existing certificate or placard for this building's fire
alarin system is different than the contractor applying for this permit, to perform
work on an existing Central Station Service Fire Alarm System, Is the required
X
17
Affidavit to Work on another Company's Certificated or Placarded Fire Alarm
System provided?
954- 862 -5223
CALVIN C. REYNOLDS JR.
Designed by: Phone #:
Signature: Created by. MDFR 11 / 2009
THIS IS A DOCUMENT ON ALL FIRE ALARM PLAN SUBMITTALS