CITY OF WEST HAVEN APPLICATION FOR FIRE PROTECTION SYSTEM PERMIT

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For office use only: DATE ISSUED PERMIT # VALUE $ FEE $ CHECK CONTROL# CITY OF WEST HAVEN APPLICATION FOR FIRE PROTECTION SYSTEM PERMIT HOUSE # STREET Project name or Tenant Name: Property Owner s Name Signature: Property Owner s Mailing Address: Contractor LICENSE # TYPE Contractor s Address Contractor s Phone Email Design Professional LICENSE # PE Layout Tech Address Phone Email Office use only Total value of work: $ Fee: $ Final Cert of Approval $ Total $ App. Date: Building Official Approval: Date: FM Approval: Date: The undersigned owner or authorized agent applies for a permit to install a fire protection system in accordance with the laws and ordinances of the City of West Haven CT and the Connecticut General Statutes, the CT State Building Code, and the CT State Fire Safety Code and intends to comply with same. permits are issued to the owner in fee, and compliance with all regulations is the responsibility of the owner in fee of the subject parcel. I hereby swear that the this application is authorized by the owner in fee and that said applicant is authorized by the owner in fee to make said application. Personally Appeared Authorized agent for: Owner Who made oath that the statements herein were true and correct before me this day of Notary Public My Commission Expires: Fire Protection Permit Application 4/19/17

CITY OF WEST HAVEN APPLICATION FOR FIRE PROTECTION SYSTEM PERMIT System Type: NFPA-13 NFPA13-D NFPA-13-R Kitchen Hood Suppression Standpipe System Fire Pump Other Wet Dry Pre-action Deluge Chemical Fire Pump type: Fuel: Back up Emergency Generator: GPM: Other: # of Risers: Riser Size: Hand Hose Outlets: Type of alarm: Monitoring type; FD Connection : See Fire Marshal for instructions Water Supply: Public Size of water lateral pipe: Existing Proposed: Private Gallons of tank storage: Building Information: Use Group: Construction Class: Building Size: Square Foot: Stories: Occupancy Hazard Classification: Commodity Classes Protected: Document Check List: Stamped Plans Owners Certificate (Statement of use and commodity) Design Specifications Hydraulic Calculations Manufacturer s specification sheets on all proposed devices Evidence of Workers Comp Insurance Fire Marshal Approval Letter Kitchen Hood drawing List drawing numbers and dates Remarks:

This application for a fire protections system permit is governed by the current applicable CT State Statutes, CT State Building and Fire Codes, as amended, and applicable ordinances enacted by the City of West Haven. MUNICIPAL ORDINANCE 81-8 Taxes Due No building application shall be approved by the West Haven Building Department, (WHBD) if it is determined by the WHBD that there are delinquent taxes or sewer use charges against the property for which the application is made; the applicant is to provide to the WHBD a statement from the Office of the Tax Collector that the owner of the property for which an application is made has entered into a payment program approved by the Tax Collector to pay off the delinquent taxes or sewer use charges which may be due. As used in this section the term "building application" shall include any application for a building permit, plumbing, mechanical or electrical permit. : The Building Official shall not issue a permit where taxes are due on the subject property. 2016 CT State Building Code: States in part and material relevance: Section 105.3.1 ACTION ON APPLICATION reads in part: The Building Official shall examine or cause to be examined application for permits and amendments thereto within 30 days after filing and either issue or deny a permit within such 30 day period. If the application or construction documents do not conform to the requirements of this code and pertinent laws, the Building Official shall reject such application in writing stating the reasons therefore. Section 105.3.1.1 ZONING APPROVAL reads in part: No Building Permit shall be issued in whole or in part for a building use or structure subject to the zoning regulations of the municipality without certification in writing by the official charged with enforcement of such regulations that such building, use or structure is in conformity with such regulations or is a valid non-conforming use under such regulations. Section 105.3.1.2 FIRE MARSHAL APPROVAL reads in part: No Building permit for a building structure or use subject to the requirements of the 2016 CT State Fire Code, [as amended], shall be issued in whole or in part without certification in writing from the local Fire Marshal that the construction documents for such building, structure, or use are in substantial compliance with the requirements of the 2016CT State Fire Code [as amended]. Section 107.2.2 FIRE SPRINKLER SYSTEM SHOP DRAWINGS Shop drawings for fire sprinkler system (s) shall be submitted to indicate conformance to this code and the construction documents and shall be approved prior to the start of the system installation. Shop drawings shall contain all information as required by the referenced installation standards in Chapter 9. Such documents shall be accompanies by evidence of licensure by the state pursuant to section 29-263ah of the CT General Statutes.