Fire Department Pre-Plan Form

Fire Department Pre-Plan Form

Please complete this form to provide essential information for pre-planning purposes.
- Building Type
  
  Other
- Business Name
- Building Name
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Building Layout
- Number of Floors
- Construction Class
- Roof Type
- Roof Covering
- Occupancy Type
- Adults
- Children
- Elderly
- Elderly Location/Needs
- Disabled
- Disabled Location/Needs
- Designated Evacuation Location/s
- Main Access
- Secondary Access
- Roof Access
- Attic Access
- Basement Access
- Additional Important Accesses needed
- Fire Alarm System
- Automatic Sprinkler System
- Fire Extinguishers
- Emergency Lighting
- Knox Box
- Knox Box Location
- Picture of Knox Box Location
  
  Cancelof
- Fire Alarm Panel Location and access
- Picture of Fire Alarm Location
  
  Cancelof
- Sprinkler room Location and access
- Picture of Sprinkler Room Location
  
  Cancelof
- Fire Department Connection (FDC) Location
- Picture of FDC Location
  
  Cancelof
- Are any of the following Present
- Natural Gas Meter Location
- Picture of Natural Gas Meter Location
  
  Cancelof
- Propane Tank Location
- Picture of Propane Tank Location
  
  Cancelof
- Solar Panel Battery & Shut off location
- Picture of Solar Panel Battery Location & Shut off Location
  
  Cancelof
- Back-up Generator Location & Shut off Location
- Picture of Back-up Generator Location & Shut off Location
  
  Cancelof
- Power Meter Location
- Location of Power Meter Location/s
  
  Cancelof
- Water Main Shut off
- Picture of Water Main Shut Off Location
  
  Cancelof
- Presence of Hazardous Materials
  
  Other
- Types of Hazardous Materials
- Hazardous Materials List
  
  Cancelof
- Storage Location of Hazardous Materials
- Picture of Hazardous Materials Storage Location/s
  
  Cancelof
- Primary Contact Name
  
  First NameLast Name
- Primary Contact Phone
  Please enter a valid phone number.Format: (000) 000-0000.
- Secondary Contact Name
  
  First NameLast Name
- Secondary Contact Phone
  Please enter a valid phone number.Format: (000) 000-0000.
- Special Instructions for Firefighters
- Other Relevant Information
- Basic Floor Plan
  
  Please Upload a Drawing of your floor plan (Hand drawn or CAD). Please be sure to include all floors. Each floor should be on a separate page. If possible please label all rooms.
- Basic Floor Plan
  
  Cancelof
- Please provide the following
  
  We may contact you for more information and/or schedule a "Walk through" if applicable.
- Name of person Submitting
  
  First NameLast Name
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
  example@example.com
- Please verify that you are human
- Should be Empty:

Fire Department Pre-Plan Form

Basic Floor Plan

Please provide the following