FS Transmittal Fillable 4-2010

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FS Transmittal Fillable 4-2010 Powered By Docstoc
					For SFM Use Only
                                                                 Oklahoma State Fire Marshal
Number                                                                     2401 NW 23rd, Suite 4
PO                          Permit Fee                                Oklahoma City, Oklahoma 73107
Number                      Owed                                    (405) 522-5005 Fax: (405) 522-5028
Uniform Building Code Commission Fee             $4.00
Total Amount Owed
                                                                     Fire Sprinkler Plan Review
Date Paid
                                  Amount                                  Transmittal Form
Until payment or PO is received all plans will be on hold           IS THIS PROJECT ON ANY TRIBAL TRUST LAND?
and will not be put into circulation for review.
                                                                                  YES     NO
       Project Name                                                   Date
       Address                                                        City / Zip Code
       County                                                         Occupancy Type
       Construction Type                                              Number of Stories
       Footprint/Total Square
       Footage                                   /                    Occupant Load
       Fire Sprinkler
                                                                      Phone Number
       Fax Number                                                     E-mail Address
                                                                      Individuals Sprinkler
       Estimated Cost
                                                                      License Number
                                        Dry System
       Alarm             Yes                         Yes              Suppression         Yes          Elevator           Yes
                                       or Pre-action
       Installed          No                         No               Installed           No           Installed          No

       I, the undersigned, am submitting all items required for review of fire sprinkler to the Oklahoma State
       Fire Marshal’s Office.
                  representing _          Company License #
                  Submitter                Sprinkler Company
             I wish to pick the reviewed plans up at the OSFM office upon completion. Please contact                           at
               the following phone number
             Please mail reviewed plans to the following address:
       (All plans will be mailed through USPS using standard media mail)
       City:                  State:    Zip:
          Please return using third party carrier:
       (Fed Ex / UPS etc.) Preferred Carrier                   Account #
       (All items shipped through a third party carrier will be at the customer’s expense. A properly filled out return label must be
       provided to our office and any pickup fees will be at the customer’s expense)


                  State Fire Marshal Use Only        State Fire Marshal Use Only      State Fire Marshal Use Only
             st                                       nd
            1 Contact: Date/Time/Person              2 Contact: Date/Time/Person                 3rd Contact: Date/Time/Person

       This form replaces all previous editions. Previous editions should no longer be used after January 1, 2010. Please
       recycle all previous forms