SUMMARY ACCOMPLISHMENT REPORT ON FIRE CODE FEES COLLECTION

For the Month and year

FORM 5/5

Fire Safety Inspection Fee Installation Clearance Fee Other Fees

Other Installation Clearance (not mentioned

in the group and future forms for Installation
Installation of Flammable and Combustible

Certified True Copy of FSEC/FSIC/ Other

Installation of Building Service Equipment
Fire Code Fees for Occupancy
City/Municipality

Installation of LPGAS System

Fire Code Fees for Business

Conveyance Cleance Fee

Fire Code Administrative

Fire Code Proceeds Tax

Storage Clearance Fee

Fire Incident Clearance

Fire Code Construction

Liquids Storage Tanks

Filing Fees for FSEC

Electrical Installation
Installation of KHSS
Installation of FDAS

Fumigation/Fogging
Installation of AFSS
Fire Code Premuim

Fireworks Display
Fire Code Realty

Fire Code Sales

Protest Fee

Appeal Fee
Clearances
Clearance)

Fire Drill
Fines
Tax

Tax
Tax

Tax
628-BFP-01 628-BFP-02 628-BFP-03 628-BFP-04 628-BFP-05 628-BFP-06 628-BFP-07 628-BFP-08 628-BFP-09 628-BFP-10 628-BFP-11-a
Business Establishments

TOTAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(Past year same month)

Variance
Government Buildings

TOTAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(Past year same month)

Variance
PEZA Establishments

TOTAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
(Past year same month)

Variance
Grand Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Prepared by: Certified Correct by: Noted by:

FSED, Staff Regional Chief, FSED Regional Director

BFP-QSF-FSED-052E Rev. 00 (07.13.20)

 Open Flame

0.00
0.00
0.00
0.00
Fire Prevention and Safety Seminar

0.00
0.00
0.00
0.00
Soundstage and Approved Production

0.00
0.00
0.00
0.00
Facilities and Locations

Welding, Cutting and Other Hotworks

0.00
0.00
0.00
0.00

BFP-QSF-FSED-052E Rev. 00 (07.13.20)

Other Fees (not mentioned in the group

0.00
0.00
0.00
0.00
and future clearances)

Certificate of Competency (COC) Fees

0.00
0.00
0.00
0.00
628-BFP-11-b

0.00
0.00
0.00
0.00
Total