BUREAU OF FIRE PROTECTION

Region 4A
Laguna Provincial Office
Biñan City Fire Station
FSEC
APPLICATION
(049) 511-9111
Brgy. Poblacion,Biñan City, Laguna (049) 511-9111 binanfirestation@yahoo.com
(Station Email) DISAPPROVAL FORM

FIRE SAFETY EVALUATION CLEARANCE

PROJECT OWNER
PROJECT TITLE

PROJECT LOCATION
OWNER ADDRESS
NAME OF CONTRACTOR/
GENERAL CONTRACTOR
AUTHORIZED REPRESENTATIVE
TOTAL FLOOR AREA (M2): NO. OF STOREY:

CONTACT NUMBER : EMAIL ADDRESS:

Your application for FSEC is hereby disapproved for the following reason/s:
THREE (3) COMPLETE SETS OF THE FOLLOWING (PROPOSED PLAN):
[I/N] ARCHITECTURAL DOCUMENTS
[I/N] CIVIL/STRUCTURAL DOCUMENTS
[I/N] ELECTRICAL DOCUMENTS
[I/N] MECHANICAL DOCUMENTS
[I/N] PLUMBING DOCUMENTS
[I/N] ELECTRONICS DOCUMENTS
[I/N] SANITARY DOCUMENTS
FIRE PROTECTION PLAN
[I/N] PROTECTION OF VERTICAL OPENING AND COMBUSTIBLE CONCEALED SPACES (IF
NECESSARY)
[I/N] FIRE DETECTION, ALARM, AND COMMUNICATION SYSTEMS (IF NECESSARY)
[I/N] AUTOMATIC SPRINKLERS AND OTHER EXTINGUISHING EQUIPMENT (IF NECESSARY)
[I/N] STANDPIPES SYSTEMS (IF NECESSARY)
[I/N] PORTABLE FIRE EXTINGUISHERS (IF NECESSARY)
[I/N] SEGREGATION AND PROTECTION OF HAZARDS (IF NECESSARY)
[I/N] UTILITIES (IF NECESSARY)
[I/N] HEATING, VENTILATING AND AIR-CONDITIONING(IF NECESSARY)
[I/N] SMOKE CONTROL SYSTEMS (IF NECESSARY)
[I/N] RUBBISH CHUTES, LAUNDRY CHUTES, AND FLUE-FED INCINERATORS (IF NECESSARY)
[I/N] ELEVATORS AND ESCALATORS (IF NECESSARY)
[I/N] LPG PIPING LAYOUT (IF NECESSARY)
[I/N] KITCHEN HOOD SUPPRESSION SYSTEM (IF NECESSARY)
[N] PHOTOCOPIES OF VALID LICENSES OF INVOLVED PROFESSIONAL
[ I / N ] ONE (1) SET COST ESTIMATE OF THE BUILDING INCLUDING LABOR COST SIGNED AND SEALED BY THE
DESIGNER/CONTRACTOR DULY NOTARIZED
[ I / N ] ONE (1) SETS OF FIRE SAFETY COMPLIANCE REPORT (FSCR) (IF NECESSARY)
[N] FIRE SAFETY CLEARANCE FOR WELDING, CUTTING, AND OTHER HOT WORK OPERATIONS (IF REQUIRED)

NOTE:
I – INCOMPLETE N – NO
(Encircle I for incomplete requirement and N for no or lacking requirements)

DATE RECEIVED BY THE OWNER/

___________________________
AUTHORIZED REPRESENTATIVE
BFP – CRO

PAALALA: “MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF FIRE PROTECTION SA MGA KAWANI NITO ANG MAGBENTA O
MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER”
“FIRE SAFETY IS OUR MAIN CONCERN”

BFP-QSF-FSED-049 REV.01 (08.24.20)