Project Name :

Factory/UNIT NUMBER: NAME:

TENANT DETAIL
Tenant’s Name:
E-mail Address:
Date: Contact (Office):
Tenant’s Signature & Stamp: Contact (Mobile):

Initial Submission Yes/No Resubmission Yes/No

SUBMISSION DETAIL
Modification Yes/No Upgrade Yes/No
Description of work:
Document Required
SI. No Check List Submitted Remarks
1. Detailed Drawing YES
2. Work Description YES
3. Fit-out Undertaking Letter YES
4. Agreement Letter YES
5. Fit-out Policy and Procedures YES
6. Modification of work letter YES
7. Machine Specification YES
8. Electrical Load N/A
9. Method of Statement YES
10. Risk Assessment YES
11. Consultant Documents (If applicable) N/A
9. NOC Required for the work? N/A
11. Any Ministry Documents to be signed? N/A
12. Others N/A
Modification of Fire System?
12. FA/FF Drawing N/A
13. FACP (Sub Panel Installation) N/A
14. Additional Heat /Smoke Detector N/A
15. Fire Extinguishers (Type ………………………….) N/A
16. Blanket N/A
Tenant Comment:

1 of 2
 FM Manager
⃝ Approved(With No Comment)
Name & Designation
Health & Safety
Officer
⃝ Approved(With No Comment)
Name & Designation
QDB Engineer
⃝ Approved(With No Comment)
Name & Designation
⃝ Approved (With Comment) ⃝ Reject
Signature & Stamp
⃝ Approved (With Comment) ⃝ Reject
Signature & Stamp
⃝ Approved (With Comment) ⃝ Reject
Signature & Stamp
2 of 2