Republic of the Philippines

Department of the Interior and Local Government

BUREAU OF FIRE PROTECTION
(Region)
(District/Province Office)
(Station)
(Station Address)
(Telephone No./Email Address)

FSCIFDAS NO. R____________ __________

DATE
FIRE SAFETY CLEARANCE
INSTALLATION OF FIRE DETECTION, ALARM AND COMMUNICATION SYSTEM
TO WHOM IT MAY CONCERN:
By virtue of the provisions of RA 9514 otherwise known as the “Fire Code of the Philippines of 2008”
and its Revised Implementing Rules and Regulations (RIRR), this CLEARANCE is hereby issued for the
Installation of Fire Detection, Alarm and Communication System (FDAS) to
__________________________________________________________________________________________
(Name of Building/Structure/Facility)
located at _________________________________________________________________________________
(Address)
owned by _______________________________ and to be installed by ________________________________.
(Name of Owner) (Name of Installer /Company)

Type of Activation: Manual Initiation Automatic Detection Extinguishing System Operation Others: ___________________________
√
No. of Zones/Loops: ____________________________________________________________________________________________
Fire alarm pull stations and annunciators Location: ______________________________________________________________________________
Addressable Conventional Addressable Conventional
Automatic Initiating Devices Supervisory Signal-Initiating Devices
(Qty) (Qty) (Qty) (Qty)
Smoke Detectors For Sprinkler System Supervisory
Heat Detectors Devices
Duct Smoke Detectors For Fire Pump Supervisory Devices
Flame Detectors For Elevator
Others: ___________________ Others: __________________________
Alarm Notification Appliances:
In-Building Fire Emergency Voice Alarm Communication System(No. of single voice alarm channel): _______ No. of Speaker: ________
Non-voice Notification Appliances: Horns: ____ With Visible:____ Chimes:____ With Visible ____ Bells: _____ With Visible: _____
Visible only: __________ Others (describe): __________________________________________
Control Unit Primary Power:
Input Voltage: ________ Control Panel Amps: ________ Location of Primary Supply Panel Board: ______________________
Control Unit Secondary Power:
Generator Location: ___________________________________________________
Uninterruptible Power System (UPS) Location: ___________________________________________________
Batteries Location: _______________ Type: ________ Amp/Hour Rating: ____________
This clearance is hereby granted after fire detection, alarm and communication system design, plans and
other documents submitted have been duly evaluated and found to be complied with the provisions of the Fire Code of
the Philippines, latest edition of Philippine Electronics Code, latest edition of Philippine Electrical Code (PEC) and other
internationally accepted standards.

Violation of the provisions of RA 9514 shall cause this Clearance NULL AND VOID after appropriate
proceeding and shall hold the owner and his/her installer/contractor liable to the penalties provided under RA
9514.

Fire Code Fees: RECOMMEND APPROVAL:

Amount Paid:
O.R. Number:
Date:

CHIEF, FSES

APPROVED:

CITY/MUNICIPAL FIRE MARSHAL

NOTE: “This Clearance is accompanied with PLANS SIGNED AND SEALED BY PROFESSIONAL ELECTRICAL
ENGINEER/PROFESSIONAL ELECTRONICS ENGINEER DULY EVALUATED AND REVIEWED BY THE BFP and does not take the
place of any license required by law and is not transferable. Any change or alteration in the design and specification during
installation shall require a new clearance”
PAALALA: “MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF FIRE PROTECTION SA MGA KAWANI NITO ANG
DISTRIBUTION: MAGBENTA O MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER”
Original (Applicant/Owner’s Copy)
Duplicate (BFP Copy)
“FIRE SAFETY IS OUR MAIN CONCERN”
BFP-QSF-FSED-048 REV. 01 (08.24.20)