Property Name:

Property Address

Owners Name:

Fax #:

Address:

City:

State:

Zip:

Tel:

Installers Name:

Fax #:

Address:

City:

State:

Zip:

Tel:

N.I.C.E.T. CERTIFICATION #

# VALVES

# LOW PRESSURE SWITCHES

# FLOW ALARMS

# WATER FLOW SWITCHES

# OF HEADS

# POST INDICATION VALVES

Estimated Cost

# TAMPER SWITCHES

 # OTHER DEVICES

PROVIDE THE FOLLOWING WITH THIS APPLICATION

PLANS REVIEW FEE

CUT SHEETS

SPRINKLER HYDRAULIC CALCULATIONS

STANDPIPE CALCULATIONS

FLOOR PLANS

TOTAL FLOOR AREA

Highlight all sprinkler components on plans and drawings.

Equipment must be installed in accordance with the Rochester Fire Department rules and regulations governing sprinkler systems and manufacturers’ installation instructions.

Application is hereby made for approval for installation or modification of a sprinkler systems.

DATE

Installer’s Business Name

Installer’s Name (Print)

Installer’s Signature

DATE

Inspector’s Name

Approved

Disapproved