SUALUULSA LL
CORPORATION OF THE CITY OF PORT COQUITLAM
BY~LAW NO. 1298
APPENDIX "Cc"!
APPLICATION FOR FIRELINE PERMIT

Date:

I hereby make application under provisions of the Building By-Law
to do fireline work as shown below:

ADDRESS:

OWNER: ADDRESS:

CONTRACTOR: : ADDRESS:

No person except a fire protection system contractor holding a
current municipal business license shall be granted a fireline

. permit.

PURPOSE FOR WHICH BUILDING IS TO BE USED:

OCCUPANCY PERMIT ISSUED:

Date fireline plans approved:

Remarks:

Engineering Department Signature

”

Each 30 metres of fireline

Siamese Connections

Fire Hydrants

First Sprinkler Head
Additional Heads
Hose Cabinets

Hose Outlets
Wet/Dry Outlets

“a WOM OK OM OK Ox

4

Standpipes

TOTAL

SIGNATURE OF APPLICANT: