Form Bfs 979 PDF Details

In this day and age, online security is more important than ever. With so much of our personal information accessible online, it's crucial to take the proper precautions to protect ourselves. Form Bfs 979 is one such precaution, and it's something that everyone should be using. This form helps ensure your safety by verifying your identity before completing transactions online. So why aren't more people using it? Read on to find out.

QuestionAnswer
Form NameForm Bfs 979
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesBFS-979, FSOF, application for fie safety plan examination bfs 979 04 18, E-Mail

Form Preview Example

 

 

Application for Fire Safety Plan Examination

253/257

 

Michigan Department of Licensing and Regulatory Affairs

 

 

 

Bureau of Fire Services

 

 

 

Plan Review Division

Agency Use Only

 

 

P.O. Box 30700

 

 

 

 

 

Lansing, MI 48909

 

 

 

(517) 241-8847

PROJECT #

 

 

 

 

Authority:

1941 PA 207

The Department of Licensing and Regulatory Affairs will not discriminate against any individual or group because of race,

Completion:

Voluntary

sex, religion, age, national origin, color, marital status, disability, or political beliefs. If you need help with reading, writing,

Penalty:

Project will not be reviewed

hearing, etc., under the Americans with Disabilities Act, you may make your needs known to this agency.

 

 

 

 

Note: The architect / engineer / certified firm is responsible for all fees applicable to this application.

Project Description

Facility Name

City or village in which facility is located

 

City

 

Village

Of:

Street/Site Address

County

Fire Department (REQUIRED)

Zip Code

Estimated Project Cost (REQUIRED):

 

(All Facilities - See Back)

Fee Submitted:

Project Description (Type of work; Addition, Renovation, HVAC, etc. Location of Work; Floor, Wing, etc. BE SPECIFIC)

Review Requested

Facility / Project to be Reviewed

Building Data

 

 

 

 

Construction Plans / Specs

 

 

 

 

 

 

Review/Inspection

 

 

 

Review/Inspection

 

Original Year Constucted:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Consultation

 

 

 

 

 

 

Fee REQUIRED **

 

 

 

Fee NOT Required

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your AIA/PE Job #:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

College / University (253)

Adult Foster Care

 

 

 

 

 

 

 

 

 

 

 

 

 

*Addendum / Bulletin #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dormitory (253)

 

 

 

7-12

 

 

 

 

No. of Stories (Including basement)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Modification Request

 

 

 

 

 

 

 

 

 

FSOF (257)

 

 

 

13-20

 

 

 

Sprinklers:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fire Alarm (specify below)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Completely

Partially

None

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hospital (257)

 

 

 

Change of Licensee

 

 

Submittal:

 

 

 

 

 

 

 

 

 

 

 

 

 

Door Locking

 

 

 

 

 

 

 

 

 

 

 

This

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mobile Healthcare Unit

Home for the Aged

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Hood Suppression (specify below)

 

 

 

 

 

 

 

 

Addtion

New Building

 

 

 

 

 

 

Serial #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nursing Home

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sprinkler (specify below)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Conversion

Remodeling/

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Clean Agent (specify below)

 

 

 

 

 

 

 

 

 

 

Phased

 

 

 

Phased

 

 

 

 

 

Alteration

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Square Footage -New Work

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hospital within a Hospital (257)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Hospice Residence (257)

 

 

 

 

 

Square Footage -Existing

 

 

 

 

 

 

 

 

 

 

NOT related to a current FS project

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Schools/Charter (253)

 

 

 

 

 

*Type of Construction (per NFPA

220):

 

 

 

 

 

 

Related to existing FS project #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Penal Institutions **

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

** See back - Fee Schedule & Phasing Procject

 

 

 

 

 

 

 

 

 

 

 

 

 

* See back - Miscellaneous Instructions

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Facility Contact Person

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone (Including Area Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Architect / Engineer / Certified Firm

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name (Licensed Individual)

 

 

 

 

 

 

 

 

 

 

 

 

 

License No. / Act 144 Cert. No. E-Mail Address (REQUIRED)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Company

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

State Zip Code

Telephone (Including Area Code)

Fax (Including Area Code)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BFS-979 (11/11) Front

*This information is confidential. Disclosure of confidential information is protected by the Federal Privacy Act.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Instructions for Application for Fire Safety Plan Examination

To Expedite Your Review:

-All submittals must be accompanied by an Application for Fire Safety Plan Review completely filled out. -Provide all requested information.

-An "n/a" designation is helpful for areas where information does not pertain to the project.

-Only ONE set of construction documents or related specification drawings is required.

-Construction documents must be signed and sealed by an architect or professional engineer licensed in the State of Michigan as required by 1980 PA 299.

-Fire Suppression and fire alarm shop drawings and computations are not required to be sealed by a design professional.

-Act 144 certified firms shall provide the certification number issued by the Bureau of Fire Services.

-All fees are due upon submittal (colleges, hospitals, universities, dormitories, schools, charter, schools, hospice residences, FSOF, and penal institutions submitted by a non-state agency).

**Fees are applicable on construction documents, fire alarm, door locking, sprinkler, hood suppression, and clean agent suppression system shop drawings in colleges, dormitories, free-standing outpatient facilities/ambulatory surgical centers, hospitals, universities, schools, charter schools, hospice residences, and penal institutions (submitted by a non-state agency).

Fees are not assessed for any other type of facilities, including penal institutions when submitted by a state agency.

-All floor plans shall indicate exit locations, identify all room uses, and sprinkler coverage, if any.

-Furnish approved design numbers of all fire related assemblies.

-Changes to previously reviewed drawings must be specifically brought to our attention for review and comment.

-Submit a seperate check or money order for each project payable to the State of Michigan.

-Health Care Project: When applicable, identify the area(s) occupied by ambulatory/non-ambulatory patients, outpatients, and location of all smoke barriers.

-Architect / Engineer / Certified Firm: Provide all requested information. All correspondence will be sent to this e-mail address and this entity will be responsible for all fees.

Note: A hold will be placed on any project with fees owed. The project will not be sent to our field office and inspections will not take place until all fees have been paid.

**Fee Schedule

(Free-standing outpatient facilities and hospitals; colleges, universities, dormitories, schools, charter schools, hospice residences, and

penal institutions**)

Project Cost Range

Fee

$101,000.00 or less

Minimum fee of $155.00

$101,001.00 to 1,500,000.00

$1.60 per $1,000.00

$1,500,001.00 to 10,000,000.00

$1.30 per $1,000.00

$10,000,001.00 or more

$1.10 per $1,000.00 - Maximum fee $60,000

Estimated Project Cost (if original plans/specs): The Project Cost includes all costs associated with the project other than the cost of equipment that is not

"fixed'. "Fixed" equipment is defined as equipment necessary to the operation of the building, including but not limited to: air handlers, boilers, chillers, electrical switchgear, elevators, generators, modular casework, etc. If labor is being provided for the project, the cost of the labor shall be included.

*Miscellaneous Instructions

Phased Projects- A phased project is a project that requires areas to be occupied before the over all project is completed. Phased projects require a seperate application and submittal for each phase. Costs & fees shall be applied per phase. We will treat each phase with a seperate project # so the coordination with Act 144 Certified Firms will be the responsibility of the Architect.

-Hood suppression systems shall be reviewed and billed individually.

-Review of modifications, addenda, and bulletins shall be billed $155.00 for application with a one-hour review. All review time after first hour is to be billed at $50.00 per hour.

-Plan review consultation has a flat fee of $155.00.

-Modification Requests are defined as a request to a modification of a rule or section of the code.

Project Description: Please indicate floor or work site to assist in identifying the project location, as well as:

Square footage of new building, addition, remodeling, etc; Square footage of an existing building; Project Scope (description of project)

Type of Review Requested: If the review you are requesting in not on the form, please write in your request.

Type of Construction (per NFPA 220): Below is a cross-reference chart of Building Construction Types

NFPA 220

I(442)

I(332)

II(222)

II(111)

II(000)

III(211)

III(200)

IV(2HH)

V(111)

V(000)

MBC

-

IA

IB

IIA

IIB

IIIA

IIIB

IVHT

VA

VB

U.S. Postal Service

Michigan Dept. of Licensing and Regulatory Affairs

Bureau of Fire Services

Fire Safety Plan Review Division

P.O. Box 30700

Lansing, MI 48909

Courier Other Than U.S. Postal Service Michigan Dept. of Licensing and Regulatory Affairs

Bureau of Fire ServicesVALIDATION AREA - DO NOT WRITE Fire Safety Plan Review Division

525 W. Allegan, 4th Floor Lansing, MI 48913-0001

BFS-979 (11/11) Back

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Be mindful when filling in this form. Make sure that all necessary fields are completed properly.

1. It's vital to fill out the bfs 979 accurately, therefore be careful while filling out the segments comprising these particular blank fields:

Filling out section 1 of outpatients

2. Right after filling out this part, go to the next step and fill out the necessary particulars in these fields - Hood Suppression specify below, Sprinkler specify below, Clean Agent specify below, Serial, Phased, Nursing Home, Phased, Mobile Healthcare Unit, Home for the Aged, NOT related to a current FS project, Related to existing FS project, Hospital within a Hospital, Hospice Residence, SchoolsCharter, and Penal Institutions.

outpatients conclusion process outlined (part 2)

3. In this specific step, have a look at Name of Company, Address, City, State Zip Code, Telephone Including Area Code, Fax Including Area Code, BFS Front, and This information is confidential. Each one of these need to be taken care of with utmost attention to detail.

Find out how to fill out outpatients step 3

When it comes to Name of Company and Address, make certain you take a second look in this section. Both these are considered the most significant fields in this PDF.

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