BMP - PRE-CEILING COVER - VISUAL LIFE SAFETY INSPECTION

• Project name

• Location and type of report

• General contractor

• Supervisor / Phone / email

• Project manager / Phone / email

• Inspection date

  Date

• Description of work

• Permit photo(s)

  Media

• Life Safety Plan photo(s)

  Media

• Do not close ceilings until you receive a verifying signature that all issues have been resolved at the bottom of this report.

• For verification of repairs - Attach pictures of the repairs and send them back along with this report to raterry@houstonmethodist.org or contact Robert Terry @ 832-470-2297

Life Safety Inspection

Open penetrations or improperly sealed penetrations

• Is there an open penetration or improperly sealed penetration? (NFPA 101, Life Safety Code, 2012 Edition - 8.3.5.1 * Firestop Systems and Devices Required)

  Yes

  No

  N/A

• Describe exactly what the penetration or improperly sealed penetration is

• Describe the exact location

• Take photo(s)

  Media

• Note:

• Current status of issue:

  Resolved

  Not resolved
Sprinkler pipe / Sprinkler pipe hangers

• Is there an item touching the top of a sprinkler pipe or touching the sides of a sprinkler pipe hanger? (NFPA 13, Life Safety Code, 2010 Edition - 9.1.1.8.1 * Support of non-system components) (NFPA 25, Life Safety Code, 2011 Edition)

  Yes

  No

  N/A

• Describe exactly what the item is and what it is touching

• Describe the exact location

• Take photo(s)

  Media

• Note:

• Current status of issue:

  Resolved

  Not resolved
Open junction box

• Is there a junction box missing a cover or missing knockout plugs? - (International Fire Code, 2018 Edition – 605.6 * Open Junction Boxes)

  Yes

  No

  N/A

• Describe exactly what the issue is

• Describe the exact location

• Take photo(s)

  Media

• Note

• Current status of issue:

  Resolved

  Not resolved
Wall labeling

• Is there a fire or smoke wall labeled incorrectly? - (International Building Code, 2015 Edition - 703.7 * Marking and identification)

  Yes

  No

  N/A

• Describe exactly what the issue is

• Describe the exact location

• Take photo(s)

  Media

• Note:

• Current status of issue:

  Resolved

  Not resolved
Unusual observation

• Are there any items that do not meet the NFPA requirements that do not fit the above catagories?

  Yes

  No

  N/A

• Describe exactly what the issue is

• Describe the exact location

• Take photo(s)

  Media

• Note:

• Current status of issue:

  Resolved

  Not resolved

General Comments

• Any further comments or recommendations arising from this inspection?

• Add any additional relevant photos

  Media

Inspection sign off

• Name & Signature of Inspector

  Sign

Above issues marked "Resolved" have been addressed and verified.

• Name and signature of verifying person

  Sign

• The above name and signature of verifying person deems issues marked "Resolved" at rated walls and open areas above the inspected ceiling lines compliant and closed.