Kansas City Kansas Fire Department

• Document No.

• Business Name:

• Location Number

• Conducted on

  Date

Last Inspection Date

• Prepared by

• Inspector/s

• Priority Rating:

  1

  2

  3

  4

• Add location
  Address

Property Name

• Exterior Image (Not Required)

  Media

• Business Name

Address

Owner/Manager

• Name:

• Email Address:

Business Phone Number

Emergency Contact (Primary)

• Name:

Phone Number

Emergency Contact (Secondary)

• Name:

Phone Number

Exterior

• Is there Knox Box?

  Yes

  No

• Are the keys in the Knox Box the current keys to the business?

  Yes

  No

• Square Footage:

• Is the street address posted with a minimum 4" numbers with contrasting background, and visible from the street?

  Yes

  No

• IFC 2009 Fire Code Violation # 505.1

• Are the fire apparatus access roads, fire hydrants, FDCs, etc are clear of all obstructions?

  Yes

  No

  N/A

• Add media

  Media

• Roads: IFC 2009 Fire Code Violation # 503 FDCs & Hydrants 3' clearance around: IFC Fire Code Violation # 507.5.5

Building Services

• Utilities

  Select Electricity Gas Water

  • Electricity
  • Gas
  • Water

• Are utilities in good working order?

  Yes

  No

  N/A

• Location of gas shut off:

• Are there elevators?

  Yes

  No

• Does the elevator have fire service recall?

  Yes

  No

• Does the elevator/s have fire service control?

  Yes

  No

• Have the elevator/s been inspected by elevator inspector?

  Yes

  No

• What is the location of the fire service keys?

Fire Protection Systems

• Is there a fire suppression system?

  Yes

  No

• Date of annual inspection:

• Coverage:

  Building Wide

  Partial Coverage

• Type of system:

  Wet

  Dry

  CO2

  Other

• Is there a fire pump?

  Yes

  No

• Is it in the automatic position?

  Yes

  No

  N/A

• Date of last fire pump test:

• Is there clearance of at least 18" on all sprinkler heads?

  Yes

  No

  N/A

• IFC 2009 Fire Code Violation # 315.2.1

• Notes

• Is there a Fire Alarm?

  Yes

  No

• Location of Panel:

• Type of Monitoring System:

  Monitored

  Local Alarm

• Date of last system inspection:

• Type of initiation devices:

  Select Smoke Heat Manual Pulls Water Flow Other

  • Smoke
  • Heat
  • Manual Pulls
  • Water Flow
  • Other

• Fire Extinguishers Present

  Yes

  No

• Has the extinguisher been inspected in the last 12 months?

  Yes

  No

• Fire Code Violation #: 906.1

• Are the fire extinguishers mounted properly?

  Yes

  No

• NFPA Fire Code Violation # 13.6.8.1.3.8

• Date of annual inspection:

• Adequate Number?

  Yes

  No

• NFPA Fire Code Violation # 13.6.8.1

• Yes

  No

  N/A

Means of Egress

• Are there exit signs? (Required where more than one exit is required/occupant load greater than 50)

  Yes

  No

• Are the exit signs illuminated?

  Yes

  No

  N/A

• IFC 2009 Fire Code Violation # 1011.2

• Readily Visibile?

  Yes

  No

  N/A

• Clear and Unobstructed?

  Yes

  No

  N/A

• Two remote exits available in loads greater than 50?

  Yes

  No

  N/A

• Doors swing in direction of egress when required?

  Yes

  No

  N/A

• Panic/Fire exit hardware operable?

  Yes

  No

  N/A

• Doors open easily?

  Yes

  No

  N/A

• IFC 2009 Fire Code Violation # 1008.1.9.3

• Self closure operable and closes completely and latches?

  Yes

  No

  N/A

• Doors closed or held open with automatic closers?

  Yes

  No

  N/A

• Corridors and aisles of sufficient size? 44" load greater than 50; 36" load less than 50

  Yes

  No

  N/A

• IFC 2009 Fire Code Violation # 1017.2

• Stairwell re-entry?

  Yes

  No

  N/A

• IFC 2009 Fire Code Violation # 1008.1.9.10

Housekeeping

• Are all areas free of excessive combustibles/clutter?

  Yes

  No

  N/A

Electrical

• 30" width/36" depth clearance maintained around electrical panels?

  Yes

  No

  N/A

• IFC 2009 Fire Code Violation # 605.3

• Are extension cords being use as permanent wiring?

  Yes

  No

• Add media

  Media

• IFC 2009 Fire Code Violation # 605.5

Automatic External Defibrillators

• Do they have an A.E.D.?

  Yes

  No

• Location:

• Notes

• Representative of business

  Sign

• Inspector

  Sign

• Was a copy of the report emailed to business?

  Yes

  No