VRFD Occupancy Inspection Report

• Occupancy Name

• File Action:

  New File

  Change of Information

• Address / File #

• Conducted on

  Date

• Document No.

• Inspected By

  Insp. Pitre

  AC Marshall

  Insp. Faykes

Business License Information

• Business License?

  Yes

  No

• Business Name

• Nature of Business

• Hours of Operation

• Owner

• Phone Number

• Email

• Owner contact for Business?

  Yes

  No

• Contact Name

• Position

• Phone Number

• Email

Building Information

• Is the address different from the first page?

  Yes

  No
• Address
  Address

• Occupancy Classification

  Select A1 - Assembly A2 - Assembly A3 - Assembly A4 - Assembly B1 - Detention B2 - Treatment B3 - Care C - Residential D - Business and Personal E - Mercantile F1 - High Hazard F2 - Medium Hazard F3 - Low Hazard

  • A1 - Assembly
  • A2 - Assembly
  • A3 - Assembly
  • A4 - Assembly
  • B1 - Detention
  • B2 - Treatment
  • B3 - Care
  • C - Residential
  • D - Business and Personal
  • E - Mercantile
  • F1 - High Hazard
  • F2 - Medium Hazard
  • F3 - Low Hazard

• Floors

  Select 1 2 3 4 5 6 7 8 9 10

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10

Fire Safety

• Fire Alarm

  Yes

  No

• Service Company

• Phone Number

• Sprinkler System

  Yes

  No

• Service Company

• Phone Number

• Standpipe System

  Yes

  No

• Information Different than Sprinklers

  Yes

  No

• Service Company

• Phone Number

• Kitchen System

  Yes

  No

• Service Company

• Phone Number

• Fire Safety Plan

  Yes

  No

• Company

• Name

• Phone Number

General Remarks

• Notes:

• Ocuppancy

  Occupancy Approved

  Occupancy Not Approved

  Occupancy Conditional on Completion of Deficiencies

• Approval Date

  Date

• Inspector

  Sign

For Office use Only

• Initial Inspection Date

  Date

• Added to the database