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HomeMy WebLinkAboutOWNER CERT - 19-00161 - 425 S 3rd W - Sugar City Bldg 4 - FA/FS InstallOwner's Information Certificate Name/Address of property to be protected with sprinkler protection: South Fork Villas 425 S 3nd W 83448 Sugar City ID Name & Address of Owner: South Fork Development 5004 Marilyn Dr Holladay Ut 84117 Existing or planned construction is: ❑ Fire resistive or noncombustible Wood frame or ordinary (masonry walls with wood beams) ❑ Unknown Is the system installation intended for one of the following special occupancies: Aircraft Hanger ❑ Yes M No Fixed guideway transit system ❑ Yes EA No Race track stable ❑ Yes q No Marine terminal, pier, or wharf ❑ Yes OQ No Airport terminal ❑ Yes tk No Aircraft engine test facility ❑ Yes tA No Power Plant ❑ Yes IX No Water-cooling tower ❑ Yes t No If the answer to any of the above is "YES," the appropriate NFPA standard should be referenced for sprinkler density/area criteria. Indicate whether any of the following special materials are intended to be present: Flammable or combustible liquids ❑ Yes i No Aerosol products ❑ Yes] No Nitrate Film ❑ Yes No Pyroxylin plastic ❑ Yes No Compressed or liquefied gas cylinders ❑ Yes No Liquid or solid oxidizers ❑ Yes I& No Organic peroxide formulations ❑ Yes No Idle Pallets ❑ Yes Ik No If the answer to any of the above is "Yes," describe type, location, arrangement, and intended maximum quantities. Indicate Whether the protection is intended for one of the following specialized occupancies or areas: Spray area or mixing room ❑ Yes ( No Solvent extraction ❑ Yes No Laboratory using chemicals ❑ Yes IX No Oxygen -fuel gas system for welding or cutting ❑ Yes No Acetylene cylinder charging ❑ Yes No Production or use of compressed or liquefied gasses ❑ Yes No Commercial cooking operation ❑ Yes No Class A Hyperbaric chamber ❑ Yes No Cleanroom ❑ Yes No Incinerator or waste handling system ❑ Yes k No Linen handling system Q Yes No Industrial furnace ❑ Yes No Water-cooling tower ❑ Yes No If the answer to any of the above is "yes," describe type, location, arrangement, and intended maximum quantities. Will there be any storage of products over 12ft (3.6 m) in height? ❑ Yes V No If the answer is "yes," describe product, intended storage arrangement, and height. Will there be any storage of plastic, rubber, or similar products over aft (1.5 m) high except as described above? ❑ Yes � No If the answer is "yes," describe product, intended storage arrangement, and height. The following is a part of the fire service design. Please sign at the bottom to confirm the parameters, If the choices below are not acceptable, please indicate "other". Please note that any changes in the below may result in additional charges. Head Finish White 0 Chrome 0 Brass Escutcheon Finish White 13 Chrome D Brass Head Type * Semi -Recessed © Concealed (Additional cost if not in specifications) Ice" that I have knowledge of the Intended use of this property and that the abo ' tiQo is wrect. Signature of owneirs representative or agent: Dake: Name of ownees representative or agent completing certificate (print): , Jonathan Mcmullin Relationship and firm of agent (print: General Manager