Fire Department Pre-Plan Form

Building Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Building Type

Building Size (sq. ft.)

Occupancy Type

Single OccupancyMulti OccupancyMixed Use

Building Layout

Open PlanCompartmentalizedMixed Layout

Primary Contact Name

First NameLast Name

Primary Contact Phone

Please enter a valid phone number.

Secondary Contact Name

First NameLast Name

Secondary Contact Phone

Please enter a valid phone number.

Presence of Hazardous Materials

YesNoOther

Types of Hazardous Materials

Storage Location of Hazardous Materials

Fire Alarm System

YesNo

Automatic Sprinkler System

YesNo

Fire Extinguishers

YesNo

Emergency Lighting

YesNo

Special Instructions for Firefighters

Other Relevant Information