Republic of the Philippines

Department of the Interior and Local Government

Bureau of Fire Protection
NATIONAL CAPITAL REGION
Fire District IV
Taguig City Fire Station
Radian St. Arca South Western Bicutan Taguig City
Tel No. 356-9423/[email protected]

____________________
(Name of Owner) DATE

(Name of Establishment)

(Address)

FOR : CITY FIRE DIRECTOR

ATTN : CHIEF, FIRE PREVENTION SECTION

REFERENCE: INSPECTION ORDER NO.______________________ DATE ISSUED__________________

DATE OF INSPECTION: ___________________________________

NATURE OF INSPECT ION CONDUCTED: [ ] Check Appropriate Box

[ ] Building Under Construction [ ] Periodic Inspection of Occupancy
[ ] Application for 0ccupancy Permit [ ] Verification Inspection of Compliance to NTCV
[ ] Application for Business Permit [ ] Verification Inspection of Complaint Received
[ ] Others (Specify) _______________________________________________________________________________

MERCANTILE OCCUPANCY CHECKLIST

I. GENERAL INFORMATION
Name of Building _________________________________________________________________________________
Business Name _________________________________________________________________________________
Address ________________________________________________________________________________________
Nature of Business ________________________________________________________________________________
Name of Owner/Occupant___________________________________ Contact No._______________________
Name of Representative______________________________________ Contact No. ______________________
No. of Storey__________ Height of B1dg. __________(m) Portion Occupied_____________________________
Area per flr __________________________sqm Total Flr. Area ______ ___________________________sqm
Building Permit No ___________ Date Issue_______ Occupancy Permit No.______ Date Issued ___________
Latest FSIC Issued Control No. _______________ Date Issued_______________ FC Fee_____________________
Certificate of Fire Drill __________________ Date Issued_________________ FC Fee__________________
Latest Notice to Correct Violations Control No. ____________________________ Date Issued _______________
Name of Fire Insurance Co/Co-Insurer________________ Policy No.___________ Date Issued _______________
Latest Mayor's/Bus. Permit _________ Date Issued______ Municipal License No._____ Date Issued _________
Latest Certificate of Electrical Inspection No. __________________ Date Issued__________________________
Other Information _________________________________________________________________________________

II.BUILDING CONSTRUCTION
Beams ________________________ Columns_____________________ Flooring _________________________
Exterior Walls__________________ Corridor Walls_________________ Room Partitions ___________________
Main Stair_____________________ Windows_____________________ Ceiling ___________________________
Main Door____________________ Trusses_______________________ Roof ____________________________

III. SECTIONAL OCCUPANCY (Note: Indicate specific usage of each floor, section or rooms)

IV. CLASSIFICATION
Occupancy Classification: [ ] A [ ] B [ ] C [ ] Others ___________________________________________
Occupant Load:_________________ (Requirement: 2.8 sq.m per person for street level; 5.6 sq. m for upper floors and 9.3 sq. m. for
offices, storage, and shipping and not open to the general public)
Any renovations [ ] Yes [ ] No if Yes, specify ________________________________________________
Underground: [ ] Yes [ ] No Windowless: [ ] Yes [ ] No

V. EXIT DETAILS
Capacity of Horizontal Exit (Corridor Hallway):____________________ (Requirement:100 persons per unit of exit width per min)
Capacity of Exit Stair: ___________________________________ (Requirement: 60 persons per unit of exit width per min)
No. of Exits_________________________________________________ Remote [ ] Yes [ ] No
Minimum Requirement: No. of Exits: Two (2) units per floor

BFP-QSF-FSED-017 Rev. 01 (07.05.19) Page 1 of 5

 Republic of the Philippines
Department of the Interior and Local Government
Bureau of Fire Protection

Location of Exit___________________________________________________________________________________
Maximum Travel Distance Requirement from Farthest Room: 30.5 m without AFSS & 46m with AFSS
Any Enclosure Provided [ ] Yes [ ] No Min of 2-hr fire rating- 4-storey or more, Min of 1 hr, fire rung- less than 4-storey

MEANS OF EGRESS
Readily accessible [ ] Yes [ ] No Obstructed [ ] Yes [ ] No
Travel distance within limits? [ ] Yes [ ] No Dead-ends within limits [ ] Yes [ ] No
Adequate illumination [ ] Yes [ ] No Proper rating of illumination [ ] Yes [ ] No
Panic hardware operational? [ ] Yes [ ] No Door swing in the direction of exit? [ ]Yes [ ] No
Doors open easily [ ] Yes [ ] No Self-closure operational [ ] Yes [ ] No
Bldg w/Mezzanine [ ] Yes [ ] No Mezzanine with proper exits [ ]Yes [ ] No
Corridors & aisles of sufficient size [ ] Yes [ ] No
A. VERTICAL EXITS
1. Main stairway: Width___________________________ Construction _________________________________
Are there railings provided [ ] Yes [ ] No Made of _____________________________________________________
Any enclosure provided [ ] Yes [ ] No Enclosure construction________ Any opening [ ] Yes [ ] No
Fire door construction_________________________ Door equipped w/ Self-closing device [ ] Yes [ ] No
Door proper rating: [ ] Yes [ ] No Door provided w/ vision panel: [ ] Yes [ ] No If Yes, made of _____________
Door swing in the direction of exit travel (when required) [ ] Yes [ ] No
Stairways Pressurized [ ] Yes [ ] No [ ] N/A If pressurized, what type or method ________________________
Date Last Tested _________________________________________________________________________________
2. Secondary Stair/Fire Escape: Number______________________________ Width________________________
Construction_________________ Are there railings provided [ ] Yes [ ] No Made of _____________________
Location: [ ] Interior [ ] Exterior Exits accessible [ ] Yes [ ] No
Any obstruction [ ] Yes [ ] No Termination/Discharge of Exits __________________________________
Any enclosure provided [ ] Yes [ ] No Enclosure construction_________________________________
Any opening [ ] Yes [ ] No Opening protected [ ] Yes [ ] No
Are fire door provided [ ] Yes [ ] No Width_____________ Fire door construction____________________
Door provided with vision panel [ ] Yes [ ] No If Yes, made of__________________________________
Door equipped w/ Self-closing device [ ] Yes [ ] No Doors & enclosure proper rating [ ] Yes [ ] No
Doors open easily [ ] Yes [ ] No Self-closing device operable [ ] Yes [ ] No
Door equipped w/ panic hardware [ ] Yes [ ] No Operable [ ] Yes [ ] No
Door swing in the direction of exit travel [ ] Yes [ ] No Enclosure properly protected [ ] Yes [ ] No
Fire escape pressurized [ ] Yes [ ] No [ ] N/A If pressurized. What type or method___________________________
Date Last Tested _________________________________________________________________________________
B. HORIZONTAL EXITS
Width of door/s ________________ Construction_____________________ With vision panel [ ] Yes [ ] No
Door swing in the direction of egress travel [ ] Yes [ ] No With Self-closing device [ ] Yes [ ] No
Width of corridors or hall ways ________________________ Construction _____________________________
Corridor walls extended from slab to slab [ ] Yes [ ] No Properly illuminated [ ] Yes [ ] No
Exit readily visible [ ] Yes [ ] No Clear and unobstructed [ ] Yes [ ] No
Properly marked w/ illuminated exit sign [ ] Yes [ ] No With illuminated directional sign [ ] Yes [ ] No
Properly located [ ] Yes [ ] No
C. RAMPS
Provided [ ] Yes [ ] No Type: [ ] Interior [ ] Exterior Width______________ class __________________
Railings provided [ ] Yes [ ] No Height from the floor _____________________ (Requirement: 91 cm)
Any enclosure provided [ ] Yes [ ] No Construction __________________________________________________
Are fire doors provided [ ] Yes [ ] No Width__________ Fire door construction ________________________
Door equipped w/ Self-closing device [ ] Yes [ ] No Door with proper rating [ ] Yes [ ] No
Door provided w/ vision panel [ ] Yes [ ] No If Yes, made of _______________________________________
Door swing in the direction of exit travel (when required) [ ] Yes [ ] No
Any obstruction ________________________ Termination/Discharge of exit ___________________________

D. AREA OF SAFE REFUGE

Provided [ ] Yes [ ] No Type: [ ] Interior [ ] Exterior Location___________________________________
Any enclosure provided [ ] Yes [ ] No Construction ____________________________________________
Are fire door provided [ ] Yes [ ] No Width_______________ Fire door construction__________________
Door equipped w/ self-closing device [ ] Yes [ ] No Door with proper rating [ ] Yes [ ] No
Door provided w/ vision panel [ ] Yes [ ] No If Yes, made of _____________________________________
Door swing in the direction of exit travel [ ] Yes [ ] No

VI. LIGHTINGS & SIGNS

A. EMERGENCY LIGHTS
Automatic Emergency Lights Provided [ ] Yes [ ] No Source of Power [ ] AC/DC [ ] Others __________________
No. of Units per Floor___________ Located at: Hallways _____________ Stairway Landings _______________
Operational: [ ] Yes [ ] No Exit path properly illuminated [ ] Yes [ ] No
Tested Monthly: [ ] Yes [ ] No Minimum AEL Power Duration: at least one (1) hour

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 Republic of the Philippines
Department of the Interior and Local Government
Bureau of Fire Protection

B. EXIT SIGNS
Exit Signs Illuminated [ ] Yes [ ] No Location ________________________________________________
Source of Power [ ] AC/DC [ ] Others Readily visible [ ] Yes [ ] No
Minimum Letter Size ________________________ Min. Requirement: Height of 11.5 cm & width of 19.0 mm
Exit Route Plan posted on: Lobby/Hallways [ ] Yes [ ] No Rooms [ ] Yes [ ] No
Directional Exit Signs [ ] Yes [ ] No Location ________________________________________________
C. WARNING/SAFETY SIGNS
[ ]”No Smoking” [ ] “Dead End” [ ] Elevator Sign [ ] Keep Door Closed
Other, specify _ __________________________________________________________________________________

VII. FEATURES OF FIRE PROTECTION

A. PROTECTION OF VERTICAL OPENINGS
Properly protected [ ] Yes [ ] No Atrium [ ] Yes [ ] No Fire Doors good condition [ ] Yes [ ] No
Elevator opening protected [ ] Yes [ ] No Pipe Chase opening protected [ ] Yes [ ] No
Aircon Ducts system with damper [ ] Yes [ ] No Dumb Waiter opening protected [ ] Yes [ ] No
Garbage Chute opening protected [ ] Yes [ ] No
Between Floor & Glass Curtain opening protected [ ] Yes [ ] No
Date Last Tested__________________________________________________________________________________
B. ALARM SYSTEM
Fire Alarm Provided [ ] Yes [ ] No Type: [ ] Manual [ ] Automatic Centralized [ ] Yes [ ] No
Location of Central Control __________________________________________________________________________
No. of Bells per Floor ___________________ Location________________________________________________
Coverage: [ ] Budding [ ] Air Handling Unit [ ] Portion Specify_______________ Monitored [ ] Yes [ ] No
Type of Initiation Device [ ] Smoke [ ] Heat [ ] Manual [ ] Water Flow [ ] Others _______________________
No. of Pull Stations per Floor ________________ Max. Horizontal Distance Bet. Pull Stations: 61.0 m
Smoke Detectors [ ] Yes [ ] No No. of Units per Room_________________ Integrated [ ] Yes [ ] No
Heat Detectors [ ] Yes [ ] No No. of Units per Room________________ Integrated' [ ] Yes [ ] No
Power Source of Detectors [ ] AC/DC [ ] Others______________ Total Detectors per Floor_______________
Date Last Tested__________________________________________________________________________________
C. STANDPIPE SYSTEM
Type: [ ] Wet [ ] Dry Tank Capacity________________ Location _____________________________________
Siamese Intake Provided [ ] Yes [ ] No Location _____________________________________
Size _________________ No. of Units _________________________ Accessible [ ] Yes [ ] No
Fire Hose Cabinets Provided [ ] Yes [ ] No With Complete accessories [ ] Yes [ ] No
Location ________________________________________________________________________________________
No. of Units per Floor_____________ Size of Hose__________________ Length of Hose_____________________
(Note: Min Required Size of Riser & Distribution Pipe: 2 1/2 inch and 1 1/2 inch in diameter, respectively)

Type of Nozzle _______________________ Date Last Tested_________________________________________

Fire Lane Provided: [ ] Yes [ ] No Location of nearest Fire Hydrant _______________________________
D. FIRST AID FIRE PROTECTION EQUIPMENT (PORTABLE FIRE EXTINGUISHERS)
Type__________________ Capacity ____________________________ No. of Units ________________________
With PS Mark [ ] Yes [ ] No With ISO Mark [ ] Yes [ ] No
Properly Maintained [ ] Yes [ ] No Conspicuously Located [ ] Yes [ ] No Accessible [ ] Yes [ ] No
Other Types Provided, if any ________________________________________________________________________

E. AUTOMATIC FIRE SUPPRESSION SYSTEM (SPRINKLER SYSTEM)

Type of Extinguishing Agent Used ____________ Jockey Pump Capacity___________ hp ____________GPM
Fire Pump Capacity: __________________ hp _____________GPM Tank Capacity____________________ gallons
Maintaining Line Pressure ___________________ Farthest Sprinkler Head Pressure________________________
Riser Size______________________ Type of Heads Installed__________________________________________
No. of Heads per Floor ___________________ Total_______________ Spacing of Heads ____________________
Location of Fire Department Connection ______________________________________________________________
Date Last Tested __________________________ Conducted____________________________________________
Plan Submitted ___________________________ Certificate of Installation ______________________________
BFP AFSS Certificate payment under Section 13 B (5) and Fund Code No. D2531–151
F. FIREWALL
Building required with firewalls [ ] Yes [ ] No Provided [ ] Yes [ ] No
Any Opening [ ] Yes [ ] No

VIII. BUILDING SERVICE EQUIPMENT

A. Boiler Provided [ ] Yes [ ] No No. of Units provided ______________________________________
Fuel: [ ] Diesel [ ] Kerosene [ ] Coal [ ] Bunker [ ] LPG Capacity ________________________________________
Container: [ ] Above-ground [ ] Underground Location _________________________________________________
LPG Installation Covered with Permit [ ] Yes [ ] No Fuel with Storage Permit [ ] Yes [ ] No
B. Generator Set Provided [ ] Yes [ ] No [ ] Automatic [ ] Manual Fuel: [ ] Diesel [ ] Gasoline
Capacity ___________________ Location__________________ Dikes/Bund wall Provided [ ] Yes [ ] No
Container: [ ] Above-ground [ ] Underground Dispensing System [ ] By pump [ ] By gravity
Output Capacity__________________ kva Mechanical Permit ____________ Date Issued_____________

BFP-QSF-FSED-017 Rev. 01 (07.05.19) Page 3 of 5

 Republic of the Philippines
Department of the Interior and Local Government
Bureau of Fire Protection

Fuel with Storage Permit [ ] Yes [ ] No Others (specify) ______________________________________

Automatic Transfer Switch Provided [ ] Yes [ ] No Time Interval __________ sec (Requirement: Max 10 secs)
C. Refuse (Garbage) Handling Facility: Provided [ ] Yes [ ] No
Enclosure provided [ ] Yes [ ] No Fire resistive [ ] Yes [ ] No
Fire protection provided [ ] Yes [ ] No Type______________________________________________________
Frequency of collection/disposal___________ How collected ____________________________________________
D. Electrical System
Is there any electrical hazard [ ] Yes [ ] No Specify location __________________________________________
E. Mechanical System
Is there any mechanical hazard [ ] Yes [ ] No Specify location ________________________________________
No. of elevators provided____________________________________________________________________________
Fireman's elevator provided [ ] Yes [ ] No Fireman's key/switch provided [ ] Yes [ ] No
F.Other Building Service Systems
[ ] Water Treatment Facility [ ] Waste Water/Sewage Treatment Facility

IX. HAZARDOUS AREA

[ ] Kitchen [ ] Laundry [ ] Windowless Basement [ ] Storage Room [ ] Others______________________
Separation Fire Rated [ ] Yes [ ] No Type of Fire Protection provided __________________________________
No. of Units______________ Capacity__________________ Accessible [ ] Yes [ ] No
Fuel Used_______________ Where Stored ___________________ Covered by BFP Permit __________________
Chimney: Made of ___________________ Spark Arrester____________ Smoke Hood ______________________
Presence of hazardous materials [ ] Yes [ ] No Properly stored and handled [ ] Yes [ ] No

Kinds Container Volume Location

1._________________ _____________________ ____________________ ___________________
2._________________ _____________________ ____________________ ___________________
3._________________ _____________________ ____________________ ___________________

Storage Permit for Flammables/Combustibles Covered by BFP Permit _______________________________________

Clearance of Stocks From Ceiling ___________________________________________________________________
Minimum Ceiling Clearance: 1.0m for Flammable Liquids and 0.5m for Combustible Materials

X. OPERATING FEATURES
Fire Safety Program (Under the supervision of the Chief Local Fire Service)
Fire Brigade Organization [ ] Yes [ ] No
Fire Safety Seminar [ ] Yes [ ] No
Employees trained in emergency procedures [ ] Yes [ ] No
Fire/Evacuation Drill [ ] Yes [ ] No
Date Last Conducted: _______________________________________________________________________

BFP-QSF-FSED-017 Rev. 01 (07.05.19) Page 4 of 5

 Republic of the Philippines
Department of the Interior and Local Government
Bureau of Fire Protection

XI. DEFECTS / DEFICIENCIES NOTED DURING INSPECTION (Attached pictures, sketch and others)
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________.

XII. RECOMMENDATIONS
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________.

ACKNOWLEDGED BY:

________________________________________ ____________________________________________
Signature Over Printed Name of Owner/ Fire Safety Inspector/s
Representative

Date & Time ___________________________ ____________________________________________

Team Leader

RECOMMEND ISSUANCE OF FSIC/NTC/NTCV:

SINSP JOHN FREDERICK Y CASTRO_

CHIEF, FIRE PREVENTION SECTION

APPROVED / DISAPPROVED:

SUPT EDDIE W TANAWAN, BFP

CITY FIRE DIRECTOR

PAALALA: “MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF FIRE PROTECTION SA MGA KAWANI NITO ANG
MAGBENTA O MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER”

“FIRE SAFETY IS OUR MAIN CONCERN”

DISTRIBUTION:
Original (Applicant/Owner’s Copy)
Duplicate (BO or BPLO, as the case may be)
Triplicate (BFP Copy)

BFP-QSF-FSED-017 Rev. 01 (07.05.19) Page 5 of 5