South Davis Metro Fire Agency

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Agency Proudly Serving the Communities of Bountiful - Centerville - Davis County - North Salt Lake - West Bountiful - Woods Cross Fire Prevention Division Dear Business Owner: We are committed to the safety and success of your business. As such, a Fire and Life Safety Inspection may be performed on your business prior to your initial operation and routinely thereafter. We have attached a copy of our inspection form to assist with your preparation for this inspection. In addition to a Fire and Life safety Inspection, Permitted Operations will require a special inspection with an associated annual fee (see South Davis Metro Permit Declaration form for types and/or amounts). The following are Permitted Operations: Daycare $30.00 Group Home $50.00 Healthcare Facility $200.00 Firework Sales (Outdoor) $300.00 Fireworks Sales (Indoor) $150.00 Hazardous Materials Permits $150.00 - $500.00 Storage Dispensing Production: Blasting?Explosives: Motor Vehicle Fuel Dispensing Public Access: $200.00 $300.00 $450.00 $500.00 $150.00 Maximum per Business: $500.00 Please submit your Permit Declaration Form with your business licensure packet; licensure may be withheld pending submission of this form. For additional information on our Fire and Life Safety Inspection and Permitted Operations, please go to www.sdmetrofire.org, or call 801-677-2400. Best Regards, Casey T. Vorwaller Fire Marshal P.O. Box 1547 Bountiful, Utah 84011 801-677-2400 Fax 801-677-0166

Business Name: Inspection Date: Business Address: Suite: Business Phone: Emergency Contact: Phone: Email: # Violations # Violations ACCESS FIRE ALARM SYSTEMS 1 Maintain fire lane free of obstructions 24 Maintain, repair, inspect and / or test fire alarm system 2 3 Provide address numbering which is visible from the street Provide / update key box for fire district access EXITING FIRE SEPARATIONS 25 Repair holes in required fire resistive construction 26 Provide / repair self or automatic closing fire rated assemblies 4 5 Remove obstructions at exits, doors, aisles, corridors, stairways, etc. Exit door to open without a key or any special knowledge or effort ELECTRICAL 27 Discontinue use of extension cords 6 Provide sign over main exit door(s) 28 Install permanent wiring for fixed or stationary appliances 7 Repair non-operable exit door hardware 29 Provide cover plates for all junction boxes 8 Remove obstructions from doors required to be closed 30 Provide cover plates for light switches and outlets 9 Remove storage from attic, under floor and concealed spaces 31 Remove exposed wiring or protect in approved conduit 10 Remove locks, latches and/or stops from doors with panic hardware Provide a clear workspace at all electrical panels (30" in width, 36" in 32 depth and 78" in height) 11 Provide / maintain exit sign / emergency lighting FIRE EXTINGUISHERS 33 Labeling of electrical rooms and breakers 34 Provide covers for open breakers in electrical panels 12 Have fire extinguisher serviced and tagged 13 Provide / mount fire extinguisher as indicated FLAMMABLE LIQUIDS COMPRESSED GASES 35 Provide flammable liquid storage cabinet or reduce storage 14 Provide clear access to fire extinguisher 36 Remove all fueled vehicles or equipment from buildings 15 Post a sign indicating fire extinguisher location 37 Secure compressed gas cylinders / identify gas in container FIRE PROTECTION SYSTEMS STORAGE HOUSEKEEPING 16 Replace missing escutcheons 38 Arrange storage in an orderly manner to provide access / egress Replace damaged, corroded or painted sprinkler heads/ Fire Remove combustible storage from dedicated boiler, mechanical, 17 39 Department Connection (FDC) Caps electrical rooms; exits, stair enclosures 18 Secure all system control valves in the open position 40 Reduce storage to 24" below ceiling or 18" from sprinkler heads 19 Provide annual certification for sprinkler / standpipe system 41 Provide approved metal container for oily rag storage 20 Provide sprinkler coverage in unprotected areas 42 Remove waste & rubbish material from the premises daily 21 Provide spare sprinkler heads and / or compatible wrench 43 Keep dumpster 5' away from building 22 Hood and duct extinguishing system to be serviced and tagged 44 Maintain appropriate clearance from ignition sources 23 Remove grease from hood, duct and filters (keep clean) MISCELLANEOUS 45 Other violations noted in comments # Comments Cleared Thank you for allowing us to inspect your business. The purpose of this inspection is to ensure that the residents and visitors of South Davis County have a safe place to do business. More information about each violation can be found on the following pages or by calling (801) 677-2400. If a re-inspection is necessary, it will be performed no sooner than: Fire Sprinkler Service Date 5 Year Service Date Re Inspection Date Return Fire Alarm Service Date Fire Extinguisher Service Date Recipient Name Kitchen Hood Service Date Kitchen Hood Cleaning Date After 2nd follow up, all further inspections will result in an additional inspection fee. Inspector Name and Title/Station Signature of Recipient Signature of Inspector Page of

Business Name: Inspection Date: Business Address: Suite: # Comments Business Phone: Cleared Page of

Viol. Explanation 1 Fire lanes shall be free of all obstructions for a clear width of 20 feet around the building (IFC 503) 2 Building addresses must be visible from the street with a contrasting background (IFC 505) 3 Where key boxes are provided they must contain updated keys and codes (IFC 506) 4 Pathways for exits must be cleared of all obstructions (IFC 1031.2); including snow and ice (IFC 1031.3) 5 All exit doors must be able to be used without any special knowledge or tools (IFC 1010.1.9) 6 Appropriate signs must be posted adjacent to doors with deadbolt hardware, "THIS DOOR TO REMAIN UNLOCKED WHEN THIS SPACE IS OCCUPIED" (IFC 1010.1.9.3) 7 Exit hardware on doors must be in working order (IFC 1031.2) 8 Doors that are part of a fire barrier may not be held open except when the mechanism is part of an automatic fire detection system (IFC 703.2) 9 Attics, crawl spaces, under stairs and concealed spaces may not be used for storage unless they are built with fire-resistive construction with self-closing hardware or have automatic sprinklers installed (IFC 315.3.4) 10 Doors with panic hardware may not be locked with locks or latches (IFC 1010.1.10) 11 Exit signs must remain illuminated and visible at all times (IFC 1013). Emergency illumination devices must be in working order (IFC 1008) 12 Fire extinguishers must be serviced annually (IFC 906) 13 Fire extinguishes must be mounted and visible (IFC 906) 14 Fire extinguishers may not be blocked from view or access (IFC 906) 15 The location of fire extinguishers must be identified by obvious signage (IFC 906) 16 Maintain fire sprinkler system components (NFPA 13) 17 Automatic sprinkler heads and FDC caps must be in good repair and may only be painted by the manufacturer (IFC 912, NFPA 13) 18 All valves must be locked or constantly monitored to ensure that the valve is in the open position (IFC 903.4) 19 Sprinkler and standpipe systems must be inspected at least once a year (IFC 901.6) 20 Sprinkler systems must provide coverage to all areas unless special exceptions are allowed (IFC 903.3) 21 Spare sprinkler heads and a sprinkler wrench must be provided at all times (NFPA 13 6.2.9) 22 Hood and duct systems must be serviced at least once every six months (IFC 609.3.3) 23 Hoods, ducts and filters must be keep clean and free of grease (IFC 609) 24 Fire alarm systems must be inspected at least once a year and must be in working order (IFC 907.8) 25 Fire resistive construction must not have gaps where fire or smoke may cross the fire barrier (IFC 703) 26 Fire rated assemblies must be fully functional at all times (IFC 703) 27 Extension cords may only be used for temporary purposes and should be unplugged at the outlet when not in use (IFC 605.5) Grounded or polarized power taps are acceptable (IFC 605.4) 28 Stationary and fixed appliances must be connected to permanent wiring (IFC 605.7) 29 / 30 Open junction boxes and open-wiring splices shall be prohibited. Approved covers shall be provided for all switch and electrical outlet boxes. (IFC 605.6) 31 Exposed wiring is not allowed. All wiring must be in an approved conduit (NEC 334) 32 A working space of not less than 30" wide x 36" deep x 72" high shall be provided in front of electrical service equipment; if equipment is more than 30" wide, workspace to be the width of the equipment. (IFC 605.3) 33 Doors into electrical control panel rooms shall be marked with a plainly visible and legible sign stating ELECTRICAL ROOM (IFC 605.3.1) 34 Approved covers shall be provided for electrical boxes (IFC 605.6) 35 Quantities of flammable and combustible liquids in excess of 10 gallons shall be stored in liquid storage cabinets (IFC 5704.3.4.4) 36 Fueled equipment (including portable generators, portable cooking equipment, lawn-care equipment and motorcycles) shall not be stored, operated or repaired within a building (IFC 313) 37 Compressed gas containers, cylinders, tanks and systems shall be marked. (IFC 5303.4); shall be secured against accidental dislodgment and access by unauthorized personnel. (IFC 5303.5) 38 Storage shall be orderly and stacks shall be stable (IFC 315.3) 39 Combustible storage shall not be stored in boiler rooms, mechanical rooms, electrical rooms, exits or stair enclosures (IFC 315.2, 3) 40 Storage shall be maintained 2 feet or more below the ceiling in non-sprinklered areas, or at least 18 inches below sprinkler head deflectors (IFC 315.3.1) 41 Materials susceptible to spontaneous ignition, such as oily rags, shall be stored in a listed disposable container (IFC 304.3.1) 42 Rubbish and waste must not be allowed to accumulate in buildings or structures or upon premises (IFC 304.1) 43 Dumpsters shall not be stored in buildings or placed within 5 feet of buildings or roof eave lines (IFC 304.3) 44 Storage of combustible materials shall be separated from heaters or heating devices by distance or shielding so that ignition cannot occur (IFC 315.3)

SOUTH DAVIS METRO PERMIT DECLARATION A permit is required to maintain, store, use or handle materials, or to conduct processes which produce conditions hazardous to life or property. The issuance of a permit shall not be construed as authority to violate, cancel or set aside any of the provision of the fire code. Such permit shall not take the place of any license required by law. Business/Agency: Contact Name: Business Address: City: Business Phone: Emergency Phone: The items listed below, Do Daycare Group Home Fireworks Sales (Outdoor) ; Do Not apply to the business listed on this form. Healthcare Facility Fireworks Sales (Indoor) Explosives/Blasting Motor Vehicle Fuel Dispensing Hazardous Material Gases Liquids Solids Corrosives Flammables Highly Toxic Oxidizers 200 cub/ ft 200 cub/ ft 504 cub/ ft 55 Gallons 25 gallons Class 4 Class 3 1 Gallon Class 2 10 Gallons Class 1 55 Gallons Class I Class II Class III 1 gallon Class IV 2 gallon Class V No Permit 10 gallons Class 4 Class 3 Class 2 5 Gallons Class 1 10 Gallons Class 3 Class 2 5 gallons Class 1 55 gallons 1,000 pounds 100 pounds Class 4 Class 3 10 pounds Class 2 100 pounds Class 1 500 pounds Class I Class II Class III 10 pounds Class IV 20 pounds Class V No Permit 100 pounds Class 4 Class 3 Class 2 50 pounds Class 1 100 pounds Class 3 Class 2 50 pounds Class 1 500 pounds Organic Peroxides Pyrophoric Toxics Unstable Materials Water Reactive I affirm the information given on this form to be correct to the best of my knowledge and understand that intentional misrepresentation may be subject to additional fees, fines or possible revocation of business license. Application Signature: Date: