Get NE Plan Submittal Application 2015

NEBRASKA STATE FIRE MARSHAL PLAN SUBMITTAL APPLICATION Submit Plan To Main Office 246 S. 14th Street Lincoln NE 68508-1804 P 402-471-2027 F 402-471-3118 www. SFM. nebraska*gov DATE REQUIRED FIELD TO BE COMPLETED. INCOMPLETE FIELDS WILL RESULT IN A REJECTION LETTER SUBMITTING PARTY NAME OF PROJECT ADDRESS CITY / STATE / ZIP CODE CITY / COUNTY CONTACT PERSON EMAIL ADDRESS If code review via email is desired PHONE ADDITIONAL INDIVIDUALS RECEIVING CODE REVIEW OWNER EMAIL ADDRESS If different from submitting party ARCHITECT EMAIL ADDRESS If different from submitting party CONTRACTOR EMAIL ADDRESS If different from submitting party PROJECT INFORMATION STATE-OWNED OCCUPANCY TYPE YES NO PLANS SUBMITTED TO LOCAL AUTHORITY FOR REVIEW ESTIMATED START DATE ESTIMATED COMPLETION DATE Specify City or County TYPE OF PLAN Final Preliminary Fire Alarm Sprinkler Accessibility Guidelines Other NOTE Fire Alarm and Sprinkler shop drawings are to be submitted as a separate review by subcontractor. PROJECT DESCRIPTION New Building Addition Remodel Interior Finish NUMBER OF LEVELS Including Sub Levels Alteration CONSTRUCTION TYPE New Existing FIRE PROTECTION FEATURES if provided Total Sprinkler Partial Sprinkler Range Hood System Fire Alarm System Fire Extinguishers REVIEW FEE ESTIMATED PROJECT COST ACCESSIBLITY CODE REVIEW FEE If NO to local review above add 50 to the fire code review fee. Total accessibility fee shall not exceed 250. 00 1. Estimate must be included for plans to be reviewed* Estimate includes total value of all construction work as well as all finish work painting roofing electrical plumbing HVAC elevators fire extinguishing systems and any other permanent equipment. 2. The fee for reviewing plans blueprints and shop drawings to determine compliance with rules and regulations adopted pursuant to section 81-502 shall be assessed to the following schedule FIRE CODE REVIEW FEE SCHEDULE 1. 00 - 5 000. 00 5. 00 minimum 5. 00 for the first 5 000. 00 plus 2. 00 for each additional 5 000. 00 or fraction there of* 25 001. 00 - 50 000. 00 50 001. 00 - 100 000. 00 100 001. 00 - 200 000. 00 200 001. 00 OR MORE A Fee Calculator can be found on our website The total review fee shall not exceed 500. 00. IF CONSTRUCTION COMMENCES PRIOR TO THE SUBMITTAL OF PLANS A LATE FEE OF 50. 00 SHALL BE ADDED. All checks are to be made out to the Nebraska State Fire Marshal ACCESSIBILITY REVIEW FEE If applicable PLAN NUMBER DATE IN LATE FEE If applicable TOTAL FEE OFFICE USE ONLY HOW PAID RECEIPT NUMBER CHECK MONEY ORDER 1/29/15. SFM. nebraska*gov DATE REQUIRED FIELD TO BE COMPLETED. INCOMPLETE FIELDS WILL RESULT IN A REJECTION LETTER SUBMITTING PARTY NAME OF PROJECT ADDRESS CITY / STATE / ZIP CODE CITY / COUNTY CONTACT PERSON EMAIL ADDRESS If code review via email is desired PHONE ADDITIONAL INDIVIDUALS RECEIVING CODE REVIEW OWNER EMAIL ADDRESS If different from submitting party ARCHITECT EMAIL ADDRESS If different from submitting party CONTRACTOR EMAIL ADDRESS If different from submitting party PROJECT INFORMATION STATE-OWNED OCCUPANCY TYPE YES NO PLANS SUBMITTED TO LOCAL AUTHORITY FOR REVIEW ESTIMATED START DATE ESTIMATED COMPLETION DATE Specify City or County TYPE OF PLAN Final Preliminary Fire Alarm Sprinkler Accessibility Guidelines Other NOTE Fire Alarm and Sprinkler shop drawings are to be submitted as a separate review by subcontractor. PROJECT DESCRIPTION New Building Addition Remodel Interior Finish NUMBER OF LEVELS Including Sub Levels Alteration CONSTRUCTION TYPE New Existing FIRE PROTECTION FEATURES if provided Total Sprinkler Partial Sprinkler Range Hood System Fire Alarm System Fire Extinguishers REVIEW FEE ESTIMATED PROJECT COST ACCESSIBLITY CODE REVIEW FEE If NO to local review above add 50 to the fire code review fee. .