Environmental Health and Safety Department

Fire Stop Penetration Permit (FSPP)

Permit Number: Company: Responsible supervisor (non- CCF): Supervisor email: Project: CRRAS #: Cleveland Clinic Project Manager: CRRAS Issued Date: CRRAS Expired Date: Requester: Workers Name FIT 1 Cert. # FIT 1 Exp. Date

Reason For Permit: Fire Stopping

Permit is issued to Company and Requestor and must be displayed on site and made available upon request by Cleveland Clinic Fire Safety or the Cleveland Clinic Police. Permit can be revoked subject to all conditions of Vertical/Horizontal Fire/Smoke barrier Penetration-Fire stopping system.

Please note that due to the importance of public and patient risk related to fire stopping, the Office of Environmental Health and Safety, Facilities and the Office of Construction are implementing the following consequences to companies that do not properly manage their Fire Stopping Permits by allowing them to expire without being timely extended or closed out:

1st month notice of expiration – EHS to issue warning and copy Cleveland Clinic Office of Construction (CCOC)

2nd month notice of expiration – no further permits will be issued by EHS until all expired permits are extended or closed out by company with violation to contact Cleveland Clinic Office of Construction with resolution and explanation.

3rd month notice of expiration – The contractor will be removed from the Cleveland Clinic approved bidders list until all expired permits are resolved. EHS to notify companies’ in violation to the Cleveland Clinic Office of Construction. Company with violation to follow up with EHS & CCOC to reinstate bidding status.

Specifics on penetration or joint fire stopping. Note below and on additional pages as necessary. Attach PDF of each system listed for review and approval for permit by CCF Fire Protection Engineer. Available from manufacturer web site via their search engine. http://sti.fmpdata.net/system_search.html. This PDF is required for all permits. All pages must be included as they are part of the permit.

Project that require Certificate of Occupancy (C of O) must have 3rd party sign off prior to official city inspection.

Third Party Inspector Signature: ______Name(Print):______Certificate Number :______Date of Expiration : ______Company:______Date: ______Line Room Wall or Wall # STI system UL # of Penetrations Location Notes Date Item Number Floor Number or linear feet if of Inspected Number joint Penetration As N-S-E-W complete