Republic of the Philippines

Department of the Interior and Local Government

BUREAU OF FIRE PROTECTION
(FIRE STATION LETTER HEAD)

FIRE SAFETY INSPECTION CHECKLIST

I. REFERENCE:

Inspection Order No. (IO) :__________________________________________________

Date Issued :__________________________________________________

Date Inspected :__________________________________________________

II. NATURE OF INSPECTION CONDUCTED (Check appropriate box)

1. [ ] Inspection during construction

2. [ ] FSIC for Certificate of Annual Inspection (PEZA)
3. [ ] FSIC for Certificate for Occupancy
4. [ ] FSIC for Business Permit (New/Renewal)
5. [ ] Verification Inspection for Compliance:
[ ] NTC / [ ] NTCV / [ ] Abatement [ ] Closure
6. Others (Specify) : __________________________________________________________________

III. REQUIREMENTS

1. [ ] FSIC for Occupancy:

 Fire Safety Compliance and Commissioning Report (FSCCR) Yes [ ] / No [ ]

(if applicable)
2. [ ] FSIC for New / Renewal / Annual Inspection / Others:

 Fire Safety Maintenance Report (FSMR) (if applicable) Yes [ ] / No [ ]

IV. GENERAL INFORMATION

Name of Building : ________________________________________________

Address : ________________________________________________

Business Name : ________________________________________________

Nature of Business : ________________________________________________

Name of owner/Representative : ________________________________________________

Contact No. : ________________________________________________

[ ] FSIC for Occupancy:

 FSEC No. : ____________ / Date Issued :______________

 Building Permit : ____________ / Date Issued : _____________

[ ] FSIC for New / Renewal / Annual Inspection / Others:

 FSIC No. (Latest) :____________ / Date Issued : ____________

 Certificate of Fire Drill : ____________ / Date Issued : ____________

 Business Permit No. :____________ / Date Issued : ____________

 Fire Insurance Policy No. :____________ / Date Issued : ____________

(If any)

BFP-QSF-FSED-061 Rev. ØØ (06.17.22) Page 1 of 10

 Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
(FIRE STATION LETTER HEAD)

CONSTRUCTION TYPE

[ ] Type I : Concrete & Steel (Fire Resistive)

[ ] Type II : Concrete & Exposed Steel (Noncombustible)

[ ] Type III : Concrete & Wood (Ordinary)

[ ] Type IV : Heavy Timber (Large mass wood)

[ ] Type V : Wood frame (Lightweight wood)

WALLS / CEILING INTERIOR FINISH

[ ] Class A : Flame spread index, 0–25;smoke developed index, 0–450

[ ] Class B : Flame spread index, 26–75; smoke developed index, 0–450

[ ] Class C : Flame spread index, 76–200; smoke developed index, 0–450

(Note: Flame Spread Index can be seen in the technical specification of the product)

FLOOR INTERIOR FINISH

[ ] Class I : Critical radiant flux, not less than 0.45 W/cm2.

[ ] Class II : Critical radiant flux, not more than 0.22 W/cm2, but less than 0.45W/cm2

(Note: Flame Spread Index can be seen in the technical specification of the product)

SECTIONAL OCCUPANCY (INDICATE SPECIFIC USAGE OF EACH FLOOR, PART OR

PORTION OF THE BUILDING)
Basement : _____________________________________________________________________

Ground floor:_____________________________________________________________________

Second floor:_____________________________________________________________________

Third floor :_____________________________________________________________________

Fourth Floor:_____________________________________________________________________________

Nth Floor : _____________________________________________________________________________

Use separate sheet if necessary

GENERAL OCCUPANCY CLASSIFICATION

[ ] Assembly / [ ] Educational / [ ] Day Care / [ ] Health Care

[ ] Detention and Correctional / [ ] Residential / [ ] Residential Board and Care

[ ] Mercantile / [ ] Business / [ ] Industrial / [ ] Storage / [ ] Special Structure.

[ ] Educational
OTHER INFORMATION
[ ] Day care
Maximum Occupant Load: __________P/Floor Number of Stories: __________ Storey
[ ] Health Care
Building Height : __________m Highrise: [ ] Yes / [ ] No
[ ] Detention and Correctional

[ ] Residential

[ ] Hotels
BFP-QSF-FSED-061 Rev. ØØ (06.17.22) Page 2 of 10
[ ] Dormitories

[ ] Apartment Buildings
 Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
(FIRE STATION LETTER HEAD)

V. MEANS OF EGRESS

A. EXIT ACCESS

[ ] Doors / [ ] Corridors / [ ] Hallways / [ ] Passageways / [ ] Anterooms / [ ] Ramps

Horizontal components Actual Passed Failed Remarks / Corrective Action

Dimensions
Doors : ______m [ ] [ ] : ______________________________

Corridors / Hallways : ______m [ ] [ ] : ______________________________

Passageways : ______m [ ] [ ] : ______________________________

Lobby / Anteroom : ______m [ ] [ ] : ______________________________

Ramps : ______m [ ] [ ] : ______________________________

Common path of travel : ______m [ ] [ ] : ______________________________

Dead end : ______m [ ] [ ] : ______________________________

Travel distance : ______m [ ] [ ] : ______________________________

Actual
Passed Failed
Dim.
Any door leaf in a means of egress shall leave not less than one-half
of the required width of an aisle, a corridor, a passageway, or a _________ [ ] [ ]
landing unobstructed.
Any door leaf in a means of egress shall not project more than 180
mm into the required width of an aisle, a corridor, a passageway, or a
[ ] [ ]
landing, unless the door leaf is equipped with an approved self- _________
closing device.
At least two (2) means of egress for each room with occupant load ≥
50 or with hazard content. [ ] [ ]
_________
Each guest door used as means of egress shall at least 20 minutes
fire resistant. [ ] [ ]
_________
Doors that open directly onto exit access corridors shall be self-closing and self-
latching. [ ] [ ]

There shall no openings in corridor partitions other than door openings.

[ ] [ ]

Free from any obstruction. [ ] [ ]

No flammable material stored. [ ] [ ]

B. EXITS
[ ] Normal Stairs / [ ] Curved Stairs / [ ] Spiral Stairs / [ ] Winding Stairs

[ ] Horizontal Exits / [ ] Outside Stairs / Exit Passageways / Fire Escape Stairs

[ ] Fire Escape Ladder (for 1 & 2 family dwelling only)

[ ] Slide Escape (for Industrial Occupancy Only)

BFP-QSF-FSED-061 Rev. ØØ (06.17.22) Page 3 of 10

 Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
(FIRE STATION LETTER HEAD)

Components Clear Width Passed Failed Remarks / Corrective Action

: _________________________________
Exits Doors : ______m [ ] [ ]
: _________________________________
Normal Stairs : ______m [ ] [ ]
: _________________________________
Curve stairs : ______m [ ] [ ]
: _________________________________
Winding Stairs : ______m [ ] [ ]
: _________________________________
Horizontal Exits : ______m [ ] [ ]

: _________________________________
Outside Stairs : ______m [ ] [ ]
: _________________________________
Exit Passageways : ______m [ ] [ ]

: _________________________________
Fire Escape Stairs : ______m [ ] [ ]
: _________________________________
Fire Escape Ladders : ______m [ ] [ ]

: _________________________________
Slide Escape : ______m [ ] [ ]

Actual
Passed Failed
Dim.
At least two (2) means of egress for each floor. [ ] [ ]
_________
Doors assembly: 60 minutes fire resistant for three (3)
communicating level and below. _________ [ ] [ ]

Doors assembly: 90 minutes fire resistant for four (4) communicating

level and above. [ ] [ ]
_________
Exits Doors provided with Re-entry mechanism at every four (4)
storey. [ ] [ ]
_________
Stair thread: Minimum depth = 280 mm. [ ] [ ]
_________
Stair riser: Minimum / Maximum height = 100 mm / 180 mm. [ ] [ ]
_________
Minimum stair head room: 2000mm [ ] [ ]
_________
Stair provided with Guard and Handrails. [ ] [ ]
_________
Maximum handrails projections: 114 mm. [ ] [ ]
_________
Stair landing shall not be less than the required width of exit door. [ ] [ ]
_________
Exits doors open and close properly
[ ] [ ]

Doors swing in direction of egress.

[ ] [ ]

Exit Doors provided with panic hardware, vision panel, and self-closing
mechanism. [ ] [ ]

There shall be no enclosed usable space under the stairs in an exit enclosure nor
shall the open space under such stairs be used for any purpose. [ ] [ ]

Interior finish: Class B [ ] [ ]

BFP-QSF-FSED-061 Rev. ØØ (06.17.22) Page 4 of 10

 Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
(FIRE STATION LETTER HEAD)

C. EXITS DISCHARGE
Actual
Passed Failed
Dim.
Remoteness of exit discharge not less than ½ of length of the overall [ ] [ ]
dimension of the building or area to be served. _________
Remoteness of exit discharge not less than 1/3 of length of the
overall dimension of the building or area to be served is the bldg. is [ ] [ ]
protected throughout by ASASS. _________
Exterior grounds are kept clear of objects that might impede evacuation or
[ ] [ ]
firefighting equipment
Terminate directly at a public way or at an exterior exit discharge.
[ ] [ ]

VI. SIGNS, LIGHTING, AND EXITS SIGNAGE

A. MARKING OF MEANS OF EGRESS (EXIT)

Actual
Passed Failed
Dim.
Minimum letter height, 150 mm
[ ] [ ]
_________
EXIT signs are posted along Exit access, Exits and Exit discharge [ ] [ ]

EXIT signs are properly illuminated [ ] [ ]

B. MARKING OF MEANS OF EGRESS (EMERGENCY EVACUATION PLAN)

Passed Failed

Posted on strategic and conspicuous location inside the building [ ] [ ]

Drawn with a photo-luminescent background to be readable in case of power [ ] [ ]

failure.

Containing the following basic information below

1. “You Are Here/ room number/ building” Marking
2. Fire Exits
3. Primary Route to Exit (Nearest to the viewer)
4. Secondary Route to Exit (Second nearest to the viewer)
5. Fire alarm pull stations and annunciators
6. Fire extinguishers/ hose cabinets
7. Emergency Light
8. First Aid Kits locations (if applicable)
9. Emergency Call stations (if applicable
10. Areas of safe refuge (for high-rise building)
11. Assembly areas instructions
12. “In Case of Emergency” instructions

BFP-QSF-FSED-061 Rev. ØØ (06.17.22) Page 5 of 10

 Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
(FIRE STATION LETTER HEAD)

Actual
Passed Failed
Dim.
Emergency Evacuation Plan:

[ ] Size 330.2 mm wide * 215.9 mm height (Floor area < 50 m²) _________ [ ] [ ]
 Room or spaces

[ ] Size 609.6 mm wide * 457.2 mm height (Floor area = 50 – 150

m²) _________ [ ] [ ]
 Room or spaces
 Building lobbies upon entry.
 Elevator lobbies at every floor.
 Hallways and corridors.
 On every bend/corner Or every 15m interval in the case of
long hallway.

[ ] Size 609.6 mm wide * 457.2 mm height (Floor area ≥ 151m²)

_________ [ ] [ ]
 Room or spaces
 Upon entry of the building
 Area of assembly or every 25m interval in the case
auditorium & gymnasium.

Symbols/icons/logos to be used for the marking shall be in

accordance with NFPA 170, Standard for Signs and Symbols.

C. ILLUMINATION OF MEANS OF EGRESS

(All Data Below Shall be Referred from Manufacturers Specifications)

Actual
Passed Failed
Lux/Time

Floors and other walking surfaces: shall be at least 1 ft-candle (10.8

lux), measured at the floor. _________ [ ] [ ]

In assembly occupancies: walking surfaces of exit access shall be

at least 0.2 ft-candle (2.2 lux) _________ [ ] [ ]

Stairs: shall be at least 10 ft-candle (108 lux), measured at the

walking surfaces. _________ [ ] [ ]

Emergency Lighting

[ ] Illumination not less than an average of 1 ft-candle (10.8 lux) _________ [ ] [ ]

and, at any point, not less than 0.1 ft-candle (1.1 lux), measured
along the path of egress at floor level.

[ ] Emergency lighting system shall be arranged to provide the

required illumination automatically in the event of any _________ [ ] [ ]
interruption of normal lighting (e.g. Failure of a public utility, ect..)
for a period at least 1.5-hour.

[ ] Periodic Testing of Emergency Lighting Equipment (Written

record)

BFP-QSF-FSED-061 Rev. ØØ (06.17.22) Page 6 of 10

 Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
(FIRE STATION LETTER HEAD)

VII. HAZARD

Hazard Contents :_________________ Quantity (Vol. / Weight) :_______________

Hazard Identification : _________________ Within MAQ : [ ] Yes / [ ] No

Placard
Hazard :_________________ Hazard Classification:
Identification No. [ ] Low / [ ] Ordinary / [ ] High
Class :_________________ Flash Point :_________________

Low hazard contents shall be classified as those of such low combustibility that no self-propagating fire therein can
occur.

Ordinary hazard contents shall be classified as those that are likely to burn with moderate rapidity or to give off a
considerable volume of smoke.

High hazard contents shall be classified as those that are likely to burn with extreme rapidity or from which
explosions are likely.

A. OTHER FLAMMABLE LIQUIDS (I.E. ALCOHOL, ETHER, ETC…)

Passed Failed
Stored in sealed metal containers
[ ] [ ]
Properly dispensed as per SOP
[ ] [ ]
Provided with “NO SMOKING” sign.
[ ] [ ]

B. MISCELLANEOUS HAZARDS (MECHANICAL EQUIPMENT ROOM, STORAGE, SUPPLY ROOM)

Passed Failed

All no smoking areas has adequate signs.

[ ] [ ]

Gasoline/ Diesel is stored in the proper place and in a metal safety

can. [ ] [ ]

C. HOUSEKEEPING, MAINTENANCE, STORAGE & WASTE DISPOSAL

Passed Failed

Brooms, mops, rags and other cleaning supplies stored in metal [ ] [ ]

cabinets or approved cans
Paints, solvents and other flammables stored in metal cabinet: oily
rags in metal containers [ ] [ ]

Dry leaves, shrubbery trimmings and other combustibles kept away [ ] [ ]

from buildings

BFP-QSF-FSED-061 Rev. ØØ (06.17.22) Page 7 of 10

 Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
(FIRE STATION LETTER HEAD)

VIII. FIRE PROTECTION

A. Automatic Fire Suppression System (Sprinkler)

Item to Inspect Procedure How to Inspect

Passed Failed
Sprinkler Pumps Check automatic start and pressure.
[ ] [ ]
Sprinkler Valves
Valves are locked in the open position, no
[ ] [ ]
leaks, corrosion, or other defects noted.
Sprinkler water flow
Open test valve and ensure manual alarm
alarm [ ] [ ]
bell functions and sprinkler pumps start.
B. Wet Standpipe/Fire Hose Cabinet

Check that door is unobstructed and opens

Cabinet Door Operative [ ] [ ]
properly.

Check that hose is not rotted, wet, moldy,

Hose Condition [ ] [ ]
etc.
Check that nozzle is in place and operates
Nozzle [ ] [ ]
correctly.
Check that hose is hung properly so that it
Hose hung properly [ ] [ ]
can easily be un-rolled if needed.
Check that valve handles are in place and
Valves and valve
that valves operate properly and are in the [ ] [ ]
handles
open position.
C. Fire Pump
Pump System Inspect accuracy of pressure gauges and
[ ] [ ]
sensors
Pipings Check pipings if there is leak [ ] [ ]
Motor Check unusual noise or vibrations [ ] [ ]
Electrical System Check if there is corrosion in PCBs, cracked
cable/wire insulation, leak in plumbing [ ] [ ]
parts, sign of water in electrical part
D. Fire Detection System

Fire Detection System Random Test of call points and smoke

[ ] [ ]
detectors.
E. Fire Alarm Facilities

Location Signs Check all signs are in place and legible. [ ] [ ]

Alarm Panels Check that all alarm panels are functioning

correctly and are unobstructed. [ ] [ ]
F. Lifts (Elevator)

All lifts “home” to ground floor during fire

Lifts [ ] [ ]
test, doors open and lift stops.
Fans All lift fans operate correctly. [ ] [ ]
Fireman’s lift Fireman’s lift can be keyed to operate
during fire alarm test. [ ] [ ]

BFP-QSF-FSED-061 Rev. ØØ (06.17.22) Page 8 of 10

 Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
(FIRE STATION LETTER HEAD)

G. First Aid Fire Protection (Fire Extinguishers)

Minimal sizes of fire extinguishers for the

listed grades of hazards shall be provided
Fire Extinguisher Size [ ] [ ]
on the basis of table 7 & 8 of RIRR of RA
9514.
The minimum number of extinguishers
Minimum number of
shall be sufficient to meet the requirements [ ] [ ]
Extinguisher.
of table 7 & 8 of RIRR of RA 9514.
All extinguishers are in their proper
Location [ ] [ ]
location.
Extinguisher seals and tags are intact and
Seals & Tags extinguisher was serviced in the last 12 [ ] [ ]
months.
Proper marking on extinguisher to indicate
Markings the type of fire the extinguisher can be [ ] [ ]
used on.
No leaks, corrosion or other defects
Condition [ ] [ ]
noticed.
Pressure Pressure gauge reads in the “green” area. [ ] [ ]
H.
Emergency Lighting Systems
Battery Lights All battery powered emergency lighting
[ ] [ ]
turns on when mains power is removed
I.
Kitchen
Hoods, vents, fans and ducts in good
Hoods & Vents [ ] [ ]
condition and free from grease
Hood Filters Date of Last Cleaning [ ] [ ]

J.
BUILDING SERVICE EQUIPMENT

Passed Failed
1. Utilities:
Cooking equipment protected by AKHFSS (Restaurant and similar [ ] [ ]
establishment with Occupant Load > 50p)
2. Heating, Ventilating and Air-conditioning:
Design & Installation in accordance with PMEC [ ] [ ]

3. Smoke Control Systems/Smoke Management shall be provided in the

following:

[ ] All high-rise buildings (stairwells, at least 1 elevator shaft, zoned [ ] [ ]

smoke control, and vestibule).
[ ] Pressurization of smoke refuge area.
[ ] Every Atrium of covered mall of over 2- levels / Other type of
Occupancy over 3 – levels.
[ ] Underground structure and windowless facilities.
[ ] All movie houses.
[ ] All other buildings or structures with at least 1,115m² single floor area.
4. Rubbish Chutes, Laundry Chutes, and Flue-Fed Incinerators:
(not apply to detached single- or two-family dwelling)

[ ] Chutes & Incinerators shall be enclosed. [ ] [ ]

[ ] Design and Maintained in accordance with the latest edition of PMEC.

BFP-QSF-FSED-061 Rev. ØØ (06.17.22) Page 9 of 10

 Republic of the Philippines
Department of the Interior and Local Government
BUREAU OF FIRE PROTECTION
(FIRE STATION LETTER HEAD)

K. FIRE WALL (FW) (if required)

Provided with Fire Wall (minimum 2 hours fire resistance) [ ] Yes / [ ] No

FW extension above the roof surface shall not be less than 760mm [ ] Yes / [ ] No
(See MC No. 2021-064 dated 28 June 2021 for Alternative)
Wall type: [ ] 125mm Solid Concrete / [ ] 150mm Solid Masonry / [ ] 200mm Hallow Unit Masonry

DEFECTS/DEFICIENCIES

ITEM
IV:
ITEM V:

ITEM
VI:
ITEM
VII:
ITEM
VIII:

IX. RECOMMENDATIONS
X.
[ ] Comply the following DEFFECTS/DEFICIENCIES stated above and pay the corresponding Fire Code Fees
including the Storage Clearance Fee , Conveyance Clearance Fee before the issuance of Fire Safety
Inspection Certificate (FSIC)
[ ] For issuance of [ ] Notice to Comply
[ ] Notice to Correct Violation
[ ] Closure Order
[ ] Abatement Order with Administrative Fine
[ ] Closure Order for the non-payment of Administrative Fine

ACKNOWLEDGED BY:

__________________________ ____________________________ ____________________________

Signature Over__
Printed Name of Fire Safety Inspector/s Team Leader
Owner/ Representative

Date & Time: _______________

RECOMMEND APPROVAL:

_______________________________________________
CHIEF, FIRE SAFETY ENFORCEMENT SECTION/UNIT

APPROVAL:

_________________________________________________
CITY/ MUNICIPAL FIRE MARSHAL

BFP-QSF-FSED-061 Rev. ØØ (06.17.22) Page 10 of 10