07-23-08 Council Agenda - Laserfiche WebLink

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Business Name: Street Address: Owner of Building: Business Owner: Business Phone: Contact Person: After Hrs. Emergency Phone: Person & Title Corn letin_ This Form: Business Fax Number: The contact person is the after -hours contact in case of an emergency. COMPLETE THE INSPECTION AND FORM BELOW AND RETURN BY (See Assistance Guidelines for Business Self - Inspection) o All exit ways maintained clear and free of obstructions, and all exit doors in working condition. 2. o Furnace /boiler, electrical, mechanical, stairwells, free of combustible storage. Stairwells free of trash and debris. 3. o All emergency lighting and exit lights operational. 4. o Fire extinguishers shalt be serviced annually. Fill in: Date Serviced: ; Name of Company: 5. o All electrical appliances and cords appear to he safe. No splices, multiple plug adaptors or extension cords. 6. o No accumulation of trash or debris in storage rooms or outside of building. Any storage in neat and orderly rows. 7. o Reduce storage height to at least two feet below ceiling in building. 8. n Address posted on building and visible from street. 9. o Electrical panel shall have a minimum of 30" clearance. After your inspection is complete and you have checked the above items, please sign and date this forth. By doing so, you are indicating that any deficiencies found have been corrected. If an item does not apply, you may place a NA next to it with a brief explanation. Forms should be mailed to the City of Little Canada 515 E. Little Canada Rd, Little Canada MN 55117 Attn: Fire Marshal, or faxed to 651 -766 -4033. If you have any further questions or require more assistance, please contact Fire Marshal Jim Lee at 651 - 766 -4033. Thank you for taking the titne to snake your business fire safe. Signature: Date: 13