Performa of application for Periodic Renewal Certification

* Timeline 15 days
* All fields are mandatory
* Required Documents
1. Scanned challan (Head 0070 60 109 0100)
2. Scanned copy of Hydraulic pressure test certificate for Extinguisher.
3. Copy of previously issued Fire NOC.
4. List of existing fire safety equipment in building/premises as per the NBC and its working condition.

Proposed/Compounding/Building name: *

Address: *

Mobile: *

Telephone No.

Fax No.

Email: *

Pincode: *

Pan No: *

Name of Authorized Coordinator/ Contact Person: *

Email: *

Mobile: *

Select District:*

Type of Building: *

Lift with Fire Switch: *
Yes No

Emergency/Optional Source of Electric Supply: *

Exit: *
Yes No

Provision of Smoke / Fire check Doors: *
Yes No

Attachment Type: (pdf | png | jpg | jpeg | docx)*

Attachment:

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All above said information is correct with the best of my knowledge and belief. *