HomeMy WebLinkAboutMulti-Family Fire & Life Safety Checklist FormSelf-Certification Inspection Form for Multi-Family Structures
Structural Items
0 All structural and associated components (foundation, roof, walls, support members, stairs, sidewalks, etc.) are
maintained in a safe and sound condition.
0 Buildings constructed prior to July 9, 1956 are maintained in compliance with the State Fire Code. Buildings
constructed after July 9, 1956 are maintained in compliance with the State Fire Code and the Building Codes in
effect at the time of construction.
0 Required occupancy separations are provided and maintained. Examples are dwelling unit/corridor, unit/unit,
residential/parking or residential/commercial.
0 Guardrails and handrails are maintained in safe and sound condition. Handrail required for stairs with four or
more risers or as required by Building Code. Guardrail required for walkway areas with adjacent drop off
exceeding 30".
0 Passages, pipe chases, chutes, and access openings are fire and draft stopped to prevent spread of fire.
Maintenance Items
0 All doors and hardware are maintained in good and functional condition.
0 All windows and hardware are maintained in a good and functional condition and meet natural light and
ventilation requirements.
0 All interior walls, ceilings, floors and other interior public and service areas are maintained in a safe and sanitary
condition.
0 Openable windows have screens. Single pane windows in habitable areas have storms. Storms on by Nov. 1
and screens on by May 1.
0 Chimneys and flue piping are properly installed and maintained.
0 Kitchen and bathroom floor surface is intact and easily cleanable.
0 Equipment or appliances supplied by owner (e.g. garbage disposals, dishwashers, built in appliances, vent fans,
stoves, refrigerators) are properly installed and maintained in good, operable, and safe condition.
0 Pest infestation in one unit is the responsibility of the occupant. Infestation in two units and/or public areas is the
responsibility of the owner.
hisinsp/self-cert multi fam 1
hisinsp/self-cert multi fam 2
Egress
0 Every means of egress maintained in good condition and free of obstruction.
0 Required escape/rescue windows are provided and maintained.
0 Required exit signs provided and maintained in good condition.
0 Required emergency egress lighting provided and maintained in good condition.
0 Required "fire doors" maintained self-closing and self-latching.
Mechanical/Plumbing/Electrical
0 No electrical hazards from overloading, poor condition, inadequate insulation, improper fusing.
0 Fixtures and equipment are maintained as manufactured. No unapproved extension cords, multi-plugs, or
adapters.
0 Plumbing system fixtures, supply piping and drainage piping are installed and maintained in good and sanitary
condition.
0 Gas piping and appliances are properly installed and safely maintained.
0 Heating and cooling equipment is properly installed and safely maintained. No combustible storage within three
feet of fuel burning equipment.
0 Mechanical rooms and electrical service rooms maintained free of excess combustible storage. Three feet
clearance maintained in front of electrical panels and disconnects. Combustible storage is allowed in sprinklered
areas.
Fire Safety
0 All fire extinguishing devices and all early warning fire protection systems are properly installed and maintained in
good working condition.
0 Smoke alarms are installed as per manufacturer's instructions and as required by Codes in common areas, on
each floor level within dwelling units, and all bedrooms and hallways leading to bedrooms. Replace smoke
alarms more than 10 years old. All hard-wired, battery back-up alarms 10 years old or more must be replaced
with new, hard-wired, battery back-up alarms.
0 A fully charged 2A-10BC (minimum size) fire extinguisher mounted in an accessible location. Fire
extinguishers must display a noticeably visible manufacturer’s date either by tag or permanent marking on the
canister. Any fire extinguisher six years old or more must be serviced and properly tagged by a qualified
agency or be replaced with a new, properly mounted 2A-10BC (minimum size) fire extinguisher with the
manufacturer’s date displayed either by tag or permanent marking on the canister.
0 One 2A 10BC fire extinguisher for each laundry and central mechanical room (contiguous rooms can be served
by one fire extinguisher).
hisinsp/self-cert multi fam 3
0 Fire extinguishers in common areas are in approved tamperproof cabinets.
hisinsp/self-cert multi fam 4
hisinsp/self-cert multi fam 5
0 Required annual FIRE ALARM TEST AND MAINTENANCE form must be submitted to Fire Marshal for review.
0 Required biennial automatic sprinkler test and maintenance form must be submitted to Fire Marshall for review.
Other
0 Dwelling is not occupied by a number of persons greater than allowed by the Iowa City Zoning Ordinance.
0 Only rooms certified as habitable by the Iowa City Housing Dept. are inhabitated.
SIGNATURE ____________________________________________ DATE ____________________________
COMPANY NAME ___________________________________________________________________________
PROPERTY ADDRESS ________________________________________________________________________
DATE ____________________________________________________________________________________
To certify that all units within the rental structure have been inspected within ten (10) days prior to the rental licensing
inspection and are in compliance with all of the above requirements, please return this completed checklist to the
inspector at the rental licensing inspection.
City of Iowa City Housing and Inspection Services (356-5130)
February 2007