Waiver For FPS System - QCDD

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Managing Director APPLICATION FOR

Civil Defence Department MODIFICATION / WAIVER OF FIRE


Ministry of Interior
SAFETY REQUIREMENTS
State of Qatar
PO Box 6959 (Form CDD-WA)

Explanatory Notes:
a. It is advisable to have this application form completed and submitted by the consultant as the applicant.
b. In column (C) of Section II, the applicant should state with regard to the modification / waiver sought, why the particular
provision in the fire code cannot be complied with relative to the circumstances of the case.
c. Check the appropriate box ( )
d. Details of owner/ occupier/ Management Corporation shall be provided if cc copy is required for CDD’s reply letter.

* Delete where applicable

SECTION I (To be completed by applicant)


I hereby apply for modification / waiver of the fire safety requirements for the proposed development as described below :

A. Particulars of Project Proposal


Project title:

Name of Building

Unit No.
Plot No., if any

Address/Road P.O. Box :

Previous CDD Plan Ref. No., if any, for


same project
Previous Waiver Ref. No(s), if any, for
same project
Previous Consultation Ref. No(s), if
any, for same project
Building Category: * Commercial / Industrial / Residential / Institution

Name of Building Owner

B. Particulars of Applicant for the Waiver


Applicant Name Tel. No. Fax No

Company Name

Company Address : P.O. Box :

CDD-WA (Updated on 1 Feb 2007)


_________________________ __________________________ ______________
Company's Stamp Signature Date

Capacity of the Applicant for the Waiver


† Consultant
† Owner /developer
† Others (please specify : _____________________________________________________)

C. Particulars of Consultant if the Waiver Applicant is Not the Consultant


Consultant Name Tel. No. Fax No

Consultant
Company Name (if
applicable)

Consultant Company / Mailing Address: P.O. Box:

_________________________ ___________________________ ___________


Company's Stamp Signature Date

(For Official Use Only)


Waiver Reference No.

Waiver meeting date

Name of CSC Officer

Name of PO

CDD-WA (Updated on 1 Feb 2007)


SECTION II
a. To be completed by applicant except parts D, F & G Waiver Reference No : _______________
b. To use a fresh form for each waiver item
c. * Delete where appropriate Waiver item s/no: _______________

A. Description of waiver application B. Provisions made on plan C. Reasons in support of application D. Waiver Decision
& relevant clause number (For official use only)

Eg. To permit provision of one hardstanding


only – located along Salwa Road.
The waiver application is
To permit / waive / exempt / omit * Granted / Not granted / Granted with Conditions /
Pending

Conditions (if any):

Reasons for decision:

State clause number in Fire Code which is


relevant to the application:

Clause __________

Time-frame to comply with conditions (if any):


E. Applicant’s name & signature F. Processing Officer’s name & signature G. Officer chairing meeting
(For official use only) (For official use only)
______________________

* MD, CDD / Dir FSD / ____________

________________________ ______ __________________________________ _____________________________________ _______


Name & Signature Date Waiver Meeting Recorder’s name & signature Date
_____________________
Name & Signature

CDD-WA (Updated on 1 Feb 2007)

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