AHJ Email Preapproval Form

Use this convenient form to send your proposed firestopping system specs to your AHJ- (Authority Having Jurisdiction)- for preapproval. Your System is approved when the Inspector says it is! Note that you will use one AHJ form for each UNIQUE firestop product you specify.

Request for AHJ Consideration. Unique Fire Stop Products Submittal Form

To the Person Making the Request for AHJ Consideration:
-This form is designed to save you time in getting AHJ preapproval for your Unique Fire Stop Products cables firestopping project. You will fill out one form for each product you recommend. Fill it out completely using the product page on the website as a guide. Note that most fields are required, as shown by the asterisks (*).
-When you have completed the form, click "Email to Inspector" at the bottom of the form. The "Note to the Inspector" (below) will appear at the top of the email along with all the information you select on this form. You will also receive a copy at your email address.
-You also have the option to click on "Save and Continue Later". You will then receive an email with a link to the saved form.
-Call our friendly Customer Service Support if you have questions: 251-960-5018.
Note to the Inspector:
Request for AHJ Consideration
-Dear (Inspector's first and last name will appear here):
-Please review the following firestop method we propose for firestopping our telecommunication cables. When your review is finished, please return this form to the person making the request- (Your name and email will appear here) -along with a note indicating your approval or rejection and reason for rejection.
-All firestop systems will be installed to the manufacturer's specifications.
-Method of ID and documentation on all systems is by digital photo and alpha-numeric identification.
-All systems to be digitally photographed front and back and available to you upon request.
-Note that you may have to adjust your email settings to view images in this email.
AHJ Inspector Information
Name of AHJ Inspector*
First Last
Inspector's Email*
Enter Email Confirm Email
Inspector's Jurisdiction*
Submittal Date*
MM slash DD slash YYYY
Job Site Information
Name of Job Site*
Address of Job Site*
Street Address Address Line 2 City State ZIP Code
Date Expected to be On Site*
MM slash DD slash YYYY
Unique Fire Stop Product Information
Product Name (1 product per form)*
Split Sleeve Firestop Systems

Split Sleeve Firestop Systems
Smooth Firestop/Penetrator Systems

Smooth Firestop/Penetrator Systems
Threaded Firestop/Penetrator Systems

Threaded Firestop/Penetrator Systems
Core Bore Firestop Seal and Plug

Core Bore Firestop Seal and Plug
Silicone Firestop Sealant

Silicone Firestop Sealant
Membrane Firestop Cable Sleeve

Membrane Firestop Cable Sleeve
UNIQUE Firestop Caulk

UNIQUE Firestop Caulk
Firestop Pipe Collar

Firestop Pipe Collar
Type of Construction (1 type per form)*

Concrete Floor

Block Wall

Sheetrock / Drywall

Vertical Concrete

Wood Floor
Hourly Rating of Firestop System*
1 hour
1 and 2 hour
2 hour
2 and 3 hour
3 hour
3 and 4 hour
4 hour
Intumescent Fill Material*
UNIQUE Fire Stop Intumescent Putty – ASTM E814 compliant (letter)
UNIQUE Intumescent Putty Fill Kit SDS (Material Safety Data Sheet)
Core Bore Firestop Plug (made by STI) SDS (Material Safety Data Sheet)
Split Sleeve Firestop System UL Listing #*
Split Sleeve-Concrete 2 Hr UL W-J-3110
Split Sleeve-Concrete 4 Hr UL W-J-3112
Split Sleeve-Drywall 1& 2 Hr UL W-L-3232
Split Sleeve-Drywall 3 & 4 Hr UL W-L-3234
Split Sleeve-Vertical Concrete 2 & 3 Hr UL F-A-3019
W-L-3273 Sleeve for 3 or 4 hr walls / 3 hr T rating
Leakage Ratings
Smooth Firestop System UL Listing #*
Smooth Penetrator-Concrete 2 Hr UL W-J-3109
Smooth Penetrator-Drywall 1 & 2 Hr UL W-L-3231
Leakage Rating- Gypsum
Leakage Rating- Gypsum w/ Innerduc or plastic pipe
Threaded Firestop System UL Listing #*
Threaded Penetrator-Concrete 2 Hr UL W-J-3111
Threaded Penetrator-Concrete 4 Hr UL W-J-3112
Threaded Penetrator-Drywall 1 & 2 Hr UL W-L-3233
Threaded Penetrator-Drywall 3 & 4 Hr UL W-L-3234
Threaded Penetrator-Vertical Concrete 2 & 3 Hr UL F-A-3019
W-L-3273 Sleeve for 3 or 4 hr walls / 3 hr T rating
Leakage Rating
Core Bore Firestop Seal and Plug UL Listing*
Core Bore Firestop Seal and Plug UL Listing
Membrane Firestop Cable Sleeve UL Listing #*
Membrane Penetrator-Drywall 1 & 2 Hr UL W-L-3230
W-L-3220 Membrane Penetrator 1/4 hr T rating
UNIQUE Firestop Caulk UL Testing Documentation*
W-L-7187, 2 Hr. Gypsum w/ HVAC Duct
W-L-7147 Diagram, 2 Hr. Gypsum w/ HVAC Duct
W-L-3309 Diagram, 2 Hr. Gypsum w/ Cables
W-L-2539 Diagram, 2 Hr. Gypsum w/ Plastic Pipes
W-L-2494 Diagram, 2 Hr. Gypsum w/ Plastic Pipes
W-L-1422 Diagram, 2 Hr. Gypsum w/ Metal Pipes
W-J-7087 Diagram, 2 Hr. Gypsum w/ HVAC Duct
W-J-5144 Diagram, 2 Hr. Concrete w/ Insulated Pipe
W-J-3165 Diagram, 2 Hr. Concrete w/ Cables
HW-D-0523 Diagram, 2 Hr. Gypsum Joint w/ Concrete Deck
F-C-7053 Diagram, 1 Hr. Wood Floor w/ HVAC Duct
F-C-3097 Diagram, 1 Hr. Wood Floor w/ Cables
F-C-3096 Diagram, 1 Hr. Wood Floor w/ Cables
F-C-3095 Diagram, 1 Hr. Wood Floor w/ Cables
F-C-1144 Diagram, 1 Hr. Wood Floor w/ Metal Pipe
F-C- 5083 Diagram, 1 Hr. Wood Floor w/ Insulated Metal Pipe
F-A-1096 Diagram, 2 Hr. Concrete w/ Metal Pipe
F-C-1143 Diagram, 1 Hr. Wood Floor w/ Metal Pipe
W-L-3308 Diagram, 2 Hr. Gypsum w/ Cables
W-L-8084 Diagram, 2 Hr. Gypsum w/ Insulated Metal Pipe
C-AJ-1571 Diagram, 2 Hr. Concrete w/ Metal Pipe
C-AJ-2590 Diagram, 2 Hr. Concrete w/ Plastic Pipe
C-AJ-3264 Diagram, 2 Hr. Concrete w/ Cables
C-AJ-7121 Diagram, 2 Hr. Concrete w/ HVAC Duct
C-AJ-8197 Diagram, 2 Hr Concrete w/ Multiple Pipes
C-AJ-8198 Diagram, 2 hr. Concrete w/ Insulated Metal Pipes
Firestop Pipe Collar Technical Documentation*
Firestop Collars Technical Data Sheet
Firestop Pipe Collar UL Testing Documentation*
Firestop Collars System No. F-C-2153
Firestop Collars System No. F-C-2154
Unique Split Sleeve Drawings*
SSS-1 Split Sleeve System Firestop drawing (PDF)
SSS-2 Split Sleeve System Firestop drawing (PDF)
SSS-4 Split Sleeve System Firestop drawing (PDF)
Smooth Firestop System Drawings*
SP-1 Smooth Firestop Sleeve (PDF)
SP-2 Smooth Firestop Sleeve (PDF)
SP-4 Smooth Firestop Sleeve (PDF)
Threaded Firestop System Drawings*
TP-1 Threaded Sleeve Firestop drawing (pdf)
TP-2 Threaded Sleeve Firestop drawing (pdf)
TP-4 Threaded Sleeve Firestop drawing (pdf)
Core Bore Firestop Seal & Plug Drawings*
1.5 inch Core Bore Firestop Seal & Plug Drawing
2 inch to 3.5 inch Core Bore Firestop Seal & Plug Drawing
4 inch to 6 inch Core Bore Firestop Seal & Plug Drawing
Core Bore Firestop Seal & Plug Documentation*
Certificate of Compliance
Engineering Judgment for Vertical Wall
Silicone Firestop Sealant Safety Data Sheet
Silicone Firestop Sealant Non-Sag Safety Data Sheet
Installation Description and Other Details (optional)
Use this section to include any other installation details required by the AHJ along with links to any additional required submittal documentation.
Contractor Information
Contracting Company*
Company Phone Number*
Company Fax Number
Name of Person Making Request*
First Last
Email of Person Making Request*
Enter Email Confirm Email