2006, 01-25 Bldg Rec + 9 Unites: Fire Systems West Alarm System SHIED . ,
Fire Systems West, Inc.
920 North Lake Road • Spokane,WA 99212 • Phone(509)534-5180 • Fax(509)534-5221
Record of Completion (i
Name of Protected Property: '� '7 f u s
Address: 601 5. t�J• Ruff
Rep. Of Protected Prop.(name/phone):
Authority Having Jurisdiction: Si,� " e • - , , .4,
Address/Phone Number: 92 9- / ''7 0p
. 1.Type(s)of System or Service
}� NFPA 72,Chapter 3-Local Gc ��~ I'
If alarm
is.transmitted to location(s)off premises, list where received: y WA) g#' "7FZ Z 5/P5/PC)S/ 'Or - 4144/41 C g-- 4
w.9-s ,t~
NFPA 72,Chapter 3-Emergency Voice/Alarm Service
Quantity of voice/alarm channels: Single: Multiple:
Quantity of speakers installed: Quantity of speaker zones:
Quantity of telephones or telephone jacks included in system:
NFPA 72,Chapter 4-Auxiliary
Indicate type of connection:
Local Energy: Shunt: 61 4. c, g',
Location and telephone number for receipt of signal
NFPA 72,Chapter 4-Remote Station ' ;`t Atc 41.1/4
Alarm:
Supervisory:
NFPA 72,Chapter 4-Proprietary �
If alarms are retransmitted to public fire service con F r "L- ;lephone
Number of the organization receiving alarm:
("pia_✓ ��� �te_
Indicate how alarm is retransmitted:
6!J f
NFPA 72,Chapter 4-Central Station (ems
The prime contractor:
Central Station location:
Means of transmission of signals from the protected premises to the central station:
McCulloh Multiplex _One Way Radio
Digital Alarm Communicator Two Way Radio Others
Means of transmission of ala s to the public fire service communications center:
(a) . Q€w, �/L h PAgn 247AfX .
(b) y
System Location: z fL C HIV ie r2_
Organization Name/Phone Representative Name/Phone
Installer /�/K�Sft/ .�,5 £4ASe .5.7y-Pga peotem//e rt / . f ?-V//
Supplier 'L S 1/41y-$7RV r c r i
Service Organization Fii[•c• yJfG+-�f Am,Sf 4-34'-S-40 + r ' t /
Location of Record(As-Built)Drawings:
C2,1 f,'tee_ ZA4- Cis e. / Fie
Location of Owners Manuals:
OA/ Jr'� / eke..--7.- Con, �. ' ( G.1
Location of Test Reports:
/
fl it/ f Ye. / r tide- Coils 6, /ff
A contract,dated ji/a5,/04 for test and inspection in accordance with NFPA standard(s)No(s), 7z
Dated *005 , is in effect.
WA CL#FIRESWI 140B1 • ECL#FIBESWI 055LW
Fire Systems West. Inc.
920 North Lake Road • Spokane, WA 99212 • Phone(509) 534-5180 • Fax(509)534-5221.
2. Record of System Installation
(Fill out after installation is complete and wiring checked for open,shorts,ground faults,and improper branching,but prior to
conducting operational acceptance test.)
This system has been installed in accordance with the NFPA standards as shown below, was inspected by /CS W on
///7/o ,includes the devices shown below,and has been in service since /,2$%6
">e NFPA 72,Chapte .ter 4 • IN(circle all that apply)
NFPA 70,National Electrical Code,Article 760 •
X Manufac urer's Instructions
er ;•ec' •
Signed: i Date• //2. /O�
Organization: /'3
3. Record of System Operation �/Z y 1
All operational features and functions of this system were tested by F51.-,/ on Qti ,and
found to be operating properly in accordance with the requirements of
NFPA 72,Chapter F 3 4 5 6'1'(circle all that apply)
.5C NFPA 70,National Electrical Code,Article 760
Manufacturer's Instructions
•
J�. e speci`
Signed: 11:�ir��f Date: •
Organiza ion: �s�,�/ '
4. Alarm Initiating Devices and Circuits(use blanks to indicate quantity of devices)
MANUAL •
(a) / Manual Stations K Noncoded Activating Transmitters Coded
(b) Combination Manual Fire Alarm and Guard's Tour Coded Stations
AUTOMATIC
_ Coverage: Complete Partial:
•(a) Smoke Detectors Ion Photo
(b) Duct Detectors Ion Photo
(c) y Heat Detectors FT X RR FT/RR RC
(d) a Sprinkler Waterflow Switches: Transmitters )( Noncoded,Activating Coded
(e) Other(list):
5. Supervisory Signal Initiating Devices and Circuits(use blanks to indicate quantity of devices) _
(a) Coded Stations
(b) Noncoded Stations,Activating Transmitters
(c) Compulsory Guard Tour System Comprised of Transmitter Stations and
Intermediate Stations
NOTE: Combination devices recorded under 4(b)and 5(a).
SPRINKLER SYSTEM
(a) ft Coded Valve Supervisory Signaling Attachments
Valve Supervisory Switches,Activating Transmitters -
(b), Building Temperature Points
(c) Site Water Temperature Points
(d) Site Water Supply Points
Electric Fire Pump
(e) Fire Pump Power
(f) Fire Pump Running
(g) Phase Reversal
Engine Driven Fire Pump
(h) Selector in Auto Position
(i) Engine or Control Panel Trouble
(j) Fire Pump Running
Engine Driven Generator
(k) Selector in Auto Position
(I) Control Panel Trouble
(m) Transfer Switches
(n) Engine Running
WA CL 4FIRESWI 14001 • ECL 4 FIRESWI 055LW
Fire Systems West, Inc.
920 North Lake Road • Spokane, WA 99212 • Phone(509)534-5180 • Fax(509)534-5221
Other Supervisory Function(s)(specify): •
6. Alarm Notification Appliances and Circuits
Quantity of indicating appliance circuits connected to the system:
Types and quantity of alarm indicating appliances installed:
(a) Bells Inch
(b) Speakers
(c) Horns
(d) Chimes
(e) Other:
(f) /7 Visual Signals Type: 4 ex
j with audible ! w/o audible
(g) Local Annunciator
7. Signaling Line Circuits
Quantity and Style(see NFPA 72,Table 3-6)of signaling line circuits connected to system:
Quantity: / Style:
8. System Power Supplies: /
(a)Primary(Main): Nominal Voltage: /20 'ML Current Rating: 99 -/
Overcurrent Protection: T •e: •L. c..ei2 Current Rating: 4-1.•.-
Location: • ! • ' �� • j , - ZOO/f/2 c
(b)Secondary(Standby):
)( Storage Battery: Amp Hour Rating: 7
X Calculated capacity to drive system, in hours:_ x 24 _ 60
Engine driven generator dedicated to fi re alarm system:
- Location of fuel storage:
.(c)Emergency or Standby System used as backup to Primary Power Supply,instead of using a Secondary Power Supply: •
Emergency System described in NFPA 70,Article 700
Legally Required Standby System described in NFPA 70,Article 701
Optional Standby System described in NFPA 70,Article 702,which also meets the performance requirements
of Article 700 or 701
9. System Software
(a) Operating System Software Revision•Level(s):
(b) Application Software Revision Level(s):
(c) Revision Completed by: Pudb:v ,tG./eay icr c syst/ - GL s
(name) (firm)
10. .Comment
ZS • /ei2 r. 1 �/ fi'Z,57;,ra
(signed for entral .-on or Alarm Service Company (title) (date)
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s):
System deviations from the referenced NFPA standard(s)are:
(signed) for Central Station or Alarm Service Company (title) (date)
Upo mpletion of ty s m(s)satisfactory test(s)witnessed(if required by the authority having jurisdiction):
(signed)represents 1veVthe authority having jurisdiction (title) (date)
WA CL#FIRESWI 140131 • CCL N FIRESWI 055LW •