Loading...
Report • SIEMENS NFPA72REPORT �rn4.Chui�y fore v_ O / SYSTEM RECORD OF COMPLETION System Name: Washington Square- Lululemon Date of Acceptance: 11/16/2022 Contract Info: Fire alarm upgrade Supplemental Pages Attached: Yes 1. PROPERTY INFORMATION Name of property: Washington Square Address: 9546 SW Washington Square Rd. Portland,OR 97223 Description of property: Washington Square Mall Name of property representative: Washington Square Address: 9546 SW Washington Square Rd. Portland, OR 97223 Phone: 503 620 1268 Fax: None E-mail: 2. INSTALLATION, SERVICE,TESTING,AND MONITORING INFORMATION Installation contractor: Siemens Address: 9755 SW Barnes Rd. Suite 205 Portland, OR 97225 Phone: (503)207-1900 Fax: (503)207-1901 E-mail: David.hemmer(a�siemens.corn Service organization: Siemens Address: 9755 SW Barnes Rd. Suite 205 Portland, OR 97225 Phone: 503-207-1900 Fax: 503-207-1901 E-mail: David.hemmer@siemens.com Testing organization: N/A Address: Phone: N/A Fax: E-mail: None Effective date for test and inspection contract: Monitoring organization: Central Station Address: NA Phone: Security controlled Fax: NA E-mail: NA Account number: 132-6871 Phone line 1: NA Phone line 2: NA Means of transmission: digital dialer Entity to which alarms are retransmitted: NA Phone: NA 3. DOCUMENTATION On-site location of the required record documents and site-specific software: At FACP 4. DESCRIPTION OF SYSTEM OR SERVICE This is a: Modification Permit number: FPS2022-00107 NFPA 72 edition: 2015 4.1 Control Unit Manufacturer: Siemens Model number: Desiqo Modular Location: Security 4.2 Software and Firmware Firmware revision number: Zeus 14.1 4.3 Alarm Verification El This system does not incorporate alarm verification. Number of devices subject to alarm verification: NA Alarm verification set for NA seconds ©Siemens Industry,Inc.,Smart Infrastructure Division,2009-2022.All rights reserved. This report was created by TechAdvance+TM+,a service of Siemens Industry, Inc. Page 1 of 8 SIEMENS NFPA 72 REPORT (tngtewu ify-for(w fe. 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: 120V Control panel amps: 20mA Overcurrent protection: Type: Circuit Breaker Amps: 20 Branch circuit disconnecting means location: N/A Number: N/A 5.1.2 Secondary Power Type of secondary power: Storage Battery Location, if remote from the plant: Calculated capacity of secondary power to drive the system: In standby mode(hours): 24 In alarm mode (minutes): 15 5.2 Control Unit Power extender panels are listed on the supplementary form Notification Appliance Power Panel Supplementary Record Of Completion. 6. CIRCUITS AND PATHWAYS Pathway Type Dual Media Pathway Separate Pathway Class Survivability Level Signaling Line Level 0 Style 4(Class B) Level 0 Device Power Initiating Device Level 0 Class B Level 0 Notification Appliance Level 0 Class B Level 0 7. REMOTE ANNUNCIATORS Address Type Location 8. INITIATING DEVICES Type Quantity Addressable or Conventional Alarm or Supervisory Sensing Technology 9. NOTIFICATION APPLIANCES _ Type Quantity Speaker/Strobe 6 Strobe 3 10. SYSTEM CONTROL FUNCTIONS Type Quantity 11. INTERCONNECTED SYSTEMS This system does have interconnected systems. 12. CERTIFICATION AND APPROVALS 12.1 System Installation Contractor This Testing Was Performed in Accordance with Applicable NFPA Standards. ©Siemens Industry, Inc.,Smart Infrastructure Division,2009-2022.All rights reserved. This report was created by TechAdvance+Tm,a service of Siemens Industry, Inc. Page 2 of 8 SIEMENS NFPA 72 REPORT hti4RAm4ify for ttfe- Signed: Date: Printed name:Andrey Organization: Frahler Electric Title: Electrician Phone: (503)637-4627 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed: Date: //—l` —ZZ Printed name SEAN BLACKSTONE Organization: Siemens Title: Fire Alarm Technician Phone: (503)207-1900 12.3 Acceptance Test Date and time of acceptance test: 11/16/2022 Installing contractor representative: SEAN BLACKSTONE Testing contractor representative: SEAN BLACKSTONE Property representative: Security AHJ representative: City of Tigard ©Siemens Industry, Inc.,Smart Infrastructure Division,2009-2022.All rights reserved. This report was created by TechAdvance+TM,a service of Siemens Industry, Inc. Page 3 of 8 SIEMENS NFPA 72 REPORT /t,..3.etiaiiy fort.fe. POWER SYSTEMS SUPPLEMENTARY RECORD OF COMPLETION 1. PROPERTY INFORMATION Name of property:Washington Square Mall-Lululemon Address: 9546 SW Washington Square Rd. Portland, OR 97223 2. SYSTEM POWER 2.1 Control Unit 2.1.1 Primary Power Input voltage of control panel: 120V Control panel amps: 20mA Overcurrent protection: Type: Circuit Breaker Amps: 20 Location(of primary supply panelboard): Disconnecting means location: N/A 2.1.2 Engine-Driven Generator Location of generator: NA Location of fuel storage: NA Type of fuel: NA 2.1.3 Uninterruptible Power System Equipment powered by UPS system: NA Location of UPS system: NA Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): NA In alarm mode(minutes): NA 2.1.4 Batteries Location: FACP Type: Sealed Lead Acid Nominal voltage: 24 Amp/hour rating: 35ah Calculated capacity of batteries to drive the system: In standby mode(hours): 24 In alarm mode(minutes): 15 2.2 In-Building Fire Emergency Voice Alarm Communications System or Mass Notification System 2.2.1 Primary Power Input voltage of EVACS or MNS panel:_ EVACS or MNS amps: Overcurrent protection: Type:_ Amps: Location (of primary supply panelboard): Disconnecting means location: 2.2.2 Engine-Driven Generator Location of generator: NA Location of fuel storage: NA Type of fuel: NA 2.2.3 Uninterruptible Power System Equipment powered by UPS system: NA Location of UPS system: NA Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): NA In alarm mode (minutes): 15 2.2.4 Batteries Location: NA Type:_ Nominal voltage: NA Amp/hour rating: NA Calculated capacity of batteries to drive the system: In standby mode(hours): NA In alarm mode(minutes): NA ©Siemens Industry,Inc.,Smart Infrastructure Division,2009-2022.All rights reserved. This report was created by TechAdvance+TM,a service of Siemens Industry, Inc. Page 4 of 8 . SIEMENS NFPA72REPORT irekrkI4*y orGift 2.3 Notification Appliance Power Extender Panels 2.3.1 Primary Power ID Location Input Panel Over- Over- Primary Supply Location Disconnect Location Volts Amps current current Type Amps 2.3.2 Secondary Power ID Location Battery Manufactured Voltage Amp Standby Alarm Type Date Rating Rating Hours Minutes 2.3.2 Engine-Driven Generator Location of generator: NA Location of fuel storage: NA Type of fuel: NA 2.3.3 Uninterruptible Power System Equipment powered by UPS system: NA Location of UPS system: NA Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): NA In alarm mode (minutes): 15 2.3.4 Batteries ID Location Battery Battery Test Pass/ Voltage Amps Method Fail See Main System Record of Completion for additional information,certifications, and approvals. • ©Siemens Industry, Inc.,Smart Infrastructure Division,2009-2022.All rights reserved. This report was created by TechAdvance+TM, a service of Siemens Industry, Inc. Page 5 of 8 SIEMENS NFPA 72 REPORT rkgea,ti�1� �, Gfe_ NOTIFICATION APPLIANCE POWER PANEL SUPPLEMENTARY RECORD OF COMPLETION 1. PROPERTY INFORMATION Name of property: Washington Square Mall -Lululemon Address: Washington Square Rd. Portland, OR 97223 2. NOTIFICATION APPLIANCE POWER EXTENDER PANELS Address Make and Model Location Area Served Power Source See Main System Record of Completion for additional information,certifications,and approvals. ©Siemens Industry, Inc.,Smart Infrastructure Division, 2009-2022.All rights reserved. This report was created by TechAdvance+TM,a service of Siemens Industry, Inc. Page 6 of 8 . SIEMENS NFPA72REPORT K�.e mA47-for tile. 00 INTERCONNECTED SYSTEMS SUPPLEMENTARY RECORD OF COMPLETION 1. PROPERTY INFORMATION Name of property: Washington Square Mall- Lululemon Address: 9546 Washington Square Rd. Portland, OR. 97223 2. INTERCONNECTED SYSTEMS Description Location Purpose See Main System Record of Completion for additional information, certifications, and approvals. ©Siemens Industry, Inc.,Smart Infrastructure Division,2009-2022.All rights reserved. This report was created by TechAdvance+TM, a service of Siemens Industry, Inc. Page 7 of 8 . SIEMENS NFPA 72 REPORT f'N4Rwnu it'v'for Lafe. DEVIATIONS FROM ADOPTED CODES AND STANDARDS SUPPLEMENTARY RECORD OF COMPLETION 1. PROPERTY INFORMATION Name of property: Washington Square Mall Address: 9546 SW Washington Square Rd. Portland, OR 97223 2. DEVIATIONS FROM ADOPTED CODES OR STANDARDS Description Purpose See Main System Record of Completion for additional information,certifications,and approvals. ©Siemens Industry, Inc.,Smart Infrastructure Division,2009-2022.All rights reserved. This report was created by TechAdvance+*^ a service of Siemens Industry, Inc. Page 8 of 8