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HomeMy WebLinkAboutReport SIEMENS NFPA 72 REPORT f4. e n.uit! -for(f 0 / SYSTEM RECORD OF COMPLETION - ADDENDUM System Name: Washington Square—Avocado Green Date of Acceptance: 12/7/2022 Contract Info: 440P-351266 BOR1 FIS WSQ Avocado Supplemental Pages Attached: No 1. PROPERTY INFORMATION Name of property: Washington Square Address: 9339 SW Washington Square Rd, T11, 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: 503-620-1266 Fax: None E-mail: None 2. INSTALLATION, SERVICE,TESTING,AND MONITORING INFORMATION Installation contractor: Siemens Industry Address: 9755 SW Barnes Rd, Suite 205, Portland, OR 97225 Phone: 971-207-1900 Fax: 971-207-1901 E-mail: David.hem mer(q�siemens.com Service organization: Siemens Industry Address:_, Phone:_ Fax:_ E-mail: Testing organization: SIEMENS Address: 9755 SW Barnes Rd, Suite 205, Portland, OR 97225 Phone: 503 207 1900 Fax: 503 207 1901 E-mail: NA Effective date for test and inspection contract: Monitoring organization: Address: Phone:_ Fax:_ E-mail: Account number: 132-6871 Phone line 1:_ Phone line 2: Means of transmission: digital dialer Entity to which alarms are retransmitted:_ Phone: 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: FPS2023-00036 NFPA 72 edition: 2016 4.1 Control Unit Manufacturer: Siemens Model number: Desigo Modular Location: Security Office 4.2 Software and Firmware Firmware revision number: ZEUS 14.1 4.3 Alarm Verification ® 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+*M,a service of Siemens Industry,Inc. Page 1 of 3 SIEMENS NFPA 72 REPORT li mt y.orG{t 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: 120 Control panel amps: 2Q Overcurrent protection: Type: Breaker Amps: 20 Branch circuit disconnecting means location: In FACP Room Number: In FACP Room 5.1.2 Secondary Power Type of secondary power: Storage Battery Location, if remote from the plant: FACP Room by Cafe 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 SMOKE DETECTORS None Addressable Alarm DUCT DETECTORS 1 Addressable Supervisory PIR Addressable Alarm Addressable Supervisory 9. NOTIFICATION APPLIANCES Type Quantity STROBE 2 Speaker/Strobe 3 10. SYSTEM CONTROL FUNCTIONS Type Quantity Remote Relay 11. INTERCONNECTED SYSTEMS ©Siemens Industry,Inc.,Smart Infrastructure Division,2009-2022.All rights reserved. This report was created by TechAdvance+T1",a service of Siemens Industry,Inc. Page 2 of 3 SIEMENS NFPA 72 REPORT t1hr ' 'forGfe. 12. CERTIFICATIONOo AND APPROVALS 12.1 System Installation Contractor This Testing Was Performed in Accordance with Applicable NFPA Standards. Signed: Date: Printed name: David Hemmer Organization: SIEMENS Title: ENG SPECIALIST 2 Phone: 503-207-1900 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed: Date: Printed name: David Hemmer Organization: SIEMENS Title: ENG SPECIALIST 2 Phone: 503-207-1900 12.3 Acceptance Test Date and time of acceptance test: 17 APRIL 2023 0600 Installing contractor representative: David Mannix Testing contractor representative: David Hemmer Property representative: AHJ representative: Jeff Grove Tigard, Or Building Admin, ©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 3