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HomeMy WebLinkAboutReport } 2023 -<x oGI SYSTEM RECORD OF COMPLETION This form is to be completed by the system installation contractor at the time of system acceptance and approval. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Attach additional sheets,data, or calculations as necessary to provide a complete record. Form Completion Date: 5-30-23 Supplemental Pages Attached: 0 1. PROPERTY INFORMATION Name of property: Mercer GLobal Address: 12909 S 68'Parkway Description of property: Low Rise Commercial Name of property representative: Josh Fuerstenberg,Walen COnstruction Address: Phone: Fax: E-mail: 2. INSTALLATION, SERVICE, TESTING, AND MONITORING INFORMATION Installation contractor: Point Monitor Address: 5863 Lakeview Blvd Phone: 503.627.0100 Fax: E-mail: Service organization: Unchanged Address: Phone: Fax: E-mail: Testing.organization: Point Monitor Address: ' 5863 Lakeview Blvd Phone: 503.627.0100 Fax: E-mail: Effective date for test and inspection contract: Monitoring organization: Unchanged Address: Phone: Fax: E-mail: Account number: Unchanged Phone line 1: Unchanged Phone line 2: Unchanged Means of transmission: Unchanged Entity to which alarms are retransmitted: Unchanged Phone: Unchanged 3. DOCUMENTATION On-site location of the required record documents and site-specific software: Box by FACP 4. DESCRIPTION OF SYSTEM OR SERVICE This is a: ❑New system ® Modification to existing system Permit number. FPS2023-0061 NFPA 72 edition: 2019 4.1 Control Unit Manufacturer: Silent Knight Model number: 5820XL 4.2 Software and Firmware Firmware revision number: Unchanged 4.3 Alarm Verification El This system does not incorporate alarm verification. Number of devices subject to alarm verification: Alarm verification set for seconds Copyright©2012 National Fre Protection Association.Thistorn,may be copied for individual use other than for resale.It may not be copied for commercial sale or,distribution SYSTEM RECORD OF COMPLETION (continued) 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: 120 VAC Control panel amps: 4 Overcurrent protection: Type: Breaker Amps: 20 Branch circuit disconnecting means location: Number: 5.1.2 Secondary Power Type of secondary power: Batteries 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 ❑ This system does not have power extender panels ❑ Power extender panels are listed on supplementary sheet A 6. CIRCUITS AND PATHWAYS Pathway Type Dual Media Pathway Separate Pathway Class Survivability Level Signaling Line Device Power Initiating Device Notification Appliance 1 B 0 Other(specify): 7. REMOTE ANNUNCIATORS Type Location Unchanged Unchanged 8. INITIATING DEVICES Addressable or Type Quantity Conventional Alarm or Supervisory Sensing Technology Manual Pull Stations Smoke Detectors Duct Smoke Detectors Heat Detectors Gas Detectors Waterflow Switches Tamper Switches • Copyright©2012 National Fre Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. SYSTEM RECORD OF COMPLETION (continued) 9. NOTIFICATION APPLIANCES Type Quantity Description Audible Visible 4 Strobes Combination Audible and Visible 2 Horn Strobes 10. SYSTEM CONTROL FUNCTIONS Type Quantity Hold-Open Door Releasing Devices HVAC Shutdown Fire/Smoke Dampers Door Unlocking Elevator Recall Elevator Shunt Trip 11. INTERCONNECTED SYSTEMS ® This system does not have interconnected systems. ❑ Interconnected systems are listed on supplementary sheet 12. CERTIFICATION AND APPROVALS 12.1 System Installation Contractor This system as specified herein has been installed according to all NFPA standards cited herein. Signed: Printed name: Brian Downey Date: 5-30-23 Organization: Point Monitor Title: Tech Phone: 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed: Printed name: Brian Downey Date: 5-30-23 Organization: Point Monitor Title: Tech Phone: 12.3 Acceptance Test Date and time of acceptance test: 5-30-23 Installing contractor representative: Brian Downey Testing contractor representative: Brian Downey Property representative: Josh Fuerstenberg,Walen COnstruction AHJ representative: Copyright*2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. al