Report 3 607 - 5
FUNDAMENTALS OF FIRE ALARM SYSTEMS
FIRE ALARM SYSTEM
f RECORD OF COMPLETION
72 -31
Name of protected property:
/ /(a w 7 (N
Address:
Representative of protected property (name/phone):
Authority having jurisdiction:
Address/telephone number.
Organization name /phone Representative name / phone
Installer
Supplier 0A d t ; O ` a 7 - z . ✓c i i / 'e' - - - ey / -
Service organization
Location of record (as- built) drawings:
Location of operation and maintenance manuals:
Location of test reports:
A contract for test and inspection in accordance with NFPA standard(s)
Contract No(s): Effective date: Expiration date:
System Software
(a) Operating system (executive) software revision Ievel(s);
(b) Site-specific software revision date: C );,/
(c) Revision completed by: 4 AA-- / / e ° rT'e (—
(name) (firm)
1. Type(s) of System or Service
NFPA 72, Chapter 6 - Local
If alarm is transmitted to location(s) off premises, list where received: � iv; TiPO
NFPA 72, Chapter 8 - Remote Station
Telephone numbers of the organization receiving alarm:
Alarm:
Supervisory:
Trouble:
If alarms are retransmitted to public fire service communications centers or others, indicate location and telephone
numbers of the organization receiving alarm:
Indicate how alarm is retransmitted:
NFPA 72, Chapter 8 - Proprietary
Telephone numbers of the organization receiving alarm:
Alarm:
Supervisory:
Trouble:
If alarms are retransmitted to public fire service communications centers or others, indicate location and telephone
numbers of the organization receiving alarm:
Indicate how alarm is retransmitted:
NFPA 72, Chapter 8 - Central Station
Prime contractor:
Central station location:
FIGURE 4.5.2.1 Record of Completion. (NFPA 72, I of 4)
2002 Edition
re- created by fcoari
■
NATIONAL FIRE ALARM CODE
72 -32
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 alarms to the public fire service communications center:
(a)
(b)
System Location:
NFPA 72, Chapter 9 — Auxiliary
Indicate type of connection: Local energy Shunt Parallel telephone
Location of telephone number for receipt of signals:
2. Record of System Installation
(Fill out after installation is complete and wiring is checked for opens, shorts, ground faults, and improper branching,
but prior to conducting operational acceptance tests.)
This system has been installed in accordance with the NFPA standards as shown below, was inspected by
on , includes the devices shown
in 5 and 6, and has been in service since .
NFPA 72, Chapters 1 2 3 4 5 6 7 8 9 10 11 (circle all that apply)
NFPA 70, National Electrical Code, Article 760
Manufacturer's instructions
Other (specify): /► °
Signed: 1 \ s ` '� Date: 6 r v ^0
Organization: 191 X.S1- CNtZ\ �
3. Record of System Operation
Documentation in accordance with Inspection Testing Form, Figure 11.6.23, is a .ched _ 4;47
All operational features and functions of this system were tested by i , I ' , J date
and found to be operating properly in accordance with the requirements of:
?FPA 72, Chapters 1 2 3 4 5 6 7 8 9 10 11 (circle all that apply)
NFPA 70, National Electrical Code, Article 760
4 Manufacturer's instructions
Other (specify):
Signed l ` i / Date: C /5 7
Organization P 97C
4. Signaling Line Circuits
Quantity and class of signaling line circuits connected to system (see NFPA 72, Table 64.1):
Quantity: 'I Style: Class:
FIGURE 4.5.2.1 Record of Completion. (NFPA n, 2 of 4)
2002 Edition
re- created by fcoari
FUNDAMENTALS OF FIRE ALARM SYSTEMS
72 -33
5. Alarm-Initiating Devices and Circuits
Quantity and class of initiating device circuits (see NFPA 72, Table 6.5):
Quantity: Style: Class:
MANUAL
(a) Manual stations Noncoded Transmitters Coded Addressable
(b) Combination manual fire alann and guard's tour coded stations
AUTOMATIC
Coverage: Complete Partial
Selective Nomequired
(a) Smoke detectors Ion Photo Addressable 9
(b) Duct detectors Ion Photo Addressable
(c) Heat detectors FT RR FT/RR RC Addressable
(d) Sprinkler waterflow indicators: Transmitters Noncoded Coded Addressable
(e) The alarm verification feature is disabled or enabled , changed from seconds to seconds.
(f) Other (list):
6. Supervisory Signal- Initiating Devices and Circuits (use blanks to indicate quantity of devices)
GUARD' OU•
(a) - Cod:. 7 - • ons
(b) No • 4 - . stations
(c) ►•mpul-ary guard's tour system comprised of transmitter stations and intermediate stations
Note: Combination devices are recorded under 5(b), Manual, and 6(a), Guard's Tour.
SPRINKL : R SYST
Check if pro■i.:.
(a) Valve ' •ry switches
(b) Buil. '.: temperature points
(c) Si wate temperature points
(d) ' 'te wate supply level points
Electric ti . ...1
(e) Fire p - p power
(f) F' .. • I . running
Engine - . 'ven fir- ..••p:
(h) Sel: 'r in .. o position
(i) Engine o ennui panel trouble
(j) Fire P P • g
ENGINE ∎∎ RIVE ENERATOR:
(a) Select, in a a position
(b) Control ,„ el trouble
(c) Transfe itches
(d) En • g
Other supervi finwi on(s) (specify):
FIGURE 4.5.2.1 Record of Completion. (NFj4 n, 3 of 4)
2002 Edition
re- created by fcoari
NATIONAL FIRE ALARM CODE
72 -34
7. Annunciator(s)
Number. I Type: Qi G J9 Location: M 4 J y L. a d If y
8. Alarm Notification Appliances and Circuits
NFPA 72, Chapter 6 - Emergency Voice/Alamm 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:
Quantity and the class of notification appliance circuits connected to systems (see NFPA 72, Table 6.7):
Quantity: I Style: Class' /�
Types and quantities of notification appliances installed:
(a) Bells With Visible
(b) Speakers With Visible
(c) Horns With Visible
(d) Chimes With Visible
(e) Other: With Visible
(f) Visible appliances without audible: j
9. System Power Supplies
(a) Fire Alarm Control Panel: Nominal voltage: Current rating.
Overcurrent protection: Type: Current rating:
Location:
(b) Secondary (standby):
Storage battery: Amp -hour rating:
Calculated capacity to drive system, in hours:
Engine- driven generator dedicated to fire alarm system:
Location of fuel storage:
(c) Emergency system used as backup to primary power supply:
Emergency system described in NFPA 70, Article 700:
10. Comments
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) :r' tion contra or (title (date)
/ gip i IN r L 7
(sigf'd) for ala service company (title) date)
(signed) for central station (title) (date)
Upon completion of the system(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction):
(signed) representative of the authority having jurisdiction (title) (date)
FIGURE 4.5.2.1 Record of Completion. (NFPA n, 4 of 4)
2002 Edition
re- created by fcoari