Report •
i �Saeio - 0ol (3/
pi INDAMFNTAL`i OF FIRE ALARM SYSTEMS 72-91
FIRE ALARM SYSTEM
'' RECORD OF COMPLETION
I
Name of protected property: ! 1 /IH g ' C '�
Address: _ 1 U "% ( Cu ICALA . eve _... -
Representative of protected property thorny/phone): -
Authority having jurisdiction:
Address/telephone number:
Organization name phone Representative name 'phone
Installer_. u 44. , /- .t, SA, dff
Supplier f r o ..
Service organization — - ..
Location of record las- built.) drawings: c2"- tG -r
Location of operation and maintenance manuala: a" - 5 ; G -
Location of test reports: -J � - • •
A contract for teat and inspection in accordance with NFPA standard(a)
Contract No(s): —,. Effective date: _ _ Expiration date:
System Software
(a) Operating system (executive) software revision level(s):
(b) Site - specific software revision. date:
(c) Revision completed by: (name) (lIrm)
1. Types) of System or Service
—NFPA 72, Chapter 6 — Local
If alarm is transmitted to location(s) off premises, list where received: _
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 5 — Proprietary
Telephone numbers of the organization receiving alarm:
Alarm: m - -.—
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 - Ce teal Station
Prime contractor: Gods
Central station location:
(NFPA 72, 1 o14)
FIGURE 4.5.2.1 Record of Completion.
2002 Billion
72 - NATIONAL.. FIRE ALARM CODE
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 -
NP,PA 72, Chapters 1 2 3 l:J COT q 10 11 (circle all that apply)
NI'PA 70, National Electrical Code, Article 760
Manufacturer's instructions
— Other (spsci fy ):
Signed: .�� 1 Date: /0- / 3 /0
Organizati - --
3. Record of System Operation
Documentation in accordance with Inspection Testing Form, Figure 10.6.2,3, is attached
All operational features and functions of this system were tested by....... date
and found to be operating properly in accordance with the requirements of
NFPA 72, Chapters 1 2 3 4 5 6 7 8 b XO 11 (circle all that apply)
NFPA 70, National Electrical Code, Article 760
ck Manufacturer's instructions
Other (specify): _
Signed: (2,c4---' 1, rn Date /0
Organization: Sa f t - _
4. Signaling Line Circuits
Quanti and class of'signaling line circuits connected to system (see NFPA 72, Table 6.6.1):
Quantity. —_.. J . style: Class: ,,e -.
(NFPA 72, 2 01 4)
FIGURE 4.5.2.1 Continued
2002 Edition
FUNDAMENTALS OF FIRE ALARM Sl'51TMS 72 -33
5. Alarm - Initiating Devices and Circuits
Quantity and class of initiating device circuits (see NFPA 72, 7hble 8.5):
Quantity: ! Style: Y elaaa: 5 C'
MANUAL
(a) Manual stations Noncoded Transmitters Coded Addressable.
(b) Combination manual fire alarm and guard's tour coded stations
AUTOMATIC
Coverage: Complete Partial
Selective Nonrequired T _ —
(a) Smoke detectors Ion � Photo Addressable C(
(h) Duct detectors Ion Ai Photo Addressable AL
(c) Heat detectors F1' _ RR FT/RR„ _ RC Addressable
(dl Sprinkler waterflow indicators: Transmitters _ Noncuded Coded Addressable
(el The alarm verification feature is disabled or enabled _ , changed from seconds to seconds.
(f) Other (list): ,
6. Supervisory Signal - Inflating Devices and Circuits (use blanks to indicate quantity of devices)
GUARD'S TOUR
(a) Coded stations
(b) _Nonroded stations
(c) Compulsory guard's tour system comprised of transmitter stations and intermediate stations
Note: Combination devices are recorded under 6(h), Manual, and 6(a), Guard's Thur.
SPRINKLER SYSTEM
Check if provided
(a) „ Valve supervisory switches
( b) Building temperature points
(c) Site water temperature points
(d) Site water supply level points
Electric tire 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:
(a) Selector i auto position
(1)1_,.. Control panel trouble
(c) _Transfer switches
(dl Engine running
Other supervisory function(s) (specify):
(NR44 72, 3 of 4)
FIGURE 4.5.2.1 Continued
2002 Edition
72 -w4 NATIONAL FIRE ALARM CODF
7, Annunciator(s)
Number: 7 Type: std e Loca tion:. (�y AA --
8. Alarm Notification Appliances and Circuits
NFPA 72, Chapter 6 .. 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: _
Quantity and the class of notification appliance circuits connected to system (see NFPA 72, Table 8.7):
Quantity:_ 2 Style: ( _ Class:
Types and quantities of notification appliances installed:
la) Bells With Visible _,
( b i Speakers _... With Visible
( c) Horns ,. ) With Visible Y)
Id) Chimes. With Visible
(el Other: With Visible,.,
(fi Visible appliances without audible: X
9. System Power Supplies
(a) Fire Alarm Control Panel: Nominal voltage: Ili Current rating: Jam.
Overcurrent protection: Type: U I /A- fc t,e^ Current rating: IQ 4 - —_
Location: PO 4 CL 4dL-.2.
(b) Secondary (standby):
Storage battery: ) Amp -hour rating: 7 jaj.._
Calculated capacity to drive system, in hours: k S ,
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:
l i1 G Nice: •A fry - J3-
(signed) 1 r Installation co�r ractor /auppller (title) Oslo)
(sionod) for alarm service company (title) (date)
(signed) for central a = on (title) W (dale)
Upon co plotion the • em(s) satisfactory testis) witnessed (if required y the authority having jurisdiction):
r— 6/ l 0
(signors) representative of the authority Raving jurisdiction (title) (date)
(NFPA 72, 4 of 4)
FIGURE 43.2.1 Cantiuued
2002 Edition