Report (61) 1
Fire Alarm Systemr- _ 2c4c-coyziti
Record of Completion
Name of Protected Property: Triangle Pointe Ste. 210
Address: 13333 SW 68th Parkway
Representative of Protected Property (Name/Phone) S.D. Deacon
Authority Having Jurisdiction: City of Tigard
Address/Telephone Number: 13125 SW Hall Blvd, Tigard, OR 97223/503-718-242
Organization Name/Phone Representative Name/Phone
Installer: Metro Safety and Fire 503-231-2999 Marc Casey 503-231-2999
Supplier: Metro Safety and Fire 503-231-2999
Service Organization: Metro Safety and Fire 503-231-2999
Location of Record (As-Built) Drawings. Management Office
Location of Operation & Maintenance Manual(s). Management Office
Location of Test Reports: Management Office
A Contract for Test &Inspection in Accordance with NFPA standards:
Contract No(s): Effective Date: Expiration Date:
System Software:
a.Operating system(executive)software revision level(s):
b. Site-Specific software revision date: N/A
c. Revision completed by: N/A
Name Firm
1. Type(s) of System or Service:
X 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:
Trouble:
Supervisory:
if alarms are transmitted to public fire service communications centers or others, indicate location al
telephone numbers of the organization receiving arm
Indicate how alarm is transmitted
NFPA 72, Chapter 8 - Proprietary:
Telephone numbers of the organization receiving alarm:
Alarm:
Trouble:
Supervisory:
if alarms are transmitted to public fire service communications centers or others, indicate location al
telephone numbers of the organization receiving alarm
Indicate how alarm is transmitted
NFPA 72, Chapter 8 - Central Station:
Prime Contractor:
Central Station Location:
Means of transmission of signals from protected premises to the central station:
- McCulloh III Two-Way Radio
- Digital Alarm Communicator • One-Way Radio
MI Multiplex I Others
Means of transmission to the public fire service communications center:
a.
b.
System Location:
NFPA 72, Chapter 9 - Auxilliary:
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 imI
branching, but prior to conducting operational acceptance tests).
This system has been installed in accordance with the NFPA standards as shown below, was inspect
Enrique Vallejo on, Oct, 28 2015 , includes the
devices shown in 5 and 6, and has been in service since Oct, 28 2015
X NFPA 72, Chapters: 1 2 3 4 5 6 7 8 9 10 11 (circle all that apc
X NFPA 70, National Electrical Code, Article 760
X Manufacturer's Instructions.
Other (specify):
Signed: Date:
Organization: Metro Safety and Fire
3. Record of System Operation:
Documentation in accordance with Inspection Testing Form, is attached X
All operational features and functions of this system were tested by Enrique Vallejo Date:Oct, 28 20
and found to be operating properly in accordance with the requirements of:
X NFPA 72, Chapters: 1 2 3 4 5 6 7 8 9 10 11 (circle all that apT
X NFPA 70, National Electrical Code, Article 760
X Manufacturer's Instructions.
Other (specify):
Signed: Date:
Organization: Metro Safety and Fire
4. Signaling Line Circuits:
Quantity and class of signaling line circuits connected to system ( see NFPA 72, Table 6.6.1):
Quantity: Style: Class:
5. Alarm Initiating Devices &Circuits:
Quantity and class of Initiating Device circuits ( see NFPA 72, Table 6.5):
Quantity: Style: 4 Class: B
Manual
(a) Manual Stations Noncoded Transmitters Coded Addressable
(b) Combination manual fire alarm&guard's tour coded stations:
Automatic
Coverage: Complete Partial
Selective Nonrequired
(a) Smoke Detectors: Ionization 0 Photelectric Addressable
(b) Duct Detectors: Ionization Photelectric Addressable
(c) Heat Detectors: FT RR RC Coded Addressable
(d) Sprinkler Waterflow indicators: Coded Noncoded Transmitters Addressable
(d) The alarm verification feature is disabled or enabled ,changed from seconds to seconds.
(f) Other( list)
6. Supervisory Signal-initiating devices &circuits ( use blanks to indicate device quantity )
Guard's Tour
(a) Coded Stations
(b) Noncoded Stations
(c) Compulsory guard's tour system comprised of transmitter stations&intermediate stations.
Note: Combination devices are recorded under 5(b), Manual, and 6(a),Guard's Tour.
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 Fire 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 in auto position
(b) Control panel trouble
(c) transfer switches
(d) Engine running
Other supervisory function(s) (specify):
7. Annunciators
Number: Type: Location:
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 telephonejacks included in system
Quantity and the class of notification appliance circuits connected to system ( see NFPA 72,Table 6.7):
Quantity Style Class
Types&Quantities of Notification Appliances Installed:
(a) Bells with visible
(b)Speakers with visible
(c) Horns 10 with visible 10
(d) Chimes with visible
(e)Other with visible
(f)Visible appliances without audible
9. System Power Supplies
(a) Fire Alarm Control Panel: Nominal Voltage: 120vac Current Rating 1.15a
Overcurrent Protection Type Breaker Current Rating
Location: House Panel Next to FACP
(b) Secondary(standby)
Storage Battery Power Patrol SEC1075 Amp-hour rating 8
Calculated capacity to drive system, in hours 24 hours standby then 5 min in alarm
Engine driven generator dedicated to fire alarm system:
Location of fuel storage:
(c) Emergency system used as backup to primary power supply:
Emergency system desribed in NFPA 70,Article 700
10. Comments
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s):
Monthly Bells and Pull Test,and Annual Alarm Panel
System Deviations from the referenced NFPA standard(s)are:
3
Apirsigned)for n- .Ilation contractor/supplier Title (:a -)
:gned)for acrservice company Title ' (d:te)
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(signet fer. ral station Title d to
Upon ompletion of the system(s)satisfactory test(s)witnessed ( if required by the Authority Having Jurisdiction):
/7/3
(sighed) represent. ve of the Authority Having Jurisdiction Title (da e)