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Report FF5Z&1 - ©oIi 7i FUNDAMENTALS OF FIRE ALARM SYSTEMS `,..1 72-31 FIRE ALARM SYSTEM RECORD OF COMPLETION Name of protected property: DiLorenzo and Company Address: 10300 SW Greenburg Rd Representative of protected property(name/phone): Authority having jurisdiction: City of Tigard Address/telephone number: Organization name/phone Representative name/phone Installer Safe Technology Group 360-699-2130 Supplier Safe Technology Group 360-699-2130 Service organization Safe Technology Group 360-699-2130 Location of record(as-built)drawings: FACP Location of operation and maintenance manuals: FACP Location of test reports: Central Station 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 level(s): (b)Site-specific software revision date: (c)Revision completed by: (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: 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: X NFPA 72, Chapter 8—Central Station Prime contractor: Central station location: (NFPA 72,1 of 4) FIGURE 4.5.2.1 Record of Completion. 2002 Edition 72-32 NATIONAL FIRE ALARM CODE Means of transmission of signals from the protected premises to the central station: McCulloh Multiplex One-way radio X 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—Auxillary 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 Safe Technology Group Inc on 9-19-13 ,includes the devices shown in 5 and 6,and has been in service since 9-19-13 • X NFPA 72,Chapters 1 2 3 k k k 7 05 R 10 11 (circle all that apply) X NFPA 70,National Electrical Code,Article 760 X Manufacturer's instructions Other(specify): s�Signed: / 51,) Date: 9-19-13 Organization: Safe Techno gy Group 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 Safe Tech Group date 9-19-13 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 X) 11 (circle all that apply) X NFPA 70,National Electrical Code,Article 760 X Manufacturer's instructions Other(specify): Signed: /27 Date: 9-19-13 Organization: Safe Technology Group 4.Signaling Line Circuits Quantity and class of signaling line circuits connected to system(see NFPA 72,Table 6.6.1): Quantity: NA Style: Class: (NFPA 72,2 of 4) FIGURE 4.5.2.1 Continued 2002 Edition 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: NA Style: Class: MANUAL (a)Manual stations Noncoded Transmitters Coded Addressable (b)Combination manual fire alarm and guard's tour coded stations AUTOMATIC Coverage: Complete K Partial Selective Nonrequired (a)Smoke detectors Ion Photo Addressable (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'S TOUR (a) Coded stations (b) Noncoded stations (c) Compulsory 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. 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): (NFPA 72,3 of 4) FIGURE 4.5.2.1 Continued 2002 Edition • 72-34 NATIONAL FIRE ALARM CODE 7.Annunciator(s) Number: NA 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 telephone jacks included in system: Quantity and the class of notification appliance circuits connected to system(see NFPA 72,Table 6.7): Quantity: 1 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: 2 9.System Power Supplies (a) Fire Alarm Control Panel: Nominal voltage: 120VAC Current rating: Overcurrent protection: Type: Breaker Current rating: 20A Location: (b) Secondary(standby): Storage battery: 2 Amp-hour rating: Calculated capacity to drive system,in hours: 24 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: NICET IlI 9-19-13 (signed)for installs n contractor/supplier (title) (date) (signed)for alarm 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) (NFPA 72,4 of 4) FIGURE 4.5.2.1 Continued 2002 Edition