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Report • 60v ' s-�� —22 2 FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 -31 FIRE ALARM SYSTEM RECORD OF COMPLETION Name of protected property Winco Tigard Tenant Remodel - System Existing Address: 7501 SW Dartmouth Street Representative of protected property (carne, phone): g)urisdiction: Mike with bSI Authority Address/ t Ci of Ti and elePh°n frnber: 11125 SW Hall Blvd, Tig , Organization name / phone �W Installer. Representative name /phone ��� Ted, Communications, Inc 360- 737 -9725 Larry Bushaw T CQgamunications, Inc Service organization: Location of record (as-built) drawings: Engineered Structures Nation of operation and maintenance manuals: Winco Tigard Locatbnof test rivals: ESI & Winco Tigard A conhact for test and Inspection In accordance with NFPA standard(s): Contract ms Effective Data Expiration date: System Software (a) Operating system (executive sire revision level(a): Honeywell (b) note revision date: N/A Analog (c) Revision completed by N/A (name) (firm) 1. Type(s) of System or Service NFPA 72, Chapter t3 - Local !teem Is transmitted to tocation(s) off premises, fist where received: NFPA 72, Chapter 8 - R emote Station Telephone scribers of the organization receiving alarm: Alarm SupeMsory Trouble: If alarms are retransmitted to public fire service communkaiton center*: others, Indicate location and telephone numbers of the organization receMng etarm: indicate tow alarm Is retransmitted: NFPA 72, Chapter 8 - Proprietary Telephone numbers of the argenlzauon receMrg alarm: Alarm: Supervisory; Trouble: If alarms are retransmitted to public fire service communication center or others, Indicate location and telephone numbers of the organization receiving alarm: Indicate how steam is rehansinftted: NFPA 72, Chapter 8 - Central Station Prime Contractor: Central Station Location: (NFPA 72, of 4) FIGURE 4.5.2.1 Record Completion d pi 72 -32 NATIONAL FIRE ALARM CODE Means of transmission of signals from the protected premises to the central station: McCulloh MutIplac One -way radio Digital alarm cOmmunIcatcr 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 oonnectlon: Local energy Shunt Parallel Telephone Location of telephone number for receipt of signals: 2. Record of System Installation (Flu out after Instillation Is complete and wiring is checked for opens, shorts, ground faults, and Improper wing but prix to conducting operational acceptance tests.) This system has bean 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 ace NFPA 72. Chapters (d,euc.a see aPPit ❑ 1 02 ❑ 3 04 0 5 ❑ 6 ❑ 7 0 ❑ 9 ❑ 10 011 NFPA 70, National Efecbkal Code Article 760 Marsufactrxer's instructions O (specify) Signed: Date: Oqgartzstlon: 3. Record of System Operation Documentation In accordance with Inspection Testing Fonn, Figure 10.8.2.3, Is attached All operational !sabres and functions of this system were tasted by. Date: and found to be operatb g property In acoordarroe with the requirements of: NFPA 72, Chapter roma that ars") ❑ 1 02 03 04 ❑ 5 0 ❑ 7 ❑8 0 0 1 011 NFPA 70, Notional Eieancat Code, Article 780 Manufacturer's instructions Other (specify) Signed: Date: Organization: 4. Signaling Une Circuits Quantity and class of signaling Ana circuits connected to system (see NFPA 72 table 6.8.1): Q style: Class: (NFPA 72 , 2 of 4) FIGURE 4.5.2.1 Cosdlntrad FUNDAMENTALS OF FIRE ALARM SYSTEM 72-33 5. Alarm- initiating Devices and Circuits Quantity and c1as8 of Initatt1ng device circuits (see NFPA 72, Table 6.5) Ouant ty: Style: Class: MANUAL (a) Manual stations Noncodad Tran's'mitters Coded Addressable (b) Combination manual fire alarm end guard's tour coded stations: • AUTOMATIC ram= Complete Partial Selective Nonrequked (a) Smoke Detectors Ion Photo Addressable (b) Dud Detectors lei Photo Addressable (c) Heat Detectors FT RR FT/RR RC Addressable (d) SprinlderWaterlbwindicators: Transmitters Noncoded Coded Addressable (e) The alarm veri<ioadlon feature Is disabled or enabled , changed tan seconds to aeoonds. (f ) Other ): • 6. Supervisory Signal - initiating Devices and Circuits (use blanks to indicate quantity of devices) GUARD'S TOUR (a) Coded stations (b) Noncaded stations (0) Compulsory guard's tea system comprised of transmitter stations and Intermediate stet ons Na: at Combination devices ars recorded under 5(b), Manual, and 6(a), Guard's Tour SPRINKLER SYSTEM Check If Provided (a) Vatve supervisory switches ❑ (b) Building temperature ponds ❑ (0) Site water ternperabrae paints ❑ (d) Sae water supply Wet points ❑ Electric Fire Pimp: (e) Fire pump per ❑ (t) Fire lump running ❑ (g) Phase reversal ❑ Engine- driven Fire pump: (h) Selector In auto position ❑ (1) Engine or control pond trouble ❑ (j Fire pump naming ❑ ENGINE-DRIVEN GENERATOR (a) Selector In auto position ❑ (b) Control panel trouble ❑ (c) Transfer switches ❑ (d) Engine running ❑ Other supervisory function(o) (specify): FGURE 4.5.2.1 Continued (NFPA 72,3of4) • 7234 NATIONAL FIRE ALARM CODE 7.Annunciator(s) Number Type: Location: 8. Alarm Notification Appliances and Circuits NFPA 72 , Chapter 6 - Emergency Voloe/Alarm SeMce Quantity of volcdatarm channels: Single: MuHiple: Quantity of speakers Installed: Quantity of speaker zones : Quantrly of telephones or telephone )asks Included In system: Quarter anal the class of notification appliance circuits connected to system (see NFPA 72, Table 67): Quantity: Style: Class: Types and quardtties of notification appliances Installed: (a) Seas With Visible (b) Speaker' With Visible (c) Morns 3 Wheelock 24MCW With Visible Yes (d) Chimes With Visible (e) Other: With Visible (f) Visible appliances wdtotd audible: 9. System Power Supplies (a) Fire Alarm Control Panel: Nonniral Voltage: Current rating: Overcurrent protection: Type: Current rattan: Location: (b) Secondary (standby): Storage Battery. Amp -hour rating: Calculated capacity to drive system , Uh hours: Er>glne-drhren generator dedicated to fire alarm system: Location of fuel storage: (c) Emergency system used as backup to primary parer supply: Emergency system described In NFPA 70, Article MO: 10. Comments Frequency of routine tests end Inspections, if other than in accordance with the referenced NFPA standard(s); System devteUona from the referenced NFPA standard(s) are: (714 President 10 -22 -2008 (signed) for Inatallatiod or /supper (tale) (date) 1 (signed) for alarm service company (title) (date) 1 (signed) for centsal station (title) (date) Upon completion of the systern(s) satisfactory tests) witnessed (if required by the authority having ) ): 1 ( signed) representative of the authority having jurisdiction , Rte) (date) 'FIGURE 446.2.1 Continued (NFPA 72, 4 014)