Report AUG -10 -2012 14:38 FROM:LIMITED ENERGY NW 3605463728 T0:15036243681 P.1'4
LIMITED ENERGY NORTHWEST
P.M.R. 190 3439 N.E. SANDY DI.VU. PORTLAND, OR 97232 TEL :503.810.7331 FAX: 360.946.3728
CCB M 131668
FACSIMILE COVER SHEET
TO: Walter Barnett IV DATE: 10 AUG 2012
COMPANY: City of. Togard
FAX NUMBER: 503.624.3681
FROM: Ed Bullard
MESSAGE: Here is the Certificate of Completion for Permit
FPS2012- 00099. /34/ d s4_/ 7i
Thank You.
d c.
,:_
Ed Bullard
Owner
Limited Energy Northwest
PAGES, INCLUDING COVER SHEET: A-
AUG -10 -2012 14:38 FROM: LIMITED ENERGY NW 3605463728 TO:15036243681 P.2/4
National Fire Alarm Code - Certificate of Completion
Name of Protected Propett 6,4ov /glaze Permit #: 0/2 -6 609 9
Physical Address: I�, //6 �_ Suite#:
Rep. Of Protected Property (name /phone): ?ik 4CAA t Ac- S s`/ /• bye)
Authority Having 'Jurisdiction: -'r' (g.A taj
Address/Phone Number: ( .: . r - L- 41. J 4c w
I . Typc(s) of System or Service:
NFPA 72, Chapter 3 —Local
If alarm is transmitted to location(s) off premises, list where received:
CAat .s 1 .i_0 ,) AMA-P/2547 41 , 4CAPA OR
�NFPA 72, Chapter 3— 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 this System;
__NFPA, Chapter 4-- Auxiliary
Indicate Type of Connection:
Local Energy Shunt Pantllel Telephone
Location and Telephone Number for Receipt of Signals:
_NFPA 72, Chapter 4— Remote Station
Alarm:
Supervisory:
NFPA 72, Chapter 4—Proprietary
If alarms are retransmitted to public tire service communications center or others, indicate locution
and telephone number of the organization receiving the alarm:
Indicate how alarm is retransmitted: m
_NFPA 72, Chapter 4—Central Station
The Prime Contractor:
,LAt 'TED drAla2:9 A/6,47: /PD .3w7a '7 ATz7` d,!?
Central Station Location:
Seawi sal —StssimineRCE l.S7.5 4 e /2
Means of Transmission of Signals from the Protected Premise to the Central Station:
McCulloh Multiplex One -Way Radio Two -Way Radio
Digital Alarm Communicator Other
Means of transmission of alarms to the public fire service communications center:
2.
System Location:
Organization Nama/Phune Representative Name/Phong
Installer b1 olfir .= A lJ Ed , � UGC P1 -5 3 €r /4 3 /
Supplier
Service Organization $' fis-r-
RUG -10 -2012 14:39 FROM:LIMITED ENERGY NW 3605463728 TO:15036243681 P.3'4
rg
Physical Address /3'/'v —Co) 76 Aar 770
Location of Record (As- Built) Drawings:
Site
Location of Owners Manuals:
Site. C ) J27i l t.) d F
Location of Test Reports:
Site Z,A 5 e 7F J et) ,'
2, Certification of System Installation:
(Fill out after installation is complete and wiring checked for opens, shorts. ground faults, and improper
branching, but prior to conducting operational acceptance tests.)
/ This c stem has been installed in accordance with the N standards as listed below, was inspected by
c is / on R/7/P-. includes the devices listed below and has been in service since ,,/
NFPA 72, Chapters (1.)4 3 0 5 6 a (citete all that apply)
NFPA 70, National Electrical Code, Article 760
x Manufacturer's Instructions
Other (specify): �j
I
Signed: /� Date: AY/eV/2o
Organization: ,( / /740 irAE1- / ^, (44 7,4e14.1.(;
3. Certification of System Operation: /
All Operational features and functions of this system were tested by.ficr . �{ F / ?
And found to be operating properly in accordance with the requirements of
NFPA 72, Chapters () 3 5 6 f) (circle•all that apply)
✓ NFPA 70, National Electrical Code. Article 760 •
.l Manufacturer's instructions
Otberispecify):
Signed: / Date �� l?
Organization! _ _ .•
4. Alarm Initiating Devices and Circuits (Use blanks to indicate quantity of devices.):
MANUAL
a) _ Manual Stations
AUTOMATIC
a) . Smoke Detectors _ Ion I Photo
h) _ Duct Detectors _ len _ Photo
c) _ Heat Detectors _ FT _ RR _ Fr/RR _RC
d) _ Sprinkler Water Flow Switches
e) _ Other (list):
Page 2 of 3 Form 7
AUG -10 -2012 14:39 FROM: LIMITED ENERGY NW 3605463728 TO:15036243681 P.4'4
Physical Address / 4'f (5J 7 Aar /,
S. Supervisory Signal initiating Devices and Circuits (Use blanks to indicate quantity of devices.):
Sprinkler System: Electric Fire Pump:
a) _ Tamper Switches c) - Fire Pump Power
b) Building Temperature Points f1 Fire Pump Running
c) . Site Water Temperature Points g) _ Phase Reversal
cl) Site Water Supply Level Points
Engine- Driven Firc Pump: Engine- Driven Generator:
h) _ Selector in Auto Position k) Selector in Auto Position
i) Engine or Control Panel trouble I) _ Control Panel Trouble
j) _ Fire Pump Running m) Transfer Switches
n) Engine Running
Other Supervisory Function(s) (specify):
6. Alarm Notification Appliances and Circuits:
Quantity of indicating appliance circuits connected to the system: 2-
Types and Quantities of Alarm Indicating Appliances Installed:
a) _ Hells
h) Speakers
c) Horns
d) j Horn/Strobes
e) _ Speaker /Strobes
f) _ Strobes
7. Signaling Line Circuits:
Quantity and Style (See NFPA 72, Table 3-6.1) of signaling line circuits connected to system:
Quantity: � Style.
8. System Power Supplies: //
a) Primary (Main): Nominal Voltage: l/() Current Rating: 1-f.)
Overcurrent Protection: Type: Rating:
Location: U or _.d it ____ P�
b) Secondary (Standby):
Storage Buttery: Amp Hour Rating: 7 d,4
Calculated Capacity to Drive System, in hours: 24 _60
Engine- Driven Generator Dedicated to Fire Alarm System.
Location of fuel Storage :_
c) Emergency or Standby System used as back up to Primary Power Supply, instead of using a Secondary
Power Supply:
_ Emergency System Described in NFPA 70, Article 700
_ Legally Required Standby System described in NFPA 70, Article 701
_ Optional Standby System described in NFPA 70, Article 702, which also meets the performance
requirements of Articles 700 and 701.
c). System Software:
Operating System Software Revision Level(s):
Application Software Revision Level(s):
Revision Completed By: Date:
Signature:
Firm:
Page 3 of 3 Form 7