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Report "P$ f_ o00-6 Certificate of Completion Name of Protected Property: WASINGTON SQUARE MALL Address: 9618 SW WASHINGTON SQUARE RD—Suite G04/05 Helzberg Diamonds TIGARD, OR Rep. of Protected Prop. (name/phone):ROGER OTT(bldg engineer) 503-639-8860 Authority Having Jurisdiction:CITY OF TIGARD—FIRE AND RESCUE Address: 13125 SW HALL BLVD TIGARD, OR 97223 Phone Number:503-718-2439 1. Type(s) of System or Service: X NFPA 72,Chapter 3 -Local If alarm is transmitted to location(s)off premise, list where received: 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 system: NFPA 72, Chapter 4-Auxiliary Indicate type of connection: Local energy, Shunt, Parallel 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 fire service communications center or others, indicate location and telephone number of the organization receiving alarm: Indicate how alarm is retransmitted: Updated: 7/17/2013 Page 1 X NFPA 72, Chapter 4-Central Station The Prime Contractor:SIEMENS INDUSTRY, INC. Central Station Location: Dallas Call Center 1-866-552-7823 Means of transmission of signals from the protected premise 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: 1. Telephone 2. System Location: 9585 SW WASHINGTON SQUARE DRIVE TIGARD, OR Organization Name/Phone Representative Name/Phone Installer Frahler Electric Supplier SIEMENS INDUSTRY CHARLES HUGHES 503-207-1900 Service Organization SIEMENS INDUSTRY SERVICE DEPT 503-207-1900 Location of Record (As-Built) Drawings: WASHINGTON SQUARE MALL FACILITIES DEPT Location of Owners Manuals: WASHINGTON SQUARE MALL FACILITIES DEPT Location of Test Reports: WASHINGTON SQUARE MALL FACILITIES DEPT A contract, dated for test and inspection in accordance with NFPA standard(s) No.(s) dated is in effect. 2. Certification of System Installation This system has been installed in accordance with the NFPA standards as listed below, was inspected by .-4' lt,2cr.r-r ve on `7.-/-C--3 , includes the devices listed below and has been in service since '-,--a.—/3 X NFPA 72, Chapters X4 X 5 X6 X7 X 10 X NFPA 70, National Electrical Code, Article 760 X Manufacturer's Instructions Other(specify : Signed: ..,f----_ Date: 1-- id-_/? Organization: .e■-i ff—r✓S Updated: 7/17/2013 Page 2 3. Certification of System Operation All operational features and functions of this partial system were tested by Sean Blackstone on 07/16/2013 and found to be operating properly in accordance with the requirements of: X NFPA 72, Chapters X4 X5 X6 X7 X 10 X NFPA 70, National Electrical Code, Article 760 X Manufacturer's Instructions Other(speci : 4) Signed: Date: 7/16/13 Organization:SIEMENS INDUSTRY, INC. 4. Alarm Initiating Devices and Circuits MANUAL a) Manual Stations Noncoded, Activating Transmitters Coded b) Combination Manual Fire Alarm and Guard's Tour Coded Stations AUTOMATIC Coverage: Complete NO Partial YES a) 2 Smoke Detectors: Ion 2 Photo b) Duct Detectors: Ion Photo c) Heat Detectors: FT RR FT/RR RC d) Sprinkler Water Flow Switches: Noncoded, Activating Transmitters Coded e) Other(list): 5. Supervisory Signal Initiating Devices and Circuits GUARD'S TOUR a) 0 Coded Stations b) 0 Noncoded Stations Activating 0 Transmitters c) 0 Compulsory Guard Tour System Comprised of 0 Transmitter Stations and 0 Intermediate Stations Note: Combination devices recorded under 4(b) and 5(a). SPRINKLER SYSTEM a) 0 Coded Valve Supervisory Signaling Attachments Valve Supervisory Switches Activating Transmitters b) 0 Building Temperature Points c) 0 Site Water Temperature Points d) 0 Site Water Supply Level Points Updated: 7/17/2013 Page 3 Electric Fire Pump: e) 0 Fire Pump Power f) 0 Fire Pump Running g) 0 Phase Reversal Engine-Driven Fire Pump: h) _ 0 Selector in Auto Position i) 0 Engine or Control Panel Trouble j) 0 Fire Pump Running Engine-Driven Generator: k) 0 Selector in Auto Position I) 0 Control Panel Trouble m) 0 Transfer Switches n) 0 Engine Running Other Supervisory Function(s) (specify): 6. Alarm Notification Appliances and Circuits Quantity of indicating appliance circuits connected to the system: Types and quantities of alarm indicating appliances installed: a) 0 Bells Inch 0 Speakers b) Horns c) Chimes d) 0 Other: e) Visual Signals Type: with audible w/o audible f) 0 Local Annunciator 7. Signaling Line Circuits: Quantity and Style of signaling line circuits connected to system: Quantity: Style: 8. System Power Supplies a) Primary(Main): Nominal Voltage: Current Rating: Overcurrent Protection: Type: Current Rating: _ Location: b) Secondary(Standby): Storage Battery: Amp-Hour Rating Calculated capacity to drive system, in hours: Engine-driven generator dedicated to fire alarm system: Location of fuel storage: Updated: 7/17/2013 Page 4 c) Emergency or Standby System used as backup to Primary Power Supply, instead of using a Secondary Power Supply: 0 Emergency System described in NFPA 70, Article 700 0 Legally Required Standby System described in NFPA 70, Article 701 0 Optional Standby System described in NFPA 70, Article 702, which also meets the performance requirements of Article 700 or 701 9. System Software a) Operating System Software Revision Level(s): b) Application Software Revision Level(s): c) 7/16/13 Revision Completed by: Sean Blackstone SIEMENS (name) (firm) 10. Comments: This project was for the purpose of a remodel space only, it involved the addition of 2 smoke detectors in the retail area of the space. PROJECT MANAGER 07/16/2013 (signed) fo arm Service Company (title) (date) 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: None raoPROJECT MANAER 07/16/2013 (signed)for IIPP. Service Company (title) (date) Upon completion of the system(s) satisfactory test(s)witnessed (if required by the authority having jurisdiction: 07/18/2013 (signed) representative of the authority having jurisdiction (title) (date) Updated: 7/17/2013 Page 5