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Report The Star Electric Grou057SZot -oe(S'S • Stoner Electric ♦ Advanced Entry Systems • Commercial Electric ♦ Stoner Controls•Stoner Protective Systems FIRE ALARM SYSTEM RECORD OF COMPLETION To be completed by the system installation contractor at the time of system acceptance and approval. 1. Protected Property Information Name of property: Umpqua Bank—0021 PCC Address: 6610 SW Cardinal Lane,Tigard,OR.97224 Description of property: Occupancy type: commercial Name of property representative: Umpqua Bank Address: 6610 SW Cardinal Lane,Tigard,OR.97224 Phone: Fax: E-mail: Authority having jurisdiction over this property: City of Tigard Phone: Fax: E-mail: 2. Fire Alarm System Installation, Service, and Testing Information Installation contractor for this equipment: Stoner Protective Address: 1904 S.E.Ochoco Milwaukie,Or.97222 Phone: 503-462-6500 Fax: 503-659-2765 E-mail: www.stonergroup.com Service organization for this equipment: Stoner Protective Address: 1904 S.E.Ochoco Milwaukie,Or.97222 Phone: 503-462-6500 Fax: 503-659-2765 E-mail: www.stonergroup.com Location of as-built drawings: Location of Historical Test Reports: Location of system operation and maintenance manuals: A contract for test and inspection in accordance with NFPA standards is in effect as of Contracted testing company: Stoner Protective Address: 1904 S.E.Ochoco Milwaukie,Or.97222 Phone: 503-462-6500 Fax: 503-659-2765 E-mail: Contract expires: Contract number: Frequency of routine inspections: 3. Type of Fire Alarm System or Service NFPA 72*, Chapter Reference of System Type: Name of organization receiving alarm signals with phone numbers(if applicable): Alarm: Central Station monitoring Phone: 1-800-722-0364 Supervisory: Central Station monitoring Phone: 1-800-722-0364 Trouble: Central Station monitoring Phone: 1-800-722-0364 Entity to which alarms are retransmitted: Phone: Method of retransmission of alarms to that organization or location: NFPA 72, Fig.4.5.2.1 (p. 1 of 5) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 11 Lilaptu1 0,IIViC UIC 111Ca118 U1 11a118IIIISSIU11 110111 1110 1)1V101:1CU p101111805 W U1C 0Cl1Ual 81.411011. 0 Digital alarm communicator ❑McCulloh ❑Multiplex ❑2-way radio ❑ I-way radio ❑N/A If Caapter 9,note the type of connection: ❑Local energy ❑Shunt ❑N/A 3.1 System Software Operating system(executive)software revision level: 12 Site-specific software revision date: Revision completed by: 4. Signaling Line Circuits Characteristics of signaling line circuits connected to this system(see NFPA 721, Table 6.6.1): Quantity: 4 Style: Y Class: B 5. Alarm-Initiating Devices and Circuits Characteristics of initiating device circuits connected to this system(see NFPA 721, Table 6.5): Quantity: 1 Style: 4 Class: B 5.1 Manual Initiating Devices 5.1.1 Manual Pull Stations Number of manual pull stations: 7 Type of devices: ❑Addressable ®Conventional ❑Coded ❑Transmitter ❑N/A 5.2 Automatic Initiating Devices 5.2.1 Area Smoke Detectors Number of smoke detectors: 27 Type of coverage: ❑Complete area ®Partial area ❑Nonrequired partial area ❑N/A Type of devices: ®Addressable 0 Conventional ❑Coded ❑Transmitter ❑N/A Type of smoke detector sensing technology: ❑Ionization 0 Photoelectric 5.2.2 Duct Smoke Detectors Number of duct smoke detectors: 3 Type of coverage: Type of devices: ®Addressable ❑Conventional ❑Coded ❑Transmitter ❑N/A Type of smoke detector sensing technology: ❑Ionization ❑Photoelectric 5.2.3 Heat Detectors Number of heat detectors: 0 Type of coverage: ❑Complete area ❑Partial area ❑Nonrequired partial area ❑N/A Type of devices: ❑Addressable ❑Conventional ❑Coded ❑Transmitter ❑N/A 5.2.4 Sprinkler Waterflow Detectors Number of waterflow detectors: 1 Type of devices: ®Addressable ❑Conventional ❑Coded ❑Transmitter ❑ N/A 5.2.5 Alarm Verification Number of devices subject to alarm verification: Alarm verification on this system is:❑Enabled ❑Disabled ❑Set for seconds 6. Supervisory Signal-Initiating Devices and Circuits 6.1 Sprinkler System Number of valve supervisory switches: 1 Type of devices: 0 Addressable ❑Conventional ❑Coded ❑Transmitter ❑N/A 6.2 Fire Pump Type of fire pump: ❑Electric ❑Diesel Type of fire pump supervisory devices: ❑Addressable ❑Conventional ❑Coded ❑Transmitter ❑N/A Fire Pump Functions Supervised NFPA 72. Fig. 4.5.2.1 (p. 2 of 5) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. U rue pump puwcl U rut puutp iuwuug U rile pump pua.se Iev el Jill U 3ClecLUI NWJNal uul lit aulu ❑Engine or control panel trouble ❑Low fuel Other,: 6.3 Engine-Driven Generator Type of generator supervisory devices: ❑Addressable ❑Conventional ❑Coded ❑Transmitter ❑N/A ❑Engine or control panel trouble ❑Generator running ❑Selector switch not in auto ❑Low fuel Other: 7. Annunciators 7.1 Annunciator 1 ®Local ❑Remote Type: ta Addressable ❑Directory ❑Graphic ❑N/A Location: At FACP 7.2 Annunciator 2 ❑Local ®Remote Type: ®Addressable ❑Directory ❑Graphic ❑N/A Location: At Main Entry 7.3 Annunciator 3 ❑Local ❑Remote Type: 0 Addressable ❑Directory ❑Graphic ❑N/A Location: 8. Alarm Notification Devices and Circuits 8.1 Emergency Voice Alarm Service Number of single voice alarm channels: Number of multiple voice alarm channels: Number of speakers: Number of speaker zones: 8.2 Telephone Jacks Number of telephone jacks installed: Number of telephone handsets stored on site: Type of telephone system installed: ❑Electrically powered ❑Sound powered ❑N/A 8.3 Nonvoice Audible System Characteristics of notification device circuits connected to this system(see NFPA 72., Table 6.5): Quantity: 4 Style: Y Class: B 8.4 Types and Quantities of Nonvoice Notification Appliances Installed Bells: With visual device: Horns: 15 With visual device: Chimes: With visual device: Bells: With visual device: Visual devices without audible devices: 8 Other(describe): 9. Emergency Control Functions Activated ®Hold-open door releasing devices ❑Smoke management or smoke control ❑Door unlocking ®Elevator recall ❑Other 10.System Power Supply 10.1 Primary Power Nominal voltage: 120VAC Amps: 3.6 Overcurrent protection: Type: Circuit Breaker Amps: 20 Location(of primary supply panelboard): Panel L2 Ckt 8 Disconnecting means location: 2n°Floor Electrical room by FACP NFPA 72, Fig.4.5.2.1 (p. 3 of 5) Copynght©2009 National Fire Protection Association This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 1 io.h aeconuary rower Location: In FACP Type: Nominal voltage: 24vdc Current rating: • Nurtiber of standby batteries: 2 Amp hour rating: 7.5 Location of emergency generator: Location of fuel storage: Calculated capacity of secondary power to drive the system In standby mode: 24hrs In alarm mode: 10min 11.Record of System Installation Fill out after all installation is complete and wiring has been checked for opens,shorts,ground faults, and improper branching, but before conducting operational acceptance tests. The system has been installed in accordance with the following NFPA standards:(Note any or all that apply.) ®NFPA 72' ®NFPA 70k, Article 760 ®Manufacturer's published instructions ❑Other(please specify): System deviations from referenced NFPA standards: Signed: We&ow Printed name: WB Coury Date: Organization: Stoner Protective Title: Foreman Phone: 503-462-6500 12. Record of System Operation All operational features and functions of this system were tested by or in the presence of the signer shown below,on the date shown below, and were found to be operating properly in accordance with the requirements of: NFPA 72' ®NFPA 70 , Article 760 ®Manufacturer's published instructions ❑Other(please specify): ®Documentation in accordance with Inspection and Testing Form(Figure 10.6.23 of NFPA 72k)is attached Signed: Printed name: WB Coury Date: Organization: Stoner Protective Title: Foreman Phone: 503-462-6500 13.Certifications and Approvals 13.1 System Installation Contractor This system as specified herein has been installed and tested according to all NFPA standards cited herein. Signed: Vie&gay Printed name: WB Coury Date: Organization: Stoner Protective Title: Foreman Phone: 503-462-6500 13.2 System Service Contractor This system as specified herein has been installed and tested according to all NFPA standards cited herein. Signed: Vie 62=# Printed name: WB Coury Date: Organization: Stoner Protective Title: Foreman Phone: 503-462-6500 13.3 Central Station This system as specified herein will be monitored according to all NFPA standards cited herein. Signed: Printed name: Date: Organization: Central Station Title: Phone: 1-800-722-0364 monitoring NFPA 72, Fig.4.5.2.1 (p. 4 of 5) Copyright*2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 13.' rruperty Itepresen Lative I accept this system as having been installed and tested to its specifications and all NFPA standards cited herein. Signed: Printed name: Date: Organization: UB Facilities Title: Phone: 13.5 Authority Having Jurisdiction I have witnessed a satisfactory acceptance test of this system and find it to be installed and operating properly in accordance with its approved plans and specifications,its approved sequence of operations and with all NFPA standards cited herein. Signed: Printed name: Date: Organization: City of Tigard Title: Phone: NFPA 72, Fig. 4.5.2.1 (p. 5 of 5) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale It may not be copied for commercial sale or distribution.