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Report (104) 152o1 / 7 SYSTEM RECORD OF COMPLETION This form is to be completed by the system installation contractor at the time of system acceptance and approval. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Attach additional sheets,data,or calculations as necessary to provide a complete record. Form Completion Date;...._12/4/18 Supplemental Pages Attached: -.._1. 1. PROPERTY INFORMATION Name of property: Triangle Corporate Park III-Precoa Address, 13221 SW 68th Pkwy Suite 100 Tigard,OR 97223 ._._._._._. _..__. ...._.�. _ ..Description of property: Suite 100-Tenant Improvement Name of property representative CBRE Addrr:s 13221 SW 68th Pkwy Tigard,OR 97223 Phone: 503-701-8953 Fax: E-mail: 2. INSTALLATION,SERVICE,TESTING,AND MONITORING INFORMATION Installation contractor: PROTEK SYSTEMS,LLC Address:_306 SE Chkalov Drive Suite 111#361 Vancouver,WA 98683_ _,_„_ phone: (360)314-2017 _ Fax: _.__ E-mail: admin@protek.systems Service organizat.ion: -PROTEK SYSTEMS,LLC Address: 305 SE Chkalov Drive Suite 111#361 Phone: (360)314-2017 Fax: E-mail: admin@protek.systems Testing organization:_-PROTEK SYSTEMS,LLC _.................--..._....._...... ...- Address: 305 SE Chkalov Drive Suite 111#361 Phone (360)314-2017 Fax:_- _,_.._ E-mail: admin@protek.systems Effective date for lest and inspection contract: 12/5/16 Monitoring organization: Central Station Monitoring Address: ......_..-...... Phone: Fax: E-mail: ... Account number: Phone line 1: Phone line 2: Means of transmission:—._.._.._—. ................---..--- —..._....____ -__ _._......- Entity to which alarms are retransmitted: _.......__._.._..-__._.-_._N/A....__.__._. Phone:,._.._._. ._ ..N/A_ 3. DOCUMENTATION On-site location of the required record documents and site-specific software: 1st Floor-FACP 4. DESCRIPTION OF SYSTEM OR SERVICE This is a: J New system 1 Modification to existing system Permit number: 18179191 000 00 FS NFPA 72 edition: 4.1 Control Unit Manufacturer: EST ___ Model number:-.. .2_ ____- 4.2 Software and Firmware Firmware revision number: __._. N/A 4.3 Alarm Verification ' This system does not incorporate alarm verification. Number of devices subject to alarm verification:__ Alarm verification set for _.._ __seconds ©2012 National Fire Protection Association NFPA 72(p.1 0l 3) 2013 Edition 0 SYSTEM RECORD OF COMPLETION (continued) 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: 120VAC Control panel amps: IT 3.6A OverCurrent protection: Type: Breaker Amps: 20A Branch circuit disconnecting means location: House Panel Number: 5.1.2 Secondary Power Type of secondar v power:.._ Batteries-12VDC 7AH Location,if remote from the plant: Calculated capacity of secondary power to drive the system: In standby mode thoursl: 24 In alarm mode(minutes): 5 5.2 Control Unit J This system does nnt have power extender panels 2t Power extender panels are listed an supplementary sheet A 6. CIRCUITS AND PATHWAYS Dual Media Separate Survivability Pathway Type Pathway Pathway Class Level Signaling Line X B 0 Device Power Initiating Device Notification Appliance X B 0 Other(specify 7. REMOTE ANNUNCIATORS Type Location S-BUS Lobby 8. INITIATING DEVICES Addressable or Alarm or Sensing Type Quantity Conventional Supervisory Technology Manual Pull Station, Existing Smoke Detectors Existing Duct Smoke Detectors Existing Heat Detectors Existing Gas Detectors N/A W'aterilow Switches Existin Ttampbir Switches Existing ©2012 National Fire Protection Association NFPA 72(p.2 of 3) SYSTEM RECORD OF COMPLETION (continued) 9. NOTIFICATION APPLIANCES Type Quantity Description Audible Visible 3 Strobe Combination Audible and Visible 3 Horn Strobes 10. SYSTEM CONTROL FUNCTIONS Type Quantity Hold-Open Door Releasing Devices Existing HVAC Shutdown Existing Fire/Smoke Dampers Existing Door Unlocking Existing Elevator Recall Existing Elevator Shunt Trip Existing_ 11. INTERCONNECTED SYSTEMS la This system does not have interconnected systems. J Interconnected systems are listed on supplementary sheet 12. CERTIFICATION AND APPROVALS 12.1 System Installation Contractor This system as specified herein has been installed according to all NFPA standards cited herein. Signed:, , Printed name:, Adam Sweet Date: 12/24/18 Organization:_PRpTEK5Y3TEMS,LLC Title: Fire Alarm Systems NIcETIU Phone: (253)448-1604 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed: 466-m- Printed name: Adam Sweet Date: 12/24/18 Organization: PROTEK SYSTEMS,LLC Title: Fire Alarm Systems NICET Ill phone: (253)448-1604 12.3 Acceptance Test Date and time of acceptance test: installing contractor representative: Testing contractor representative: Property representative: ART representative: 0 2Q12 National Fire reiteotion Assooation NFPA 72(p 3 0/3) NOTIFICATION APPLIANCE POWER PANEL SUPPLEMENTARY RECORD OF COMPLETION This form is a supplement to the System Record of Ccmpletion.It includes a list of types and locations of notification appliance power extender panels. This form is to be completed by the system installation contractor at the time of system acceptance and approval. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Form Completion Date: 12/4/18 Number of Supplemental Pages Attached: 1 1. PROPERTY INFORMATION Name of property: Triangle Corporate Park III-Precoa Addre,-;:s: 13221 SW 68th Pkwy Tigard,OR 97223 2. NOTIFICATION APPLIANCE POWER EXTENDER PANELS Make and Model Location Area Served Power Source Silent Knight 5495 1st Floor Elec Rm Suite 100 120VAC See Main System Record of Completion for additional information,certifications,and approvals. t/2612 National Fire orotection Assoc Dijon NEPA 72