HomeMy WebLinkAbout5823 NEWTON DR; ; FS120016; Permit1/24/25, 7:28 AM FS120016 Permit Data
City of Carlsbad
Fixed Systems Permit
Permit No: FS120016
Job Address: 5823 NEWTON DR Status: APPROVED
Permit Type: FIXSYS Applied 10/15/2012
Parcel No: 2120504300 Approved: 10/20/2012
Lot #: 0
Reference No.: Issued: 10/20/2012
PC #: Inspector:
Project Title: LIFE TECHNOLOGIES 4 NEW FIXED FIRE PROTECTION
SYSTEMS FOR NEW INDUSTRIAL KITCHEN (HOOD & DUCT)
Applicant:
JAM FIRE PROTECTION INC
8254 RONSON RD
858-495-2335
Owner:
LIFE TECHNOLOGIES CORP
5791 VAN ALLEN WAY
CARLSBAD CA
Fees ($) Add'l Fees ($) j Total ($) Balance ($)
526 0 526 0
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FS 1 2-oo
Fire Suppression Certificate of Installation
To Be Completed By Fire System Distributor: Griddle Hood
Job Name: Life Technologies Job Number: 12FVG241
Job Address: 5823 Newton Ave. Type System:, Ansul XX
City_ State_Zip Carlsbad, CA 92008 Pyro Chem
Other
I U ..UIuIpIvLu LPY Ulf LVIII I#ILI IIJUWI
:C0mPau1Y Name: JAM Fire Protection, Inc. System Model: R-102-3
Address: 8254 Ronson Rd. Serial Number:
City-State-Zip: San Diego, CA 92111
Gas Valve: Mechanical: Electrical:. Size: Date Tested:
Location:
Electrical: Shunt Breaker: Breaker #: Panel #:
Date Tested: Panel Location:
Power Source: Breaker #: Panel #:
Breaker lock installed: IContactors:Location:
This. Fire Suppression System is installed in accordance with Manufacturers specifications
and drawings, NI-PA 97 and 17(A) and all applicable state and local codes. All electrical
work or work performed by others to complete the installation of this system has been
completed.
Exceptions to the above are noted below: (Use back of sheet if necessary)
Installers Name:iv'4
Signature: Date: /D31-1Z
Acceptance Test Performed By:
Tested By: 7. z,/
nature: ç'-_. / Date:
To be Completed by Owner or Owner's Representative:
I have received a copy of the Fire Suppression System Owner's Manual and I understand
it. I also understand that it is the recommendation of the National Fire Protectn Assoc.
(NFPA) that the system be inspected every six months to maintain its reliability.
Name:
Signature: L_t_ Date: (( 7 \ L
To be completed by the Authority Having Jurisdiction:
Functional tes/ have been completed and the system performs as designed.
Signature: Date: ii,
(197!V4fl
PRE ENGINELED SYSTEM INSPECTION REPORT
TIME IN TIME OUT
8254 Ronson Road.
San Diego, CA 92111
Tel (858) 495.2335
Fax (858) 496.3820
Customer Name .11 i 7e/L)cZ-o-1 £-(
Address ,ij1JA-iJI--
SYSTEM
Model(s) and serial numbers ,4'-Ji L -' 2-
Number of nozzles and Part No Ci) 2-J C) ,4
Number of detector(s) and degree rating _Cl!) 3-)'
Replacement of links V N If no, Date of last replacement
Energy shutoff devices - type and size
Other accessory equipment provided (ç etc.)
COOKING'NENTILATING EQUIPMENT
Number of duct(s) and size /
Hood size_________________________________________ Plenum type and size
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and circle number of those being protected.)
' l2/4AiL (ltt IJ4 5.
2._______________________________ 6.
7.
8.
COMMENTS: ge .tra
I understand that it is the recommendation of the National
Fire Protection Association Standard 96 and 17 that the
fire suppression System be inspected and maintained
every 6 months to ensure continued efficiency and
reliability and that the failure to do so may
result In failure of the system to operate properly.
-
TECHNICIAN NA F____________________________
SIGNATURE
DATE / a—.-
I—
CUSTOMER NAME AND TITLE_ Co NLuc-ri.
çJ -PDL-
SIGNATURE_
DATE/! —) -
#5781
Fire Suppression Certificate of Installation
To Be Completed By Fire System Distributor: (Broiler Hood/Common Exhaust ) Job Name: Life Technologies Job Number 12FvG2:F
Job Address: 5823 Newton Ave. Type System: Ansul XX
City_ State Zip: Carlsbad, CA 92008 Pyro Chem
Other
I W UPC Jiiij,.vi.vu iy W-11 v .yLIII L#ULt IL?UUI.
Company Name: JAM Fire Protection, Inc. System Model: R-102-3
Address: 8254 Ronson Rd. Serial Number:
City_State_Zip: San Diego, CA 92111
Gas Valve Mechanical: Electrical: ,\ Size: Date Tested:
Location.-
Electrical: Shunt Breaker: Breaker #: Panel #:
Date Tested: Panel Location:
Power Source: Breaker #: Pane! #:
Breaker lock installed: Contactors: Location:
This Fire Suppression System is installed in accordance with Manufacturers specifications
and drawings, NFPA 97 and 17(A) and all applicable state and local codes. All electrical
work or work performed by others to complete the installation of this system has been
completed.
Exceptions to the above are noted below: (Use back of sheet if necessary)
Installers Name:
Signature: Date: /6iy -2
Acceptance Test Performed By:
Tested By:
nature:
To be Completed by Owner or Owner's Representative:
I have received a copy of the Fire Suppression System Owners Manual and I understand
it. I also understand that it is the recommendation of the National Fire Protection Assoc.
(NFPA) that the system be inspected every six months to maintain its reliabilit'.
Name: Lt--7
Signature: Date:
To be completed by the Authority Having Jurisdiction:
Functional tey)s have been completed and the system performs as designed.
Signature: - Date: III27L1V-
(9TT
JJAM(4 PRE ENGINEERED SYSTEM INSPECTION REPORT 8254 Ronson Road.
San Diego, CA 92111
TIME IN TIME OUT Tel (858) 495.2335
Fax (858) 496.3820
Customer Name E rFtz/ -s
Address \c--Z'-; ,wtu-J 4ii Li-c( c- 9-
SYSTEM
Model(s) and serial numbers A'J L- / £Z
Number of nozzles and Part No(2T)2L,() () / i-i) (~_) 1 ,,j
Number of detector(s) and degree rathg(3)3c C/) S&
Replacement of links V N If no, Date of last replacement t-e-) / -31--
Energy shut-off devices - type and si
Other accessory equipment provided
COOKING'NENTILATING EQUIPMENT
Number of duct(s) and size 3- "z,'
Hood size_ Plenum type and size S6 A2-'6'
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and circle number of those being protected.)
5,
4 6.
3. 7
8.
COMMENTS:
TECHNICIAN NAME J
SIGNATURE_____________________________________
DATE
f /
ki-1 J-
UYES ONO
I understand that it is the recommendation of the National
Fire Protection Association Standard 96 and 17 that the
fire s on System be inspected and maintained
ev ry 6 mont to ensure continued efficiency and
reliability and that the failure to do so may
result In failure of the system to operate properly.
CUSTOMER NAME AND TITLE _\- CLC_OJ
SIGNATURE
DATE / ( - /ZI
#5787
r.
Fire Suppression Certificate of Installation
To Be Completed By Fire System Distributor: Range/Kettle Hood I Job Name: Life Technologies Job Number: 12FVG27F
Job Address: 5823 Newton Ave. Type System: Ansul XX
City_ State_Zip: Carlsbad, CA 92008 Pyro Chem
Other
10 D uiiiijieeo Dy ru LPILI 11JUL01
Company Name: JAM Fire Protection, Inc. System Model: R-102-6
Address: 8254 Ronson Rd. Serial Number:
City_State_Zip: San Diego, CA 92111
Gas Valve: Mechanical: Electrical:,>c Size: Date Tested:
Location:
Electrical: Shunt Breaker: Breaker #: Panel #:
Date Tested: Panel Location:
Power Source: Breaker #: Panel #:
Breaker lock installed: Contactors: Location:
This Fire Suppression System is installed in accordance with Manufacturers specifications
and drawings, NFPA 97 and 17(A) and all applicable state and local codes. All electrical
work or work performed by others to complete the installation of this system has been
completed.
Exceptions to the above are noted below: (Use back of sheet if necessary)
Installers Name:(.)c '
Signature: Date:
Acceotance Test Performed By:
Tested By: +E12S1 / /t9
Signature: / Date:
To be Completed by Owner or Owner's Representative:
I have received a copy of the Fire Suppression System Owners Manual and I understand
it. I also understand that it is the recommendation of the National Fire Protection Assoc.
(NFPA) that the system be inspected every six months to maintain its reliabilit.
Name:
Signature: -1_..__ Date: / 7 '
To be completed by the Authority Having Jurisdiction:
Functional ter have been completed and the system performs as designed.
Signature: Date:
PRE ENGINEERED SYSTEM INSPECTION REPORT 8254 Ronson Road.
San Diego, CA 92111
TIME IN TIME OUT Tel (858) 495.2335
Fax (858) 496.3820
Customer Name J/ft T7-dv-itj67
!!!9111111521, ME
SYSTEM
Model(s) and serial numbers_ 1—_9 (02-
Number of nozzles and Part No 07 Z30 CO 2-50 (z) ,,j (i) 2J
Number of detector(s) and degree rang QDSo '1 C!)
Replacement of links Y N If no, Date of last replacement _'%J 'o-3 I
Energy shut-off devices - type and size
Other accessory equipment provided (p etc.)
COOKING'NENTILATING EQUIPMENT
Number of duct(s) and size 23
Hood size_ ''S7-1 Plenum type and size
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to fight and circle number of those being protected.)
1/ Ptit 5__ 4
27t2 ?CcSjt 6. s
Z3 1-s22. S ?4---Z
/it"_2i4S2ir /(-2-7Z.-1- 8.
COMMENTS: DYES ONO
I understand that it is the recommendation of the National
Fire Protection Association Standard 96 and 17 that the
fire suppression System bo inspected and maintained
every 6 months to ensure continued efficiency and
reliability and that the failure to do so may
result In failure of the system to operate properly.
CUSTOMER NAME AND TITLE 717- Ca
TECHNICIAN NAME SIGNATURF__
SIGNATURE_____ DATE)-7
DATE 7/ /Z_
#c'fr':: -5?3A6 -I: #5187
Fire Suppression Certificate of Installation
To Be Completed By Fire System Distributor: Pizza Hood
Job Name: Life Technologies Job Number: .12FVG2.
Job Address: 5823 Newton Ave. Type System: Ansul XX
City_ State—Zip: Carlsbad, CA 92008 Pyro Chem
Other
I U D I..UIIIJJIeLeU Dy r-11 = aybLCIII lJlLt iuuwr;
Company Name: JAM Fire Protection, Inc. System Model: R-102-1.5
Address: 8254 Ronson Rd. Serial Number:
City_State_Zip: San Diego, CA 92111
Gas Valve: Mechanical: Electrical: c Size: Date Tested:
Location:
Electrical: Shunt Breaker: Breaker #: Panel #:
Date Tested: Panel Location:
Power Source: Breaker #: Panel #:
Breaker lock installed: IContactors: Location:
This Fire Suppression System is instal!ed in accordance with Manufacturers specifications
and drawings, NFPA 97 and 17(A) and all applicable state and local codes. All electrical
work or work performed by others to complete the installation of this system has been
completed.
Exceptions to the above are noted below: (Use back of sheet if necessary)
Installers Name:
Signature: Date:
Test Performed By;
I
Tested B
Signature:/2, Date:
To be Completed by Owner or Owner's Representative:
- I have received a copy of the Fire Suppression System Owners Manual and I understand
it. I also understand that it is the recommendation of the National Fire Protection Assoc.
(NFPA) that the system be inspected every six months to maintain its reliability.
Name: P-tLL'7
Signature:
_Date: //
To be compled by the Authority Having Jurisdiction:
Functional tes have bee
P co and the system performs as designed.
Signature: -'t' f1L Date: j,.7Z/i.-
0
PRE ENGINEERED SYSTEM INSPECTION REPORT 8254 Ronson Road.
San Diego, CA 92111
TIME IN TIME OUT Tel (858) 495.2335
Fax (858) 496.3820
Customer Name
Address
SYSTEM
Model(s) and serial numbers A7J3u .- '2I C) 2-- (
Number of nozzles and Part No 67 2c) 0) /'J
Number of detector(s) and degree rating _'-
Replacement of links Y N If no; Date of last replacement /O •-3 I
Energy shut-off devices - type and size___________________________________________________________________________
Other accessory equipment provided (pu stiti n, electri s tches, etc.)
it e1
COOKING'NENTILATING EQUIPMENT
Number of duct(s) and size /3 (
Hood size ,3 '21 1 Plenum type and size
Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and circle number of those being protected.)
1._ AJi/siI 5.
6.
7.
COMMENTS: [1YES .
Al cA
I understand that it is the recommendation of the National
t4r14 v-rviL Fire Protection Association Standard 96 and 17 that the
fire suppression System be inspected and maintained
every 6 months to ensure continued efficiency and
reliability and that the "failure to do so may
result In failure of the system to operate properly.
CUSTOMER NAME AND TITLE 13V.- Cr .i c rQ- -ri 00
TECHNICIAN NAME £u SIGNATURE
SIGNATURE DATE/)7
DATE_/7/7,1 / 'z
1411J: )?_