HomeMy WebLinkAbout6900 AMBROSIA LN; ; FS14002010/26/23, 11:23 AM FS140020 Permit Data
City of Carlsbad
Fixed Systems Permit
Permit No: FS140020
Status: APPROVED
Permit Type: FIXSYS Applied 8/21/2014
Parcel No: Approved: 8/27/2014
Lot #: 0
Reference No.: Issued: 8/27/2014
PC #: Inspector:
Project Title: AVIARA OAKS ELEM SCH INSTALL ANEW 3.0 GALLON, PRE-
ENGINEERED, R-102 RESTAURANT FIRE SUPPRESSION
SYSTEM FOR KITCHEN APPLIANCES AND HOOD.
Applicant:
SIMPLEX
3568 RUFFIN RD SOUTH
SAN DIEGO CA
858-633-9100
Owner:
CARLSBAD UNIFIED SCHOOL DISTRICT
6050 EL CAM INO REAL
LFees ($) Add'I Fees ($) Total ($) Balance ($)
333 0 333 0
about:blank 1/1
SCHOOL 14()C)2,0
Fire Suppression System Distributor CertificEJfRt? tion
To he completed by Fire System _D if
Job Name P V/fri( A. 4-A&5 61;1&)i?/2Jib Number
Job Addiëss (90 A415/t94 -AuE I , Type of System: ANSUL R-102
14
Distributor Name. /fl L iy 7Q.tL-E System Model 1ZI 0
Distributor Address ZiFF,,Q -d 3 Serial Number__________
Gas Valve: Mechanical U Electrical U Size
Electric Equipment Shut-down Tested: DYES I]NO
Installed. Tested on 2-151
(MMIDDIYYYY)
This Fire Suppression System is installed in accordance with the ManuFacturer's instructions and drawings, NFPA 96 and 17 (current
Issues) and all applicable state and local codes. All deck ical work or work performed by othem to complete the installation of this
system has been curzipleLed. Exceptiuus to the above are noted below. (Use back of sheet if necessary)
Installer's Name IJ
Signature P7 - Date
(MMIDD!YYYY)
Tobe 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 Protection Association (NFPA) that the system be Inspected every six months to maintain Its
reliability.
Signatum Date_________
-
(MMIDD!YYYY)
To be Completed by the AuthorityHavingJurisdiction
Functional tnse been witnessed and the system performs asdesigtied.
Signature .. Date
(MMIDD/YYYY)
Purchase Order, Change Order, & Distributor Certificate - Fire System CaptiveAire, v3 1-29-09