HomeMy WebLinkAbout6628 SANTA ISABEL; ; FS110018; PermitUity 01 Uarlsbad
Fixed Systems Permit
Permit No: FSII00I8
6628 SANTA ISABEL
Job Address:
ST
Permit Type: FIXSYS
Parcel No: 2153300100
Lot #: 0
Reference No.:
Status: ISSUED
Applied 6/9/2011
Approved: 6/9/2011
Issued: 6/9/2011
Inspector:
Project Title: ST. ELIZABETH SETON SPECIAL CHEMICAL AGENT SUPPRESSION
Applicant:
SIMPLEX GRINNELL
3568 RUFFIN ROAD
SAN DIEGO CA
858-633-9100
Owner:
ROMAN CATHOLIC BISHOP OF SAN DIEGO
P0 BOX 85728
SAN DIEGO CA
Fees ($) Add'I Fees ($) Total ($) Balance ($)
130 0 130 0
FS1.10019
Fire Suppression System Distributor Certificate of Installation
o be (ompletea by Kegionail UlTice
Job Name 1 Job Number
Job Address S6jTA I'SAIFSek of System:
(ARsa41 .CA 9200c Pyrochem
Other
I 0 ne Lompietea by Iire System Distributor
Company Nameis?y jNL- System Model
Address SOJ ¶ Serial Number
SAN (o °2V~TS
Fuel/Energy Shut Off Device Gas Valve: jical Electrical Size (,0
Installed. Tested on Electric Equipment Shut-down Tested: No
Date
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 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)
Installer's Nam
Signature Date \
10 be uornpleted bV Owner or Owners 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' ed every six mo ~toirntain its reliability.
Signature Ci_19 Date S //
o ne Loornpietea by tne Autnority iiaving Jurisaiction
Functional tests have been witnessed and the system performs as designed.
Print Name
Phone Nun
Signature
Jurisdiction
Date €'/ISi2d11
Fire Suppression System Dsiribuior Ceroficute of Insurance. s2 5-1-07
C