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HomeMy WebLinkAbout5475 CAR COUNTRY DR; ; FA140101; PermitFire Alarm Permit 5475 CAR COUNTRY Job Address: DR Permit Type: FALARM Parcel No: 2110800900 Lot #: 0 Permit No: FA14010I Status: ISSUED Applied 7/24/2014 Approved: 8/6/2014 Reference No.: Issued: 8/6/2014 PC #: Inspector: Project Title: HOEHN SPRINTER SERVICE BLDG INSTALL NEW FIRE ALARM SYSTEM IN A NEW ONE-STORY SPRINKLED S-I AUTOMOBILE SERVICE BLDG. -SPRINKLER SYSTEM IS MONITORED BY NEW FIRE ALARM PANEL. -INTALL A NEW SMOKE DETECTOR AND PULL STATION AT FACP. -BUILDING PERMIT WAS ISSUED UNDER 2010 CODES. -SYSTEM IS MONTORED BY CENTRAL STATION. Applicant: Owner: RIVER FIRE & SECURITY INC. HOEHN GROUP L L C 8920 ACTIVITY RD STEJ P 0 BOX 789 SAN DIEGO, CA CARLSBAD CA 858-752-6250 Fees ($) Add'I Fees ($) Total ($) Balance ($) 286 0 286 0 HOEHN SPRINTER 5475 CAR COUNTRY CARLSBAD CARLSBAD, CA. 92008 Fire Alarm Submittal 07/5/14 MA , S SUBT7ED _1k_ CAiLSBib FIRF !EPARTPT Submitted By: RIVER COMMUNICATIONS 8920 ACTIVITY ROAD, SUITE J San Diego. California 92126 License#896646 FA1 40101 HOEIIN SPRINTER Fire Alann Submittal Equipment List Description Model Manufacture CSFM# Fire Alarm Panel IFP-50 SILENT KNIGHT 7170-0559:144 Smoke Detector IIllJ(S1(I SILENT KNIGHT 7272-0559:149 Pull Station IDP-PULL-SA SILENT KNIGHT 7150-0559:157 Addressable Input Module IDP-Iv1TNIM01) SILENT KNIGHT 7300-0559-155 Connection to Existing Waterfiow Farenhyt Intelligent Fire Alarm Control Panel IFP-50 IFP-50 is an intelligent analog/addressable fire control panel (FACP). IFP-50 has a single line circuit (SLC) loop for connecting addressable detectors and modules and has two notification appliance circuits that can be programmed for notification outputs or auxiliary power. IFP-50 also has a built-in dual line digital fire communicator, Form C trouble relay, and two programmable Form C relays. The firmware has powerful features such as detector sensitivity, day/night thresholds, drift compensation and pre-trouble maintenance alert. IFP-50 supports a variety of other devices that can be added to the system such as RA-100 or RA-1000 remote annunciator, 5824 serial/parallel printer interface module (for printing system reports), and 5496 intelligent power module, and SD or IDP devices. Features Built-in support for up to 50 SD devices or 50 IDP detectors and 50 IDP modules Uses standard wire—no shielded or twisted pair required Built-in digital communicator for remote reporting of system activity and system programming Central station reporting by point or by zone Jumpstart® auto-programming Supports Class B (Style 4) and Class A (Style 6 or Style 7) configuration for SLC Distributed, intelligent power Built-in synchronization for appliances from AMSECO, Gentex®, Faraday, System Sensor®, and Wheelock® Sensor sensitivity settings and day/night sensitivity setting and automatic drift compensation Notification circuits can be configured as 1 Class A (Style Z), 2 Class B (Style Y), or auxiliary power for resettable, constant, or door holder power Built-in annunciator with a backlit 80-character LCD display RS-485 bus provides communication to system accessories Built-in RS-232 interface for programming via PC Built-in Form C trouble relay rated at 2.5 amps at 24 VDC Two built-in Form C programmable relays rated at 2.5 amps at 24 vDC SLC device locator can be used to locate a single or multiple devices on a SLC loop System automatically performs detector sensitivity test 13 preset notification cadence patterns (including ANSI 3.41) and four user programmable patterns Upload or download programming, event history, or detector status onsite or from a remote location using a PC and 5650/5651 Silent Knight Software Suite (SKSS) Improvements in SKSS deliver five times faster upload/downloads Non volatile event history stores up to 1000 events 125 software zones and 125 output groups D SILENT KNIGHT by Honeywell Agency Listings UO L' MEA 429-92-E Vol. XVI lFP-50 2.5 amp power supply and maximum charging capacity of 35 amp hours (An additional cabinet enclosure is required for batteries in excess of 7 amp hours). Programmable date setting for Daylight Saving Time Compatibility The IFP-50 SLC supports multiple device types of the same protocol: SD IDP You cannot mix SD and IDP devices on a FACP. However, any combination of addressable devices of the same protocol can be used on the IFP-50. Specifications Physical Dimensions: 12.75'W x 15.2'H x 3.4'D (36.8 W x 62.9 H x 9.8 0 cm) Weight: 11.5 lbs. (5.2 kg) Color: Red P/N 350328 Rev J © 2014 Honeywell International Inc. CALIFORNIA DEPARTMENT OF FORESTRY & FIRE PROTECTION OFFICE OF THE STATE FIRE MARSHAL FIRE ENGINEERING - BUILDING MATERIALS LISTING PROGRAM LISTING SERVICE LISTING No. 7165-0559:0144 Page 1 of 2 CATEGORY: 7165-- FIRE ALARM CONTROL UNIT (COMMERCIAL) LISTEE: SILENT KNIGHT SECURITY7550 Meridian Circle, Maple Grove, MN 55369-4927 Contact: Michael Mclsaac (763) 493-6400 Fax (763) 391-5464 Email: mike.mcisaac@honeywell.com DESIGN: Models *lFp..50 and *5700 Fire Alarm Control Units. Power limited, automatic, manual, local, remote station, central station, water-flow, water releasing and sprinkler supervisory service. Refer to listee's data sheet for additional detailed product description and operational considerations. System components: IFP-50, 5700 Control Units 7628 EOL Resistor 5860/5860R/RA-1000 Annunciator 5897 Power Supply 5496 *Notification Power Expander 5824 Serial/Parallel Interface 5865-3/5965-4 LED Annunciator 5880 LED 10 Module 5883 Relay Interface Board SDSOO-LlM Line Isolation Module SD505-61B Isolation Base RA-1 00 Remote Annunciator 3158 Reverse Polarity Module 5220 Direct Connect Module RATING: 120 VAC Primary, 24 VDC Secondary INSTALLATION: In accordance with listee's printed installation instructions, applicable codes and ordinances and in a manner acceptable to the authority having jurisdiction. MARKING: Listees name, model number, electrical rating, and UL label. APPROVAL: Listed as control units for use in high-rise structures when used in conjunction with Model SKE-360 Voice-Tone Evacuation Unit (CSFM Listing No. 6912-0559:122); EVAX Audio Adjunct System Models EVAX-25 (CSFM Listing No. 06911-1446:100), EVAX-50 or EVAX-50E (CSFM Listing No. 06911-1446:102); EV)(-2ZA or EV)(-4Z Zone Splitters (CSFM Listing No. 06912-1446:101); HMX-MP or HMX-DP Voice Evacuation System (CSFM Listing No. 06911-1446:103), two-way firefighter telephone and separately listed electrically and functionally compatible initiating and indicating devices. Also suitable for non-high rise applications where the voice evacuation and two-way firefighter telephone are not required. Refer to listee's Installation Instruction Manual for details. Rev 10-3-08MA This listing is based upon technical data submitted by the applicant. CSFM Fire Engineering staff has reviewed the test results and/or other data but does not make an independent verification of any claims. This listing is not an endorsement or recommendation of the item listed. This listing should not be used to verify correct VV operational requirements or installation criteria. Refer to listee's data sheet, installation instructions and/or other Date Issued: July 01, 2014 Listing Expires June 30, 2015 Authorized By: JAMES PARSEGIAN, Program Coordinator Fire Engineering Division CALIFORNIA DEPARTMENT OF FORESTRY & FIRE PROTECTION OFFICE OF THE STATE FIRE MARSHAL FIRE ENGINEERING - BUILDING MATERIALS LISTING PROGRAM LISTING SERVICE LISTING No. CATEGORY: LISTEE: DESIGN: INSTALLATION: MARKING: APPROVAL: 7150-0559:0157 Page 1 of 1 7150-- FIRE ALARM PULL BOXES SILENT KNIGHT SECURITY7550 Meridian Circle, Maple Grove, MN 55369-4927 Contact: Michael Mclsaac (763) 493-6400 Fax (763) 391-5464 Email: mike.mcisaachoneywell.com Model IDP-PULL-SA manual pull box. Refer to listee's data sheet for detailed product description and operational considerations. In accordance with listee's printed installation instructions, applicable codes and ordinances and in a manner acceptable to the authority having jurisdiction. Listee's name, model number, rating, and UL label. Listed as fire alarm pull boxes for use with separately listed compatible fire alarm control units. * These manual pull boxes meet the requirements of UL Standard 38, 1999 Edition and California amendments. XLF: 7150-0028:0199 *Updated 09-08-09 fm This listing is based upon technical data submitted by the applicant. CSFM Fire Engineenng staff has reviewed the test results and/or other data but does not make an independent verification of any claims. This listing is not an endorsement or recommendation of the item listed. This listing should not be used to verify correct operational requirements or installation criteria. Refer to listee's data sheet, installation instructions and/or other Date Issued: July 01, 2014 Listing Expires June 30, 2015 Authorized By: JAMES PARSEGIAN, Program Coordinator Fire Engineering Division CALIFORNIA DEPARTMENT OF FORESTRY & FIRE PROTECTION OFFICE OF THE STATE FIRE MARSHAL FIRE ENGINEERING - BUILDING MATERIALS LISTING PROGRAM LISTING SERVICE LISTING No. 7272-0559:0149 Page 1 of 1 CATEGORY: 7272 -- SMOKE DETECTOR-SYSTEM TYPE-PHOTOELECTRIC LISTEE: SILENT KNIGHT SECURITY7550 Meridian Circle, Maple Grove, MN 55369-4927 Contact: Michael Mclsaac (763) 493-6400 Fax (763) 391-5464 Email: mike.mcisaac©honeywell.com DESIGN: Models IDP-PHOTO, lDPPHOTOR*, IDP-PHOTO-T, IDP-ACCLIMATE, SK-PHOTO, SKPHOTOR*, 5K-PHOTO-I and SK-ACCLIMATE photoelectric type smoke detectors. Model IDP-PHOTO-T employs a 1350F supplement integral heat sensor which only assists in a fire situation. This thermal circuitry is NOT approved for use in lieu of a required heat detector. Refer to listee's data sheet for additional detailed product description and operational considerations. RATING: 24 VDC INSTALLATION: In accordance with listee's printed installation instructions, applicable codes & ordinances and in manner acceptable to the authority having jurisdiction. MARKING: Listee's name, product number, electrical rating and UL label. APPROVAL: Listed as photoelectric type smoke detector for use with listee's separately listed compatible fire alarm control units and bases. All models are suitable for open areas and inside duct installations with air velocities between 0-4000 FPM. Models IDP-PHOTO and IDP-PHOTOR are approved for installations inside System sensor duct housing DNR (OSFM Listing No. 3242-1653:209) and DNRW (OSFM Listing No. 32421653:210)*. Models SK-PHOTO and SK-PHOTOR are approved for installations inside Silent Knight SK-DUCT (OSFM Listing No. 3242-0559:162) and System Sensor DNRW (OSFM Listing No. 32421653:210)* NOTE: The photoelectric type detectors are generally more effective at detecting slow, smoldering fires that smolder for hours before bursting into flame. Sources of these fires may include cigarettes burning in couches or bedding. The ionization type detectors are generally more effective at detecting fast, flaming fires that consume combustible materials rapidly and spread quickly. Sources of these fires may include paper burning in a waste container or a grease fire in the kitchen. XLF: 7272-0028:0206 Rev. 02-01-10fm This listing is based upon technical data submitted by the applicant. CSFM Fire Engineenng staff has reviewed the test results and/or other data but does not make an independent verification of any claims. This listing is not an endorsement or recommendation of the item listed. This listing should not be used to verify correct operational requirements or installation criteria. Refer to listee's data sheet, installation instructions and/or other Date Issued: July 01, 2014 Listing Expires June 30, 2015 Authorized By: JAMES PARSEGIAN, Program Coordinator Fire Engineering Division CALIFORNIA DEPARTMENT OF FORESTRY & FIRE PROTECTION OFFICE OF THE STATE FIRE MARSHAL FIRE ENGINEERING -BUILDING MATERIALS LISTING PROGRAM LISTING SERVICE LISTING No. 7300-0559:0155 Page 1 of 1 CATEGORY: 7300 -- FIRE ALARM CONTROL UNIT ACCESSORIES/MISC. DEVICES LISTEE: SILENT KNIGHT SECURITY7550 Meridian Circle, Maple Grove, MN 55369-4927 Contact: Michael Mclsaac (763) 493-6400 Fax (763) 391-5464 Email: mike.mcisaachoneywell.com DESIGN: Models IDP-Relay-6, SK-Relay-6, relay module, lDP-Control-6, 5K -Control-6, supervising control module, IDP-Monitor-10, 5K-Mon-1 0, input monitor module, lDP-Zone-6, SK-Zone-6 six zone interface module, lDP-Monitor, lDP-Minimon, lDP-Zone, SK-Monitor, SK-Minimon, SK-Zone monitor modules, I DP-Control, lDP-Relay, SK-Control, SK-Relay, control modules, lDP-Monitor-2, SK-Monitor-2, dual monitor modules,and *IDP..RELAYMON2 *SK.RELAYMON.2 with 2 input/2 output relay modules. All devices are intended to be connected between the signaling line circuit of a compatible fire alarm control panel. Refer to listee's data sheet for additional detailed product description and operational considerations. RATING: 16-33 VDC Primary INSTALLATION: In accordance with listee's printed installation instructions, applicable codes & ordinances and in manner acceptable to the authority having jurisdiction. MARKING: Listees name, product number and UL label. APPROVAL: Listed as control unit accessories for use with listee's separately listed compatible fire alarm control units. NOTE: If an external power supply is used for Model SK-Zone-6 and IDP-Zone-6, the negative of the external power supply is referenced to the negative of the auxiliary supply of the compatible control panel. This is done in order to detect ground faults on the initiating circuit. XLF: 7300-0028:0219 *Rev. 10-25-11 mt This listing is based upon technical data submitted by the applicant. CSFM Fire Engineering staff has reviewed the test results and/or other data but does not make an independent verification of any claims. This listing is not an endorsement or recommendation of the item listed. This listing should not be used to verify correct v' operational requirements or installation criteria. Refer to listee's data sheet, installation instructions and/or other Date Issued: July 01, 2014 Listing Expires June 30, 2015 Authorized By: JAMES PARSEGIAN, Program Coordinator Fire Engineering Division f 3 FA 140101 FIRE ALARM AND EMERGENCY COMMUNICATION SYSTEM RECORD OF COMPLETION 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. PROPERTY INFORMATION / Name of property: Hoehn Sprinter Service Building j' Address: 5475 Car Country Carlsbad Drive Carlsbad, Ca. 92008 %./ Description of property: Occupancy type: Name of property representative: Address: Phone: Fax: E-mail: Authority having jurisdiction over this property: Phone: Fax: E-mail: INSTALLATION, SERVICE, AND TESTING CONTRACTOR INFORMATION Installation contractor for this equipment: River Fire & Security, Inc. Address: 8920 Activity Road, Suite J San Diego, Ca. 92126 License or certification number: 896646 Phone: 858.752.6250 Fax: 858.752.6260 E-mail: rbaldwin@river4ire.com Service organization for this equipment: Address: License or certification number: Phone: - Fax: E-mail: A contract for test and inspection in accordance with NFPA standards is in effect as of: Contracted testing company: Address: Phone: Fax: E-mail: Contract expires: - Contract number: - Frequency of routine inspections: DESCRIPTION OF SYSTEM OR SERVICE O Fire alarm system (nonvoice) Fire alarm with in-building fire emergency voice alarm communication system (EVACS) Mass notification system (MNS) Combination system, with the following components: 0 Fire alann 0 EVACS 0 MNS 0 Two-way, in-building, emergency communication system F-1 Other (specify): . NFPA 72, Fig. 10.18.2.1.1 (p. 1 of 12) 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. 3. DESCRIPTION OF SYSTEM OR SERVICE (continued) NFPA 72 edition: 2-0/ 0 3.1 Control Unit Manufacturer: 3.2 Mass Notification System 3.2.1 System Type: o In-building MNS—combination 0 In-building MNS—stand-alone C1 Other (specify): 3.2.2 System Features: Additional description of system(s): Model number: Bf This system does not incorporate an MNS 0 Wide-area MNS 0 Distributed recipient MNS C] Combination fire alarni/MNS 0 MNS autonomous control unit 0 Wide-area MNS to regional national alerting interface C3 Local operating console (LOC) 0 Direct recipient MNS (DRMNS) 0 Wide-area MNS to DRMNS interface C] Wide-area MNS to high-power speaker array (HPSA) interface 0 In-building MNS to wide-area MNS interface C1 Other (specify): 3.3 System Documentation An owner's manual, a copy of the manufacturer's instructions, a written sequence of operation, and a copy of the numbered record drawings are stored on site. Location: /14.,.4,fG1_fr1 i• 3.4 System Software This system does not have alterable site-specific software. Operating system (executive) software revision level: Site-specific software revision date: Revision completed by: 0 A copy of the site-specific software is stored on site. Location: 3.5 Off-Premises Signal Transmission Name of organization receiving alarm signals with phone numbers: Alarm: -' Supervisory: %j Trouble: :c 13 rr Entity to which alarms are retransmitted: Method of retransmission: 0 This system does not have off-premises transmission. Phone: 8' F, Phone: II Phone: I, Phone: If Chapter 26, specify the means of transmission from the protected premises to the supervising station: If Chapter 27, specify the type of auxiliary alarm system: 0 Local energy 0 Shunt 0 Wired 0 Wireless NFPA 72, Fig. 10.18.21.1 (p. 2 of 12) Copyright 5 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. 4. CIRCUITS AND PATHWAYS 4.1 Signaling Line Pathways 4.1.1 Pathways Class Designations and Survivability Pathways class: 8 Survivability level: Quantity: (See NFPA 72, Sections /2.3 and /2.4) 4.1.2 Pathways Utilizing Two or More Media Quantity: Description: 4.1.3 Device Power Pathways separate power pathways from the signaling line pathway Power pathways are separate but of the same pathway classification as the signaling line pathway Power pathways are separate and different classification from the signaling line pathway 4.1.4 Isolation Modules Quantity: 0 4.2 Alarm Initiating Device Pathways 4.2.1 Pathways Class Designations and Survivability Pathways class: 6 Survivability level: Quantity: (See NFPA 72, Sections 12.3 and /2.4) 4.2.2 Pathways Utilizing Two or More Media Quantity: 0 Description: 4.2.3 Device Power Pathways 29-No separate power pathways from the initiating device pathway Power pathways are separate but of the same pathway classification as the initiating device pathway Power pathways are separate and different classification from the initiating device pathway 4.3 Non-Voice Audible System Pathways 4.3.1 Pathways Class Designations and Survivability Pathways class: Survivability level: Quantity: (See NFPA 72, Sections 12.3 and /2.4) 4.3.2 Pathways Utilizing Two or More Media Quantity: . Description: 4.3.3 Appliance Power Pathways 0 No separate power pathways from the notification appliance pathway Power pathways are separate but of the same pathway classification as the notification appliance pathway Power pathways are separate and different classification from the notification appliance pathway NFPA 72, Fig. 1018.2.1.1 (p.3 of 12) 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 sate or distribution. 5. ALARM INITIATING DEVICES 5.1 Manual Initiating Devices 5.1.1 Manual Fire Alarm Boxes Type and number of devices: Addressable: Other (specify): 5.1.2 Other Alarm Boxes Description: Type and number of devices: Addressable: Other (specify): 5.2 Automatic Initiating Devices 0 This system does not have manual fire alarm boxes. Conventional: Coded: Transmitter: This system does not have other alarm boxes. Conventional: Coded: Transmitter: 5.2.1 Smoke Detectors 0 This system does not have smoke detectors. Type and number of devices: Addressable: 1 Conventional: Other (specify): . V Type of coverage: 0 Complete area IJ Partial area 0 Nonrequired partial area Other (specify): - - Type of smoke detector sensing technology: 0 Ionization Photoelectric 0 Multicriteria 0 Aspirating 0 Beam Other (specify): V 5.2.2 Duct Smoke Detectors 10 This system does not have alarm-causing duct smoke detectors. Type and number of devices: Addressable: Conventional: Other (specify): . V Type of coverage: V Type of smoke detector sensing technology: 0 Ionization 0 Photoelectric 0 Aspirating 0 Beam 5.2.3 Radiant Energy (Flame) Detectors This system does not have radiant energy detectors. Type and number of devices: Addressable: Conventional: - Other (specify): V - Type of coverage: 5.2.4 Gas Detectors 4'his system does not have gas detectors. Type of detector(s): V Number of devices: Addressable: Conventional: V Type of coverage: V V V V 5.2.5 Heat Detectors i .This system does not have heat detectors. Type and number of devices: Addressable: Conventional: Type of coverage: 0 Complete area 0 Partial area 0 Nonrequired partial area 0 Linear 0 Spot Type of heat detector sensing technology: 0 Fixed temperature 0 Rate-of-rise 0 Rate compensated NFPA72,Fig. 1018211 (V4Of 12) 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. 5. ALARM INITIATING DEVICES (continued) 5.2.6 Addressable Monitoring Modules Number of devices: 5.2.7 Waterfiow Alarm Devices Type and number of devices: Addressable: / 5.2.8 Alarm Verification Number of devices subject to alarm verification: 5.2.9 Presignal Number of devices subject to presignal: Describe presignal functions: 5.2.10 Positive Alarm Sequence (PAS) Describe PAS: 5.2.11 Other Initiating Devices Describe: gThis system does not have monitoring modules. 0 This system does not have waterfiow alarm devices. Conventional: Coded: Transmitter: .This system does not incorporate alarm verification. Alarm verification set for seconds ,This system does not incorporate pre-signal. jZ This system does not incorporate PAS. ,This system does not have other initiating devices. 6. SUPERVISORY SIGNAL-INITIATING DEVICES 6.1 Sprinkler System Supervisory Devices 0 This system does not have sprinkler supervisory devices. Type and number of devices: Addressable: / Conventional: Coded: Transmitter: Other (specify): - - 6.2 Fire Pump Description and Supervisory Devices 4 This system does not have a fire pump. Type fire pump: 0 Electric pump 0 Engine Type and number of devices: Addressable: Conventional: Coded: Transmitter: Other (specify): 6.2.1 Fire Pump Functions Supervised o Power 0 Running 0 Phase reversal 0 Selector switch not in auto 0 Engine or control panel trouble 0 Low fuel Other (specify): 6.3 Duct Smoke Detectors (DSDs) 0 This system does not have DSDs causing supervisory signals. Type and number of devices: Addressable: Conventional: Other (specify): Type of coverage: - Type of smoke detector sensing technology: 0 Ionization 0 Photoelectric 0 Aspirating 0 Beam 6.4 Other Supervisory Devices $This system does not have other supervisory devices. Describe: NFPA 72, Fig. 10.18.2.1.1 (p. 5 of 12) 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. 7. MONITORED SYSTEMS 7.1 Engine-Driven Generator 7.1.1 Generator Functions Supervised Engine or control panel trouble 0 Generator running Other (specify): 7.2 Special Hazard Suppression Systems Description of special hazard system(s): 7.3 Other Monitoring Systems Description of special hazard system(s): ANNUNCIATORS 8.1 Location and Description of Annunciators Location 1: Location 2: Location 3: This system does not have a generator. N. 0 Selector switch not in auto 0 Low fuel This system does not monitor special hazard systems. This system does not monitor other systems. 0 This system does not have annunciators. ALARM NOTIFICATION APPLIANCES 9.1 In-Building Fire Emergency Voice Alarm Communication System 419LThis system does not have an EVACS. Number of single voice alarm channels: Number of multiple voice alarm channels: Number of speakers: Number of speaker circuits: Location of amplification and sound-processing equipment: Location of paging microphone stations: Location I: Location 2: - - - Location 3: 9.2 Nonvoice Notification Appliances 0 This system does not have nonvoice notification appliances. Horns: ,' With visible: Bells: With visible: Chimes: With visible: Visible only: - Other (describe): 9.3 Notification Appliance Power Extender Panels This system does not have power extender panels. Quantity: - Locations: NFPA 72, Hg. 10.18.21.1 (p.60f12) 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. MASS NOTIFICATION CONTROLS, APPLIANCES, AND CIRCUITS X This system does not have an MNS. 10.1 MNS Local Operating Consoles Location 1: Location 2: Location 3: 10.2 High-Power Speaker Arrays Number of HPSA speaker initiation zones: Location 1: Location 2: Location 3: 10.3 Mass Notification Devices Combination fire alarm/MNS visible appliances: MNS-only visible appliances: Textual signs: Other (describe): Supervision class: 103.1 Special Hazard Notification o This system does not have special suppression predischarge notification. C] MNS systems DO NOT override notification appliances required to provide special suppression predischarge notification. TWO-WAY EMERGENCY COMMUNICATION SYSTEMS 11.1 Telephone System This system does not have a two-way telephone system. Number of telephone jacks installed: - Number of warden stations installed: Number of telephone handsets stored on site: Type of telephone system installed: 0 Electrically powered 0 Sound powered 11.2 Two-Way Radio Communications Enhancement System This system does not have a two-way radio communications enhancement system. Percentage of area covered by two-way radio service: Critical areas: % General building areas: % Amplification component locations: Inbound signal strength: - dBm Outbound signal strength: - dBm Donor antenna isolation is: - dB above the signal booster gain Radio frequencies covered: - Radio system monitor panel location: . NFPA 72, Fig. 10.18.2.1.1 (p.7of 12) 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. TWO-WAY EMERGENCY COMMUNICATION SYSTEMS (continued) 113 Area of Refuge (Area of Rescue Assistance) Emergency Communications Systems is system does not have an area of refuge (area of rescue assistance) emergency communications system. Number of stations: Location of central control point: Days and hours when central control point is attended: Location of alternate control point: Days and hours when alternate control point is attended: 11.4 Elevator Emergency Communications Systems .jLhis system does not have an elevator emergency communications system. Number of elevators with stations: Location of central control point: Days and hours when central control point is attended: Location of alternate control point: Days and hours when alternate control point is attended: 11.5 Other Two-Way Communication Systems Describe: CONTROL FUNCTIONS This system activates the following control fuctions: o Hold-open door releasing devices 0 Smoke management 0 HVAC shutdown 0 F/S dampers 0 Door unlocking 0 Elevator recall 0 Fuel source shutdown 0 Extinguishing agent release 0 Elevator shunt trip 0 Mass notification system override of fire alarm notification appliances Other (specify): 12.1 Addressable Control Modules ,This system does not have control modules. Number of devices: Other (specify): SYSTEM POWER 13.1 Control Unit 13.1.1 Primary Power Input voltage of control panel: Control panel amps: Overcurrent protection: Type: tr.€'.1/?-4t Amps: 2. Location (of primary supply panel board): 5prsi A6ir' I21Sei Disconnecting means location: E/ec-fr/CJ12 13.1.2 Engine-Driven Generator %Zli is system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: NFPA 72, Fig. 10.18.2.1.1 (p.8 of 12) 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. SYSTEM POWER (continued) 13.1.3 Uninterruptible Power System WThis system does not have a UPS. Equipment powered by a UPS system: Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode (hours): In alarm mode (minutes): 13.1.4 Batteries 1219_CP Location: Type: /)k Nominal voltage: / 2.. Amp/hour rating: Calculated capacity of batteries to drive the system: In standby mode (hours): ,. 1/ In alarm mode (minutes): Batteries are marked with date of manufacture 0 Battery calculations are attached 13.2 In-Building Fire Emergency Voice Alarm Communication System or Mass Notification System 62ZThis system does not have an EVACS or MNS system. 13.2.1 Primary Power Input voltage of EVACS or MNS panel: EVACS or MNS panel amps: Overcurrent protection: Type: Amps: Location (of primary supply panel board): Disconnecting means location: 13.2.2 Engine-Driven Generator aThis system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 13.2.3 Uninterruptible Power System KThis system does not have a UPS. Equipment powered by a UPS system: Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode (hours): In alarm mode (minutes): 13.2.4 Batteries Location: Type: Nominal voltage: Amp/hour rating: Calculated capacity of batteries to drive the system: In standby mode (hours): In alarm mode (minutes): D Batteries are marked with date of manufacture 0 Battery calculations are attached NFPA 72, Fig. 10.182.1.1 (p.9 of 12) 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. SYSTEM POWER (continued) 13.3 Notification Appliance Power Extender Panels 13.3.1 Primary Power Input voltage of power extender panel(s): Overcurrent protection: Type: Location (of primary supply panel board): Disconnecting means location: .JJuis system does not have power extender panels. Power extender panel amps: Amps: 13.3.2 Engine-Driven Generator jhis system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 13.3.3 Uninterruptible Power System This system does not have a UPS. Equipment powered by a UPS system: Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode (hours): In alarm mode (minutes): 13.3.4 Batteries Location: Type: Nominal voltage: Amp/hour rating: Calculated capacity of batteries to drive the system: In standby mode (hours): In alarm mode (minutes): Batteries are marked with date of manufacture 0 Battery calculations are attached 14. 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. This is a: KNew system 0 Modification to an existing system Permit number: The system has been installed in accordance with the following requirements: (Note any or all that apply.) &NFPA 72, Edition: aOl C 0 NFPA 70, National Electrical Code, Article 760, Edition: 0 Manufacturer's published instructions Other (specify): System deviations from referenced NFPA standards: Signed: Printed name: /9 Date: ,e c-20/ 7' Organization: ,t/tf F)' L Title: Phone: 'ss-éifO NFPA 72, Fig. 10.18.2.1.1 (p. 10 of 12) 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. RECORD OF SYSTEM OPERATIONAL ACCEPTANCE TEST 1gw system 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 for the following: 0 Modifications to an existing system All newly modified operational features and functions of the 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 the following: 0 NFPA 72, Edition: 0 NFPA 70, National Electrical Code, Article 760, Edition: 0 Manufacturer's published instructions Other (specify): 0 Individual device testing documentation [Inspection and Testing Form (Figure 14.6.2.4) is attached] Signed: Printed name: Date: 10 Organization: F '- Title: Phone: CERTIFICATIONS AND APPROVALS 16.1 System Installation Contractor: This system, as specified herein, has been installed and tested according to all NFPA standards cited herein. Signed: Printedname: 12c4% '4- Date: /o S Organization: i- Title: Phone: 16.2 System Service Contractor: The undersigned has a service contract for this system in effect as of the date shown below. Signed: Printed name: Organization: Title: 16.3 Supervising Station: This system, as specified herein, will be monitored according to all NFPA standards cited herein. Date: Phone: Signed: Printed name: Date: Organization: Title: Phone: NFPA 72, Fig. 10.18.2.1.1 (p. 11 of 12) Copyright 0 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. 16. CERTIFICATIONS AND APPROVALS (continued) 16.4 Property or Owner Representative: I accept this system as having been installed and tested to its specifications and all NFPA standards cited herein. Signed: Printed name: Date: Organization: Title: Phone: 16.5 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, with its approved sequence of operations, and with all NFPA stand rds cited herein. Signed: Printed name: ._(yteV't1?ffr4 Date: Jf3 /2 Organization Title: IfIZ 2~I4- Phone: 7(0O .z'74éS NFPA 72, Fig. 10.18.21.1 (p.12 of 12) 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.