HomeMy WebLinkAbout2265 CAMINO VIDA ROBLE; ; FA160002; PermitCity of Carlsbad
Fire Alarm Permit
Permit No: FA160002
2265 CAMINO VIDA
Job Address:
ROBLE
Permit Type: FALARM
Parcel No: 2130502400
Lot #: 0
Reference No.:
PC #:
Project Title: THE FIELDS CHURCH
Status: APPROVED
Applied 1/15/2016
Approved: 2/9/2016
Issued: 2/9/2016
Inspector:
Applicant:
DIALCOM SYSTEM SERVICES
1541 SIMPSON WAY
ESCONDIDO, CA
760-233-9787
Owner:
RBCORELP
P0 BOX 1780
LA MESA CA
Fees ($)
1
Add'l Fees ($) Total ($) Balance
519.5 0 519.5 0
f4(0 o 0 2,
VILE CO1!
FIRE ALARM AND EMERGENCY COMMUNICATION SYSTEM RECORD OF COMPLETION
To be completed by the system installation contractor at the time ofsystem acceptance and approval.
It shall be permitted to mod,5' 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.
I- PROPERTY INFORMATION
Name of property: The Fields Church
Address: 2265 Camino Vida Roble Carlsbad, CA. 92011
Description of property: Church and school
Occupancy type: A-3,B,E,S-1
Name of property representative: Brad Robinson
Address: same
Phone: 1-713-503-9225 Fax: NIA E-mail:
Authority having jurisdiction over this property: City of Carlsbad Fire Prevention
Phone: 760-6024665 Fax: E-mail:
bradthefieldschurth.org
INSTALLATION, SERVICE, AND TESTING CONTRACTOR INFORMATION
Installation contractor for this equipment Dialcom Systems Group Inc
Address: 1541 Simpson Way Escondido, Ca 92029
License or certification number: CIO-703343
Phone: 760-520-5044 Fax: 160-839-5892 E-mail: jamiedialcomsystemsgroup.net
Service organization for this equipment: same as above
Address:
License or certification number: C-b 0 #703343
Phone: 760520-5044 Fax: 760-839-5892 E-mail: admindiaIcomsystemsgroupnet
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 9
Fire alarm system (nonvoice)
C) Fire alarm with in-building fire emergency voice alarm communication system (EVACS)
Mass notification system (MNS)
C] Combination system, with the following components:
0 Fire alarm 0 EVACS 0 MNS 0 Two-way, in-building, emergency communication system
Other (specify):
NFPA 72, Fig. 10.18.2.1.1 (p. 1 of 12)
Copyright 02009 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: 2013
3.1 Control Unit
Manufacturer: Edwards
3.2 Mass Notification System
3.2.1 System Type:
In-building MNS—combination
El In-building MNS—stand-alone
C1 Other (specify):
Additional description of system(s):
Model number: VS-1
This system does not incorporate an MNS
0 Wide-area MNS 0 Distributed recipient MNS
3.2.2 System Features:
Combination fire alarm/MNS 0 MNS autonomous control unit 0 Wide-area MNS to regional national
alerting interface
Local operating console (LOC) 0 Direct recipient MNS (DRMNS) 0 Wide-area MNS to DRMNS interface
Wide-area MNS to high-power speaker array (HPSA) interface 0 In-building MNS to wide-area MNS interface
Other (specify):
3.3 System Documentation
0 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:
3.4 System Software ED This system does not have alterable site-specific software.
Operating system (executive) software revision level:
Site-specific software revision date: Revision completed by:
El A copy of the site-specific software is stored on site. Location:
3.5 Off-Premises Signal Transmission 0 This system does not have off-premises transmission.
Name of organization receiving alarm signals with phone numbers:
Alarm: Central Monitoring Station - Poway Phone: 858-578-3266
Supervisory: same Phone: same
Trouble: same Phone: same
Entity to which alarms are retransmitted: Carlsbad Fire Department Phone:
Method of retransmission: CMS operator calls Carlsbad Fire
If Chapter 26, specify the means of transmission from the protected premises to the supervising station:
DACT
If Chapter 27, specify the type of auxiliary alarm system: 0 Local energy 0 Shunt 0 Wired 0 Wireless
NFPA 72, Fig. 10.18.2.1.1 (p.2 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.
4. CIRCUITS AND PATHWAYS
4.1 Signaling Line Pathways
4.1.1 Pathways Class Designations and Survivability
Pathways class: B Survivability level: 0 Quantity: 4
(See NFPA 72, Sections 12.3 and 12.4)
4.1.2 Pathways Utilizing Two or More Media
Quantity: Description:
4.1.3 Device Power Pathways
No 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: B Survivability level: 0 Quantity:
(See NFPA 72, Sections 12.3 and 12.4)
4.2.2 Pathways Utilizing Two or More Media
Quantity: Description:
4.2.3 Device Power Pathways
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 12.4)
4.3.2 Pathways Utilizing Two or More Media
Quantity: Description:
4.33 Appliance Power Pathways
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. 10182.1,1 (p. 3 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,
5. ALARM INITIATING DEVICES
5.1 Manual Initiating Devices
5.1.1 Manual Fire Alarm Boxes
Type and number of devices: Addressable: 2o
Other (specify):
5.1.2 Other Alarm Boxes
Description:
Type and number of devices: Addressable:
Other (specify):
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 Automatic Initiating Devices
5.2.1 Smoke Detectors 0 This system does not have smoke detectors.
Type and number of devices: Addressable: 1 Conventional:
Other (specify):
Type of coverage: 0 Complete area 0 Partial area 0 Nonrequired partial area
Other (specify): Above FACP only
Type of smoke detector sensing technology: 0 Ionization D Photoelectric 0 Multicriteria 0 Aspirating 0 Beam
Other (specify):
5.2.2 Duct Smoke Detectors 0 This system does not have alarm-causing duct smoke detectors.
Type and number of devices: Addressable: Conventional:
Other (specify):
Type of coverage:
Type of smoke detector sensing technology: 0 Ionization 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):
Type of coverage:
5.2.4 Gas Detectors This system does not have gas detectors.
Type of detector(s):
Number of devices: Addressable: Conventional:
Type of coverage:
5.2.5 Heat Detectors 0 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
NFPA 72, Fig. 10.18.2.1.1 (p.4of12l
Copyright 0 2009 National Are 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: 4
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:
0 This system does not have monitoring modules.
0 This system does not have waterflow alarm devices.
Conventional: Coded: Transmitter:
This system does not incorporate alarm verification.
Alarm verification set for seconds
This system does not incorporate pre-signal.
This system does not incorporate PAS.
D This system does not have other initiating devices.
6. SUPERVISORY SIGNAL-INITIATING DEVICES
6.1. Sprinkler System Supervisory Devices 0 This system does nothave sprinkler supervisory devices.
Type and number of devices: Addressable: I Conventional: Coded: Transmitter:
Other (specify):
6.2 Fire Pump Description and Supervisory Devices 0 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): t1WI i10-e4 (C/ Z€e55fttk /'ie'Lh)kS
Type of coverage:
Type of smoke detector sensing technology: 0 Ionization 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 o 121
Copyright 02009 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 This system does not have a generator.
7.1.1 Generator Functions Supervised
Engine or control panel trouble 0 Generator running 0 Selector switch not in auto 0 Low fuel
Other (specify):
72 Special Hazard Suppression Systems This system does not monitor special hazard systems.
Description of special hazard system(s):
7.3 Other Monitoring Systems 0 This system does not monitor other systems.
Description of special hazard system(s):
8. ANNUNCIATORS This system does not have annunciators.
8.1 Location and Description of Annunciators
Location I: /)eAI(
Location 2:
Location 3:
9. ALARM NOTIFICATION APPLIANCES
9.1 In-Building Fire Emergency Voice Alarm Communication System ED This 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 1:
Location 2:
Location 3:
9.2 Nonvoice Notification Appliances 0 This system does not have nonvoice notification appliances.
Horns: 3 With visible: 4 /3 Bells: / With visible: 0
Chimes: With visible:
Visible only: 12 Other (describe):
9.3 Notification Appliance Power Extender Panels This system does not have power extender panels.
Quantity: f
Locations: 47- ffrf
NFPA 72, Fig. 10.18.2.1.1 (p.60f12)
Copyright 0 21309 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sole or distribution.
MASS NOTIFICATION CONTROLS, APPLIANCES, AND CIRCUITS 0 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:
10.3.1 Special Hazard Notification
This system does not have special suppression predischarge notification.
0 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
IXI 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: dBrn
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. 7 of 12
Copyright 02009 National Are Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sate or distribution.
TWO-WAY EMERGENCY COMMUNICATION SYSTEMS (continued)
11.3 Area of Refuge (Area of Rescue Assistance) Emergency Communications Systems
This 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
IZI This 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:
Hold-open door releasing devices 0 Smoke management 0 HVAC shutdown 0 F/S dampers
Door unlocking 0 Elevator recall 0 Fuel source shutdown 0 Extinguishing agent release
Elevator shunt trip 0 Mass notification system override of fire alarm notification appliances
Other (specify):
This system does not have control modules. 12.1 Addressable Control Modules
Number of devices:
Other (specify):
13. SYSTEM POWER
13.1 Control Unit
13.1.1 Primary Power
Input voltage of control panel: 120VAC
Overcurrent protection: Type: Breaker
Location (of primary supply panel board): Service in building
Disconnecting means location: House panel breaker #
Control panel amps: 1.5
Amps: 20
13.1.2 Engine-Driven Generator This 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 121,
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.
13. SYSTEM POWER (continued)
13.1.3 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):
13.1.4 Batteries
Location: FACP Type: Lead-Acid Nominal voltage: 12vdc Amp/hour rating: lOah
Calculated capacity of batteries to drive the system:
In standby mode (hours): 24 In alarm mode (minutes): 5
II 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
This system does not have an EVACS or MNS system.
13.2.1 Primary Power
Input voltage of EVACS or MNS panel:
Overcurrent protection: Type:
Location (of primary supply panel board):
Disconnecting means location:
EVACS or MNS panel amps:
Amps:
13.2.2 Engine-Driven Generator This system does not have a generator.
Location of generator:
Location of fuel storage: Type of fuel:
13.2.3 Uninterruptible Power System ED 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):
13.2.4 Batteries
Location: Type: Nominal voltage: Amp/hour rating:
Calculated capacity of batteries to drive the system:
In standby mode (hours): In alarm mode (minutes):
0 Batteries are marked with date of manufacture 0 Battery calculations are attached
NFPA 72, Fin. 10.18.2.1.1 (p.9of12)
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.
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:
This system does not have power extender panels.
Power extender panel amps:
Amps:
13.3.2 Engine-Driven Generator This system does not have a generator.
Location of generator:
Location of fuel storage: Type of fuel:
13.3.3 Uninterruptible Power System Q 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):
0 Batteries are marked with date of manufacture 0 Battery calculations are attached
RECORD OF SYSTEM INSTALLATION
Fill out after all installation is complete and wiring has been checkedfor opens, shorts, groundfaults, and improper
branching, but before conducting operational acceptance tests.
This is a: 0 New 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: 2013
NFPA 70, National Electrical Code, Article 760, Edition:
Manufacturer's published instructions
Other (specify):
System deviations from referenced NFPA standards:
Signed: Printed name: çç 2,4L/ Date: Organization: I/fr/ êO#'1 y~fl Title: Phone: 7/o 2O 5 ' W
thv10 fj! I
NFPA 72, Fig. 10.18.2.1.1 (p. 10 of 12)
Copyright 02009 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
New system
All operational features andfunctions 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:
o Modifications to an existing system
All newly modified operational features andfunctions 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:
El NFPA 72, Edition: 2013
0 NFPA 70, National Electrical Code, Article 760, Edition:
0 Manufacturer's published instructions
Other (specify):
O Individual device testing documentation [Inspection and Testing Form (Figure 14.6.2.4) is attached]
Signed: Printed name: Date:
Organization: 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: )C) ,E71' Printed name: rj1ciq
Organization: )jfr/j £y'6rcl15 Title:
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: Date:
Organization: Title: Phone:
16.3 Supervising Station:
This system, as specified herein, will be monitored according to all NFPA standards cited herein.
Signed: Printed name: Date:
Organization: Title: Phone:
NFPA 72, Fig. 10.181.11 (p.11 of 12)
Copyright 02009 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.
Date:
Phone:
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.
Sign 7~_..._ Printed name: 61)i &SO1.7 Date:
Organ tion Title: Phone:71 , _
165 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 standards cited herein.
Signed: Printed name: Date:
Organization: Title: Phone:
NFPA 72, Fig. 10182.1i (p. 12 of 12
copyright 02009 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.