HomeMy WebLinkAboutFIRE ALARM TEST-INSPECTION - 16-00052 - 250 W 1st N - 12 Plex - Bear Building 1 - East101 AW Alk
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larm
PROTECTING YOUR HOME AND BUSINESS SINCE 19W
Boise, Idaho (208) 323-1199
Idaho Falls, Idaho (208) 524.4282
Salt Lake City, Utah (88011,) 486-7231
ACCOUNT NUMBER: k5 — 09 (z Z
PROPERTY -NAME:
Name: t n
Address W • 1'5�
Owner Cone ?�
Telephone:
APPROVINGAGELVC k6,, t
Contact: lLt
Telephone:
TYPE TRANSMISSION: 4 DIGITAL ❑ NONE
SERVICE: 'i Annual ❑ Other: A3
PANEL PANEL MAKE/MODEL: S,len ' r.1
CKT STYLES: AlNO, OF CKT :-
ALARM INITIATING DEVICES AND CKT INFO
Qty of Ckt Style
_! _?L_ Manual pull station
_ 2- PE Smoke
Duct detectors
I 7- Heat detectors
21_ Waterflow switches
Supervisory switches
Other:
ALARM NOTIFICATION DEVICES & CKT INFO
Qty of Ckt Style
Bells
Horn/Strobes
Strobes-n-
�_ Other: 4uf/�.� iron
SIGNALING LINE CKTS
Qty of: f Style:
SYSTEM POWER SUPPLIES
Primary: Voltage: Ila Am s: 2'11;�
Overcurrent protection Type:
AC disconnect location: j f;qe-h7
Secondary: Sealed Lead -Acid battery
I L AH
Calculated backup: Z l Hours
PRIOR TO ANY TESTING
Notifications are made:
Yes
No
Monitoring Entity
-a-
❑
Building Occupants
.I-
❑
Local Dispatcher
W
❑
Other:
❑
❑
PAC 142
SYSTEM TESTS AND
Type:
Control panel
Lamps/LEDs
Primary Power
Fuses
Ground Fault Indication
Disconnect Switches
Trouble Signals
SECONDARY POWER
Type:
Battery condition
Load Voltage
Visual Functional
Before: After:
REMOTE ANNUNCIATORS
Type: Visual Functional
❑ ❑
NOTIFICATION APPLIANCES
Type:
'Cr
Functional
EF-
❑
❑
-0"
8'
la'
.0'
LK
1 -
Visual
Functional
Alarm/Restoral Signal
13
❑
T-
Before: After:
REMOTE ANNUNCIATORS
Type: Visual Functional
❑ ❑
NOTIFICATION APPLIANCES
Type:
Visual
Functional
Audible
@
$
Visual
0'
Q-
ON/OFF PREMISE MONITORING
YES
NO
Alarm/Restoral Signal
13
❑
Trouble/Restoral Signal
a
❑
Supervisory/Restoral Signal
B'
❑
TESTING COMPLETE
Notifications are made:
Yes
No
Monitoring Entity
e-
❑
Building Occupants
❑-
❑
Local Dispatcher
lr
❑
Other:
❑
❑
The following did not operate properly: Al I7
System Restorqd to normal operations
Date: P% 3/ Time: Oeo
This testing was performed in accordance with
applicable NFPA standards
Inspector Name: l.-qQ
Signature: �"-
Date: 31 1 11 b
Owner Rep Name:
Signature:
FIRE ALARM SYSTEM RECORD OF
COMPLETION (NFPA 72. Fie 4.5.2.1)
Installer: Peak AlararComgany
Service Org.: Peak Alarm Company
Location of Dwgs: Peak Alarm Office
Location of owners manual: On-site
Location of Test Reports: On-site
Contract for Tests and Inspections dated:
1. Type of System or Service
NFPA 72, Chapter 6 - Local
_,UNFPA 72, Chapter 8 - Remote Station
Telephone No. of organization receiving
Alarms/Supervisory/Troubles:
Peak Alarm Company -1 (800) 444-7231
NFPA 72, Chapter 8 - Central Station
Prime Contractor:
Central Station Location:
Means of transmission of signals from protected premise
to central station: _-_�-_DACT None
2. Record of System Installation
This system has been installed IAW NFPA standards as
sho elow, was inspected by lw94ty a-4 a-- on
30 t `,e includes the devices sh� 5 and 6,
and has been in service since At 30 11 ) .
---,<-NFPA 72, Chapters 12 4 5 6 7 8 9 10 11
NFPA 70, National Electric Code, Article 760
Mannufacturers Instructions
Signed: Date: 8 30 i>•
Organization: Peak Alarmedirmany
3. Record of System Ooeration
Documentation IAW Inspection Testing Form, Figure
10.6.2.3, of NFPA 72 is attached qm5
All opperation features of this syst ere tested by
i -- Date aI 1 io and were
found to be operating properly IAW the requirements of:
e72, Chapters 12 3 4 5 6 7 8 9 10 11
NFPA 70, National Electric Code
Manufacturers Instructions
Signed: 9.. - Date: �t )
Organization: Peak Alarm mgany
4. Signaling Line Circuits
Quantity and class of SLC connected to system (see
NFPA 72, Table 6.6.1):
Quantity:---(_Style:�Class:
5. Alarm Initiatina Devices and Circuits
Quantity and class of initiating device circuits
(see NFPA 2, Table 6.5):
Qty:— I :Class:
MANUAL
MPS: Non Coded Addressable_
AUTOMATIC
Coverage Complete Partial
(a) Smoke Detectors: Photo Addressable "t_-
(b) Duct Detectors: Photo Addressable_
C Heat Detectors: FT_RR_FT/RR
Addressable
(d) Sprinkler Waterflow, indicators:
Noncoded Addressable /
(e) The alarm verification feature is disabled or
enabled , changed from
seconds to _seconds.
(f) Other (list):
6. Sunervisory Signal Initiating Devices and Circuits
(a)Sprinkler valve tamper switches:_
(b)Other:
. nnuciat rs
Number:ype:
Location(s):
8. Alarm Notification Aooliances and Circuits
Quantity and class of notification appliance circuits
connected to s stem (see NFPA 72, Table 6.7)
QTY:Style cF Class_ 9
Types and quantity of notification appliances installed:
(a) Bells With visible_
(b) Speakers With visible_
(c) Horns With visible
(d) Chimes With visible_
(e) Other With visible_
(f) Visible appliances without audible:_
9. System Power Sunolies
(a) Fire Alarm Control Panel
Nominal Voltage:j0 Current rating
Overcurrent Protection: Type: Circuit Breaker Tri
Location: s:2. %_d-- Ar ",e-( b ✓ FA Lim
(b) Secondary (standby) Calculated chpacity to drive
system, in hours: >2�k Battery AH rating: IZ.
10. Comments
Frequency of tests and inspections, if other than IAW the
referenced NFPA standards: ZM f%x-
System Deviations from the referenced NFPA standard(s)
are: 4,hor
Upon completion of the stems) satisfactory test(s)
witnessfdfArequired bA to AHJ):
Signed:
Title: