HomeMy WebLinkAboutFIRE SUPPRESSION CERTIFICATE - 17-00265 - 1490 N 2nd E - Panda Express - Automatic Fire SystemFire Suppression System Distributor Certificate of Installation
ro be Completed by Keglional office
Job Name r.! yj cf ���%SS ��f'X(a)� Gf Job Number Z(oq % -7
Job Address ) ��� �Z ti/c�G S Type of System: Ansul S'
Pyrochem F112 ex %�y /2�. � �� hyo
Other
To be Completed bV Fire bVstem Distributor
Company Name L. f { Sef0i'ce O Z d c, h c) System Model 12
Address (" I c V106 ���i �� Serial Number
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Fuel/Energy Shut Off Device
Installed. Tested on `6 P(,111-7
Gas Valve: Mechanical V Electrical ❑
Shunt Breaker
Size 2
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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 Name ffQZ,"
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Signature
Date qb l o//7
To be Completed by owner or owner's Kepresentative
I have received a copy of the Fire Suppression System Owner's Manual and I understand it. I also
understand tW it is the recommendation of the National Fire Protection Association (NFPA) that
the system VjYinspectedpvery six months to maintain its reliability.
Signatu
ate a n/4�, ;/ %
To be Completed by the Authority Having Jurisdiction
Functional tests have beenwitnessed and the system performs as designed.
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Signature /, we Date a � 2 4 Z