Loading...
HomeMy WebLinkAboutFA REPORT - 18-00034 - 1160 Bond Ave - Dish One Satellite - New BuildingKvie X C •t7 � c 1 FIRE ALARM AND EMERGENCY COMMUNICATION SYSTEM RECORD OF COMPLETION To be completed by the system installation contractor at the time of stem acceptance and approval. It shall be permitted to mod fy 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: ILA I b e / 0 t aw z - Address: Ave—, G Description of property: 5Gcfe Occupancy type: GROUP AA,� Name of property representative: !' 1( Address: tlGu C5­te Phone:/ U� ' �d�- 2Z .2. .Fax: E-mail: Lc.--@...�.1<h moi' sm�i' > Gc,�•.� Authority having jurisdiction over this property: - REXBURG FIRE MARSHAL Phone: Fax: E-mail: 2. INSTALLATION, SERVICE, AND TESTING CONTRACTOR INFORMATION Installation contractor for this equipment: 4S1ght Security, L.L.C. Address: 6944 Big Bend, Idaho Falls, ID 83406 License or certification number: Contractor: # RCE -37051 In ELE-SC-021298 Phone: 208-403-1434 Fax: E-mail: Trevor(cD4sightsecurityorg Service organization for this equipment: 4Sight Security, L.L.C. Address: 6944 Big Bend, Idaho Falls, ID 83406 License or certification number: Contractor: # RCE -37051; ID ELE-SC-0.21298 Phone: 208-403-1434 Fax: E-mail: A contract for test and inspection in accordance with NFPA standards is in effect as of. Contracted testing company: 4Sight Security, L.L.C. Address: 6944 Big Bend, Idaho Falls, ID 83406 Phone: 208-403-1434 FaN: E-mail: Contract expires: RENEW Contract number: NIA Frequency of routine inspections: ANNUAL 3. DESCRIPTION OF SYSTEM OR SERVICE 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: Fire alarm EVACS MNS Two-way, in -building, emergency communication system 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. Other (specify): 3. DESCRIPTION OF SYSTEM OR SERVICE (continued) NFPA 72 edition: 2010 3.1 Control Unit Manufacturer: $tLfcpQfiifl�ig7Vf 3.2 Mass Notification System MNS 3.2.1 System Type: In -building MNS--combination In -building MNS--stand-alone Other (specify): Additional description of system(s): Wide -area MNS Model number: -50=4t. Fi-�C This system does not incorporate an Distributed recipient MNS 3.2.2 System Features: Combination fire alarm/MNS MNS autonomous control unit Wide -area MNS to regional national alerting interface Local operating console (LOC) Direct recipient MNS (DRMNS) Wide -area MNS to DRMNS interface Wide -area MNS to high-power speaker array (HPSA) interface In -building MNS to wide -area MNS interface Other (specify): 3.3System 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: 3ASystem Software software. Operating system (executive) software revision level: Site-specific software revision date: 12-20-2018 A copy of the site-specific software is stored on site. Location: This system does not have alterable site-specific Revision completed by: MIKE BLACKBURN 3.50ff-Premises Signal Transmission transmission. This system does not have off -premises Name of organization receiving alarm signals with phone numbers: Alarm: AVANT GUARD MONITORING Phone: 877-206-9141 Supervisory: AVANT GUARD MONITORING Phone: 877-206-9141 Trouble: AVANT GUARD MONITORING Phone: 877-206-9141 Entity to which alarms are re-transmitted: Method of re- DIGITAL VIA TELCO transmission: 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: Local energy Shunt Wired 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: N/A Survivability level: (See NFPA 72, Sections 12.3 and 12.4) Quantity: 4.1.2 Pathways Utilizing Two or More Media Quantity: 0 Description: N/A 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 4.2Alarm Initiating Device Pathways 4.2.1 Pathways Class Designations and Survivability Pathways class: C Survivability level: 1 (See NFPA 72, Sections 12.3 and 12.4) Quantity: 1 4.2.2 Pathways Utilizing Two or More Media Quantity: 1 Description: ALARM INITIATING AND NAC'S RUN TOGETHER 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: B Survivability level: 1 (See NFPA 72, Sections 12.3 and 12.4) Quantity: 8 4.3.2 Pathways Utilizing Two or More Media Quantity: 8 Description: ALARM INITIATING AND NAC'S RUN TOGETHER 4.3.3 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. 10.18.2.1.1 (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 This system does not have manual fire alarm boxes. Type and number of devices: Addressable: 7 Conventional: Coded: Transmitter: Other (specify): 5.1.2 Other Alarm Boxes Description: Type and number of devices: Addressable: Conventional: Other (specify): 5.2 Automatic Initiating Devices 5.2.1 Smoke Detectors Type and number of devices: Addressable: 33 Conventional: Other (specify): Type of coverage: Complete area Partial area Nonrequired partial area Other (specify): This system does not have other alarm boxes. Coded: Transmitter: This system does not have smoke detectors. Type of smoke detector sensing technology: Ionization Photoelectric Multicriteria Aspirating Beam Other (specify): 5.2.2 Duct Smoke Detectors X 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: Ionization Photoelectric Aspirating 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 Type of detector(s): Number of devices: Addressable: Conventional: Type of coverage: 5.25 Heat Detectors Type and number of devices: Addressable: Conventional: Type of coverage: Complete area Partial area Nonrequired partial area Type of heat detector sensing technology: Fixed temperature Rate -of -rise This system does not have gas detectors. This system does not have heat detectors. Linear Spot Rate compensated NFPA 72. Fig. 10.18.2.1.1 (p. 4 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 (continued) 5.2.6 Addressable Monitoring Modules Number of devices: This system does not have monitoring modules. 5.2.7 Watertlow Alarm Devices devices. This system does have waterflow alarm Type and number of devices: Addressable: 1 Conventional: Coded: Transmitter: 5.2.8 Alarm Verification verification. This system does not incorporate alarm Number of devices subject to alarm verification: Alarm verification set for 5.2.9 Presignal seconds Number of devices subject to presignal: This system does not incorporate pre -signal. Describe presignal functions: 5.2.10 Positive Alarm Sequence (PAS) Describe PAS: This system does not incorporate PAS. 5.2.11 Other Initiating Devices Describe: This system does not have other initiating devices. 6. SUPERVISORY SIGNAL -INITIATING DEVICES 6d Sprinkler System Supervisory Devices This system does not have sprinkler supervisory devices. Type and number of devices: Addressable: _2 Conventional: Coded: Other (specify): Transmitter: 62 Fire Pump Description and Supervisory Devices This system does not have a fire pump. Type fire pump: Electric pump Engine Type and number of devices: Addressable: Conventional: Coded: Other (specify): Transmitter: 6.2.1 Fire Pump Functions Supervised Power Running Phase reversal Selector switch not in auto Engine or control panel trouble Low fuel Other (specify): 5.3 Duct Smoke Detectors (DSDs) This system does not have DSDs causing Type and number of devices: Addressable: 1 supervisory signals. Conventional: Other (specify): Type of coverage: Type of smoke detector sensing technology: Ionization Photoelectric Aspirating 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 9 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 Generator running Other (specify): 72 Special Hazard Suppression Systems Description of special hazard system(s): 7.3 Other Monitoring Systems Description of special hazard system(s): 8. ANNUNCIATORS 81 Location and Description of Annunciators Location 1: EXISTING BUILDING MAIN ENTRY Location 2: Location 3: 9. ALARM NOTIFICATION APPLIANCES This system does not have a generator. Selector switch not in auto Low fuel This system does not monitor special hazard systems. This system does not monitor other systems. This system does not have annunciators. 9.1 In -Building Fire Emergency Voice Alarm Communication System 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 l: Location 2: Location 3: 92 Nonvoice Notification Appliances This system does not have nonvoice notification appliances. Horns: - 29. With visible: 29 Bells: - With visible: Chimes: With visible: Visible only: 6 Other (describe): 9.3 Notification Appliance Power Extender Panels Quantity: Locations: This system does not have power extender panels. NFPA 72, Fig. 10.18.2.1.1 (p. 6 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. 10. MASS NOTIFICATION CONTROLS, APPLIANCES,AND CIRCUITS This system does not have an MNS. 101 MNS Local Operating Consoles Location 1: Location 2: Location 3: 102 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. MNS systems DO NOT override notification appliances required to provide special suppression predischarge notification. 11. TWO-WAY EMERGENCY COMMUNICATION SYSTEMS 111 Telephone System Number of telephone jacks installed: Number of telephone handsets stored on site: Type of telephone system installed: Electrically powered This system does not have a two-way telephone system. Number of warden stations installed: Sound powered 112 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: Donor antenna isolation is: dB above the signal booster gain Radio frequencies covered: Radio system monitor panel location: I: NFPA 72, Fig. 10.18.2.1.1 (p. 7 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. It TWO-WAY EMERGENCY COMMUNICATION SYSTEMS (continued) 113 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 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: 115 Other Two -Way Communication Systems Describe: 12 CONTROL FUNCTIONS This system activates the following control functions: Hold -open door releasing devices Smoke management HVAC shutdown F/S dampers Door unlocking Elevator recall Fuel source shutdown Extinguishing agent release Elevator shunt trip Mass notification system override of fire alarm notification appliances Other (specify): 12.1 Addressable Control Modules Number of devices: Other (specify): 13. SYSTEM POWER 13.1 Control Unit 13.1.1 Primary Power This system does not have control modules. Input voltage of control panel: 120 VAC Control panel amps: 20 Overcurrent protection: Type: BREAKER Amps: 20 Location (of primary supply panel board): MAIN ELECTRICAL ROOM Disconnecting means location: ELECTRICAL PANEL, MARKED ON PANELS 13.1.2 Engine -Driven Generator Location of generator: Location of fuel storage: Type of fuel: This system does not have a generator. NFPA 72, Fig. 10.18.2.1.1 (p. 8 of 12) Copyright ©2009 National Fire Protection Association. This form maybe 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: IN PANEL Type: LEAD ACID Nominal voltage: 12 Amp/hour rating: 7 VDC X 2 Calculated capacity of batteries to drive the system: In standby mode (hours): 24 In alarm mode (minutes): 15 Batteries are marked with date of manufacture 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: 13.2.2 Engine -Driven Generator Location of generator: Location of fuel storage: EVACS or MNS panel amps: Amps: Type of fuel: This system does not have a generator. 13.2.3 Uninterruptible Power System 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: Calculated capacity of batteries to drive the system: In standby mode (hours): In alarm mode (minutes): Batteries are marked with date of manufacture Battery calculations are attached This system does not have a UPS. Amp/hour rating: NFPA 72, Fig. 10.18.2.1.1 (p. 9 of 12) Copyright ©2009 National Fire Protection Association. This form maybe 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): 120 VAC Overcurrent protection: Type: BREAKER L This system does not have power extender panels. Power extender panel amps: 6 Amps: 20 Matron (01 prunary Supplv panel board), MAIN ELECTRICAL RON Disconnecting means location: ELECTRICAL PANEL, MARKED ON FIRE PANELS 133.2 Engine -Driven C ---t— rnis sy ascan do— not liavG A�;ci erittor. 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): 133.4 Batteries Location: IN PANEL Type: LEAD ACID Nominal voltage: 12 Amp/hour rating: 7 VDC X 2 Calculated capacity of batteries to drive the system: In standby mode (hours): 24 In alarm mode (minutes): 15 Batteries are marked with date of manufacture 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: New system 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: 2016 NFPA 70, National Electrical Code, Article 760, Edition: 2014 Manufacturer's published instructions Other (specify): System deviations from referenced NFPA standards: NONE Signed: 4Sight Security LLC Printed name: Trevor Blackburn Date: Organization: Title: JOURNEYMAN TECHNICIAN Phone: 208-881-3510 NFPA 72, Fig. 10.18.2.1.1 (p. 10 of 12) Copyright 02009 National Fire Protection Association 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: Ze;le y allreo^ Jam.^ jZ� Organi ti f`� r Date: G �E>s legis zap Title: 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 standards cited herein. Signed: Printed name: 434, Date: Organization: Rexburg FIRE DEPTG " Title: FIRE MARSHAL Phone. NFPA 72, Fig. 10.18.2.1.1 (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. 15. RECORD OF SYSTEM OPERATIONAL ACCEPTANCE TEST New 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: 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: NFPA 72, Edition: 2016 NFPA 70, National Electrical Code, Artic Ie 760, Edition: 2014 Manufacturer's published instructions Other (specify): Individual device testing documentation [Inspection and Testing Form (Figure 14.6.2.4) is attached] Signed: Printed name: Trevor Blackburn 4Sight Security LLC Date: Organization: Title: JOURNEYMAN TECHNICIAN Phone: 208-881-3510 16. 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: Printed name: Trevor Blackburn 4Sight Security LLC Organization: Title: JOURNEYMAN TECHNICIAN 16.2 System Service Contractor: The undersigned has a service contract for this system in effect as of the date shown below. Signed: ranted name: Trevor Blackburn 4LC Organization: Sight Security L - Title: JOURNEYMAN TECHNICIAN 16.3 Supervising Station: This system, as specified herein, will be monitored according to all NFPA standards cited herein. Signed: 4Sight Security LLC Printed name: JASON PERRON . Organization: Title: JOURNEYMAN TECHNICIAN Date: Phone: 208-881-3510 Date: Phone: 208-881-3510 Date: Phone: 208-881-3510 NEPA 72, Fig. 1 Q.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.