HomeMy WebLinkAboutFA RECORD OF COMPLETION - 20-00744-20-00745 - Teton River Flats - B1-B2SYSTEM RECORD OF COMPLETION
This form is 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.
Form Completion Date: 819/21 Supplemental Pages Attached:
1. PROPERTY INFORMATION
Name of property. Teton River Flats
Address 280 E Lorene St, Rexburg, ID 83440
nescriptionofproperty: Apartment complex Rtiilrlinas 5 .S7 6
Name of property representative:
Address
Phone:
Fax
2. INSTALLATION, SERVICE, TESTING, AND MONITORING INFORMATION
Installation contractor Nephi Electric
Address
Phone:
Fa.:
Service organization- Fire Services of Idaho
Address: 610 Mallard St, Chubbuck, ID 83202
Phone: (208) 232-3640 Fa.:
IitliTi 1
Testing organization: Fire Services of Idaho
Address: 610 Mallard St, Chubbuck, ID 83202
Phone (208) 232-3640 Fax l_-, ail
Effective date for test and inspection contract:
Monitoring organization: Avantguard Monitoring
Address 366 Grand Loop, Rexburg, ID 83440
Phone: (866) 383-6694 Fa.: E-mail:
Account number: 89-7591 Phone line I : Phone line 2:
Means of transmission- Cellular dialer
Entity to which alarms are retransmitted:
3. DOCUMENTATION
On -site location of the required record documents and site -specific software:
4. DESCRIPTION OF SYSTEM OR SERVICE
This is a: ® New system ❑ Modification to existing system Permit number:
NFPA 72 edition: 2016
4.1 Control Unit
Manufacturer. Notifier
4.2 Software and Firmware
Firmware revision number 1.02
4.3 Alarm Verification
Number of devices subject to alarm verification
Phone:
Model number. NFW-50X
❑ This system does not incorporate alarm verification.
4 Alarm verification set for 5 seconds
Copyright Q2012 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.
(p. 1 of 3)
SYSTEM RECORD OF COMPLETION (continued)
5. SYSTEM POWER
5.1 Control Unit
5.1.1 Primary Power
Input voltage of control panel: 120
Overcurrent protection: Type: Circuit breaker
Branch circuit disconnecting means location: Between two complexes
5.1.2 Secondary Power
Type of secondary power: 12V 18AH batteries
Location, if remote from the plant:
Calculated capacity of secondary power to drive the system:
In standby mode (hours): 24
5.2 Control Unit
® This system does not have power extender panels
❑ Power extender panels are listed on supplementary sheet A
5. CIRCUITS AND PATHWAYS
Control panel amps:
Amps: 20
Number: 5
20
In alarm mode (minutes): 5
Pathway Type
Dual Media Pathway
Separate Pathway
Class
Survivability Level
Signaling Line
B
Device Power
B
Initiating Device
B
Notification Appliance
B
Other (specify):
7. REMOTE ANNUNCIATORS
Type Location
S. INITIATING DEVICES
Type
Quantity
Addressable or
Conventional
Alarm or Supervisory
Sensing Technology
Manual Pull Stations
Smoke Detectors
2
Addressable
Alarm
Photoelectric
Duct Smoke Detectors
NIA
Beat Detectors
NIA
Gas Detectors
NIA
waterflow Switches
2
Addressable
Alarm
Switch
Tamper switches
1
Addressable
Supervisory
Switch
Copyright Q2012 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.
(p. 2 of 3)
SYSTEM RECORD OF COMPLETION (continued)
9. NOTIFICATION APPLIANCES
Type
Quantity
Description
Audible
24
Low frequency horn
Visible
NIA
Combination Audible and Visible
2
Outside horn/strobe
10. SYSTEM CONTROL FUNCTIONS
Type
Quantity
Hold -Open Door Releasing Devices
N/A
HVAC Shutdown
NIA
Fire/Smoke Dampers
NIA
Door Unlocking
NIA
Elevator Recall
NIA
Elevator Shunt Trip
N/A
11. INTERCONNECTED SYSTEMS
® This system does not have interconnected systems.
❑ Interconnected systems are listed on supplementary sheet
12. CERTIFICATION AND APPROVALS
12.1 System Installation Contractor
This system as specified herein has been installed according to all NFPA standards cited herein.
Signed: Printed name: Date:
Organization: Title: Phone:
12.2 System Operational Test
This system aAire
' herein has tested according to all NFPA standards cited herein.
Signed: ~ Printed name: Joe Monsen
Organization:
ervices of Idaho Title. Alarm technician
12.3 Acceptance Test
Date and time of acceptance test:
Installing contractor representative:
Testing contractor representative:
Property representatives
AHJ representative:
819121 2:00PM
Date: 819121
Phone: (208) 589-1498
Copyright Q2012 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.
(p. 3 of 3)