HomeMy WebLinkAboutFA REPORT - 21-00767 - Yellowstone Heights Condos - Bldg 2 - 12 PlexSYSTEM 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: 09/08/2023 Supplemental Pages Attached:
1. PROPERTY INFORMATION
Name o£property: Yellowstone Heights BLDG C
Address: 238 Ella St. Rexburg, Idaho 83440
Description of property: Apartment BLDG C. (3 floors of 4 apartments).
Name of property representative: Robert Bishop
Address:
Phone: 208-604-1407 In: E-mail:
2. INSTALLATION, SERVICE, TESTING, AND MONITORING INFORMATION
Installation contractor: State Fire Idaho/ Robbins Electrical
Address: 610 Mallard St, Chubbuck, ID
Phone: 208-232-3640 Fate: E-mail:
Service organization: State Fire Idaho
Address:
Phone: Faz: E-mail:
I- :m State Fire Idaho
Address'
Phone: Fax: E-mail:
Effective date for test and inspection contract: 09/08/2023
Monitoring organization: State Fire Idaho/ Avantgard
Address: 610 Mallard St, Chubbuck, ID
Phone: 877-206-9141 Fax: E-mail:
Account nunber:
897687 Phone line 1: None Phone line 2: None
xno,.. r „;ae; „• Star ink Cell Dialer
Entity to which alamts are retransmitted: Avantgard Phone: 877-206-9141
3. DOCUMENTATION
On -site location of the required record documents and site -specific
Thumb Drive in panel
software:
4. DESCRIPTION OF SYSTEM OR SERVICE
This is a: ® New system ❑ Modification to existing system Permit number: 22-00306
NFPA 72 edition: 2017
4.1 Control Unit
Manufacturer: Notifler
4.2 Software and Firmware
Firmware revision number:
Modelnumber: NFW-50X
4.3 Alarm Verification ® This system does not incorporate alarm verification.
Number of devices subject to alarm verification: Alarm verification set for seconds
Copyright®2012 National Fee Protection Association. This femn may be copied for individual use other than for resale. It may not be copied for mmmeroal sale or disbibulbn.
c r 3;
SYSTEM RECORD OF COMPLETION (continued)
5. SYSTEM POWER
5.1 Control Unit
5.1.1 Primary Power
Input voltage of control panel: 120vac
Overcutrentprotecfion: Type: Breaker
Branch circuit disconnecting means location:
HOA Panel
5.1.2 Secondary Power
Type of secondary power: Battery backup
Location, if remote from the plant:
Calculated capacity of secondary power to drive the system:
In standby mode (hour;): 3.42 hr
Control panel amps:
Amps: 20
Number: 2
15
In alarm mode (minutes): .07hr
5.2 Control Unit
® This system does net have power extender panels (1)Notifier PSE-6 with 18amp batteries
❑ Power extender panels are listed on supplementary sheet A
uTC AAIM nATIAn1/AVC
Pathway Type
Dual Media Pathway
Separate Pathway
Class
Survivability Level
Signaling Line
B
Device Power
B
Initiating Device
B
Notification Appliance
B
Other (specify):
TI\rl�. I1C\/IPCC
Type
Quantity
Addressable or
Conventional
Alarm or Supervisory
Sensing Technology
Manual Pull Stations
1
Addressable
Alarm
Switch
Smoke Detectors
13
Addressable
1alarm 12super
Photo
Duct Smoke Detectors
Heat Detectors
Gas Detectors
4 CO
Conventional
Supervisory
CO
Watertlow Switches
1
Conventional
Alarm
Switch
Tamper Switches
12
Conventional
Supervisory
Switch
copyright 0 2012 National Fire PmtecUw Assnciaaon. This form may be copier! for Individual use other than for resale. It may hat be copied for commercial sale or distribution.
SYSTEM RECORD OF COMPLETION (continued)
0 NATIFICATIAkl APPI IANCFS
Type
Quantity
Description
Audible
30
System sensor wall low frequency horns
Visible
2
ADA restroom strobes
Combination Audible and visible
7
ADA horn/strobe and FDC horn/strobe
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: Travis Date:
Organization: Robbins Electric Title: Phone: 208-709-6344
12.2 System Operational Test
This cyst • sp ci t e n has tested according to all NFPA standards cited herein.
Signed: Printedname: Michael Beal
Organization: State Fire Idaho Title: Install Technician
12.3 Acceptance Test
Date and time of acceptance test:
Installing contractor
representative:
Testing contractor representative:
Property representatives
AHJ representative:
09/08/2023
Date: 09/08/2023
Phone: 208-251-9431
Copyright ® 2012 National Fire Protection Association. This form may be copied Por individual use o0ber than for resale. It may not be copied for commercial sale or distdhulion.
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