HomeMy WebLinkAboutFA REPORT - 22-00798 - Madison Station Apartments - Bldg 4FIRE ALARM AND EMERGENCY COMMUNICATION SYSTEM RECORD OF COMPLETION
To be completed by the system im,flafion contractor at the it., ofsystem acceptance and approval.
""hall be permitted to m1d6 this form as needed m provide a more complete and/or clear record.
Insert N/A in a!1 unused lines.
Attach additions! sheets, data or calculations as necessary to provide a complete record.
1. PROPERTY INFORMATION
Name of property: Madison station building 3
Address: 577 trejo Rexburg Idaho
Description of property: Apartment Building
Occupancy type: GROUP
Name of property representative: Aaron Oconner
Address;
Phone: Fax:
E-mail:
Authority havingiurisdiction over this property:
Rexburg FIRE MARSHAL
Phone: Fax:
E-mail:
2. INSTALLATION, SERVICE, AND TESTING CONTRACTOR INFORMATION
Installation contractor for this equipment: 48ighl Security, L.L.C.
Address: 6944 Big Send, Idaho Fells, ID 63406
License or certification number: Contmooc # RCE-37051;
ID ELE-SC-021298
Phone: 208-40&1434 Fan:
E-mail: T,,vm04si,h,acufityaq
Service organisation for this equipment 4Sighl Security, L.L.C.
Address: 6944 Big Bard, Idaho Falls, ID 83406
License or certification number: Contractor. #RCE-37051;
ID ELE-SC-021298
Phone: 20840&1434 Fax:
E-mail:
A contract for test and inspection in accordance with NFPA standards
is in effect as of:
Contracted testing company: 45ight Security, L.L.C.
Address: 6944 Big Bend, Idaho Falls, ID 83406
Phone: 208403-1434 Fax:
E-mail:
Contract expires: RENEW Contract number: N/A
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 wmmunication system
NFPA 72, Fig, 10.18.2, 1.1 (p. 1 of 12)
(Mengh10 axe Natmal Flre P,declkn papas,_. Thv b,m may to pPlsd b rdWidual uo,a ,re 1p,eaale. It m., rut eue'. ft or cYl aeq 0ElaNW
Other (specify):
3. DESCRIPTION OF SYSTEM OR SERVICE(conteto.0
NFPA 72 edition: 2017 Additional description ofsystem(s):
3.1 Control Unit
Manufacturer. Potter Modelnumber: AFC 1D0)
3.2 Mass Notification System
MNS This system does not incorporate an
MN
3.2.1 System Type:
In -building MNS— combination
In -building MNS—stand-alone Wide -area MNS Distributed recipient MNS
Other(specify):
3.2.2 System Features:
Combination fire almnIMNS MNS autonomous control unit Wide -area MNS to regional national
alerting interface
Local operating console (LOC) Direct recipient MNS (DAMNS) Wide -area MNS W DRMNS interface
Wide -area MNS to high -power speaker array (NPSA) 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 ofolumnion, and notify of
the numbered record drawings are stored on site. Location: FACP
3ASystem Software This system does not have alterable she-s
software. Peck
Operating system (executive) software revision level:
Site -specific software revision date: Revision completed by: Trevor BLACKBURN
A copy of the site -specific software is stored on site. Location:
3.5 Off -Premises Signal Transmission This system does not have off -premises
transmission.
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: ld1h1Falls Fire Phone:
Method oft, DIGITAL VIA Sterna Radio
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 Wed Wireless
NFPA 72, Fig. 10.18.2.1.1 (p. 2 of 12)
caaynamozaas xm'ionai re rm�auio� nsmcauon. m'�aroim mar m ��a �mmaamwa awtn.� mrreWk. a mav,wc ea wgaa ro<mmmeroai aare oreimw�an.
4. CIRCUITS AND PATHWAYS
4.1 Signaling Line Pathways
4.1.1 Pathways Class Designations and Survivability
Pathways class: N/A Survivability level: Quantity
(See NFPA 72, Sections 12.3 and 12.4)
4.12 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 some 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 Quantity: 1
(See NFPA 72, Sections 12.3 and 124)
422 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 me separate and different classification from the initiating device pathway
4.3 Non -Voice Audible System Pathways
43.1 Pathways Class Designations and Survivability
Pathways class: B Survivability level: 1 Quantity: 12
(See NFPA 72, Sections 12.3 and 12.4)
432 Pathways Utilizing Two or More Media
Quantity: 12 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 ofthe same pathway classification as the notification appliance pathway
Power pathways me separate and different classification from the notification appliance pathway
NFPA 72, Fig. 10.18.2.1.1 (p. 3 of 12)
CMyitat 0 ZWa fossal Fire Praaaun Psw[ vam'6fsm may melee mr MJVmen uce wM than tM re%b,a may ran e% mpeE tw tlanm9eoal saw a,antaEmlm.
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:
1 Conventional: Coded: Transmitter:
Other(specify):
5.11 Other Alarm Boxes
This system does not have other alarm boxes.
Description:
Type and number of devices: Addressable:
Conventional: Coded: Transmitter:
Other(specify):
5.2 Automatic Initiating Devices
51.1 Smoke Detectors
This system does not have smoke detectors.
Type and number ofdevices: Addressable:
2 Conventional:
Other (specify):
Type uI coverage: Complete area Partial area Nonrequired partial area
Other(specify):
Type of smoke detector sensing technology:
Ionintion Photoelecnic Multicriteria Aspirating Beam
Other(specify):
5.2.2 Duct Smoke Detected;
X This system does not have alarm -causing duct smoke detector:.
Type and number of devices: Addressable:
Conventional:
Other(specify):
Type of coverage:
Type of smoke detector sensing technology:
lonimtion Photoelectric Aspirating Beam
513 Radiant Energy (Flame) Detectors
This system does not have radiant energy detectors.
Type and number of devices: Addressable:
Conventional:
Other(specify):
Type of coverage:
5.14 Gas Detectors
This system does not have gas detectors.
Type of detecror(s):
Number of devices: Addressable:
Conventional:
Type of coverage:
515 Heat Dander,
This system does not have beat detectors.
Type and number of devices: Addressable:
Conventional:
Type of coverage: Complete area Partial area Noaregoined partial area Linear Spot
Type of heat detector sensing technology:
Fixed temperature Rate-ofrise Rate compensated
NFPA 72, Fig, 10.18.2,1.1 (p. 4 of 12)
CWyrgM 02CnO Nallonel Fve Pmlayun Xooc Wl ,, rho rmm may c wpi MiWivtlual um Nan Wreub.11-W- ba cp W W mmxt'al sak ordP&WM
5. ALARM INITIATING DEVICES (continued)
51.6 Addressable Monitoring Modules This system does not have monitoring modules.
Number of devices:
5.2.7 Watertlow Alarm Devices This system does have watertlow alarm
devices.
Type and number of devices: Addressable: I Conventional: Coded: Transmitter:
5.2.6 Alarm Verification This system does have incorporate
alarm vedfica0on.
Number of devices subject to alarm vedficadom 1
5.2.9 Presignal
Number of devices subject to presignal:
Describe presignal functions:
5.210 Positive Alarm Sequenlnl(PAS)
Describe PAS:
52.11 Other Initiating Devices
Describe:
Alarm verification set for seconds
This system does not incorporate pre -signal.
This syslem does not incorporate PAS.
This system does not have When iinuabng 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: Transmitter:
Other (specify):
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: Transmitter:
Other(specify):
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):
63 Duct Smoke Detectors (DSDs) This system does not have DSDs causing supervisory signals.
Type and number of devices: Addressable: 0 Conventional:
Other(specity):
Type of coverage:
Type of smoke detector sensing technology: limiatlon Photoelectric Aspirating Beam
6A Other Supervisory Devices This system does not have other supervisory devices.
Describe:
NFPA 72, Fig. 10.18.2.1.1 (p. 5 of 12)
--Wile- 2009 Nelbnal Fve Fr..e Miaioai Tno _ met,_&d mr MAduel—.1,r a (wheels. a nal ml be fc- rn ammxcisl se@ a di. Miori.
7. MONITORED SYSTEMS
7.1 Engine -Driven Generator
7.1.1 Generator Functions Supervised
Engine or control panel trouble Generatormmning
Other(specify):
72 Spnclal Hazard Suppression Systems
Description of special hazard system(s):
72 Other Monitoring Systems
Description of special hazard system(,):
8. ANNUNCIATORS
&I Location and Description ofAnnunciators
Location 1:
Location 2:
Location 3:
9. ALARM NOTIFICATION APPLIANCES
This system does not have agenerator.
Selector switch not in auto Low fuel
This system does not monitor special hazard systems.
This system dues 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 sister channels:
Number of speakers: Number of speaker circuits:
Location of amplification and sound -processing equipment:
Location of paging micmphone stations:
Location 1:
Location 2:
Location 3:
92 Nonvoice Notification Appliances
Horns: 36 With visible: 48 Bells:
Chimes: With visible:
Visible only: Other (describe):
93 Notification Appllanw Power Extender Panels
Quantity: 1
Locations: Riar mom
With visible:
This system does have power extender panels.
NFPA 72, Fig. 10.18,2.1.1 (p. 8 of 12)
eWP ®2009 Netewwl N-PrrvssnMeocis.tr-asm-W- mFWhv MWuel use d 11l mrnaeb.,m, nm ee s Mmmmemel aknare,vsvz.
10. MASS NOTIFICATION CONTROLS, APPLIANCES, AND CIRCUITS This system does not have an MNS.
IOJ MNS Local Operating Consoles
Location 1:
Location 2:
Location 3:
tat High -Power Speaker Arrays
Number of HPSA speaker initiation2ones:
Location I:
Location 2:
Location 3:
fOJ Mass Notification Devises
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
11.1 Telephone System This system does not have a two-way telephone system.
Number of telephone jacks installed: Number of warden stations installed:
Number of telephone handaets stared on site:
Typeoftelephone system installed: Electricallypoweied Sound powered
III 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 aress: %General building areas: %
Amplification component locations:
Inbound signal strength: dBm Outbound signal strength: dHm
Donor antenna isolation is: dB above the signal booster gain
Radio frequencies covered:
Radio system monitor panel location:
NFPA 72, Fig. 10.18.2, 1.1 (p. 7 of 12)
copyrlem02008 Nelkrel Pre 1..wor g6w ... Thh Toren met W mppe for wlNdual use. eonmr refelB. Amer M.". M mmmemial:ala vises aam
It TWO-WAY EMERGENCY COMMUNICATION SYSTEMS (continued)
113 Area of Refuge (Area of Rescue Assistance) Emergency Communications Systems
This system does not have mum 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 accused:
Location of alternate control point:
Days and hours when alternate control point is attended:
IIA 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 attenuate control point is attended:
11S 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 Elevatorrecall Fuel source shutdown Extinguishing agent release
Elevator shunt trip Mass not cation system override of fire atann notification appliances
Other (specify):
12.1 Addressable Control Modules This system does not have control modules.
Number of devices:
Other(specify):
13. SYSTEM POWER
13.1 Control Unit
13.1.1 Primary Power
Input voltage ofcomml panel: 120 VAC Control panel amps: 20
Overcurrent protection: Type: BREAKER Amps: 20
Location (of primary supply panel board): From riser roan
Disconnecting means location: ELECTRICAL PANEL, MARKED ON PANELS
13.11 Engine -Driven Generator This system does not have a generator.
Location ofgeneralor:
Location of fuel storage: Type of fuel:
NFPA 72, Fig. 10.18.2.1A (p.8 of 12)
CopyiSM®20r/A Nalnrel Ffe PrMMOn gaeml6lWn.11liblpm racy ea ¢pletl br mVltlwl uee dtM Ihai lorreaak.11 mry col M¢µetlb¢mm0cal sale ue61tlp11pn.
13. SYSTEM POWER (continued)
13.1.3 Uninterruptible Power System This system does or 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.IA Batteries
Location: IN PANEL Type: LEADACID Nominal voltage: 12 Amp/hour ruling: 18
VDCX
2
Calculated capacity of batteries to drive the system:
In standby mode (hours): 24 In alarm mode (minutes): 5
Batteries are marked with dale ofmanufacture Battery calculations are attached
132 In -Building Fire Emergency Voice Alarm Commuvieation System or Mass Notification System
This system does not have an EVACS or MNS system.
132.1 Primary Power
Input voltage of EVACS or MNS panel: EVACS or MINIS panel amps:
Overourrent protection: Type: Amps:
Location (of primary supply panel board):
Disconnecting means location:
132.2 Engine -Driven Generator This system does not have a generator.
Location ofgenerator:
Location of fuel storage: Type of fuel:
1323 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):
132.4 Batteries
Location: Type: Nominal voltage: Amp/hour rating:
Calculated capacity of batteries to drive the system:
In standby mode (hours): In alarm mode (minutes):
Batteries me marked with date ofmanufacture Battery calculations are attached
NFPA 72, Fig. 10A8.2.1.1 (p. 9 of 12)
Cc usn 09M9 NRUi Fire Pogo PeSociallcn.Thufarmiw--PW As usNoOaI use Oror um br re¢ak. a may ml-¢-'M—m 6MlWe IXdurMsM.
13. SYSTEM POWER (continued)
133 Notification Appliance Power Extender Panels This system does not have power extenderpanels.
133.1 Primary Power
Input voltage of power extender panel(s): 120 VAC Power extender panel amps: 6
Ovenement protection: Type: BREAKER Amps: 20
Location (ofprimary supply panel board): Fire Front Rlar ROOM
Disconnecting means location: ELECTRICAL PANEL, MARKED ON FIRE PANELS
1332 Engine -Driven Generator This system does nolhave a generator.
Location ofgenemtor:
Location of fuel storage: Type of fuel:
1333 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):
133A Batteries
Location: IN PANEL Type: LFADACID Nominalvoltage: 12 Amp/hour rating: 18
VDCX
2
Calculated capacity of batteries to drive the system:
In standby mode (hours): 24 In alarm mode (minutes): 5
Batteries are marked with date ofmunubsemre Battery calculations are attached
14. RECORD OF SYSTEM INSTALLATION
Fill out after all installation is complete and wiring has been checked jor opens, shorts, groundfauls, 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: 2019
NFPA 70, National Electrical Code, Ankle 760, Edition: 2017
Manufacturer's published instmebons
Other(specify):
System deviations from referenced NFPA standards: NONE
Signed: Printed name: Trevor Blackburn Date:
4Sighl Security LLC
Organization: Title: JOURNEYMAN TECHNICIAN Phone: 208-881-3510
NFPA 72, Fig. 10.18.2.1.1 (p. 10 of 12)
G-loan®mac wmal F-1.n Anode. mnm�m mean �r.ar«ma�hsuei esaw.o, �nm m,anw.nmeY se�r.e a,mm ui wea munewon.
15. RECORD OF SYSTEM OPERATIONAL ACCEPTANCE TEST
New system
All operational features andjunctions ofthis system were tested by, or in the presence of, the signer shown
below, an the dare shown below, andwere found to be operating properly in accordance with the requirements
for the fallowing:
Modifications to an existing system
All newly modijted operational fearures and junctions ofthe 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 ofthe following:
NFPA 72, Edition: 2017
NFPA 70, Nadmm1 Flectricol Code, And, le 760, Edition: 2017
Manufacturer's published instructions
Other(specity):
Individual device testing documentation [Inspection and Testing Form (Figure 14.6.2.4) is attached]
Signed: Printed name: Trevor Blackburn Date:
4Sight Security LLC
Organization: Title: JOURNEYMAN TECHNICIAN Phone: 208-881-35111
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: 4Sight Security LLC Printed name: Trevor Blackburn Date:
Organization: Title: JOURNEYMAN TECHNICIAN Phone: 208-881-3510
16.2 System Service Contractor:
The undersigned his a service contact for this system in effect as of the date shown below.
Signed: Printed name: Trevor Blackburn
45ght Securty LLC
Organization: Tithe: JOURNEYMAN TECHNICIAN
163 Supervising Station:
This system, as specified herein, will be monitored according to all NFPA standards cited herein.
Signed: Printed name: JASON PERRON
4Sight Security LLC
Organization: Title: JOURNEYMAN TECHNICIAN
Date:
Phone: 208-881-3510
Date:
Phone: 208-881-3510
NFPA 72, Fig. 10.18.2.1.1 (p. l l of 12)
eoatrigal02000 rvmMwl Fie rawaico Resociafwn. Thin rmm mat I WNea 11 on"'in.o rtlw 1,-6 nmer nw o'¢ -oarm ira lsob wd tntnlon.
16. CERTIFICATIONS AND APPROVALS (continued)
16.4 Property or Owner Representative:
I accept this system as having been installed and tested W its specifications and all NFPA standards cited berein.
Signed: Printed name Daze:
Organization: _. _... Titles _. Phone: _
16.5 Authority Having Jurisdiction:
I have witnessed a satisfacu ry 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: .-'. 11"� Y Printed name: /4 �1(.... ".'uY.n.� Date. 11 )7 /Z 1 ...
Organization: C,`}y,% of Ke k,,� Title: �/, � �' y� f ro ZWpj 2�4-13IO
� i Phone
NFPA 72, Fig. 10.18.2A.1 (p. 12 of 12)
Ccpyaghl®]Wa NMll Fire RMoam Pssot--I-M mryE o iW for Mrsysu aW a ru W rev,. a men Me.¢ das Wd M—srl b6 or daalauluw