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N�SrmrFomo 0 o Oo°mmo0 cm30 a oo0 -0 ON 0 3 D y o 0 a a y mm�. 6 0 m 2 wDa °m mm ummZ3om o m0 a�v m 0N 0 3 Oomm^w O 0 N _0 O< o vo 2 3w0 O p 3 n 00 0 'm 2moQNm o m OC4z 0 0. O m SF n a yoa AxV 00 0S 0 M < 5N0 CO -0 <. p O *d y0 C 3uj NN z Q m O < O 0 SD D a 6 O U 0 o n 0- �TdFSmmOSa' ' N m O -2m1 -cOm yyO' ==•N-' 0 md mm=Nmdn m^0 . v0 0 z < 0 D 0 < a) da O O O a n3 0p O 0 0 0d3D b b .Z! n� T °z ^C F2202.1- OZ63 114 McVcAcklen P1 FUNDAMENTALS OF FIRE ALARM SYSTEMS 72-31 FIRE ALARM SYSTEM 'e RECORD OF COMPLETION Name of protected property: 5hk,&.r e e -. Address: I I H con P u. (ti • AE Representative of protected property (name/phone): & ✓ ° / - 6011 Authority having jurisdiction: Address/telephone number: /� Organization name/phone Representative name /phone Installer 1't e. 94—toea �7f eG ire - Supplier UA a Co7't Service organization Location of record (as.built) drawings: r ocy~4T' O.cn6 Location of operation and maintenance manuals: cln,•... es.T 60)c Location of test reports: oroc.r. OA -Y omc A contract for test and inspection in accordance with NFPA standm d(s) Contract No(s): Effective date: Expiration date: System Software (a) Operating system (executive) software revision level(s): A/fA (b) Site-specific software revision date: /V/A (c) Revision completed by: AIVA (name) (firm) I.Type(s) of System or Service NFPA 72, Chapter 6 — Local If alarm is transmitted to location(s) off premises, list where received: _NFPA 72, Chapter 8 — Remote Station Telephone numbers of the organization recalm Alarm: -CLftr�*h- nAiyA : + k,11 % Supervisory: Trouble: If alarms are retransmitted to public fire service communications centers or others, indicate location and telephone numbers of the organization receiving alarm: Indicate how alarm is retransmitted: _NFPA 72, Chapter 8 — Proprietary Telephone numbers of the organization receiving alarm: Alarm: 'V`aAw JT✓/*Vyy .e-. I s.w - Supervisory: Trouble: If alarms are retransmitted to public fire service communications canters or others, indicate location and telephone numbers of the organization receiving alarm: Indicate how alarm is retransmitted: _NFPA 72, Chapter 8 — Central $talion Prime contractor: PC U +N5 Central station location: (NFPA 72, 1 of 4) FIGURE 4.5.2.1 Record of Completion. 2002 Edition FIRE ALARM CODE Means of transmission of signals from the protected premises to the central s a 'on: McCulloh Multiplex One-way radio Digital alarm communicator Two-way radio Others Means of transmission of alarms to the public fire service communications center: (moi (h) System location: —NFPA 72, Chapter 9—Auaillary Indicate type of connection: Local energy Shunt Parallel telephone Location of telephone number for receipt of signals: 2. Record of System Installation (Fill out after installation is complete and wiring is checked for opens, shorts, ground faults, and improper branching, but prior to conducting operational acceptance tests.) This system has been installed in accordance with the NFPA standards as shown below, was inspected by on , includes the devices shown in 5 and 6, and has been in service since _NFPA 72, Chapters 1 0'M 0 0 (e) 7 8 9 10 11 (circle all that apply) NFPA 70, National Electrical Code, Article 760 Manufacturer's instructions _ Other (specify): Signed: Organization: Date: 3. Record of System Operation Documentation in accordance with Inspection Testing Form, Figure 10.6.2.3, is attached All operational features and functions of this system were tested by and found to be operating properly in accordance with the requirements of: _NFPA 72, Chapters 1 W 7 8 9 10 11 (circle all that apply) _ NFPA 70, National Electrical Code, Article 760 _Manufacturer's instructions Other (specify): Signed: Organization: Date: 4. Signaling Line Circuits Quantity and class of signaling line circuits connected to system (see NFPA 72, Table 6.6.1): Quantity: Style: Class: FIGURE 4.5.2.1 Continued 2002 Edition date (NFPA 72,2 of 4) FUNDAMENTALS OF FIRE ALARM SYSTEMS 72-33 5. Alarm -Initiating Devices and Circuits Quantity and class of initiating device circuits (see NFPA 72, Table 6.6): Quantity: i Style: Class: MANUAL Manual stations Noncoded Transmitters Coded Addressable (b) Combination manual fire alarm and guard's tour coded stations AUTOMATIC Coverage: Complete Selective Nonrequired (a) Smoke detectors Ion Photo Addressable (b) Duct detectors Ion Photo Addressable c) eat detectors i FT RR FT/RR RC Addressable (d) Sprinkler waterflow, indicators: Transmitters Noncoded Coded Addressable (e) The alarm verification feature is disabled or enabled , changed from seconds to seconds. (D Other (list): 6. Supervisory Signal -Initiating Devices and Circuits (use blanks to indicate quantity of devices) GUARD'S TOUR (a)— Coded stations (b) Noncoded stations (c)—Compulsory guard's tour system comprised of transmitter stations and intermediate stations Note: Combination devices are recorded under 5(b), Manuel, and 6(a), Guard's Tour. SPRINKLER SYSTEM Check if provided (a) I Valve supervisory switches (b)_Building temperature points (c)_Site water temperature pointe (d) Site water supply level points Electric fire pump: (e)—Fire pump power (f) Fire pump running (g)_Phase reversal Engine -driven fire pump: (h)_ Selector in auto position (i) Engine or control panel trouble 0) _Fire pump running ENGINE -DRIVEN GENERATOR: (a)_ Selector in auto position (b)—Control panel trouble (c)_Transfer switches (d)_Engine rumssng Other supervisory function(s) (specify): FIGURE 4.5.2.1 Continued (NFPA 72,3 of 4) 2002 Ed1bon 72-34 NATIONAL FIRE ALARM CODE 7. Annunciator(s) • Number:i 1rType: Location: jx'r-Doal2 8. Alarm Notification Appliances and Circuits NFPA 72, Chapter 6 — Emergency Voice/Almin Service Quantity of voice/alarm channels: Single: Multiple: Quantity of speakers installed: Quantity of speaker zones: Quantity of telephones or telephone jacks included in system: Quantity and the class of notification appliance circuits connected to system (see 1VFPA 72, Table 6.7): Quantity: Style: Class: Types and quantities of notification appliances installed: (a) Bells With Visible (b) Speakers With Visible (c) Horns With Visible (d) Chimes With Visible (e) Other: With Visible (£) Visible appliances without audible: 9. System Power Supplies (a) Fire Alarm Control Panel: Nominal voltage: Current rating: Overcurrent protection: Type: Bk -1- Current rating: Location: kyCr+ 'CA nLMk1- (b) Secondary(standby): Storagebattery: 11\) Amp -hour rating:I.0 moii .�r Calculated capacity to drive system, in hours: L4 kW_ Engine -driven generator dedicated to fire alarm system: Location of fuel storage: (c) Emergency system used as backup to primary power supply: Emergency system described in NFPA 70, Article 700: 10. Comments Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s): System deviations from the referenced NFPA standard(s) are: (signed) for installation contra or/suppller (flue) (date) - (signed) for alarm service company (flue) (date) (signed) for central station (title) (date) Upon completion of the systems) satisfactory test(s) witnessed (if required by the authority having jurisdiction): (signed) representative of the authority having Jurisdiction (title) (date) (NFPA 72, 4 of 4) FIGURE 4.5.2.1 Cordinued 2002 Edition