The URL can be used to link to this page

Home My WebLink AboutF2019-0198 - Miscn T ZZ m g g K R D o 0< D N O w O O m O m O 0 0 n n N O 0 O O O Z< O A n m 0, O a Z m 0 G) m G) m � � A 'n � � 'n m Z T O T O N G) Z m=< Z O O N O O O N N O O OZ Z o c e o a m O 3 3 Z m Q, D T D '-� A D m D ; T D '� A D 9 D m m m Z p D p y m 'm N> Z Z ZO m m N r m p O m p m Emil A Ol (O N n A 0 O m O m � F _ A A W O O A m A O A O O O z °m p N m m p 6 m o m o m m o m o m z o m m o m o m m m < y m Z O O D A T T D T A T Ul N n 0 8 0 0 N m m O y m D m A O > z x m x x$ C T Z A r < T A z m m O N m C V T z z o c z o c o �O m 0 r D r D O m mF s m m m m m m m m m m m m m m m m m m m O O O O O O O g m a m v m m v CJ O O o o O o O n F J V V J V J V � m rn m m rn m m 0 Ro v m m m m m m a 'o m 3 m m � m u 0 0 0 N M o 3 m rt o m �q' _e 1 � N O � m m g g S Io 3 I � ,O o � 0 0 a m m m rn rn m 2 m m rn m m �i m m m m m rn m m rn m m m y m m n m N 13 N N N N N N N N N N 13 N N N N N N N N N N N 13 N N O q 'J y�l n1 m m m m m mN m m m m m m m m m m m m m m m A m it p N N 13 N N 123 2 Nm Nm Nm N N t0 (O (D O l0 t0 tD (O t0 (O m fD (O l0 (O f0 f0 m f0 O f0 f0 f0 f0 f0 m (O v O O O O O O O O O O O O O O O O O O O O O O O O O O O t0 O t0 f0 t0 m (O (O (O t0 t0 m O m W m (O t0 (O (O t0 lO (O l0 t0 (O NA {D !J N N IJ J f N J !J N N IV IV IJ IJ N N N IV h1 NI m m V V m W m (O N N W W W W 5 W A m (T m 01 m O7 m m m m m� O 1 m m O t0 t0 V W N N O W � N W m Am N V N W O A J fm0 O (Wp fW0 Z � O £ o f ao r r r r r r E: r I v o v o v a o u o 0 0 0 0 o O o 0 o O o D d I D D D D Tl D ,ZI D D D D D ,T D D D m n T ZZ m g g K R D o 0< D N O w O O m O m O 0 0 n n N O 0 O O O Z< O A n m 0, O a Z m 0 G) m G) m � � A 'n � � 'n m Z T O T O N G) Z m=< Z O O N O O O N N O O OZ Z o c e o a m O 3 3 Z m Q, D T D '-� A D m D ; T D '� A D 9 D m m m Z p D p y m 'm N> Z Z ZO m m N r m p O m p m Emil A Ol (O N n A 0 O m O m � F _ A A W O O A m A O A O O O z °m p N m m p 6 m o m o m m o m o m z o m m o m o m m m < y m Z O O D A T T D T A T Ul N n 0 8 0 0 N m m O y m D m A O > z x m x x$ C T Z A r < T A z m m O N m C V T z z o c z o c o �O m 0 r D r D O m mF s m m m m m m m m m m m m m m m m m m m O O O O O O O g m a m v m m v CJ O O o o O o O n F J V V J V J V � m rn m m rn m m 0 Ro v m m m m m m a 'o m 3 m m � m u 0 0 0 N m L 3 m rt o m �q' _e N N O � m m g g S Io 3 I � ,O o � 0 0 a e N i ®0 2 m 3 m N m O 9 a m � 3 m Z NN O z O z M m m m � O N N J A Z N V N R 0 N O N 6 d d m m d I � m m N IC N N '^ O N f201q-olg8 3010 R;V01; ,fCENTRAL STATION ZONE p# Address Type CustomLabel 164 5 TROUBLE MON TELGUARD 7 165 6 WATER FLOW 3000-3009 WATER FLOW 166 7 SMOKE CONVEN 3000-3009 SMOKE DETECTOR 167 8 PULL STATION 3000-3009 PULL STATION 168 9 SUPERVSRYAR 3000-3009 TAMPER 169 10 TROUBLE MON 3000-3009 TROUBLE 170 11 WATER FLOW 3010-3021 WATER FLOW 171 12 SMOKE CONVEN 3010-3021 SMOKE 172 13 PULL STATION 3010-3021 PULL 173 14 SUPERVSRYAR 3010-3021 TAMPER 174 15 TROUBLE MON 3010-3021 TROUBLE 175 16 WATER FLOW 3022-3028 WATER FLOW 176 17 SMOKE CONVEN 3022-3028 SMOKE 177 18 PULL STATION 3022-3028 PULL 178 19 SUPERVSRY AR 3022-3028 TAMPER 179 20 TROUBLE MON 3022-3028 TROUBLE 180 21 WATER FLOW 3029-3035 WATER FLOW 181 22 SMOKE CONVEN 3029-3035 SMOKE 182 23 PULL STATION 3029-3035 PULL 183 24 SUPERVSRY AR 3029-3035 TAMPER 184 25 TROUBLE MON 3029-3035 TROUBLE 185 26 WATER FLOW 3036-3047 WATER FLOW 186 27 SMOKE CONVEN 3036-3047 SMOKE 187 28 PULLSTATION 3036-3047 PULL 188 29 SUPERVSRYAR 3036-3047 TAMPER 189 30 TROUBLE MON 3036-3047 TROUBLE 190 31 WATER FLOW 3048-3055 WATER FLOW 191 32 SMOKE CONVEN 3048-3055 SMOKE 192 33 PULL STATION 3048-3055 PULL 193 34 SUPERVSRY AR 3048-3055 TAMPER 194 35 TROUBLE MON 3048-3055 TROUBLE 195 36 WATER FLOW 3056-3062 WATER FLOW 196 37 SMOKE CONVEN 3056-3062 SMOKE 197 38 PULL STATION 3056-3062 PULL 198 39 SUPERVSRY AR 3056-3062 TAMPER 199 40 TROUBLE MON 3056-3062 TROUBLE 200 41 WATER FLOW 3063-3074 WATER FLOW 201 42 SMOKE CONVEN 3063-3074 SMOKE 202 43 PULL STATION 3063-3074 PULL 203 44 SUPERVSRYAR 3063-3074 TAMPER 204 45 TROUBLE MON 3063-3074 TROUBLE 205 46 WATER FLOW 3075-3082 WATER FLOW 206 47 SMOKE CONVEN 3075-3082 SMOKE 207 48 PULLSTATION 3075-3082 PULL 208 49 SUPERVSRY AR 3075-3082 TAMPER 209 50 TROUBLE MON 3075-3082 TROUBLE 210 51 WATER FLOW 4099-4105 WATER FLOW 211 52 SMOKE CONVEN 4099-4105 SMOKE 212 53 PULLSTATION 4099-4105 PULL 213 54 SUPERVSRYAR 4099-4105 TAMPER 214 55 TROUBLE MON 4099-4105 TROUBLE 215 56 WATER FLOW 4086-4098 WATER FLOW 216 57 SMOKE CONVEN 4086-4098 SMOKE 217 58 PULL STATION 4086-4098 PULL 218 59 SUPERVSRY AR 4086-4098 TAMPER 219 60 TROUBLE MON 4086-4098 TROUBLE 220 61 SUPERVSRY AR 4086-4098 OS&Y 221 62 WATER FLOW 4079-4085 WATER FLOW 222 63 SMOKE CONVEN 4079-4085 SMOKE 223 64 PULL STATION 4079-4085 PULL 224 65 SUPERVSRY AR 4079-4085 TAMPER 225 66 TROUBLE MON 4079-4085 TROUBLE 226 67 WATER FLOW 4075-4078 WATER FLOW 227 68 SMOKE CONVEN 4075-4078 SMOKE 228 69 PULL STATION 4075-4078 PULL 229 70 SUPERVSRY AR 4075-4078 TAMPER 230 71 TROUBLE MON 4075-4078 TROUBLE 231 72 WATER FLOW 4062-4074 WATER FLOW 232 73 SMOKE CONVEN 4062-4074 SMOKE 233 74 PULL STATION 4062-4074 PULL 234 75 SUPERVSRYAR 4062-4074 TAMPER 235 76 TROUBLE MON 4062-4074 TROUBLE 236 77 SUPERVSRY AR 4062-4074 OS&Y 237 78 WATER FLOW 4044-4061 WATER FLOW 238 79 SMOKE CONVEN 4044-4061 SMOKE 239 80 PULL STATION 4044-4061 PULL 240 81 SUPERVSRY AR 4044-4061 TAMPER 241 82 TROUBLE MON 40444061 TROUBLE 242 83 WATER FLOW 4044-4047 WATER FLOW 243 84 SMOKE CONVEN 4044-4047 SMOKE 244 85 PULL STATION 4044-4047 PULL 245 86 SUPERVSRYAR 4044-4047 TAMPER 246 87 TROUBLE MON 4044-4047 TROUBLE 247 88 SUPERVSRY AR 4044-4047 OS&Y 248 89 WATER FLOW 4028-4043 WATER FLOW 249 90 SMOKE CONVEN 4028-4043 SMOKE 250 91 PULLSTATION 4028-4043 PULL 251 92 SUPERVSRY AR 4028-4043 TAMPER 252 93 TROUBLE MON 4028-4043 TROUBLE 253 94 WATER FLOW 4023-4026 WATER FLOW 254 95 SMOKE CONVEN 4023-4026 SMOKE 255 96 PULL STATION 40234026 PULL 256 97 SUPERVSRYAR 4023-4026TAMPER 257 98 TROUBLE MON 4023-4026 TROUBLE 258 99 WATER FLOW 4010-4026 WATER FLOW 259 100 SMOKE CONVEN 4010-4026 SMOKE 260 101 PULL STATION 4010-4026 PULL 261 102 SUPERVSRYAR 4010-4026TAMPER 262 103 TROUBLE MON 4010-4026 TROUBLE 263 104 SUPERVSRYAR 4010-402605&Y 264 105 WATER FLOW 4000-4009 WATER FLOW 265 106 SMOKE CONVEN 4000-4009 SMOKE 266 107 PULLSTATION 4000-4009 PULL 267 108 SUPERVSRY AR 4000-4009 TAMPER 268 109 TROUBLE MON 4000-4009 TROUBLE „ � F20Iq-o►qg 30►0 R;vol; FIRE ALARM AND EMERGENCY COMMUNICATION SYSTEM RECORD OF COMPLETION To be completed by the system installation contractor at the time ofsystem acceptance and approval. It shall be permitted to modify thisfarat 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. 1. PROPERTY INFORMATION Name of property: NEWPORT BLUFFS (IAC PART 2) Address: 3000 -4009 RIVOILI, NEWPORT BEACH, CA 92660 Description of property: APARTMENT COMPLEX Occupancy type: R-2 -- Name of property representative: ADAM JENSEN Address: 131 THEORY, IRVINE, CA 92617 Phone: 951-452-5567 Fax: _. E-mail: ajensen@iminecompany.com Authority havingjurisdiction over this property: NEWPORT BEACH FIRE DEPARTMENT Phone: Fax: E-mail: 2. INSTALLATION, SERVICE, AND TESTING CONTRACTOR INFORMATION Installation contractor for this equipment: Interface Systems Address: 3750 Schaufele Ste 200, Long Beach, CA 90808 License or certification number: 469046 Phone: 800-922-9154 Fax: E-mail: joe.mandalindan@interfacesys.com Service organization for this equipment: Interface Systems Address: 3750 Schaufele Ste 200, Long Beach, CA 90808 License or certification number: 469046 Phone: 800-922-9154 Fax: E-mail: joe.mandalindan@interfacesys.com A contract for test and inspection in accordance with NFPA standards is in effect as of Contracted testing company: N/A Address: Phone: Fax: E-mail: Contract expires: Contract number: Frequency of routine inspections: 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 (MINS) ❑ Combination system, with the following components: ❑ Fire alarm ❑ EVACS ❑ MNS ❑ Two-way, in -building, emergency communication system ❑ Other (specify): NFPA 72, Fig. 10.18.2.1.1 (p. 1 of 12) Copyright ®21109 National FireProtection Association. This form maybe copied for individual use other than for resale. It may not be copied for commercial sale a distribution. 3. DESCRIPTION OF SYSTEM OR SERVICE (continued NFPA 72 edition: 2016 3.1 Control Unit Manufacturer: FIRE -LITE 3.2 Mass Notification System 3.2.1 System Type: ❑ In -building MMS—combination ❑ In -building MNS—stand-alone ❑ Other (specify): N/A Additional description of system(s): Model number: MS-9600-UDLS ® This system does not incorporate an MNS ❑ Wide -area MNS ❑ 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 (DAMNS) ❑ Wide -area MNS to DRMNS interface ❑ Wide -area MNS to high-power speaker array (BPSA) interface ❑ In -building MNS to wide -area MNS interface ❑ Other (specify): N/A 3.3 System 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: BY FACP 3.4 System Software ® This system does not have alterable site-specific software. Operating system (executive) software revision level: Site-specific software revision date: _ _ _ Revision completed by: ❑ A copy of the site-specific software is stored on site. Location: 3.5 Off -Premises Signal Transmission El This system does not have off -premises transmission. Name of organization receiving alarm signals with phone numbers: Alarm: INTERFACE CENTRAL STATION Phone: 866-593-3487 Supervisory: INTERFACE CENTRAL STATION Phone: 866-593-3487 Trouble: INTERFACE CENTRAL STATION Phone: 866-593.3487 Entity to which alarms are retransmitted: NEWPORT BEACH FD Phone: _ Method of retransmission: VIA COPPER PHONE LINE AND TELGUARD TG7 CELL DIALER 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 FireProtection Association. This form maybe copied for individual use other than for resale. It may not be copied for oommeroiai sale a distrbution. 4. CIRCUITS AND PATHWAYS 4.1 Signaling Line Pathways 4.1.1 Pathways Class Designations and Survivability Pathways class: B _ Survivability level: 1 Quantity: 2 (See NFPA 72, Sections 12.3 and 12.4) 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 4.2 Alarm Initiating Device Pathways 4.2.1 Pathways Class Designations and Survivability Pathways class: N/A _,_.__.___ Survivability level: N/A Quantity: (See NFPA 72, Sections 12.3 and 11.4) 4.2.2 Pathways Utilizing Two or More Media Quantity: 0 Description: N/A 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: N/A Survivability level: Quantity: (See NFPA 72, Sections 113 and 12.4) 4.3.2 Pathways Utilizing Two or More Media Quantity: 0 Description: N/A 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) Copynghl®2009 National Fire Protection Associeaon. 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: Conventional: 20 Coded: Transmitter: Other (specify): N/A 5.1.2 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 5.2.1 Smoke Detectors ❑ This system does not have smoke detectors. Type and number of devices: Addressable: Conventional: 20 Other (specify): N/A Type of coverage: ❑ Complete area ❑ Partial area ❑ Nomequired partial area Other (specify): ABOVE EACH FACP IN LOW VOLTAGE CLOSETS OF 20 BUILDINGS Type of smoke detector sensing technology: []Ionization ®Photoelectric ❑ Multicriteria ❑ Aspimting ❑ Beam Other (specify): N/A 5.2.2 Duct Smoke Detectors ® This system does not have alarm -causing duct smoke detectors. Type and number of devices: Addressable: Conventional: Other (specify): N/A 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: 5.2A Gas Detectors ® This system does not have gas detectors. Type of detector(s): Number of devices: Addressable: Conventional: Type of coverage: 5.2.5 Heat Detectors ® This system does not have heat detectors. Type and number of devices: Addressable: Conventional: Type of coverage: ❑ Complete area ® Partial area ❑ Nonrequired partial area ❑ Linear ❑ Spot Type of heat detector sensing technology: ® Fixed temperature ❑ Rate -of -rise ❑ Rate compensated NFPA 72, Fig. 10.18.2.1.1 (p. 4 of 12) Copyright®2009 National Firs Protection Association. This form maybe copied for individual use other than for resale. It may not be copied for commercial sale or distdbulion. 6. ALARM INITIATING DEVICES (continued) 5.2.6 Addressable Monitoring Modules Number of devices: 5.2.7 Waterilow Alarm Devices Type and number of devices: Addressable: 5.2.8 Alarm Verification Number of devices subject to alar verification: 5.2.9 Presignal Number of devices subject to presignal: Describe presignal functions: 5.2.10 Positive Alarm Sequence (PAS) Describe PAS: 5.2.11 Other Initiating Devices Describe: ® This system does not have monitoring modules. ❑ This system does not have watertlow alarm devices. Conventional: 1 Coded: Transmitter: ® This system does not incorporate alarm verification. Alarm verification set for seconds ® This system does not incorporate pre -signal. ® This system does not incorporate PAS. ® This system does not have other initiating devices. 6. SUPERVISORY SIGNAL -INITIATING DEVICES 6.1 Sprinkler System Supervisory Devices ❑ This system does not have sprinkler supervisory devices. Type and number of devices: Addressable: 4 Conventional: 20 Coded: Transmitter: Other (specify): N/A 6.2 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): 6.3 Duct Smoke Detectors (DSDs) ® This system does not have DSDs causing supervisory signals. Type and number of devices: Addressable: Conventional: Other (specify): N/A 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®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): 7.2 Special Hazard Suppression Systems Description of special hazard system(s): 7.3 Other Monitoring Systems Description of special hazard system(s): ® 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. 8. ANNUNCIATORS 8.1 Location and Description of Annunciators Location 1: MAIN ENTRANCE TO LEASING OFFICE AT 100 VILLAGIO Location 2: Location 3; ❑ This system does not have annunciators. 9. ALARM NOTIFICATION APPLIANCES 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 1: Location 2: Location 3: 9.2 Nonvoice Notification Appliances Homs: 80 Willi visible: Chimes: With visible: Visible only: _ - _ _ Other (describe); 9.3 Notification Appliance Power Extender Panels Quantity: Locations: ❑ This system does not have nonvoice notification appliances. Bells: 20 With visible: ® 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 maybe copied for individual use other than for meals. It may not be copied for commercial sale a distribution. 10. MASS NOTIFICATION CONTROLS, APPLIANCES, AND CIRCUITS ®ibis system does not have an MNS 10.1 MNS Local Operating Consoles Location 1: Location 2: Location 3: 10.2 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 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 handsets stored on site: Type of telephone system installed: []Electrically powered ❑ Sound powered 11.2 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: dBm 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) Copyright ®2008 National Fire Protection Assoclation. This form may be copied for individual use other than for reads. It may not be copied for commercial sale ordistribution. 11. TWO-WAY EMERGENCY COMMUNICATION SYSTEMS (continued) 11.3 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: 11A 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: 11.5 Other Two -Way Communication Systems Describe: N/A 12. CONTROL FUNCTIONS This system activates the following control fictions: ❑ 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 ® 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 of control panel: 120 VAC Overcurrent protection: Type: Circuit Breaker Location (of primary supply panel board): ELECTRICAL ROOM Disconnecting means location: ELECTRICAL ROOM 13.1.2 Engine -Driven Generator Location of generator: Control panel amps: 4.8 Amps: 20 ® This system does not have a generator. Location of fuel storage: _ _ _ _ _ _ Type of fuel: NFPA 72, Fig. 10.18.2.1.1 (p. 8 of 12) Copyright ® 2009 National FireProtection Association. This form maybe copied for individual use other than for resale. a 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: Inside FACP _ _ Type: Nominal voltage: 12 Amp/hourmting: 2 x18 Calculated capacity of batteries to drive the system: In standby mode (hours): 24 _ In alarm mode (minutes): 5 ® 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: EVACS or MNS panel amps: Overcurrent protection: Type: Amps: Location (of primary supply panel board): Disconnecting means location: 13.2.2 Engine -Driven Generator ® This system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 13.2.3 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): 13.2.4 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 are marked with date of manufacture ❑ Battery calculations are attached NFPA 72, Fig. 10.18.2.1.1 (p. 9 of 12) Copyright 02oe9 Nsfioaal Flre Protectlon Assoclafim, This form my be copied for individual use other than for resale. It may not be copied for commercial sale a distribution, 13. SYSTEM POWER (continued) 13.3 Notification Appliance Power Extender Panels ® This system does not have power extender panels. 13.3.1 Primary Power Input. voltage of power extender panel(s): _.- Power extender panel amps: Overcurrent protection: Type: Amps: Location (of primary supply panel board): Disconnecting means location: 13.3.2 Engine -Driven Generator ® This system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 13.3.3 Uninterroptible 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: Type: _-_ - Nominal voltage: Amp/hourrating: 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 14. RECORD OF SYSTEM INSTALLATION Fill out after all installation is complete and wiring has been checkedfor opens, shorts, groundjaults, 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: 2016 ® Manufacturer's published instructions Other (specify): System deviations from referenced NFPA standards: None known Signed: Printed name: T Sarkisyan Date: 6/24/2019 _.. _. Organization: ce ystems Title: PM Phone: 818-448-1822 NFPA 72, Fig. 10.18.2.1.1 (p. 10 of 12) Copyright ®2009 National FireProtection Association. This tone maybe 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 andfunctions 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, Article 760, Edition: 2.0_1.6_ ® Manufacturer's published instructions Other (specify): D Individual device testing documentation [Inspection and Testing Form (Figure 14.6.2.4) is attached) Signed: __. Printed name: T. Sarkisyan Date: 6/24/2019 Organization: a ace ystems Title: PM Phone: 818-448-1822 16. CERTIFICATIONS AND APPROVALS 16.1 System Installation Contractor: This system, as specified herei , has been installed and tested according to all NFPA standards cited herein. Signed: , Printed name T. Sarkisyan Date: 6/24/2019 Organization: Int c Syste Title: PM Phone: 818-448-1822 16.2 System Service Contractor: The undersigned has a service contract for this system in effect as of the date shown below. �� / �J �� Signed: N/A J Printed name: V ` _- "�'t ,� "" Date: �%p"�-/I Organization: /� Title: -_(l -._._ Phone: (gf6 lf.,YGf ZZ 16.3 Supervising Station: This system, as specified herein, will be monitored according to all NFPA standards cited herein. < 7 Signed: N/A � Printed name: �' Organization: �-�Title: �' / Date: Phone: NFPA 72, Fig. 10.18.2.1.1 (p. 11 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 commeroial sale or distribution. 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: Organizatioin: 16.5 Authority Having Jurisdiction: Printed name: _ Title: Date: GLe l c Phone: 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: �l�lk_Y�v� -U`^�Vv .. Printed name: K)A Iva `-(bVoiDate: Organization: /�c!7_-_ Title: Phone: f�-r-�IPec�i�� Phone: q --- f'0 4 L4-3 l (� NFPA 72, Fig. 10.18.2.1.1 (p. 12 of 12) Copyright 0 2009 National Fire Protection Association. This forth may be copied for individual use other then for resale. It may not be copied for commercial sale a distribution,