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F2022-0335 - Permits
SYSTEM RECORD OF COMPLETION Form Completion Date:01/03/2023 Supplemental Pages Attached: 1. PROPERTY INFORMATION Name of property: THE CAY AT MARINER SHORES ------ 1244IRVINE AVE. BUILDING 11 NEWPORT BEACH, CA. 92660 Description of property: V-B Name of property representative: MATT CARSON Address: 2 ADA SUITE 200 IRVINE CA 92618 Phone: 949-526-8842 Fax: 2. INSTALLATION, SERVICE, TESTING, AND MONITORING INFORMATION Installation contractor: HCI SYSTEMS Address: 1354 S PARKSIDE OR, ONTARIO CA 91761 Phone: 1909) 628-7773 Fax. E-mail: Service organization: HCI SYSTEMS Address: 1354 S PARKSIDE DR, ONTARIO CA 91761 Phone: (909) 628-7773 Fax. - E-mail: Testing organization: HCI SYSTEMS Address: 1354 S PARKSIDE DR, ONTARIO CA 91761 Phone: (909) 628-7773 Fax. E-mail: Effective date for test and inspection contract: 01/03/2023 - Monitoring organization: ADVANCED MONITORING INC. Address: 1354 S PARKSIDE DR, ONTARIO CA 91761 rn._ (909) 628-7773 F.v. _ _ E-mail: Account number: HCI 1166 Phone line 1: l000-°a�-140r Means of transmission: DACT Entity to which alarms are retransmitted: NEWPORT BEACH FIRE DEPT Phone line 2: 1855-857-4886 949-644-3104 3. DOCUMENTATION DOCUMENT CABINET On -site location of the required record documents and site -specific software: 4. DESCRIPTION OF SYSTEM OR SERVICE This is a: m New system OModification to existing system Permit number: F2022-0335 NFPA 72 edition: 2016 4.1 Control Unit n,r__.-e.._..-_.._ KIDDIE 4.2 Software and Firmware Firmware revision number: — 4.3 Alarm Verification Number of devices subject to alarm Model number: FX-5RD m This system does not incorporate alarm verification. Alarm verification set for seconds NFPA 72 (p. 1 of 3) © 2018 National Fire Protection Association. This form maybe copied for individual use other than for resale. It may not be copied for commercial sale LOA or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized NFPA use, contact licensing@nipa.org. aoaa- 01-it) SYSTEM RECORD OF COMPLETION (continued) 5. SYSTEM POWER 6.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: 120 VAC Control panel amps: 7 Overcurrent protection: Type: BREAKER Amps: 20 Branch circuit disconnecting means location: BREAKER PANEL 1 Number: CKT 1 5.1.2 Secondary Power Type of secondary power: BATTERY Location, if remote from the plant; N/A Calculated capacity of secondary power to drive the system: In standby mode (hours): 24 In alarm mode (minutes): 15 5.2 Control Unit ® This system does not have power extender panels EM Power extender panels are listed on supplementary sheet A 6. CIRCUITS AND PATHWAYS Dual Media Separate Survivability Pathway Type Pathway Pathway Class Level Signaling Line N/A X B 1 Device Power N/A X B 1 Initiating Device WA X B 1 Notification Appliance N/A X B 1 Other (specify): N/A N/A N/A N/A 7. REMOTE ANNUNCIATORS T'ype Location N/A N/A S. INITIATING DEVICES Addressable or Alarm or Sensing Type Quantity Conventional Supervisory Technology Manuel Pull Stations 1 CONVENTIONAL ALARM TOGGLE Smoke Detectors i CONVENTIONAL ALARM PHOTO Duct Smoke Detectors N/A Heat Detectors N/A Gas Detectors N/A Carbon Monoxide Detectors N/A Waterflow Switches 1 CONVENTIONIAL ALARM TOGGLE Tamper Switches 1 CONVENTIONAL ISUPERVISORY TAMPER SWITCH NFPA 72 (p. 2 of 3) Qaa�� ® 2018 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale 71' or distribution. No other reproduction or transmission In any form permitted without written permission of NFPA. For inquiries or to report unauthorized NR use, contact licensing@nfpa.org. SYSTEM RECORD OF COMPLETION (continued) 9. NOTIFICATION APPLIANCES Type Quantity Description Audible 1 120VAC FLOW BELL Visual N/A Combination Audible and Visual N/A 10. SYSTEM CONTROL FUNCTIONS Type Quantity Hold -Open Door Releasing Devices NIA HVAC Shutdown N/A Fire/Smoke Dampers N/A Door Unlocking N/A Elevator Recall N/A Elevator Shunt Trip N/A 11. INTERCONNECTED SYSTEMS O 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 s ecifiso herein has been installed according to all NFPA standards cited herein. '� (( JOHNDALE YAPO Printed name: Date: 01/03/2023 Orgam: : : HCI SYSTEMS INC. Title: FOREMAN Phone: 909-996-6036 12.2 System Operational Test This system ae s ecified herein has tested according to all NFPA standards cited herein. SignettPrinted name: JOHNDALE YAPO Date: 01/03/2023 Organization: HCI SYSTEMS INC. Title: FOREMAN Phone: 909-996.6036 12.3 Acceptance Test Date and time of acceptance test: Installing contractor representative: JOHNDALE YAPO Testing contractor representative: HCI SYSTEMS INC. Property representative: MATT CARSON AHJ representative: NFPA 72 (p. 3 of 3) Qyi 02018 National Fire Protection Association. This form maybe copied for individual use other than for resale, It may not be copied for commercial sale MF or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized use, contact licensing@nfpa.org.