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126 3RD AVE N (4)JZ (P 32O AvC, N SNOHOMISH CO. Serving Brier, Edmonds, and 12425 Meridian Ave S Mountlake Terrace Everett, WA 98208 Phone (425) 551-1200 www.FireDistrictl.org Fax (425) 551-1272 LOCATION: 126 3 rd Avenue N 98020 BUSINESS NAME: Alister Place Condos PHONE: MAILING ADDRESS: 126 3rd Avenue N, Edmonds, WA 98020 BUSINESS OWNER: Fluury, Steve. HOME PHONE: .EMERGENCY-1: Fleury, Marcia HOME PHONE: 2065101928 KEY ACCESS-2: HOME PHONE: EMAIL: PERSON CONTACTED: j NAME OF INSPECTOR:s /�,' FIRE SYSTEM : FE y// ((—FD Lk Box 1"') FIRE PREVENTION INSPECTION REPORT ❑ EDMONDS ❑ BRIER ❑ MOUNTLAKE TERRACE ❑ UNINCORPORATED FREQUENCY I STATION 8 SHIFT Annual 17-A SCHEDULED DATE DUE ► Oct 2015 UFIR ► 423 202 CURRENT YES NO CITY BUSINESS LICENSE INITIAL IN PECTI N DATE �-i < �- . . 1 /1 _— '-7 Date Last Service �T iv J 7 HAZARDS FOUND A LOCA COM CAT 1 1 2 — — — 7-7 2 3 3 5 5 6 6 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X In our continuing effort to promote fire safety and prevention within the community, your fire department conducts regularly scheduled "Fire Safety Survey Inspections" of all businesses and multi -family occupancies in the Cities covered by Snohomish County Fire District 1. You are to be congratulated on the relative good condition of your occupancy in regards to fire safety. Above you will find the item(s) that were noted during. our inspection which require attention to bring them into compliance with the minimum standards adopted by the above jurisdictions. Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions or violation. If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-7720; for Mountlake Terrace or Brier, call (425) 744-6231. =.. ,�FIRE PREVENTION ,.r a- r .sNoxo�iss co. ,..•� Serving Brier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT FIRE Mountlake Terrace Everett, WA 98208 ❑ BRIER s ❑BRIER Phone (425) .5.51-1200 ❑ MOUNTLAKE TERRACE DISTR IT [I UNINCORPORATED www FireDistrictl. org Fax (425) 551-1272 FREQUENCY STATION & SHIFT LOCATION: 126 3 rd Avenue N 98020 Annual 17-A BUSINESS NAME: Allster Place Condos PHONE: SCHEDULED Oct DATE DUE 2015 MAILING UFIR / 423 202 ADDRESS: 126 3rd-Avenue N, Edmonds, WA 98020 BUSINESS OWNER: Fluery, Steve HOME PHONE: EMERGENCY-1 Fleury; Marcia HOME PHONE: 2065101928 CURRENT KEY ACCESS-2: HOME PHONE: CITY YES NO *' BUSINESS EMAIL: LICENSE PERSON CONTACTED: INITIAL IN ECTI N DATE NAME OF' INSPECTOR: ' / S FIRE SYSTE AS 5/10 -4/15-E %�FD Lk Box /) Date Last Service .. S / HAZARDS FOUND A LOCATI • . S / OMMU ICATIQN$ I . 2 _ _ �_ ---- - - — - _ 2- . - ...... . 3 .3 I • 4 7 , :-5. 6 6 -I'AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X tst RE -INSPECTION / 2nd RE -INSPECTION EXTENSION FINAL RE -INSPECTION VIOLATIONS DATEDUE: I�l (Q DATE DUE: GRANTEDTO: DATE DUE: CITED: PERSON PERSON PERSON .EOETZTED j L CONTACTED: CONTACTED: INSPECTOR: U INSPECTOR: 2 INSPECTOR: — -.— DATE: l_ DATE: — DATE: 3 VIOLATION VIOLATIONS" PRE -CITATION T — CITATION ISSUED 4 4 LETTER SENT — NUMBER• 2 � � 2 6 __—..,'-• DATE: SECTION: CODE 5 RETURN RECEIPT _ e 3 7 3 7 RECEIVED DISPOSITION: 8 4 8 DATE: LETTER, NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO r 8 FIRE�PREVENTION ServingBrier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT SNOHOMISH C#o. � � EDMONDS FIREMountlake Terrace Everett, WA 982088 BRIER `"` '`T Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE DISTRwww.FireDistrict].org Fax (425) 551-1272 ❑ UNINCORPORATED 126 3 rd Avenue N 98020 WEQUE�CY STAT1Dy SHIFT Nnnua 1 (ti LOCATION: Alister Place Condos SCHEDULED Oct 2016 BUSINESS NAME: PHONE: DATE DUE ► MAILING 126 3rd Avenue N, Edmonds, WA 98020 UFIR ► ADDRESS: Fluery, Steve BUSINESS OWNER: HOME PHONE: Fleury, Marcia 2065101928 EMERGENCY-1: HOME PHONE: [—URRENT El KEY ACCESS-2: HOME PHONE: CITY YES NO EMAIL: s los S.S yV\(�+ �' i 00W'_ BUSINESS LICENSE PERSON CONTACTED: 1 INITIAL INSPECTION 'DATE NAME OF INSPECTOR: V'�` /�—�� S `� 11 — Date Last Serviced: 5 1 HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 1 T ram. �t 1 I mil. t 5 7 + rJ ! u d" �� �a I �,tA 80 S W4-1 2 2 3 4 4 5 5 6 6 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION 2nd RE -INSPECTION € FINAL RE -INSPECTION VIOLATIONS EXTENSION DATE DUE, DATE DUE, GRANTED TO* GATE DUE, CITED: PERSON PERSON i PERSON CONTACTED- CONTACTED, CONTACTED. INSPECTOR: INSPECTOR: INSPECTOR 2 DATE. V L l,;MjA w_ V7 DATE. PATE VIOLATIONS .. 9 VIOLATIONS VIOLATIONS PRE -CITATION _ CITATION ISSUED 4` 5 LETTER -SENT NUMBER: CODE 5 2 ; 6 2 : 6 DATE. SECTION. RETURN RECEIPT 6 3 , 7 3 7 RECEIVED DISPOSITION - 7 4 8 4 8 DATE: LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO 8 EXPLANATION OF CODE PERMITS: 1. Obtain a perm it from the Fire Department: I.F.C. 105.1 2. Maintain hazardous materials/processes according to your Department permit requirements: I.F.C. 105.1 3. Renew expired Fire Department permit: I.F.C. 105.1.2/105.3.1 4. Conspicuously post Fire Department permit in appropriate location: LF,C. 105.3.5 5. Obtain business license 6. Obtain permit from Building Department for: FIRE PROTECTION: 7. Remove all foreign material from the sprinkler heads or replace the sprinkler heads: I.FC.901.6.1 8. Nothing shall be placed on or hung from sprinkler piping: I.F.C. 901.6.1 9. Install approved cover(s) on the Fire Department sprinkler connection: I.F.C. 901.6.1 10. Remove all storage from around sprinkler system control valves: I.F.C. 901.6.1 11. Repair sprinkler system deficiencies: I.F.C. 901.6.1 12. Remove all items that might block access to sprinkler control valves or Fire Department hose connections: I.F.C. 901.6.1 13. Lower the storage to a minimum of 18" below the sprinkler head deflectors: I.F.C. 315.3.1 14. Annual confidence test must be performed on sprinkler system(s) by a qualified person, and documentation must be provided to Fire Marshal: I.F.C. 901.6.1 15. Fusible link or sprinkler head must be replaced on hood and vent extinguishing system: I.F.C. 904.11.6.3 16. Hood and vent extinguishing system must be serviced semi-annually by a qualified person: I.F.C. 904.11.6.2 17. Remove all accumulations of grease from the range hood, filters and connecting grease flue and institute periodic cleaning to prevent such accumulation in the future: I.F.C. 609.3.3.1 18. Spray booth filters shall be maintained and changed in accordance with: I.F.C.1504.3 19. Remove all items or conditions, which might interfere with proper use of fire hydrant: I. F.C.507.5.4 20. Repair fire alarm system: I.F.C. 907.8.5 21. Fire alarm system shall be tested and maintained annually: NFPA 72 Documentation shall be provided to Fire Marshal: I.F.C. 907.7.2 22. Install portable fire extinguishers: I.F.C. 906.1 23. The fire extinguisher(s) must be inspected/tagged annually: NFPA 10 24. The fire extinguisher(s) must be serviced/recharged by a qualified person: NFPA 10 25. Fire/life safety systems must be tested and maintained, documentation must be provided to the Fire Marshal: I.F.C. 901.6.1 26, The dry standpipe shall be hydrostatically tested every five years: I.F.C. 901.6 27. All devices in approved locations: I.F.C. 907.1 EXI �$ Maintain exit pathway lighting: I.F.C.1006.1/1006.3 29. Maintain exit sign illumma 30. Provide approved signs indicating the direction of travel to fire exits: I.F.C. 1011.1 31. Provide approved signs indicating the fire exit(s): I.F.C. 1011.1 32. Exits shall not be blocked or obstructed in any way, and the required width of aisles leading to exits shall be maintained: I.F.C. 1030.2 33. Properly repair the panic hardware on the exit door(s): I.F C. 1008.1.10.1 34. Exit doors shall be openabie from the inside without the use of a key or any special knowledge or effort. Exit doors shall not be locked, chained, barred, latched, or otherwise rendered unusable. All locking devices shall be of an approved type: I.F.C.1008.1.9 35. in group A-3, B, F M & S occupancies, in all churches main exit door(s) may have key -locking hardware if an approved sign is posted, stating, "This Door To Remain Unlocked During Business Hours": I.F.C. 1008.1.9.3 36, Provide a minimum of 36" of clear aisle width: I.F.C. 1018.2 37. Provide a minimum of 44" of clear aisle width: I.F.C. 1018.2 38. Every building of three or more stories shall have approved stairway identification signs posted: I.F.C. 1022.8 39. All assembly occupancies shall have occupant load posted in conspicuous place: I.F.C.1004.3 40. Overcrowding of a room or building shall not be permitted: I.F.C. 107.5 ELECTRICAL" 41. Install approved covers on the open electrical service panel(s) or junction box(es): I.F.C.605.6 42. A junction box with an approved cover is required at every splice. Therefore, provide such boxes: I.F.C. 605.6 43 Maintain a minimum of 3' clearance in front of electrical panels: I.F.C. 605.3 44, Provide documentation that electrical wiring, panels, etc., have been inspected and approved by Washington State electrical inspector: I.F.C. 605.1 45. Electrical wiring and equipment in any vapor area shall be explosion -proof type approved for use in such hazardous location: I.F.C. 1503.2.1/3403.1/2201.5 46. Extension cords shall not be used as a substitute for permanent wiring: I.F.C. 605.5 47. The current capacity of an extension cord shall not be less than the rated capacity of the appliance or fixture served by that cord: I.F.C. 605.5.2 48 Extension cords shall be maintained in good condition without splices, deterioration, or damage: I.F.C. 605.5.3 49. Extension cords shall be of the grounded type when serving grounded appliances or fixtures: I.F.C. 605.5.4 FIRE SEPARATIONS: " 50. Discontinue blocking or wedging open fire doors: I.F.C. 703.2 51. Repair the fire door(s) so they close completely and in proper sequence: I.F.C. 703.2f703.2.3 52. If an open fire door is necessary for ventilation or convenience, a hold open device approved by the Fire Marshal must be used: I.F.C. 703.2.2/I.B.C. 716.3.7.2 53. All required occupancy separations, area separation walls, and draft stop partitions, shall be maintained as specified in the International Building Code: I.F.C. 701.11703.1 54. Repair the damaged plaster with a fire -resistive material equivalent to the surrounding surfaces: I.F.C. 703.1 FLAMMABLE LIQUIDS GASES AND HAZARDOUS MATERIALS 55. Reduce the quantity of flammable liquids: CHAPTER 57 56, Flammable liquids not exceeding 120 gallons may be stored in an approved storage cabinet. Such cabinet shall be conspicuously labeled in red letters: "Flammable -Keep Fire Away": CHAPTER 57 57. Remove the accumulation of combustible residues from the walls, floor and ceiling of the spray room area: CHAPTER 25 58. Dispensing devices shall be of an approved type. Class I -A flammable liquids shall not be dispensed from tanks, drums, barrels, or similar containers by gravity. Approved pumps taking suction from the top of the container shall be used: CHAPTER 57 59. Hose nozzle valves used at self-service stations for dispensing of Class I flammable liquids shall be listed automatic closing: CHAPTER 23 60. When damage to LP gas systems from vehicular traffic is a possibility, precautions against such damage shall be taken, therefore provide posts or a protective barrier to prevent such damage: CHAPTER 61 61. All compressed gas cylinders in service or storage shall be secured to prevent falling or being knocked over: CHAPTER 57 62. Oil burning equipment shall be of an approved type: I.F.C. 603.1.2 63. Install/repair woodworking refuse removal system: CHAPTER 28 64. Post signs stating location of emergency pump shutoff: CHAPTER 23 65. Post "NO SMOKING" sign(s) on LPG tank: CHAPTER 61 66, Remove and safely dispose of damaged or leaking containers of flammable hazardous material: CHAPTER 57 67. Use, dispensing, storage and handling of hazardous materials shall be in accordance with I.F.C. Chapter 57 and your Fire Department permit: CHAPTER 50 68. Provide Material Safety Data Sheets (MSDS): CHAPTER 50 69, Provide Hazardous Material Inventory Statement (HMIS): CHAPTER 50 70. Provide Hazardous Materials Management Plan (HMMP): CHAPTER 50 STORAGE: 71. Remove all flammable or combustible storage from the unfinished attic area: I.F.C. 315.3.4 72. Remove all combustible material from beneath the structure: I.F.C. 315.3.4 73. Lower the storage to a minimum of 24" below the ceiling: I.F.C. 315.3.1 74. Lower the storage to a minimum of 18" below the sprinkler head deflectors: I.F.C.315.3.1 75. Remove all combustible or hazardous material: I.F.C. 315.1 76. Unlawful to park or store any fueled equipment in any dwelling unit, office, exit way or location that would create a fire or life hazard: I.F.C. 315.1 77. Boiler rooms, mechanical rooms, and electrical panel rooms shall not be used for storage: I.F.C. 315.3.3 78. Any exterior door that has been rendered non-functional in an approved manner by the Chief shall be posted in an approved manner with the words, "This Door Blocked": I.F.C. 504.2 79. Dumpsters and containers with an individual capacity of 1.5 cubic yards or greater shall not be placed within 5 feet of combustible walls, openings, or combustible roof eave lines: I.F.C. 304.3.3 80. Remove and properly dispose of the combustible tall grass, brush and other debris: I.F.C. 304.1.2 MISCEL 1 ANEMIC• 81. Strictly enforce "NO SMOKING" restrictions: I.F.C. 310 82. Post "NO SMOKING" signs: Washington Clean Air Act of 1985 and I.F.C. 310.3 83. Discontinue the practice of illegal outdoor burning: I.F.C. 307.1 84. Secure this vacant building to reduce the fire hazard: I.F.C. 311.1 85. All decorative materials are required to be of flame retardant material or treated to provide flame resistant characteristics: I.F.C. 806/807 86. Any owner, operator, occupant or other responsible person who shall fail to take immediate action to abate a fire hazard when ordered or notified to do so by the Fire Chief, shall be guilty of a misdemeanor: I.F.C. 109 87. Post and maintain the correct street address number in an approved manner: I.F.C.505 88. Post and maintain the correct suite or unit designator: I.F.C. 505.1 89. Striping and "Fire Lane - No Parking" signs/markings shall clearly indicate where the approved fire lane is located I.F.C. 503.3 90. Provide a key box for emergency access to the building: I.F.C. 506.1 91. Provide appropriate access to the building: I.F.C. Section 503 . .�' ,hsco olutio:�� Certification Given „,�:.•:::.:..:.....•:::::....,...,....,.,..:,,.,•,: ..-.,.,•:::., .:.:•:,.:.:::. RED YELLOW WHITE ... CONFIDENCE TEST ®/ 19023.14' Avc N, Sui(a:r•., Lynnw:uwt, WA 99M6ILS.A. REPAIRS (425) 771-I 166 Fny (425) 771-"22 „.„.?a.lt'ri.; tit iii iC•:i...i` } Occupancy Name: Building Owner: Owner Agent: FIRE ALARM SYSTEMS (One System per Report) Aiistcr Plasc Umd(+s Occupancy Address: 126 3rd Ave N , Suite 103, Edmonds t.oldwe-li BankerDanfuW) & Assoe Phone Number: 206-d1.7-1935 Manion t ZCSF Phone Number: 206-1917-1935 Date of Inspection: 05/11V2()16 Inspection Type: V Annual Quarterly Testers Name: Ken Day SFD Certification Number: SCt*-�06 2Z Monitoring: A(:i Phone #: IHOLI-752-2440 Account #: 8'-,�d14 FACP Manufacturer: Fri Model #: 10@-2D Location: Main entu # of Initiating Circuits: 1 # of Signal Circuits: 4 Notes: r. ALARM SYSTEM FUNCTIONALITY C Yes No N/A All notification circuits operational? All circuits checked for electrical supervision? All auxiliary equipment operates (elevators, fans, darn ors Key to panel available? (% Operating instructions at panel? Trouble indicators. function properly? 'test record posted at panel? Signals received at central station? Operator # Problems Found: �L Corrected By: Corrections Made: Date Corrected: SFD Certification M This certifies that this Hire and life safety system has In properly inspected for reliability to cover the items listed in this report and is consistent with Seattle (Fire Department Fire Code standards, and that iscrep ancl oted and have been reported to the building Owner/Manager for c rre iv@ acts Signature of Tester: Phone #: �g(�C� 3_ Signature of Owner: _ ID 1:w SYSTEM DEVICES MODEL # TOTAL TESTED SATISFACTORY? Yes No NIA HorniStrobas UX904W 12 Strobe Only 6 6 k Horn Only GFC.'2.111()WW 25 Speaker/Strobes Speaker Only Sounder Base Bells vAlucluc k 10" 1 �C Manual Pulls ',gilcm Knight 1 I Photo Smoke Detectors lan Smoke Detectors FCl ASnPL 20 �p Combination Smoke/Heat 13SO Rate of Rise Heat 2000 Rate of Rise Heat 135` Fixed Temp Heat 200` Fixed Temp Heat Duct Smoke Detectors Detector Remote Indicators Remote Annunciator; 1 Elevator Recall Output 2 Fan Pressurization Door Holders J 3 Door Unlock Curtains/Roll-down Doors Y Fire Fighter Phones Main FACP Trouble with AC off? No Battery backup operational? es No Battery voltage (no load) volts Battery voltage (full load) at volts Charge circuit voltage -1 volts Battery Size reanel type,- N ftt i roume with Ab on f No Battery backup operational? No Battery voltage (no load) volts Battm vita full load volts Charge circuit voltage volts Battery Size nyLn Panel Type: Trouble with AC off? Yes No Battery backup operational? Yes No Battery voltage (no load) volts Battery voltage (full load) volts Charge circuit voltage volts Battery Size i rouble with AC off Yes Rio Battery backup operational? Yes No Battery voltage (no load) volts Batte voltage full loadl I volts Charge circuit voltage volts Battery Size i 111, be I how November 17, 2015 Infinity Fire Protection LLC 17701 108Th Ave Se #426 Renton, WA 98055 Subject: UL Reference Numbers: UL Reference Numbers: Dear Submitter, Report on Sprinklers Sampled from the Following Location: Aliisst_er Place Condos---� 126-3Rd_Ave North — Edmonds, WA 98020 G233731FS#2236753 UL has completed the sensitivity and functionality testing on samples installed in the referenced location. The results of this testing is intended to assist interested parties including the local Authorities Having Jurisdiction (AHJ) in accessing the operating characteristics of the sprinkler's. Please consult the local Authorities Having Jurisdiction (AHJ) regarding the interpretation of the test results described in the attached Test Summary Table(s). In no event shall UL be responsible for whatever use or nonuse is made of the information contained herein and in no event shall UL, its employees, or its agents incur any obligation or liability for damages arising out of or in connection with the use or the inability to use information contained herein. Thank you for your continued interest in UL's services and we appreciate your business. We look forward in serving your future sprinkler submittals in accordance with the Standard for Inspection, Testing and Maintenance of Water- Based Fire Protection Systems, NFPA 25. Should you should have any questions or comments, please feel free to contact the undersigned. Very Truly Yours, Hector Salazar, Jr. Field Sprinkler Coordinator T: 847-664-2316 E: Hector.Salazarjr@ul.com UL LLC 333 Pfingsten Road, Northbrook, IL 60062-2096 U5A T: 847.272.8800 / F: 847.272.8129 / W: UL.com Reviewed by: Scott Dankert Staff Engineering Associate T: 847-664-2678 E: Scott.S.Dankert@ul.com Page 1 of 3 Issue Date: November 17, 2015 Reference Number: G233731 FS#2236753 Total Number of Sprinklers Received: 4 (3) sprinklers were submitted consisting of the following characteristics: Manufacturer: Reliable Releasing Mechanism Type: Glass Bulb Model: R5734 Sprinkler Orientation: Horizontal Sidewall Sprinkler Type: Dry Special Sprinkler Features: None Water Seal Configuration: Teflon -Belleville Spring Response Type: Quick TEST SUMMARY TABLE 1 Releasing Mechanism Sprinkler Location of Sprinkler Room Temperature °F Year Nominal K-Factor Sprinkler Condition Response Time, sec. Operation Classification Number in System Environment Rating, Marking 356920 Moderately 1 2nd fl se comer Other 155 2002 5.6 corroded or loaded 16.8 Normal 356921- Moderately 2 3rd fl se comer 1 Other 155 2002 5.6 corroded or loaded 14.5 Normal 356922- Moderately 3 2nd fl se comer Other 155 2002 5.6 corroded or loaded 15 Normal Sprinkler Condition: Please refer to the Standard for Inspection, Testing and Maintenance of Water -Based Fire Protection Systems, NFPA 25, for requirements and information related to determining when sprinklers are to be replaced. The Authority Having Jurisdiction (AHJ) should be consulted to determine when sprinklers need to be replaced due to their condition. The referenced sprinkler condition is UL's visual observation of the received sample sprinklers. Operation Classification: Normal — Indicates sprinkler operation within the applicable time frame for the response type and temperature rating. Page 2 of 3 Issue Date: November 17, 2015 Reference Number: G233731 FS#2236753 Total Number of Sprinklers Received: 4 (1) sprinkler was submitted consisting of the following characteristics: Manufacturer: Reliable Releasing Mechanism Type: Glass Bulb Model: R5714 Sprinkler Orientation: Pendent Sprinkler Type: Dry Special Sprinkler Features: None Water Seal Configuration: Teflon -Belleville Spring Response Type: Quick TEST SUMMARY TABLE 2 Releasing Mechanism Sprinkler Location of Sprinkler Room Temperature Year Nominal Sprinkler Condition Response rime, sec. Operation Classification Number in System EmrironmeM Rating, T Marking K-Factor Moderately 356923- 1 3rd fl se comer Other 155 2002 5.6 corroded or loaded 15.3 Normal Sprinkler Condition:. Please refer to the Standard for Inspection, Testing and Maintenance of Water -Based Fire Protection Systems, NFPA 25, for requirements and information related to determining when sprinklers are to be replaced. The Authority Having Jurisdiction (AHJ) should be consulted to determine when sprinklers need to be replaced due to their condition. 'Ile referenced sprinkler condition is UL's visual observation of the received sample sprinklers. Operation Classification: Normal — Indicates sprinkler operation within the applicable time frame for the response type and temperature rating. Page 3 of 3 t m wX 1w V, . . Otaw wiir- ei-owelm, ec, FIRE DEPARTMENT NOTIFICATION MISSED DAL r 7ksr 360-4S6-1441 Date: 12/30/2015 360-438-4245 FAX Fire Department Snocom Dispatch* Fax Email Alarm Install/Service Company Absco Alarms, Inc. Phone 425-771-1166 Fax Email jaspnesAabscoalarms.com Site Information: Account Type 81 Name Allister Place Condos Address 126 3rd Ave N City Edmonds State WA Postcode 98020 Phone # Comments: This is notification of a single missed daily test signal from the site and on the date noted above. This can be caused by a momentary outage on the phone line, a garbled transmission, or causes other than a bad fire alarm panel or communicator and does not necessarily mean the system is not capable of transmitting other fire, trouble, or supervisory signals. The alarm servicing company has been advised. If this notification should be sent to a different jurisdiction, please advice us of the correct jurisdiction and the correct email address or fax number. Thank youl November 17, 2015 Infinity Fire Protection LLC 17701 108Th Ave Se #426 Renton, WA 98055 Subject: UL Reference Numbers: UL Reference Numbers: Dear Submitter, RE tiE VED Report on Sprinklers Sampled from the Following Location: Alister Place Condos 126 3Rd Ave North Edmonds, WA 98020 G23373/ FS#2236753 UL has completed the sensitivity and functionality testing on samples installed in the referenced location. The results of this testing is intended to assist interested parties including the local Authorities Having Jurisdiction (AHJ) in accessing the operating characteristics of the sprinklers. Please consult the local Authorities Having Jurisdiction (AHJ) regarding the interpretation of the test results described in the attached Test Summary Table(s). In no event shall UL be responsible for whatever use or nonuse is made of the information contained herein and in no event shall UL, its employees, or its agents incur any obligation or liability for damages arising out of or in connection with the use or the inability to use information contained herein. Thank you for your continued interest in UL's services and we appreciate your business. We look forward in serving your future sprinkler submittals in accordance with the Standard for Inspection, Testing and Maintenance of Water- Based Fire Protection Systems, NFPA 25. Should you should have any questions or comments, please feel free to contact the undersigned. Very Truly Yours, Hector Salazar, Jr. Field Sprinkler Coordinator T: 847-664-2316 E: Hector.Salazarjr@ul.com UL LLC 333 Pfingsten Road, Northbrook, IL 60062-2096 USA T: 847.272.8800 / F: 847.272.8129 / W: UL.com Reviewed by: Scott Dankert Staff Engineering Associate T:847-664-2678 E: Scott.S.Dankert@ul.com Page 1 of 3 Issue Date: November 17, 2015 Reference Number: G233731 FS#2236753 Total Number of Sprinklers Received: 4 (D] (3) sprinklers were submitted consisting of the following characteristics: Manufacturer: Reliable Releasing Mechanism Type: Glass Bulb Model: R5734 Sprinkler Orientation: Horizontal Sidewall Sprinkler Type: Dry Special Sprinkler Features: None Water Seal Configuration: Teflon -Belleville Spring Response Type: Quick TEST SUMMARY TABLE 1 Releas[ng Mechanism Location of Sprinkler Room Temperature Year Nominal Sprinkler condition Response Thne, sec. operation classification F56920- In System Environment Rating,'F Marking K-Factor Moderately 2nd tl se comer Other 155 2002 5.6 corroded or loaded 16.8 Normal Moderately 356921- 2 3rd fl se comer Other 155 2002 5.6 corroded or loaded 14.5 Normal 356922- Moderately 3 2nd fl se comer Other 155 2002 5.6 corroded or loaded 1 15 Normal Sprinkler Condition: Please refer to the Standard for Inspection, Testing and Maintenance of Rater -Based ire Protection Systems, NFPA 25, for requirements and information related to determining when sprinklers are to be replaced. The Authority Having Jurisdiction (AHJ) should be consulted to determine when sprinklers need to be replaced due to their condition. The referenced sprinkler condition is UL's visual observation of the received sample sprinklers. Operation Classification: Normal — Indicates sprinkler operation within the applicable time frame for the response type and temperature rating. Page 2 of 3 Issue Date: November 17, 2015 Reference Number: G233731 FS#2236753 Total Number of Sprinklers Received: 4 (1) sprinkler was submitted consisting of the following characteristics: Manufacturer: Reliable Releasing Mechanism Type: Glass Bulb Model: R5714 Sprinkler Orientation: Pendent Sprinkler Type: Dry Special Sprinkler Features: None Water Seal Configuration: Teflon -Belleville Spring Response Type: Quick TEST SUMMARY TABLE 2 Releaslrnl Mechanism Sprinkler location of Sprinkler Room Temperature Year Nominal Sprinkler Condition Response Time, sec. Operation classification Number to System Environment Rating, °F Marking K-Factor at Moderately 356923- Other 155 2002 5.6 corroded or loaded 15.3 l Normal 1 3rd fl se comer Sprinkler Condition: Please refer to the Standard for Inspection, Testing and Maintenance of Water -Based Fire Protection Systems, NFPA 25, for requirements and information related to determining when sprinklers are to be replaced. The Authority Having Jurisdiction (AHJ) should be consulted to determine when sprinklers need to be replaced due to their condition. The referenced sprinkler condition is UL's visual observation of the received sample sprinklers: Operation Classification: Normal — Indicates sprinkler operation within the applicable time frame for the response type and temperature rating. Page 3 of 3 ram=0 Certrfication Gina RED YELLOW WHI TE ' CONFIDE-1.TENCE T RE PAJ R S. FIRE ALARM SYSTEMS (OneSystern per Report) Occupancy Name-. Allslcr 21-.,i:c (-on&ms OCCUpancy Address: 126- 31d Ave N, SIe "i')T '0 C -%W I V �N- I )4n f f�',t T 1 Building Owner: Phone Number, Owrwr AUorji. Phone Nurriber, I Date of Inspection, Inspection Type, Annual Quarteriy k i Testers Name.- t x SFD Certification Number- SCP- McinitorinU! Ar— PhO111D Model ation: lr-, �n i!�i, FACP Manufacturer of initiating circuits-1. # of Signai Circuits,,'_____..._ � �s=_._________ ._ ALARN! SYSTEM FUNCTIONALITY Yore NcN,A --------- - All notification OrcWts. operertiorQf? All circuits chvck�d for electrical supervisfori1l All auxiliary equipment oporai" folevatcors, fans, ciampersy? Key to panel available? Opt "ratil',0 iriSlirliC at ParI411? fridiratorf, functioti Properly? ---- Test record postoe at pancl? sigoals recPhVed at Garltr A station? Operat a r - ---- - - - ---- Probleins Found: Corrected BY Corrections Made- Date Corrected- - - ----------- - SFD Cattification tt- This certifies that this fire and life safety system has been properly ii-ispocted for reliaWl ity to cover the Items listed in this repo d is consistent with Seattle Fire Department Fire Code standards, and th4djscre clew Q noted and have been reported to the buiWing Owrier/Manager for r'Vo coon, Signature of Tester- X Phone*: q2- Signaiure of Owner- A SYS—EM D"VICES WI Q 12,101, E L 9 HorniStrolms t.; x Y)j V., Stroho Only I Horn only I iC Vi tIv t Spenker Only )7 -.MSTED SA-f�SFACTQRY? 141A Sounder Base t t, r Photo Smokq Doteclars f C1 to t loll Srviokr,, Detec.zors 1.2's, Rato of 'Zino t!Ozt i 121101 Raw of Rise. Heai 11 35` FlteU Temp Hsnt 200' Fl:,od Tcrr.r Hc-7t ' Duct Srnoke Detectors Detactor Romoto Indizators Rcmotc Annunmiatcm 't Elovatcr Ror--Ml Output i - i Fan Preestuization 'Door Holders Door Unlock Curtairs[Roll-dotkin Doors Ct-Lr! rigihter Phoitan Main FACP T roubla with AC off? 'Baftery I backup wv-mflonp17 4 )?eatery voltag!) (no load) Gattary voltage (full Goad) circwtueltaF.-c E-sattcftj wino FanelType; Trouble wMi N; gift? (YRL NIP A voltat ga(noloaad) voW, Lqh C!riptj it vrkmgf� ze AC aE-T 9-10 CpnrMln-mal? yp-E� NO Saiwry V012agzt (Mi ioaj) C;LI i Fanet Type-. Batter- v4aq i4f.; (,,,4jf3 coad� -'r n it 1411v a I t z 4 f3 rr VrAt.:- :� ... 14073 354 A4*: V,J Z�stc E. LjYs-f-V in3A ',hIA 39-33.3 U zi.F - - t�;:ti)771-I15G Occupancy 9 ame Building Owner: Owner Agent - Certification Given RED 'ELL�ITE I/ i CON FIOE�CE TFEST REPAIRS FIRE ALARM SYSTEMS (One Byetein per Repoil) tiiisr4Pill" coild"s Occupancy Address-, -tab 3rd AVe N , suite 103, Edniunds A iatcr Place Hanicolmiers As,,gau, Phtsne Number: 423-2`3-3241 Anwlia llannath Phone Number: 415-775-5241 Date of Inspection: 03 . 2013 ll��pectior� Type: .� Annual Testers N akne: lii;ll roar - SFb Cenification N umb6r: Monitoring: ACT Phone #: 1800-752-2410 FRCP Manufacturer: RA Model #: 7100-2D # of Initiating Circuits: b # of Signal Circuits: Account #: K-6414 Location: Mull Eurr3, 1-1 ot: Quarterly ALARM SYSTEM FUNCTIONALITY Yes No NIA All notification circuits operational`? 1/ All circuits checked for electrical supervision 2 V auxiliary equipment operates (elevators, flans, dampers)? �- �All FIcyto panel availalilc? �- V Operating instructions at pane-17 ✓ Trouble indicators function properl�P Teat record posted at panel? ✓ Signals ri ceived at central station? Operator k_ Problems Found: Corrections Made: Date Corrected: Corrected By:_— SFD Certification*: This certifies that this fare and life safety system has been properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building OwnerJi'kfianagerfor correytive ,action.,e­\ Signature of 'Tester: Signature of Owner: Phone SYSTEARW DEVICES MODEL TOTAL TESTED AM F T Y? Yes No NIA HornlStrobea C 90 NV — 12 — strobe 0n y f C - Horn Only CirC241 IOIM1'W 7E _ a poak�rlrobos � Speaker Only -� Sounder 1 aso x Bells Manual Pulls ill-t,i Knight --- Photo Smei;a i� 2 tctio s FO ASDPL d{i --- lon Sinaloa Detectom Co mbiriatiari SmokolHcaf 135' Cate of Rise Heat --- � X ?99° date of rise Heat — —� 1:15' Fixed Temp Heat 20X Fixed Tomp Heat Duct Smoke Detectors Detector Remote Indicators Remote Annunciators ! ( x - Elavatar Rawl Outpta z x Fan Pressurisation Dour Holders Door Unlock CurtsinalRoll-down Daarj f Mop Fighter phones I [Main FRCP Trouble with Ate off? `e No Battery backup operational? a No Battery voltage (no load) 1 oohs [Batturyvoltaga (full load) Alt volts arge circuit voltage volts Battery Size Panel Tv-pe: Trouble with AC off? Yes No Battery backup operational? Yes No Battery voltage (no load) volts Battery voltage (full load) volts Charge circuit voltage volts Battery Sine Panel T%. k Trouble with AC off? e . Nz Battery backup operational? Yo , No Battery voltage (na lead) I volts Battery voltage Gull load) {t r volts Charge circuit voltage Z volts Battery Size Trouble with AC off? Yes No Battery backup operational? Yes No Battery voltage (no load) volts Battery vol2azge (fuO load) wilts Charge circuit voltaga volts )Battery Size H CO. Serving Brier; Edmonds .' aNOHOMIS F��� Mountlake Terraeeand the `Town of Woodwayp.,"..�� ST T www FireDistricti. org' LOCATION: 126 3rd Ave N BUSINESS NAME: Alister Place Condos MAILING 126 3rd Ave N #301 FIREPREVENTION 12_425 Meridian Ave S INSPECTION REPORT Eve❑BRIERrett, WA 98208 ; i ❑ S RIER Phone (425) 551-1200 ❑ WOODWAY [IMOUNTLAKE TERRACE Fax (425) 551-1272 ❑ UNINCORPORATED PHONE: ADDRESS: Edmonds 90020 BUSINESS OWNER: FI A HOME PHONE: 2065101928 FREQUENCY STATION & SHIFT 365 17 B SCHEDULE DATE DUE D 10/01/12 UFIR ► 423 591 1 t252 eUIY2 arCia EMERGENCY-1: HOME PHONE: CURRENT KEY ACCESS-2: HOME PHONE: CITY YES NO BUSINESS LICENSE PERSON CONTACTED: N A INITIAL INSPECTION DATE NAME OF INSPECTOR: 7 I 1 /5 FIRE FA 3/12 A /10 FD Lk[3x FE SYSTEMS: 3//,Z3/ 1 2 ANNUAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 1 O �0 0 2 2 3 t 3 4 4 I 5 5 6 6 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: ` EXTENSION GRANTED TO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: 1 INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: DATE: 3 VIOLATIONS 1 5 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 2 6 2 6 DATE: CODE SECTION: 5 3 7 3 7 RETURN RECEIPT RECEIVED 5 4 8 4 6 DATE: DISPOSITION: LETTER NEEDED ❑ YES ❑ 'NO LETTER NEEDED ❑ YES ❑ NO g FIRE DEPARTMENT COPY 03/22/13 08:44:06 PRINT REQUESTED BY TERMINAL EFPC07 Incident History for: #EF13001049 Xref: #EP13006347 Case Numbers: $DF13004121 $EF13001297 $LF13001546 $S213005545 $TF13000799 Received 03/22/13 01107:51 BY SCPC01 SC718 Entered 03/22/13 01:08:12 BY SCPC01 SC718 Dispatched 03/22/13 01:08:22 BY SCPC06 SC715 Enroute 03/22/13 01:12:26 Onscene 03/22/13 01:14:54 Closed 03/22/13 04:19:11 Initial Type: FAR Initial Alarm Level: 1 Final Alarm Level: 1 Final Type: PC (FIRE - COMMERCIAL) Pri: 1 Dispo: Police BLK: E040 Fire BLK: EF202 Map Page: 454F-5 Group: EF2 (EFl) Beat: DFi li Loc: 126 3 AV N 4202 ,EDM btwn MAIN ST & BELL ST (V) Loc Info: ALLISTER PL CONDO Name: GORDON CAROL Addr: 126 3 AV N 4202 ,EDM Phone: 4257751728 /0108 (SC718 ) ENTRY /0108 (SC715 ) DISP E17 ,NO FURTHER INFORMATION #FD9115 CAMPBELL,T-C [E,M] #FD0721 BAILEY,J-F (E, M, R] #FD0707 SCHMITZ,S-F [P] $ASNCAS E17 $EF13001297 ASST DFX1 $ASNCAS DFX1 $DF13004121 ASST TAC21 $ASNCAS TAC21 $5213005545 CHANGE TYP: FAR ---> PAS ASST E16 #FD8807 YOAKUM,A-C [M,E,H] #FD9114 KRUGMIRE,D-F (L) (E,M] #FD9812 AFFELDT,C-F (C) [R] ASST B16 #FD8902 DAHL,D-B [E,M] AIQ TAC21 ASST TAC21 CHANGE (SC718 ) CHANGE (SC715 ) CHANGE CHANGE (SC803 ) AIQ TAC21 AIQ DFX1 (SC715 ) CHANGE CHANGE ASST B11 ASST MS021 ASST L20 ASST TR21 : ASST E19 /0110 $ASNCAS E19 /0110 ASST M17 i ,ABSCO ALM.#85 SWFA TYP: PAS --> FC, RSP: 510 --> 512, PRI: 2 --> 1, TXT: FEMALES SAYS HER ALARM IS SSOUNDING AND THA T THERE IS LOTS OF SMOKE IN HER APARTMENT LOCI: --> ALLISTER CONDO LOCI: ALLISTER CONDO --> ALLISTER PL CONDO ,PER ALM CO: R/0107 N/0108 N10110 8007522490 ,NO REST #FD8401 KELLY,D-C (B) #FD9701 DUNCAN,R-C,[P,H) #FD9815 WELCH,D-C [R] #FD0706 MCCORMICK,J-F [P] #FD0817 GUIDRY, C-F [E] #FD0610 KEENE,T-F [P,R] #FD9101 CHEEK, B-F [R] 4FD9802 LARSON,E-F [P,RI #FD9007 GULLICKSON,R-F (C) (P] #FD9111 WEBER,N-F (C) #FD0106 HANSON,C-F [P] $TF13000799 #FD9705 ANDERSON,E-F (C) [P] Dave Moll Production Coordinator • SERVPRO® of Edmonds Fire & Water - Cleanup & Restoration" SERVPRO® of Lynnwood Robin Ferrante _ to ° Project Manager SERVPRO® of Edmonds Fire & Water - Cleanup & Restoration" SERVPRO® of Lynnwood 19327 21st Ave W Lynnwood, WA 98036 c 24 Hour Emergency Service Independently Owned and Operated Like it never e� t Bus: (425) 774-1148 Mobile: (425) 905-0132 Fax: (425) 361-1074 robinf@scrvproofedmonds.com SERVPE`921 L6 servproo fedmonds. com en happened! ? I -1A-4 z-�Z4 T 6 V 0 (, a-.AIIV' 2,, hi ��, FIRE PREVENTION Serving Br'rer; Edmonds 12425 Meridian Ave S INSPECTION REPORT SNOHOMISH CO. Mountlake Terrace, and `. Everett, WA 98208 ❑ EDMONDS ❑BRIER FIRE.. the Town of Woodway Phone (425) 551-1200 WOODWAY ❑ Dl&-.7jLR ❑ AKE TERRACE wwwFireDistrictl.org Fax (425) 551-1272 UNINCORPORATED ❑UNINCORPORATED FREQUENCY STATION & SHIFT LOCATION: 126 3rd Ave N 365 17 A BUSINESS NAME: Alisfer Place Condos PHONE: DATE DUE SCHEDULED► 10/01/11 MAILING 126 3rd Ave N ##301 UFIR ► 423 591 11252 ADDRESS: Edmonds 98020 BUSINESS OWNER: Fleury,$rCta HOME PHONE: 2065101927 EMERGENCY-1: HOME PHONE: CURRENT YES NO KEY ACCESS-2: HOME PHONE: CITY BUSINESS LICENSE INITIAL INSPECTION DATE ' PERSON CONTACTED: Ahr7L NAME OF INSPECTOR: , !� FIRE FA 3t11 AS 6110 FD L & FE �! do2 SYSTEMS: -/4i� l�LG �— ANNUAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS ir. 5 r 1 f 5 .e, r Yee 1 1 f ,� �,' i/ 2� �O�s' "o VI'Ll l� f�h o 2 r 3', 3 4 4 5 5 6 -6 7 7 1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION 2nd RE -INSPECTION EXTENSION FINAL RE -INSPECTION VIOLATIONS DATE DUE: DATE DUE: GRANTED TO: DATE DUE: CITED: PERSON PERSON PERSON CONTACTED: CONTACTED: CONTACTED: INSPECTOR: INSPECTOR: INSPECTOR: 2 3 DATE: DATE: DATE: VIOLATIONS VIOLATIONS PRE -CITATION CITATION ISSUED 4 1 5 1 15 LETTER SENT NUMBER: CODE 5 2 6 2 6 DATE: SECTION: RETURN RECEIPT 6 3 7 3 7 RECEIVED DISPOSITION: 7 4 18 4 g DATE: LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO 8 FIRE DEPARTMENT COPY f s J.•*'� � tM1Yl t1i'hi`. .t�MhM1 vh4ti�1HM11hM1YhM1Y�WMNhM1rAiiiN�l1M1•• 5M4.N 1 M1 Xxx��W�.• V����� Mh',W V.•��vvJJxx�� Vtr,Y•'hM1M1YXhM1WJ.yY�MYJ``��// ��[[�� 4YM 4lNYA41'rh'JJh�,4WrrAV.V xxhVhYh`hY•t41YAiYMSh'l.VJJJj` Y Certification Given RED YELLOW I WHITE ✓ CONFIDENCE TEST ✓ REPAIRS FIRE ALARM SYSTEMS (One System per Report) Occupancy Name: Alisttu P1twu Co"dos Occupancy Address: 126 3rd Ave N , Suite iM, Edntwda Building Owner: Mr-wr Platy Hoinwwnt:rs As". phone Number: 425-275-5241 Owner Agent: Amelia 1 tannah Phone Number: 425-275-5241 Date of Inspection: Q3/15n012 Inspection Type: ✓ Annual Quarterly Testers Name: KCn Dgy SFD Certification Number: SCP- DW223 Monitoring: AC9 Phone M 1800-752-2490 Account #: 91-6414 FACP Manufacturer: FLI Model #• 71W213 Location: MA,;j E dr+ # of Initiating Circuits: 6 # of Signal Circuits: 2 Notes: ALARM SYSTEM FUNCTIONALITY Yes No NfA All notification circuits operational? All circuits checked for electrical supervision? �( All auxiliary equipment operates (elevators, fans, dampers)? 1< Key to panel available? .x Operating instructions at panel? x Trouble indicators function properly? Teat record posted at panel? Signals received at central station? Operator # Problems Found: Corrected By: WeAj bA f Corrections Made: / Date Corrected: SFD Certification M tJ o4� Re 0 /med �� B.Lj Lie r This certifies that this fire and life safety system has been properly Inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for Corr ive a Signature of Tester: Phone #: aofv 3- , Signature of Owner: N SYSTEM DEVICES MODEL # TOTAL TESTED SATISFACTORY? Yes No N/A Horn/Strobes GX904W 13 � ;Z Strobe Only 6 6 Horn Only GFr241 IOWW 0 Speaker/Strobes Speaker Only Sounder Base Bells Wheelock I (r I Manual Pulls SilcrtrRM ght I I Photo Smoke Detectors FCT ASDTL 20 v Ion Smoke Detectors Combination SmokeMeat 135• Rate of Rise Heat 20V Rate of Rise Heat 1350 Fixed Temp Heat 200' Fixed Temp Heat Duct Smoke Detectors x' Detector Remote Indicators Remote Annunciators I Elevator Recall Output 2 X Fan Pressurization Door Holders 3 x Door Unlock Curtains/Roll-dawn Doors Fire Fighter Phones x Main FACP Trouble with AC off? No Battery backup operational? No Battery voltage (no load) a7, 3 volts Battery voltage (full load) —,volts Charge circuit voltage a2,. volts Battery Size Panel Type: -- s,aj.iv Trouble with AC off? No Battery backup operational? a No Battery voltage (no load) a . ZL volts Battery voltage (full load) volts Charge circuit voltage 7a ,�y volts Battery Size r]Atp Panel T Trouble with AC off? Yes No Battery backup operational? Yes No Battery voltage (no load) volts Battery voltage (full load) Vohs Charge circuit voltage volts Battery Size PanelType: Troupe with AC off? Yes No Battery backup operational? Yes No Battery voltage (no load) Volts Battery voltage (full load) volts Charge circuit voltage volts Battery Size in. .A �A � .... ... .... . RED 19023 3e Ave W. Sntfe E. Lylmwood, WA 98036 U.S.A. (415) 771-I l dd Pan (425) 771-4422 - r ' Certification Given FIRE ALARM SYSTEMS (One System per Report) YELLOW I WHITE ✓ CONFIDENCE TEST I ✓ REPAIRS Occupancy Name: Allistw Place wn&m Occupancy Address: US and Ave N , EdnuvWs Building Owner. Owner Agent: Mistu Maw condos Amelia Ilannah Phone Number. 425-275-5241 Phone Number. 425-275-5241 Date of Inspection: 03A)HnOI I Inspection Type: ✓ Annual Testers Name: Kan T*y SFD Certification Number: Monitoring: Phone #: qsyg I�:=D Quarterly SCP. O(e21 Account #: / ,y I y FACP Manufacturer: 7100-2n Model #: Fri Location: # of Initiating Circuits: io # of Signal Circuits: 2 Notes: ALARM SYSTEM FUNCTIONALITY Yes No NIA All notification circuits operational? All circuits checked for electrical supervision? All auxiliary equipment operates (elevators, fans, dampers)? Key to panel available? Operating instructions at panel? iL Trouble indicators function properly? Test record posted at panel? Signals received at central station? Operator Problems Found: t 1(IA/•C Corrections Made: A]0Ak Date Corrected: Corrected By: SFD Certification M This certifies that this fire and life safety system has been properly Inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrgctive a n. Signature of Tester: Phone #: ab b 3 5 6 46 03 Signature of Owner: . SYSTEM DEVICES MODEL # TOTAL TESTED SATISFACTORY? Yes No NIA Hornffitrobes Gcntax jp i Strobe Only Horn Only Gentex �( Speaker/Strobes Speaker Only Sounder Base Bells i Manual Pulls Silent Knight I I Photo Smoke Deteaors FC'T A.�PL 21) Ion Smoke Detectors Combination SmokeMeat 135• Rate of Rise Heat �( 20v Rate of Rise Heat X 135• Fixed Temp Heat 20V Fixed Temp Heat Duct Smoke Detectors Detector Remote Indicators Remote Annunciators I Elevator Recall Output Alt+Pri 2 Fan Pressurization Door Holders 3 Door unlock Curtains/RolWown Doors Fire Fighter Phones Main FACP Trouble with AC off? No Battery backup operational? No Battery voltage (no load) QDJJ Vohs Battery voltage (full load) 2kLL Vohs Charge circuit voltage �i Vohs Battery Size Panel Type: Trouble with AC off? No Battery backup operational? Y44 No Battery voltage (no load) '4 volts Battery voltage (full load) gj0.> volts Charge circuit voltage Vohs Battery Size PanelType: Trouble with AC off? Yes No Battery backup operational? Yes No Battery voltage (no load) volts Battery voltage (full load) volts Charge circuit voltage volts Battery Size Panel T Trouble with AC off? Yes No Battery backup operational? Yes No Battery voltage (no load) volts Battery voltage (full load) volts Charge circuit voltage volts Battery size P . -, 'I r} •A`: � : u �x � ,.y. yyy. � µµow :: ' �:Y.i}SSYh "'• �'. ..'SSY.-}}}Yfi:�'i}ia'}YrY.�y�X}}yir}}:�r}}rr}}S�'rh':�}% 19023 36a Ave W, Suite E. Lym►Vjn..L WA 9K036 U.S.A. (42.� 771-1166 Fax (425) 771-44I2 Certification Given RED YELLOW I WHITE c-� CONFIDENCE TEST ✓ REPAIRS FIRE ALARM SYSTEMS (One System per Report) Occupancy Name: Allistu- Plncc condos Occupancy Address: 126 3rd Avis N , Edmands suming awnar: .nul8ta r1dw: Buauus Phone Number' y.23-27=1-5141 Owner Agent' Amelia i lannah Phone Number 425-275-524 i Date of Inspection: 0M•'-/OW Inspection Type: ✓ Annual Testers Name: Scott C '.noon SFD Certification Number: Quarterly SCP- Monitoring: _ Ally.-m c giyyW Phone M 90r9 -7S-7aY'7a Account #: 9/- !a 1// V FACP Manufacturer 7100-21D Model #: FC1 Location: / Ems- y # of Initiating Circuits:_ # of Signal Circuits: Ca Notes: ALARM SYSTEM FUNCTIONALITY Yes No NIA All notification circuits operational? All circuits checked for electrical supervision? All auxiliary equipment operates (elevators, fans, dampers)? Key to panel available? I/ Operating Instructions at panel? Trouble indicators function properly? Test record posted at panel? (/ Signals received at central station? Operator #—If— Problems Found: / Weeuldt—E S v a •v-,04C f / k1 OC-i¢e i /fir OPT, 7-•�1 G ( � Y a� Sy�,BF,;f �a �:,1 �� Corrections Made: Date Corrected: Corrected By: SFD Certification #: This certifies that this fire and life safety system has been properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code standards, and that discre n a ar led and have been reported to the building Owner/Manager for carrec ' Signature of Tester: _ Phone #: Signature of Owner: SYSTEM DEVICES MODEL # TOTAL TESTED SATISFACTORY? Yes No N/A Hom/Strobes Guntux 30 J?0 v' Strobe Only o2 ".; 7 - Ham Only Gentex 12 Speaker/Strobes o/ Speaker Only Sounder Base Bolls t Y Manual Pulls silent Ktdght I I Photo S►noke Detectors FCT A4D-PL 20 Q Ion Smoke Detectors ✓ Combination Smoke/Heat ✓ 1350 Rate of Rise Heat 2000 Rate of Rise Heat t/ 135" Fixed Temp Heat 20V Fixed Temp Heat ./ Duct Smoke Detectors Detector Remote Indicators Remote Annunciators I ©evator Recall Output Alt+Pri 2 C21- Fan Pressurization Door Holders 3 3 V/ Door Unlock Cunains/Roll-dawn Doors Fire Fighter Phones Main FACP Trouble with AC off? Y No Battery backup operational? (Y-aa No Battery voltage (no load) volts Battery vokage (full load) �A/olt8 Charge circuit,vohage a?� 9jvolts Battery Size /av ZAi X 2 Panel Type: Trouble with AC oft? Yes No Battery backup operational? Yes No Battery voltage (no load) volts Battery voltage (full load) volts Charge circuit voltage volts Battery Size Panel Type: Sit) 1-Q Trouble with AC off? Yea No Battery backup operational? Yes No Battery voltage (no load) 'aL. VOIts Battery voltage (full load) It! 6voks Charge circuit voltage �7 5�2volts Battery Size 4.k 7,44 x 2 Panel T Trouble with AC off? Yea No Battery backup operational? Yes No Battery voltage (no load) volts Battery voltage (full load) volts Charge circuit voltage voles Battery Size