201 3RD AVE NAuE
SNOHOMIS11 CO. Serving Brier Edinonds, and
Mountlake Terrace
FIR
DISTRTwww.FireDistrictl.org
1
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 55,1-1272
LOCATION: 201 3 rd Avenue N 980�0
BUSINESS NAME: La Fave Condos PHONE: 4257757840
MAILING
ADDRESS: 201 3rd Avenue N Q-W, Edmonds, WA 98020
BUSINESS OWNER: HOA HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
El BRIER
0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
FREQUENCY 1, STATION & SHIF*N
AnnL 17-C
SCHEDULED
DATE DUE 0 Dec 2015
UFIR 0 427 202
J
EMERGENCY-1:-,<,,
HOME PHONE: 4256792682 —'CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
EMAIL:
BUSINESS r--1 F]
LICENSE L_j
PERSON CONTACTED: fjVj,.g_, J_djF4
v.. i 3 1-7
INITIAL INSPECTION DATE
NAME OF INSPECTOR: Q,4-4.-
13 13
j('
FIRESYSTEMS: AS3L1 FA3/1 FE6/1
i i
FDLkBo
SP 3/1
i. I
Date Last Servicel lol'63�
3
HAZARDS FOUND AND LOCATIONS I COMMUNICATIONS
( >f
p *
rvvll
!reAoVI'� AZ
k-j
OL <'
2
3
. . ... .....
3
4
'7-
4
5
5
6
6
.. ....... . .
7
------- ... ..
...
7
I AGREE TO cbRR8CT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1 st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
_�ATE DUE,_
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
ONTACTED:
INSPECTOR:
INSPECTOR:
hNSPECTOR:
2
DATE:
DATE:
3
VIOLATIONS�-.
5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
DATE:
CODE
SECTION:
5
7
3
RETURN RECEIPT
RECEIVED.
4
DATE,
DISPOSITION.
LETTERNEEDED C] YES El NO
LETTERNEEDED YES
0 NO
8
77
FIRE.,PREVENTION
SNOHONIISH CO.
Serving Brier, Edinonds, and
12425 Meridian Ave S
MPECTION REPORT
Motintlake Terr*ace
Everett, WA 98208
OEDMONDS
0 BRIER
""��Arr AL
DISTM
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
www.FireDis'trict].org
Fax (425) 551-1272
LOCATION: 201 3 rd Avenue N 98020
La Fave Condos
BUSINESS NAME:
PHONE:
MAILING
ADDRESS: 201 3rd Avenue N #213, Edmonds, WA 98020
BUSINESS OWNER: HOA Pres. Robert Wingfield -'11 HOME PHONE:
EMERGENCY-1: Robert Unit 213 HOME PHONE:
KEYACCESS-2: HOME PHONE:
EMAIL.
PERSON CONTACTED:
NAME OF INSPECTOR:
4259485376
4257711252
RIEQUUEVCY STIT
nn a I _B& SHIFT
SCHEDULED Dec 2016
DATE DUE 0
4Z1 4U:e
U
FIR
CURRENT
CITY YES NO
BUSINESS F--j
LICENSE i I E,
INITIAL INSPECTION DATE
0
4
ul;
CcAfficzUron 0- iven
gt
FF. ...... ....
R, F- F" "�.q
,uvu u L�-uL�
d7 P:�, 2 A LA-,." n S,:,CT.—qn S,
jono
L-.i Fa,;c (.'ondCv.iII1IIum 201 Jr-d Ave Iq Edr#),.ittu--
FFi June N' umbsr:
Owner Agent:
Date of 9 ns pec��on: C,3/Vv2,-,I 5 gmopceiEon Type: Annuag oomn"�6y
I -)> -C) -Z 3
este is mama: %..k WD Cortificat0on
4—
FACP Manuf,)�ctvreT-:-FC) V;00-1"-6 �J. S lip-2 Location- I. -A floor elcv, ItNtb�--
V 01 InWatin" clvaul-,Q:
of CiveUaG:
:ALARM SYSTEM FUkRCTi0WALMTY v0s No
All notificat1wi c1ropitz, opwatlarm?
X i
IC
All --uxiharV oquipmont oparatoG (egovalorz, ians, dnrapar�Y)*?
KGy �G panri avaisiub;01?
at panel?
Tvauble, irditatom tun=vori piopm-ly?
7cut mcorcEl po!DWd ag pvnd-?
at t&mtrml st,'.)kiory'?
.r--hev elemldv—
Cau,recilons Made: Dzte Carre,�-tzz�:---. SFD Cuitil5caUun tr.-
U4,—n �o7
�U!
Code stendard->, and thet or-3, rot?�Vl F-4nd &tave 6 . 7.-,(--n reporteO to t-he
& T--,r�)toQ.
SIgnalum of Owner:
00
SYSTEM CZVMES MODEL VESTED! F-'f?
Y,�O No KIA
114orn Orly
--------------
knT nOw
.;nrxn
Sounder Base
ni AL-'
I I
I
C
Whoto Smakq Datectem
ESL 440t
Ion Sm"o DoteciorLi
Cc-nbination ZmcC4c1H!=t
Plino
1 Vj" RatG of HeLA
2000 Rkno of Rise Heat
135' Finad Tc,,-;Ip Hezi
200' Flmrl Tcrnp ftat
I Duct Smoke Detectors
notoGtor Rat"Oto
Romotc Annurmiaf=
Elavotrr Rarall 07itput
;Fan PiessurIzatioti
Denr Urlr)c%
CurtainslRoll-down Doom
i4
ar
1
Firo Fightat Phone6
Main FACi4 I
Trouble v�71th AC oft?
Mn-ttr."j backup opr�",—Monz5?
N, 0
Bnnry voluge (no load)
Vcho
Battx3ry vahzge (fuli load)
-10 UZ;
Chnirgo circuit voitagi,
cattory S;::o
Panel Type;
Trou ble vvRh '\C of,'? FrS No
Battcvy tavcktip r-,pamVonal? Yc--- No
Baftery voltage (no lead) —vo ts
Baftery % cAtago (ft.13 fond) voila
FBM;Gry 81ze_
P-,-atnel
TrroUbeL,'L1Mh AC off?
Ye;:-,
No
h—"Cl=p OptTationao?
vcFlaga (na 8aqdl,
113aacry vaE2,:-.ga (lull �rj--dp
E"7-Q
Paravl Type:
Ntc-v
NO
P,--,M7y trxkvp r-poriticraW
mo
t 6;njtc)rV YoUaqa (no load)
v,-4.!taqc
. . , - - - W .1 �. . I . � . .. �;
AINCIr
VIKINGAUTOMATIC SPRINKLER COM
WA.: VI-KI-NA-S373NT LEVEL/H
Fire Protection Contractors since 1930
3434 First Ave. So., Seattle, WA 08134, 206.622.4656
602 California Way, Longview, WA 98632,360,425.7620
Fire Sprinkler� Inspection Report
REPORTTO: ZA JOB NO. Ahr-r4k—,724 DATE:
STREET: &L' IAIIA ;A —BLDG. / LOCATION -'51, OL.
CITY/STATE: A 0, 4 Y elAo, —INSPECTOR:
Page:102
I.GENERAL
YES
N.A.
a. Is the building occupied ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . .
b. Is occupancy the same as previous Inspection ? . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . .
c. Are all systems In service ? . . . . . . . . . . . . . . . . . .. . . . . . . . . . . .
. . . . . . .
d. Are all fire protection systems the same as last Inspection ? . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .
a. Is the building completely sprinklered ? . . . . . . . . . . . . . ... . . ... . . . . . .
. . . . . . . . . . ..
100
f. Are all now additions and building changes properly protected ? - - - - - - - -
----
Is all stock or storage properly below sprinkler piping ? . . . . . . . . . . . . . . . .
h. Was property free of fires since last Inspection ? (Explain any fire on Page 2) . . . . . . . . . . . . .
. . . . . .
.
J�
1. In areas protected by wet systems, Is building properly heated, I.e.: blind attics, perimeter areas, and are all exterior openings protects , d against the cold ?
2. CONTROL VALVES (See Section 17)
a. Are all sprinkler system main control valves open ? . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .
b. Are all other control valves In proper position ? - - - - - - - - - - I . . . . . . . . . . .. .
. . .
c. Are all control valves In good condition and sealed or supervised ? . . . . . . . . . . . . . . . .
. . . . . . . . . .
X
3. WATER SUPPLIES (See Section 18)
a. Was a water flow test preformed and were the results satisfactory ? . . . . . . . . . . . . . . . .
. . . . ... . . . .
4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS
a. Are fire pumps, gravity tanks, resevoirs and pressure tanks In good condition and properly maintained ? . . . .
. .. . . . . .
X
b. Are Fire Department Connections In satisfactory condition, couplings free, caps In place and check valves tight
5. WET SYSTEMS (See Section 13)
.
a. Are cold weather valves open or closed as necessary ? . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .
b. Have antifreeze systems been tested and left In satisfactory condition ? Temp. ? . . . . . . . .
. . . . . . . . . . .
c. Are alarm valves, water flow Indicators and retard chambers In satisfactory condition ? . . . . . . . . . .
. . . . . . . . . . .
. X
6. DRY SYSTEMS (See Section 1-4)
a. Are dry valve(s) In service and In good condition ? . . . . . . . . . . . . ... . . . . . . .
. . . . . . . . . . . .
. X
b. Are pressure and priming water levels normal ? . . . . . . .. . . . . . . . . . . . . . . . .
. . . . . .
c. Is air compressor In good condition ? - - - - - - - - - - - - - --- .... . . . . ... . . .
. . . . . . . . . . .
d. Were low points drained during fall and winter Inspections ? - - - - - - - - - ----- .. .
. . .
a. Are Oulck- opening devices In service ? . . . . . . . . . . . . . . . . ... . . . . . I .
. . . . . . . . . . .
Ix
f. Has piping been checked for stoppage within the past ten (10) years ? . . . . . . . . . ... . . . .
. . . . . . . . . .
X
g. Has piping been checked for proper pitch within the past five (5) years ? . . . . . . . . . . ... . .
. . . . . . .
h. Have dry valves been trip tested satisfactorily as required ? . . . . . . . . . . . . . . . . . . .
. ... . . . . . . . .
.
1. Are dry valves adequately protected fromfreezing ? . . . . . . . . . . . .. . . . . . . . .
. . . . . . . . .
Are valve house and heater conditions satisfactory ? . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . .
.
7. SPECIAL SYSTEMS (See Section 16)
a. Were valves tested as required ? . . . . . . . . . . . w . . . . . . . . . . . . . . . .
. . . . . . . ... . .
b. Were all heat -responsive systems tested and were the results satisfactory ? . . . . ... . . . . . . .
... . . . . . . . . .
c. Were supervisory features tested and were the results satisfactory ? . . . . . . . . . . ... . . . .
. . . . . . . . . . .
8. ALARMS
a. Is the water motor and gong test satisfactory ? . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . .
b. Is the electric alarm test satisfactory ? . . . . . . . . . . . . . . . . .
. . . . . . .
Is the test ? Monitoring Co. J-0 AlAte IfN/Ph
. . . - - -
c. supervisory alarm service satisfactory
Code-
9. SPRINKLERS - PIPING
a. Are all sprinkler heads In good condition, not obstructed and free from corrosion or ;1pdI ? . . . . . . . . . . . . ... . . .
. . i7g. -
b. Are all sprinkler heads less than fifty (50) old? Head Manufacturer:— Date
years of head
WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY
WHITE:'VIKING COPY YELLOW: INVOICE COPY PINK, FIRE DEPAhTK4ENT'COPY—Gb[CFBL)ILDINTCOPY
Fire Protection Contractors, since 1930
-n 3434
NTKLER �COMP N/ Fl�
VIKING AUTOMAT ' iC SP COM N 981 i4, 206'. M2. 4656
VIP RINKLER 3434F1mtAve..�o.,.SeaftWA
�602UffankWay,Law
WA.: V1 -K1-NA--;S373NT iEVEL X
L V�L III 0 C MAMM'366.425.71520
COMPANY:.
JOB NO.: DATE
JA I
00
STREET: PROPERTY NAME i LOCATIOW:
e=
CITY/STATE.-
INSPECTOR: ';7 ev
"DRYPI, P't". iV'A' LV E T E ST
DRY,P.IPEL VAU E S''
No.
:-Nb.2
No'i3
Valve description
a. Size
b. Make
C. Model
d. Year of Mfg.
2. Control Sprinklers in
A /A j
3. Pressure (1b) beforejests:
b. Water
4. Control Valve
a. Wide open
b. No (No.of turns to open)
5. Operated at:
a. Air pres sure (Lb)
-Tirrie (Min.,Se-c.)
6 Op'b rati on ind i date'd'
a—Si3tis6ctory
b. Partia satisfactory
c. Failed
7. Reason for:
a. failure
b. partially satisfactory
8. Valve reset dry? (yes/no)
9. Condition.:
a. Interior of body.,
b. Water for. test.'pipe
eh
IM
C -Dving- pprIs
d. Seats
ell
*._e Rubber facing
10. A rn s - o pe ra te d ? (y e s/ n.10 .
11.Inspectoris. e6t,trip time- (Sec.)
jr�, e-'
12.Quick Opening Devices:
QUICK:OPENING DEVICES
a. M a'k e
b. Model
c., Year
'13�Operit.-ionl-.Ihd�i.ciatod,:
a Satisfactory,
b.-: 1764-Jed't.
o s hot of f
F-
j;:
4. - o' f r 6 p"a i r s m a d e
A11.1 A,
Signature / Title of person performing test Witness (owner / lessee of property ) and date signed.
'T
1400�w
SNOHOMIS7H CO. Serving Briet; Edmonds, and 12�25 Meridian Ave S
FIRE9row Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
"DISTR IT wwwFii,-eDistrictl.org Fax (425) 551-1272
FREQUENCY STATION & SHIFF)
LOCATION: 201 3rd k/enue N 98020 Annual 17-A
SCHEDULED
BUSINESS NAME: La Fave Condos PHONE: 4257757840 Dee2013
I- U C UUC
MAILING FIR 1, 427
ADDRESS: 201 3rd Avenue N #G1 7, Edmonds, WA 98020 IU
BUSINESS OWNER: HOA HOME PHONE:
Email:
EMERGENCY-1: Ken HOME PHONE:
KEY ACCESS-2: HOME PHONE:
EMAIL:
PERSON CONTACTED: J 01 A
NAME OF INSPECTOR:
F
FIRE SYSTEMS: AS-23 FA 6/13 FE D Lk Box SP 3/12
FIRE PREVENTION
INSPECTION REPORT
DEDMONDS
El BRIER
0 MOUNTLAKE TERRACE
[I UNINCORPORATED
CURRENT
CITY
YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
HAZARDS FOUND ANVL
'CATIOVC,OMKhUjlCATIONS F0
1
2
2
3
3
4
4
5
5
6
6
7
7-'
I AGREE TO CORRECT THE ABOVIE"'VIbLATION(S) IN THII NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
FINAL RE -INSPECTION
EXTENSION
VIOLATIONS
DATE DUE.
DATE DUE.
GRANTEDTO
DATE DUE:
CITED:
PERSON
PERSON-
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
I
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 5
1 5
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
DATE:
SECTION:
RETURN RECEIPT
3
3
7-
RECEIVED
6
SITION:
DISPO,
4
18
4
18
DATE:
7
LETTER NEEDED E] YES El NO
LETTER NEEDED [:] YES' [:]'NQ
8
FIRE DEPARTMENT COPY
lvl: K*_'-'
I X-0
19,313 34t'Av-� VJ ZUto E. LyinfvnmA W-�.3036 U
f-U.Tj 771-1 ISG F:,!: �423) 771-4,02
Occupancy Name:
Building owner:
owney Agent:
La Favi� Coados
Certification Given
RED
TYELLOW
[ WHITE
CONFIDENCE TEST
REPAIRS
�1 r1rr-? r
FIRE ALARM SYSTEMS
(One System per Report)
U Favt Condo Ahrwc.
K�;n
Date of Inspection: 06-14-12013
Testers Ham. e: Kim Day
Monitoring. N-'A
FACP Manufacturer: FU
# of gnitiating Circuits: 2
Occupancy Addresq: 201 Srd.A:%ja N, Edrtiwds
Phone Number: 4-15-6197-20'82
Phone Number: 425-W-2682
lhapeCtion lWe: v( Annual Quarterly
SFD Certification Number: SCP.*b "
Phone M -N/A
Model #:;BP-2
# of Signal Circuits: I
Account#: N/A
Location: Istfluor ukv- lobby
Notes:wp"""
e'-A-Se--C4-D- 7—!'
FALARDA SYSTEM, FUNCTIONALITY
Yes
No
NIA
All notification circuits operational?
A&I circuits chuckod far electrical supervision?
Al. au-gigiary iiquipment operates (elevators, fans, dampers)?
Koyto pancl avallabk?
OPP-m--ifti.1 iMM-19MOM e PahnP
TFoublo indicatars funrztion proparlp,
Tcs—t rccord poziad at pand?
Signa�s. raceivad at central atation? Operator q_
PveWems Found:
_A00-4-le-a-)
94--
C-Orreciians Made:
Date Corrected:
Corrected By:—
SFD Certification *
7h5u ceni0a,3 that this fire and life safety system has been properly inspected for reliability
to zcvc�y V*,Ua �Iems listed in this report and is consistent with Seattle Fire Department Fire
cod�� and that discrepancies are noted and have been ireported to the building
.1cir qor corrective action.
Phone #:
S v'—RT I—S k rL3 E - V h C E S
MODEL#
TOTAL
TESTED
SATISFACTORY?
Yes
No
NIA
MIRTONE '4201
W101
7V
2 6
�Ly
Allha-larn) Aj,MTR-Fi624'
i i
I
EDWARDS
iWtQVS
ERL 440C
10
ly.
Ae rRi5� e Heat
—�,�:-np HLat
71, n
D—s—:tors
L
-T-
No
s
volts
�Qad)
VORS
volts
11-
V ;fA
C-4
-U
Yes
Nz
VQ!"&
vo�
vo�'Z&
1:11anel Type -
Trouble with AC ofr?
Yes No
Battery backup operationd?
Yes No
�Etattary voltage (nio load)
� —
— volts
�----7—_ - -
RaMry v@�tzgo (full load)
volts
Chame circuit vc1tage
volts
rZZOVY 5 20
.-Danz2 Two:
I.,
f UU:�'.o Vild-, AC off? Yor. No
Yes Ma
d go (nu'a&Lr)
vaks
y y o, ii, b e (i, uo � o 4 es)
V0446
��Iiavgiii CiveUk Voitage
voks
Fire Protection Contractors since 1930
KIN& VIKING AUTOMATIC SPRINKLER COMPANY 3434 First Ave. So., Seattle, WA 98134, 206.622.4656
WA.: VI-KI-NA-S373NT LEVEL N 602 California Way, Longview, WA 98632,360,425.7620
Fire Sprinkler Inspection Report
Pa9e:1of2
REPORT TO: (A V(-
$
J 0 B N 0. 1A 7 14 J DATE:
3 -,;-, _T -
STREET: 7 A
0211
BLDG./LOCATION: -7
ef I
CITY/STATE: /_'/A*":��&�I.A
ift/h 9 e,
INSPECTOR: '71Z,,4,i
r<,Il ll,,*J 7
IU00 I U A I Uf% I
I.GENERAL
a. Is the building occupied ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Is occupancy the same as previous Inspection ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
C. Are all systems In service ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. Are all fire protection systems the same as last Inspection ? . . . . . . . . . . . . 7 . . . . . . . . . . . . . . . . .
a. Is the building completely sprinklered ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
f. Are all new additions and building changes properly protected ? . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Is all stock or storage properly below sprinkler piping ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
h. Was property free of fires since last Inspection ? (Explain any fire on Page 2) . . . . . . . . . . . . . . . . . . . . . . . .
1. In areas protected by wet systems, Is building properly heated, I.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ?
2. CONTROL VALVES (See Section 17)
a. Are all sprinkler system main control valves open ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Are all other control valves In proper position ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
c. Are all control valves In good condition and sealed or supervised ? . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. WATER SUPPLIES (See Section 18)
a. Was a water flow test preformed and were the results satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - -
4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS
a. Are f Ire pumps, gravity tanks, resevoirs and pressure tanks In good condition and properly maintained ? . . . . . . . . .
b. Are Fire Department Connections In satisfactory condition, couplings free, caps In place and check valves tight?. fr;�'w
...........
5.WETSYSTEMS (SeeSectIon13)
a. Are cold weather valves open or closed as necessary ? . . . . . . . . . . . . . . . . . . . . . . . ... . . .
b. Have antifreeze systems been tested and left In satisfactory condition ? Temp. ? . . . . . . . . . . . . . .. . . .. . .
c. Are alarm valves, water flow Indicators and retard chambers In satisfactory condition ? . . . . . . . ... . . . . .
6. DRY SYSTEMS (See Section 14)
a. Are dry valve(s) In service and In good condition ? . . . . .. . ..... . . . . . . . . . . . ... . . . . .. . . .
b. Are pressure and priming water levels normal ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
c. Is air compressor In good condition ? ... . . . ... . . .. . . ... . . . . . ... . . . . . . . . ... . . . .
d. Were low points drained during fall and winter Inspections ? - - --- - - - - - - - - - - - - - - - - - - - - - - - ---
a. Are 6ulck- opening devices In service ? . . . . . . . . . . . . ... . . . . . .
f. Has piping been chocked for stoppage within the past ton (10) years ? - - - - - XZ012 . . . . . . . I . . . . . .... . . . .
g. Has piping been checked for proper pitch -within the past five (5) years ? - - - - - - - - - - - - - - - - - --- - - - - -- -
h. Have dry valves been trip tested satisfactorily as required ? . . . . . . . . . . . . . . . . . . . . . . . ... .. .
1. Are dry valves adequately protected from freezing ? - - - --- - - - - - - - - -- - - - - - - - - - - - - - - - - - -
J. Are valve house and heater conditions satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - -
7. SPECIAL SYSTEMS (See Section 16)
a. Were valves tested as required ? - - - - - - - - . . . . . . . . . ... 7 -- - - - - - - - - - - - - — -
b. Were all heat-responalve systems tested and were the results satisfactory ? - - - - - - - - - - - - - - --- - - --- - - - -
c. Were supervisory features tested and were the results satisfactory ? - - - - - - - - - - - --- - -- - - - - - - - - - - - -
&ALARMS
a. Is thewater motor and gong test satisfactory ? - - - - - - - - - - - --- . . . . . . . . . . . . . . .
b. Is the electric alarm test satisfactory ? . . . . . . . . . . . . . 7 . . ... . . .. . . . . . . . . .
gvf, le, R Ph.: '60—
c. Is the supervisory alarm service test satisfactory ? Monitoring Co. Codw
9. SPRINKLERS - PIPING
a. Are all sprinkler heads In good condition, not obstructed and free from corrosion or loading ? . . . . . . . . . . . . . . .
b. Are all sprinkler h6ads less t han fifty (50) years'old ? Head h Date of head
WHrrE: VIKING COPY YELLOW: INVOICE . COPY PINK: FIRE DEPAR�MENT COPY GOUD� BUILDING COPY
lk
L Fire Protection Contractors since 1930
virJNG AummincSPRINKLE R COMPANY 3434 Rr8t AWL S&, Seaft WA W134, 206. 622-4656
WA.: VMG�M-W73NT LEVEL X 602 Caffkrnfa W, LongdiW WA 98M, 360. 425. 7620
Fire Sprinkler Inspection Report Page:W2
9. SPRINKLER / PIPING (Continued) YES N.A. NO
c. Are exiii sprinkler heads, readily available ? - - - - - ----- - - - - - - -
. . . . . . . . . . . . . . . . Ix
d. Is condition of.piping, 'essure gau��, ? 7-27
drain valves, check valves. hangers, in 3pen sprinklers, and strainers sedfactory
6. Are all-spiInkfirs of proper,temperaturfi rating?
a
I. Are portable Are extinguishers
9" Fc�ndftlpn ?
g. Is hand hose on sprinkler systems satisfactory ? . . . . . . . . . . ... . . . . . . . . . . . . . ... . . . . .
10. Date Dry System Piping last chocked for stoppage .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
11. Date Dry System Piping last chocked for proper pitch - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ft 14
12. Date Dry Pipe Valve last trip tested -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
13. Wet systems: Number: Make / Model I Year. #
14. Dry Systems: Number: Make/ Model /Year. z
15. Accelerator: Make / Model / Year:
16. SpeclalS at ms: Number, Type:
y
Make Model / Year Condition
17. CONTROL VALVES
a. City Connection Control Valves . . . . . .
b. Tank Control Valves . . . . . . . . .
c. Pump Control Valves - - - - - - - - -
d. Sectional Control Valves - - - - - - - - -
a. System Control Valves - ; - - - - - - -
Number
Type
Ye .0 n
No
Secured
Yes No
Closed
Yes No
YaaSIgn
No
Condition
X
X
18. WATER OLOWTEST
a. Water Pressure Source ,'GC[ty, OTank, 0 Fire Pump, Water Flow Test taken if not,reason:'
Test Pipe Location
Size Test. Pipe
Pressure Before
Flow Pressure
Pressure After
A T
19. Explanation of any "No" answers: -:
20. R'e'ce4nft changes In building occupancy or fire protection equipment:
21. Adjustments or corrections made:
T z
22. Desirable Improvements:
23. Has building owner/ representative been notified of any deficiency to the fire protection system? 0 Yes 0 No, Person notified
If answer Is "No",explain:
24. Inspector's Signature: Witness (property owner / lessee) and date:
WHITE: \AKIN6000PY YELLOW: INVOICE'COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY
Fire Protection Contractors since 1930
10"ar, j '
VIKING AUTOMATIC SPRINKLER.,'COMPANY 3434 First Ave. So., Seattle, WA 98134, 2o6. 622. 4656
WA.: VfKi-NA_S373NT LEVEL,fll 602 Califamia Way, LorIpiew, WA 98632, 3�0. 425. 7620
COMPANY- Fewl IJ& JOB NO. DATE:
STREET:. 7-/-)/ T'/' AbIE PROPERTY NAME LOCATION:
:7111A1
CITY / STATE 10h 7701& INSPECTOR: . _40e
DRY, PIPEVALVE TEST
1. Valve description
a. Size
b. Make
C. Model
d. Year of Mfg.
2. Control Sprinklers in
3. Pressure (Lb) before tests:
b. Water
4. Control Valve
a. Wide open
b. No (No.of turns to open)
5. Operated at:
a. Air pressure (Lb)
b. Time (Min.,Sec.)
6,Op'&ation Indicated:
a. S6ti sifactory,
b. Partially satisfactory
c. Fa-iled
7. Reason -for:
a. failure
b. partially satisfactory
8. Valve reset dry?, (yes/no)
9. Condition:
j. Interior of body
b. Water for test pipe
c... M,oving_ga,r.,js_..
d. Seats
q. Rubber facing
1O.Al'arms operated? (yes/no).
11 Inspector's Test trip ti ' me (Sec.)
12.Quick Opening Devices:
a. Make
b. Model
c. Year,
13.'0 oe rati On'l n d i ctated:
a. Sati sfactor
Fa'i I ed. -to shut. off
I A I 't
SA %X 1WRIM110 11100a:
--DRY- PIPE VALVES
No.1''. No.2 No.3
PlIA090 Avlwg,
Re, A,,
Ile,
QUI,CK OP'ENING"-DEVICES
Signature /jtitle of, arson performing test Witness (owner / lessee of property ) and date signed.
jf
.............
............ ....... ....... ......
. . . . . . ........
. . . . . . . . . . .. :ik
19023 30 Ali. W, Sl�� E, L-ptMId, WA 98036 U.S.A.
(4,LS) 771 .11 dd Fox (42Sj 77 1 -4472
Occupancy Name:
Building Owner
Owner Agent:
Date of Inspection:
Testers Name:
Certification Given
RED YELLOW )C, I WHITE
CONFIDEkCE TEST I
REPAIRS
FIRE ALARM SYSTEMS
(One System per Report)
I -a Favc Condos Occupancy Address: 201 3rd Ave N, Ednionds
La Favc Coado Assoo. Phone Number: (42-5)697-2682
Ken Phone Number: (425)697-2682
I I A) 112012 Inspection Type: V Annual Quarterly
Simtt Andcrwn SFD Certification Number: SCP-
Monitoring: N/A
FACP Manufacturer: FC1
# of Initiating Circuits: 2
Phone#: N/A Amount #: N/A
Model #: SBP-2 Lmcation: I st floof Jmiaor lobby
# of Signal Circuits: 1 Notes:
ALARM SYSTEM FUNCTIONALITY
yes
No
N/A
All notification circuits operational?
All circuits checked for electrical supervision?
All auxiliary equipment operates (elevators, fans, dampers)?
Key to panel available7
Operating instructions at panel?
Trouble indicators function properly?
Test record posted at panel7
Signals received at central station? Operator
Problems Found:
4'h� a 4:1:�Q 12 '5 C- 4 k- - - P- �Y-e ed fo 9Z
AMTI-15F-�- 1,4 e-Jdd,.V-A /2WZMZAA
J- Corrected Bv: lmm�' saffqrdw
Corrections Made: Date Corrected: 1111�k- SFD Certification M fK-P fi--,OW , j4r)
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 co7rrive action. A
C6-7,7
Signature of Tester: Phone #: 0-8 &8V
Signature of Owner:
SYSTEM DEVICES
MODEL#
TOTAL
TESTED
SATISFACTORY?
Yes
No
N/A
Hom/Strobes
MIRTUNF 74201
Strobe Only
V7
Ham Only
26
?
Speaker/Strobes
Speaker Only
Sounder Bass
Rolls
AlrJia-larno AL-MTR-RQ4'
I I
Manual Pulls
EDWARDS
9
Photo Smoke Detectors
F-%L 440C
14)
Ion Smoke Detectors
Combination SmokelHeat
135' Rate of Rise Heat
2000 Rate of Rise Heat
135* Fixed Ternp Hoe
200" Fixed Tamp Heat
Duct Smoke Detectors
Detector Remote Indicators
Remote Annunciators
Elevator Recall Output
Fan Pressurization
Door Holders
12
Door Unlock
Curtains/Rall-down Doors
4
Fire Fighter Phones
I
K*1
Main FACP
TFoubla%Mth AC off?
Q!;) No
Battery backup operational?
(D;> No
Battery voltage (no load)
lc- - -t,3vohg
Battery voltage (full load)
2LCV01ts
Charge circuit voltage
volts
[Battery Size
PanelType:
Trouble with AC off7
Yes No
Battery backup operational?
Yes No
Battery voltage (no load)
volts
Batteryvaltage (full load)
volts
Charge circuit voltage
volts
Battery Size
PanelType:
Trouble with Ac off7
Y" No
Battery backup aparational?
Yes No
Battery voltage (no load)
volts
Battery voltage (full load)
volts
Charge circuit voltage
Volta
Battery Size
PanelType:,
Trouble with AC off7
Yes No
Battery backup operational?
Yes No
Battery voltage (no load)
volts
Battery voltage (full load)
volts
Charge circuit voltage
volts
L Battery -Size
Fire Protection Contractors since 1930
G Al ITOMATIC SPRINKLER COMPANY 3434 First Ave. So., Seattle, WA 98134, 266.622.4656
WA.: V1-K1-NA-S,173NT LEVEL N 602 California Way, Longview, WA 98632, 360.425.7620
Fire Sprinkler Inspection Report Page: 1 of 2
REPORT TO: 6�A) bn Q JOB NO. 1AZ Q 29 DATE:.. 3
STREET: BLDG. / LOCATION: 'eq
A,
CITY/ STATE: INSPECTOR:
1.GENERAL
a. Is the building occupied ? - - - - - - - - - - - - --- - -
--------------------
b. Is occupancy the same as previous Inspection ? . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . .
C. Are all systems In service ? --- - - - - - - - - - - --- - - - - - - - - - --- - - - - - - - - -
d. Are all fire protection systems the same as lastinspection ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
e. Is ti�e building completely sprinklered ? - - - - - - - - - -- - - - - - - - - - - - - - - - - -
I. Are all new additions and building changes properly protected ? - - - - - - - - - - - - - - - - - - - - - - - - -
g. Is all stock or storage properly below sprinkler piping ? - - - - - - - - - - - - - - - - - - --- - - - ---
h. Was property free of fires since last Inspection ? (Explainany fire on Page 2) . . . . . . . . . . . . . . . .. . . . . . . . .
I. In areas protected by wet syste me, Is building property heated, Le.: blind aides, perimeter areas, and are all extort or openings protected against the cold ?
2. CONTROL VALVES (See Section 17)
a. Are all sprinkler syste m main control valves open ? - - - - - - - - --- - - - - - - - - - - - - - - - - - - -
b. Are all other control valves In proper position ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
c. Are all control valves In good condition and sealed or supervised ? - --- - - - - - - - - - - - - - - - - - - - - - - - -
3. WATER SUPPLIES (See Section 18)
a. Was a water flow test preformed and were the results satisfactory ? - - - - - - - - - - . . .. . . . . . . . . . . . . .
4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS
a. Are fire pumps, gravity tanks, resevoirs and pressure tanks In good condition and properly maintained ? --- - - - -- - - - - - -
b. Are Fire Department Connections In satisfactory condition, couplings free, caps In place and check valves tight ?_
5. WET SYSTEMS (See Section 13)
a; Are cold weather valves open or closed as necessary ? . . . . . . . . . . . . . . . . .... . . . .. . . . . . .
b. Have antifreeze systems been tested and left In satisfactory condition ?. Temp. ? - - - - - - - - - - - - -
c. Are alarm valves, water flow Indicators and retard chambers In satisfactory condition ? . . . . . . .. . . - - - --- - - - - ---
6. DRY SYSTEMS (See Section 14)
a. Are dry valve(s) In service and In good condition ? -- - - - - - - - - - - - - - - - - -- - - - - - - - - - - -- - - - -
b. Are pressure and priming water levels normal ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - -
c. Is air compressor In good condition ? - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - - - ---- -
d. Were low points drained during fall and winter Inspections ? - - - - - - - - - - - - --- - - - - --- - - - - - - - - -
a. Are Quick- opening devices In service ? - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - -
I. Has piping been checked for stoppage within the past ten (10) years ? - - - - - - - - - - -- - - - - - -
g. Has piping been checked for proper pitch within the past five (5) years ? - - - - - - - - - - - - - - - Uw
h. Have dry Valves been trip tested satisfactorily as required ? - -- - - - - - - - -- - - - 7
I. Are dry valves adequately protected from freezing ? 7 . . . . . . . . . . . . . ... . . . . ...
J. Are valve house and heater conditions satisfactory ? - - - - - - . . . . . . .. . . . . . . . . . . . . . . . . .
7. SPECIAL SYSTEMS (See Section 16)
a. Were valves tested as required ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - -
b. Were all heat -responsive systems tested and were the results satisfactory ? - - - - - - - - - - - - - - - -- - - -- - - - - -
c. Were
ALARM:upervisory features It . sated and were the results a I atisfactory ? - - - ------ - - - -
a. Is the water motor and gong test satisfactory ? - ----- ------ - - - - - - - - - - - - --- - - - - - - - - - -
b. Is the electric alarm test satisfactory ?
- - - - - - - - - - — - -
c. Is the supervisory alarm service test satisfactory ? Monitoring Co. /)&1V-<—' ;0.12 -7 Ph.: 11114 C.d.:—AZP-0--
9. SPRINKLERS - PIPING 3eu am
a. Are all sprinkler heads in good condition, not obstructed and free from corrosion or loading ? -- - - --- - - - - -
'KA, o 11, 7
b. Are all sprinkler heads less than fifty (50) years old ? Head Manufacturer it- - — Date
WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARIMENT COPY GOLD: BUILDING COPY
Fire Protection Contractors since 1930
3 AUTOMATIC SPRINKLER COMPANY 3434 First Ave. So., Seattle, WA 98134, 206. 622. 4656
WA.: VI-KI-NA-S373NT LEVEL M 602 Calffbmia Way . Longview, WA 98632, 360. 425. 7620
Fire Sprinkler Inspection Report Page:202
9.
SPRINKLER / PIPING (Continued)
YES
N.A.TNO�
c. Are extra sprinkler heads readily available, ? - - - - - - - - - - - - - w - - - - - - - - - - - - - - - - -
- - - -
d. Is condition of. piping, drain valves, check valves, hangers, pressure gauges, open sprinklers, and strainers satifactory ? - - - - -
- - - -
a. Are all sprinklers of proper temperature rating? - - - - -----------------------------
7
f, Are portable.fire extinguishers In good condition ? - - - - --- - - - - - - - - - - - - - - - - - ---
- - - -
g. Is hand hose on sprinkler systems satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
10.
Date Dry System Piping last checked for stoppage — - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - - -
11.
Date Dry System Piping last checked for proper pitch -- - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
12.
Date Dry Pipe Valve last trip tested -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
- - - -
13.
Wetsystems: Number: —Make/ Model /Year:
14.
11
Dry Systems: Number: —/-- Make/ Model/ Year: C Amp W
15.
Accelerator: Make I Model / Year: nJA
16.
SpecialSystems: Number; —Type:
Make / Model i Yea r Condition:-
17. CONTROL VALVES
a. City Connection Control Valves - - - - - -
b. Tank Control Valves - - - - - - - - -
c. Pump Control Valves - - - - - - - - -
d. Sectional Control Valves - - - - - - - - -
e. System Control Valves - - - - - - - - -
18 WATER FLOW TEST
Condition
a.Water Pressure Source :dcity, OTank, 13 Fire Pump, Water Flow Test taken ? If not, reason:
Test Pipe Location
Size Test Pipe
Pressure Before
Flow Pressure
Pressure After
2&T R;SeA
19. Explanation of any "No" answers:
20. Recent changes in building occupancy or fire protection equipment:
21. Adjustments or corrections made: AVe 11,114P=
22. Desirable improvements:
23. Has building owner / representative been notified of any deficiency to the fire protection system? 0 Yes 0 No, Person notified:
If answer is "No",explain:
24. Inspector's Signature: Witness (property owner / lessee) and date:
FIRE DEPARTMENT COPY
22. Desirable improvements:
23. Has building owner / representative been notified of any deficiency to the fire protection system? 0 Yes 0 No, Person notified:
If answer is "No",explain:
24. Inspector's Signature: Witness (property owner / lessee) and date:
FIRE DEPARTMENT COPY
Fire Protection Contractors since 1930
VIKING AUTOMATIC SPRINKLER COMPANY 3434 FustAve. So., Seaft, WA 96134,206. 622.4656
WA.: VI-KI-NA-W73NT LEVEL H/ W2 Cd&mia Way, Lonpiew, WA 9MV, 360.425.7620
COMPANY: JOB NO.:/A-)-�7 DATE:
STREET: RO PROPERTY NAME /LOCATION:-- 5;)/)1 "Op
CITY /STATE: 4- 0'7 45 6') P. 9Y INSPECTOR:
DRY PIPE VALVE TEST
Valve description
a. Size
b. Make
C. Model
Year of Mfg.
2. Control Sprinklers in
3. Pressure (Lb) before tests:
a. Air,
b. Water
4. Control Valve
a. Wide open
b. No (No.of turns to open)
5. Operated at:
a. Air pressure (Lb)
b. Time (Min.,Sec.)
6. Operation Indicated:
a. Satisfactory
b. Partially satisfactory
c. Failed
7. Reason for:
a. failure
b. partially satisfactory
8. Valve reset dry? (yes/no)
9. Condition:
a. Interior of body
b. Water for test pipe
c. Moving parts
d�`Seats
e. Rubber fac ing
10.Alarms operated? (yes/no)
11. Inspector's Test trip time (Sec.)
12.Quick Opening Devices:
a. Make
b. Model
c. Year
13.0peraition Indictated:
a. Satisfactory
b. Failed to shut off
14-List of repairs made:
DRY PIPE VALVES
No.1
No.2
No.3
mo
QUICK OPENN—G DEVICES
up
ature / Title of person performing
Witness (owner / lessee of property ) and date signed..
EDMONDS � FIRE DEPARTMENT
CONFIDENCE TESTING
.STANOPIPES
VIKING AUTOMATIC SPRINKLER CO.
VI-KI-NA-S373NT
3434 1 U AVENUE S.
SEATTLE, WA 98134
(206)6224656
Address:. A)
Occupied as. Ue tV Q
Bui 1 ding. Owner 2hone —.7
Address C i ty .5 Zip Code 1802!�2.
Date.-.oi I 9specti on. Via
Type of Test: '5-year--,/— Other
Type of Standpipe: -5/6 W -f-2-
(Dry). Class. I_1_ (Wet)�Class II (Combinati(oh) Class: -III
Class 1: (5-year)
Hydro tested 175__�pi. —qr. 5Vp07g_rea`t_6r_than head
pressure for 2 hrs:
No
All outlet. Val ves and hose threads checked:
Yes_../ No
,Was 25 psi ai.r test conducted?
Yes-- No
Are pumper. connect ion cla pper valves free of
Yes. No
I ast 11: (5 Year)
:Arec.- a] I hoses, valves, and controlling nozzles'
in good'conditioh?'.
Yes.. No
Have. f l.G.w: tests been conducted. at highest level
.for at least 30 seconds to- make� su re nozzle wi- 11
work at: pressure available?
Yes No
00 qpm. at
nimum
3.5 �Psi mi Y
14a ve. con tro 1 .1 i-nq val ves - -been -tested. to 4eriti....
-that pressure: regulating valves operate properly?
Not-to:,exceed 1QO..psi..t.ip,pressure, ..Yes
No
RE: Standpipe tests (continued)
Class 111: (5 Year)
..Hydro tested at 175 psi or 50 psi greater than
highest operating pressure? Yes No.
Was 25 psi air test conducted? Yes No
All.outlet valves and hose threads checked? Yes No
flow tests conducted to verify operating.pressure of
pressure regulating Valves (notto exceed 175 psi flowing) Yes No
300 GPM-fl'ow at roof through each riser? Yes No
Fire pump(-s) 'start. ftom..roof f I ow? Yes No
General:
..All Fire. Department inlets -and -outlets equipped with approved
plugs or. caps? (1/8 i.nch pressure. -.relief hole i.n caps) Yes No
Class I and 11 standpipes have 12" wrench clearance? Yes J No
Pi -ping between.Fire.Department connection and
check valve hydro tested?
Verify'that water flow switches operate.
Pumper connections. are not obstructed..
ATI control valves left in open p6s:ition?
(Except normally . close,d valves)
Problems'fouhd
Yes No
.fV Yes No -
Yes
Yes_,/ No-
Correcti.ons made
7
TRIS IS JO'CERTIFY THAT.THE STANDP I.PE /HOSE CAB I..NET SYSTEM HAS BEEN PROPERtY TESTED
AND INSPECTED- FOR. RELIABILITY- TO COVER THE ITEMS LISTEVIR THI-S REPORT, is
CONSISTENT WITH MANUFACTURER'S REQUIREMtNTS,,:AMD:-ALL,CORRECTIONS-.HAVE BEEN MAID E
SIGNATURE OF TESTER.:
VIKING AUTOMATIC SPFUNKLER CO.
VIXW-S�73NT
3434 1 S'r AVENUE S.
SEATTLE, WA 98134
'EbMONDs FIRE DEPARTMENT '(206) 622-4656
CONFIDENCE TESTING
STANOPIPES
Address 2C)l 3JZ0. jqt)j!� [V Q�m
Occupied as._/,4
Building Owner h o n e
Address I - :3120 Ave— fy City EDryt)jj)D I zip Code (790-2,0
Date -of I nspect i on. Z 9-12-
Type of Test: 5-yea Other
Type of Standpipe:
(Dry). Class. I (Wet)� Class Il (C.ombinatiop) Class: III
Class I:. (5-year)
Hydro tested 175 psi, o * r. 50 psi greater than head
pressure for 2 hrs: Yes_j No
All outlet. valves and hose threads checked: Yes_j No
Was 25 psi air'test conducted?. Yes NO-2—
Are pumper.connection clapper valves free of Pbstructions? Yess/ No
C1 ass 11:. (5.. Yiw)
-Are-all hoses, valves, and controllin§ nozzles
in good: condition? Yes.. No
Havef l.Gw tests been conducted, at highest level
for at least 30 seconds to.makei su re nozzle will
work at, -pressure available? �Yes No -
(50 gpm, at �57psi mi n.i mum)
Rave.controlli:ng Va. I Ve s been teste4 to -veri fy,
that :9 valves operate properly?
pressure replatin
kot-to.:,exceed 100-psi..tip pressure. Yes No
...CTF'-3: (tu*mblO
4V . .. 10
RE: Standpipe tests (continued)
Class 111: (5 Year)
Hydro tested at 175 psi or 50 psi greater than
highest operating pressure?
Was 25 psi air test conducted?
�.All::outlet valves and hose threads checked?
..Flow tests conducted to verify operating pressare of
Pressure regulating valves (nofto exceed 175 psi. f I owing)
300 GPM fl*ow-at*roof through each riser?
Fire punp(s)-start. from roof flow?
..General:
Yes
No.
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Fito. Department inlets -and-outlets equipped with approved
plugs or caps? (1/8 inch pressure- relief hole ip caps) Yes No
Class I and II standpipes have 12".wrench clearance? Yesj No
Piping between Fire Department connection -and
check valve- hydro tested? Yes No,
Verify that water flow switches operate. iVA Yes No
Pumper connections. are not obstructed., Yes NO J
_Z_
All control valves left in open position? Ye s No
(Except normally 'cl ose.d val-ves)
Problems found
orrec6ons made
THIS IS TO CERTIFY THAT THE STANDPIPEMOSE i*%.ABI,NET SYSTEM H - AS BEEN PROPEREY TESTED,
AND JNSPECTED-. FOR RELIABILITY. TO. COVER� THE ITEMS LISTED.AK THIS. REPORT, � IS.
CONSISTENT WITH MANUFAPTUREWS REQUIREMENTS,: AND:.ALL. CORRECTIONS -.HAVE BEEN':MADE-..
.SI:GNATURE-OF TE-STER-
Serving'Bilei; Edinonds 12425 Meridian Ave S
SNOHOMIS11 CO.�'-
Moun.ld ke Terrcice,djrd - Everett, WA 98208
TIRE
e Town of- Woodway Phone (425) 551-1200
STR T Thww.FireDistrictl.org. Fax . (425) 551-1272
LOCATION: 201 3rd Avenue N
I '/
BUSINESS NAME: La Fave Condos
MAILING 201 3rd Ave N
ADDRESS: Edmonds
BUSINESS OWNER:
PHONE: 4257757840
98020
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
0 EDMON DS
0 BRIER
0 WOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY _rTION & SHIFT:_'N
365 17 C
SCHEDULED 12/01/11
DATE DUE
1;202
(UFIR � 427 !!�j
PREFIRE
-1: lRcfibner,KenfP3l7 HOME PHONE: 4256972112 CURRENT
EMERGENCY
YES NO
KEY ACCESS-2: HOME PHONE: CITY
B 'INESS
US
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED: 4A
NAME OF INSPEC��
FIRE 43111 F 1 SP12/05 I" FE 101 11
SYSTEMS: �_� �Vl ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
<, F01
2
2
3
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT4,30 DAYS X
lst RE -INSPECTION
DATE DUE:
1
2nd RE -INSPECTION
DATE DUE:
I
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
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
6
4
8
j
4
8
DAM
DISPOSITION:
LETTER NEEDED E] YES NO
1%
LETTER NEEDED C] YES NO
I
I
I
8
FIRE DEPARTMENT COPY
Oortl 961 cation Given
...........
. . . . . . . . . . .
RED
__["ELLOV
�� . . . . . ....
........... CONFIDENC TESTj
E
1!�023 16E. Av,- %V, SwL- E, LyanwoA XVA 98U-i6 U.S.A. I
(41S) 7'71-1166 fxx�42�,)771-4422 REPAIRS
FORE ALARM SYSTEPUM OR 7 FF
(One sy5�pm pair Repon)
M-mij.panny Name,
SjulldOng nDwncu-
Owne F Agent -
Date, of Inspection:
T e n I e vs Na it m:
UlFaw-co"dar, —
Mckippfnrzy Midirp-np,: 20' 3rit Ave N , Edmorids I
Phone Numbar: 42�-582-7796
UMJI� I
Phone 54 ,eV: 42-1-5SZ-7786
t/ Annual au'-w-tedly
SED Canifir-ation Wuml�--r: SeN b002ZI1
AJ f+ Phone 4: V AccouM#:
FACP manufauturen FLI Vjode� 0. SP-P-2
0 of �njt�atjVjg CjVGU�JS: 2 3V 01'Wgna� ch-cuits: I Notes:
L'I FtIvr Condo Arsol�'.
1 W2,MN 11
V, r, n T*y
ALARAM SYSTEM FUNCTIONAUTY
Yes
IN 0
H/A
A01 nutificatiwi civeuita apepationai?
All cirruas dierked for 4or-Krl"l supervision?
equipment operates lallavator6, fane, dampem)?
Koy zo pancl avaflahk7
oporating 11751,vur'Votis at Panel?
Trouble indicators function properly?
TorA rccord pstod at panol?
Signalu
rauaivtid at Gentrag station?
pvob�oms Found:
Camer-Cang Made:
Ba�e Conecied: /0
I I/ . /V
&,IDTU7e-CVeVI Ld!j:_".V
SFD caullificaVon 1:
This cen',Nfies that this five and We safety sys'.1,em has �,een pvoparly inapacved 'ilor i-eliabflaw-y
to cavar the kems Hzft-d �n tWs lrepo�,t and �,s consislesit vvfth Sealt�e Rre DepaRtment FiTe.
Code standairds, and IhzViscrepanrie,5 am noted and have been repmied lo Ihe h0ding
Cwubeo-Manag-er fe r V 11"Ve ar,200p,-�
Signature of Tester: ---A ( r Phone#: ;-&-AgLqw—
. -�
Signature of Owner-,::::��
SYS TEW4i' DEMCIR5 0 6 0 H, L 707AL Li7 1� ij
MIRTONIF, 74,2DI
Zoundiar Base
F
[ILos
Alph AL-MTR-362-�.j
W,;:ivaja� pu";G
11DVIV I 'IDS
ID
Pho-LO Gi-Floko bacaov�,-
EqL 446C
iun Si -nuke DeteeLOVS
Combination Srnoke/Heat
135' Rate of Rise Heat
2000 Rate of Riso Heat
US' Fixed Temp Heat
2000 Fixod Temp Heat
Duct Smoke Detecters
Datoozor
A-nvnc�,itorc
Sevator Recal Outpw
-4-
Fan Pressurization
Door UMOCI�
�C—
L
L
Main FACP
TmWrn v*h AC off 7 y imp
I nattery beu!wp upEFotivonal?
GaTzery vo�Kagw (fu-"! 10�ad)
VL41agL,
— ----------
siic
Panel T"�. o.,
Ulale wfth AC Of ?
nattory vdtege fn,-� INAid) q 'Lj&tLl
9,4
TrnuHc. wi?h AC off?
wo I
-2,1 bz=kup Op--,r3ti=2l?
v 6
me,
ChLvge Circuit voj%�G'-'
M-oovv gi2o
Tpinub�euvith AC oit?
Yes M 0
vc, - , N!O
"tic %-�J)
C! % ge
CATY OF EDMONbS
FIRE PREVENTION
SAFETY SURVEY
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
201 3rd Avenue N
FREQUENCY
STATION & SHIFT
17 6
LOCATION:
13USINESS NAME:
La Fave Condos PHONE:
4257757840
SCHEDULED 12]()11.1()
DATE DUE
MAILING
201 3rd Ave N
LIFIR 10 427 1202
ADDRESS:
Edmonds 98020
BUSINESS OWNER:
HOME PHONE:
PREFIRE
EMERGENCY-1:
Scribner, Ken #317 HOME PHONE:
4256972682
KEY ACCESS-2:
HOME PHONE:
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE AS1/08 FA8/08 SP12/05 I'D LkBx—
FEZ2,Z4:>
SYSTEMS: '3// / -5 p- ANM IAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS ENTER CODE ONLY ONCE 0
L/
VIOLATION CODE
2
2
3
3
4
4
5 . .....
5
6
6
7
7
8
8
lst RE -INSPECTION
2nd RE -INSPECTION
EXTENSION FINAL RE -INSPECTION
VIOLATIONS
DATE DUE,
2ATE DUE-
_GRANTED TO, DATE DUE,
CITED:
k
PERSON
CONTACTED.
1
PERSON
CONTACTED.
PERSON
CONTACTED:
INSPECTOR:
2
INSPECTOR:
INSPECTOR:
DATE.
DATE:
3
VIOLATIONS
PRE -CITATION CITATION ISSUED
LETTER SENT NUMBER:
4
VIOLATIONS
1 5
2
6
.5
2 6
CODE
DATE: SECTION-
5
3
7
3 7
RETURN RECEIPT
RECEIVED
6
7
1
4
DISPOSITION:
DATE:
4
18
LETTERNEEDED [::. YES 77 NO
8
YES F-
LETTER NEEDED j NO
FIRE DEPARTMENT COPY
71
Fire Protection Contractors since 1930
VIKING AUTOMATIC SPRINKLER COMPANY 3434 First Ave. So., Seattle, WA 98134, 206.622.4656
WA.: VI-KI-NA-S373NT LEVEL N 602 California Way, Longview, WA 98632,360,425.7620
Fire Sprinkler Inspection Report Page:lof2
REPORTTO: bX Al. JOB NO. DATE:
STREET: 2e)l 3121 -411)' _2 BLDG./ LOCATION:
CITY / STATE: "r"I""'41 �- A 17 _.
- INSPECTOR: — 11'e,
I GENERAL I'll
a. Is the building occupied ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Is occupancy the same as previous Inspection ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c. Are all systems in service ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. Are all fire protection systems the same as last Inspection ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
a. Is the building completely sprinklered ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
f. Are all now additions and building changes properly protected ? . . . . . . . . . . . . . . . . . . . . . . . . . . . .
g. Is all stock or storage properly below sprinkler piping ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
h. Was property- tree -of fires, since lost Inspection ?,(Explain any fire -on. Page 2). _ --- _ ., _ -.- .__ ., __ _ � __7z . _ . .- . _. . - . - 1.
1. In area protected by wet systems, Is building properly heated, I.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ?
2. CONTROL VALVES (See Section 17)
a. Are all sprinkler system main control valves open ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Are all other control valves In proper position ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c. Are all control valves In good condition and sealed or stipervised ? . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. WATER SUPPLIES (See Section 18)
a. Was a water flow test preformed and were the results satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - -
4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS
a. Are fire pumps, gravity tanks, resevoirs and pressure tanks In good condition and properly maintained ? . . . . . . . . . . . . . . .
b. Are Fire Department Connections In satisfactory condition, couplings free, caps In place and check valves tight ? - - - - - - - - - - - -
s. WET SYSTEMS (See Section 13)
a. Are cold weather valves open or closed as necessary ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Have antifreeze systems been tested and left In satisfactory condition ? Temp. ? . . . . . . . . . . . . . . . . . . .
c. Are alarm valves, water flow Ind6tors and retard chambers In satisfactory condition ? . . . . . . . . . . . . . . . . . . . . .
6. DRY SYSTEM (See Section 14)
a. Are dry valve(s) In service and In good condition ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Are pressure and priming water levels normal ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
c. Is air compressor In good condition ? - - - - - - - - -- * - - - - - - - - - - - - - - - - - - - - - - - 7 - - - -
d. Were low points drained during fall and winter Inspections ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
9. Are Quick- opening devices In service ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
f. Has piping been chocked for stoppage within the past ten (10) years ? - - - - - - - - - - - - - - - - - - - - - - - - - -
g. Has piping been checked for proper pitch within the past five (5) years ? . . . . . . . . . . . . . . . . . . . . . . . . .
h. Have dry valves been trip tested satisfactorily as required ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1. Are dry valves adequately protected from freezing ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
1. Are valve house and heater conditions satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
7. SPECIAL SYSTEMS (See Section 16)
a. Were valves tested as required ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Were all heat -responsive systems tested and were the results satisfactory ? . . . . . . . . . . . . . . . . . . . . . . . .
c. Were supervisory features tested and were the results satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - -
S. ALARMS
a. Is the water motor and gong test satisfactory ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Is the electric alarm test satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
c. Is the supervisory alarm service test satisfactory ? Monitoring Co._rl, Al". Ph .: ielz-Jo 44 Code: 14-�-
If
9. SPRINKLERS - PIPING
A. Are all sprinkler heads In good condition, not obstructed and free from corrosion or loading ? . . . . . . . . . . . . . . . . . .
b. Are all sprinkler heads less than fifty (50) years old? Head Manufacturer:— 0,*h Dateofhead:_ /70fi3
WHITE: VIKING COPY YELLOW. INVOICE COPY PINK. FIRE DEPARTMENT COPY GOLD. BUILDING COPY
dr
t�;IrJNG A
WA.: VAKI-NA-W73AfT LEVEL N 602 CManta Wily, LangArAK WA 4W. 7W
Fire Sprinkler Inspection Report Page:W2
9. SPRINKLER I PIPING (Continued) YES NA. NO
c. Are extra sprinkler heads readily available ? - - - - - -- - --- - - - - - - - - - -- - - - - - - - - - - - - - - - -
d. Is conditio n of piping, drain valves, check valves, hangers, pressure gauges, open sprinklers, and strainers satifactory ?
a. Are all sprinklers of proper temperature rating? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... .
f. Are portable fire extinguishers In good condition ? - - - - - - - - - -- - - - - - - - - - - - - - - - - - - A
g. Is hand hose on sprinkler systems satisfactory ? . . . . . . . . . . . . . . - - - - - - - - - --- - - - - - - - -
10. Date Dry System Piping last chocked for stoppage -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - /V 114
It. Date Dry System Piping last checked for proper pitch. - - - - - - - - - - - - - - - - - - - - - - - - PA4
12. Date Dry Pipe Valve last trip tested -- - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - -
13. Wet systems: Number: Make I Model I Year.
14. Dry Systems: Number: Make/ Model/ Year.
15. Accelerator: Make i Model Year:
16. Special Systems: Number: —Type:
Make Model / Year Condition
17. CONTROL VALVES
aACIty Connection Control Valves
b. Tank Control Valves - - - - - - - - -
c. Pump Confro I Valves - - - - - - - - -
d. Sectional Control Valves - - - - - - - - -
a. System Control Valves - ; - --- - - - -
IS. WATER FLOW TEST
a. Water Pr . assure Source.jOcity, 07ank, 0 Fire*Pump, Water Flow Test taken Knot, reason:
Test Pipe Location
Size Test Pipe
Pressure Before
Flow Pressure
Pressure After
r
-A
19. Explanation of any "No" answers:
20. R4 I changes in building occupancy or fire protection equipment:
21. Adj I ustments or corrections made:X Ple-1 1014 iel 61 X,
22
23. Has building owner / representative been notified of any deficiency to the fire protection system? 0 Yes 0 No, Person notified:
If answer Is "No",explain:
24. Inspector's Signature: &j�5� —.Witness (property owner / lessee) and date:
,4E: VIWKG COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMErFF COPY GOLD: BUILDING COPY
VIKING AUTOMATIC SPRINKLEA COMPANY
IVA.: V1-K1-NA-W73NT LEVEL X
11 �, k� - '!�, �Vr I - I � � .� I ; I . - i _?
3434 First Ave. So., Seattle, WA 98134, 206. W. 4656
602 Uilbmia Way, LwWWw, WA 98632,350.425. 7620
COMPANY: JOBNO.: DATE:
STREET:. 701 10111JI14 PROPERTY NAME/ LOCATION:
CITY/ STATE: 5�0 Q/
DRY PIPE VALVE TEST
1. Valve'description
a. Size
b. Make
C. Model
d. Year of Mfg.
2. Control Sprinklers in
3. Pressure (Lb) before tests:
a. Air
4. Control Valve
a. Wide open
b. No (No.of.turns to open)
5. Operated at:
a. Air pressure (Lb)
b. Time (Min.,Sec.)
6. Operation Indicated:
a. Satisfactory
b. Partially satisfactory
c. Failed
7. Reason for:
a. failure
b. partially satisfactory
8. Valve reset dry? (yes/no)
9. Condition:
a..Interior of body
Water for test pipe-
c,�,Mov_i:n-g.,.parts_,.
eats
Rubber facing-
10.Alarms operated? -(yes/no)
11. Inspector's Test trip time (Sec.)
12.Quick Opening Devices:-..
a. Make
b. Model
c Year
13.Oper.ation -Indictated-
a. Satisfactory
b. Failed to shut. off-
14.1ist of repairs made:
Signature /Jitle of person performing test
Witness (owner / lessee of property ) and date signed.
....................
. . .......... ....... ....... ......
RK::
19023.3& AV. W, &lit. E,Lylbim..�WA 98036U.SA,
(4'Li) 771 -1 L 66 F2x (425) 771-4472
Occupancy Name:
Building Owner.
Owner Agent:
Date of Inspection:
Testers Name:
Certification
RED YELLOW VI WHITE
CONFIDENCE TEST I
REPAIRS
FIRE ALARM SYSTEMS
(One System per Report) F
I -a Faw Condos Occupancy Address: 201 3rdAvtN,Edmonds
La Faw LAjado Awju. Phone Number: (421) 697-2682
Ken,Scribner 1/317 Phone Number: (425) 697-2682
1 OAA120 10 Inspection Type: V Annual Quarterly
5FD Certification Number: SCP-1&�!
Monitoring: 1i I a-
FACP Manufacturer:
# of Initiating Circuits: 2
Phone#: AJJ A- Account #:
Model #: SBP-2 / Location: ts-�- Ase, E)ev LAt
# of Signal Circuits: I Notes: ly
ALARM SYSTEM FUNCTIONALITY
Yes
No
NIA
All notification circuits operational?
All circuits chocked for electrical supervision7
All auxiliary equipment operates (elevators, fans, dampers)?
V1*10
Key to panel avallabW
Operating ihatrUetiona at Panel?
Trouble indicators function properly?
Test record posted at panel?
oe
Signals received at central station? Operator
Found: SP4-4<P?C"S /�)
IL 6)t�A4g,,— A.
Corrections Made:
Date Cortected:
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 4iscrepan I
,p�re noted and have been reported to the building
Owner/Manager for correAive acti6n. N
Signature of Tester: Phone#:
Signature of Owner: am
�-. 1 40%
77-
SYSTEM DEVICES
MODEL#
TOTAL
TESTED
SATISFACTORY?
Yes
No
N/A
Harn/Strobas
MIRTUNE 74201
i(p.-
Strobe Only
Horn Only
Speaker/Strobes
Speaker Only
Sounder Base
Bells
Alplia-larm AL-MTR-R624'
I I
Manual Pulls
EDWARD!;
9
Photo Smoke Detectors
IESL 440C
10
Ion Smoke Detectors
)<
Combination Smoke/Heat
135' Rate of Rise Heat
2000 Rate of Rise Heat
135' Fixed Temp Heat
200' Fixed Tamp Heat
Duct Smoke Detectors.
Detector Remote Indicators
Remote Annunciators
Elevator Recall Output
Fan Pressurization
Door Holders
12
Door Unlock
Curtains/Roll,down Doors
Fire Fighter Phones
Main FACP
Trouble with AC off?
No
Battery backup operational?
No
Battery voltage (no load)
volts
Battery Voltage (full load)
volts
Charge circuit voltage
volts
Battery Size
IWA
PanelTvpe:
Trouble with AC off?
Yes No
Battery backup OpOatiahal?
Yes No
Battery voltage (no load)
volts
Tattery voltage (full load)
volts
Charge circuit voltage
volts
Battery Size
PanelType:
Trouble with AC off?
Yea No
Battery backup operational?
Yes No
Battery voltage (no load)
volte.
Battery voltage (full load)
volts
Charge circuit voltage
volts
Battery Si2d
PanelType:
Trouble vvith AC off?
Yes No
Battery backup operational?
Yes No
Sattaq voltage (no lead)
volt&
Battery voltage (full load)
�-Volts-
Charge circuit voltage
Vohs
lad cry Size
Fire Protection Contractors since 1930.
VIKING AUTOMAnC SPRINKLER COMPANY 3434 First Ave. So., Seattle, WA 98134, 206.622.4656
WA..;_V1-K1-NA-S373NT L EVEL /it 602 California Way, Longview, WA 98632,360,425.7620
Fire Sprinkler Inspection Report
Page:W2
REPORTTO: JOBNO. 62LC DATE: 7--Z-/4)
STREET- BLDG. / LOCATION:
CITY/STATE: INSPECTOR: _94ef�
1.GENERAL
a. Is the building occupied ? - - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
b. Is occupancy the same as previous Inspection ? . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .
C. Are all systems In service ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
d. Are all fire protection systems the same as last Inspection ? . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .
a. Is the building completely sprinklered ? . . . . . . . . . . . . . . - - - -- - -
I. Are all new additions and building changes properly protected ? - - - - - - - - - - - - - - - - - - --- -
g. Is all stock or storage properly below sprinkler piping ? - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - -
h. Was property free of fires since lost Inspection ? (Explain any fire on Page 2) - - - - - - - - - - - - - - - - - - - - - - - -
1. In areas protected by wet systems, Is building properly heated, Le.: blind attics, perimeter areas, and am all exterior openings protected agal6st t6i �.*Icf?-
2. CONTROL VALVES (See Section 17)
a. Are all sprinkler system main control valves open ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
b. Are all other control valves In proper position ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
c. Are all control valves In good condition and sealed or supervised ? - - - - - - - - - - - - - - - - - - - - - - - - - - -
3. WATER SUPPLIES (See Section 18)
a. Was a water flow test preformed and were the results satisfactory ? - - - - ----- -- - - -- - - -- - - - - - - - - - - - - -
4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS
a. Are fire pumps, gravity tanks, resevoirs and pressure tanks in good condition and properly maintained ? - - - - - - - - - - - --- -
b. Are"Fire Department Connections In satisfactory condition, couplings free, caps In place and check valves tight ? - - - - - - - - - - - -
5. WET SYSTEMS (See Section 13)
a. Are cold weather valves open or closed as necessary ? - - - - - - - - --- - - - - - - - - --- - - - - -- - - - - - -
b. Have antifreeze systems been tested and left In satisfactory condition ? Temp. ? — - - - - - - - - - - - - - - - - - -
c. Are alarm valves, water flow Indicators and retard chambers In satisfactory condition ? - - - - - - - - - -
- - - - - - - - - - -
6. DRY SYSTEMS (See Section 14)
a. Are dry valve(s) In service and In good condition ? - - - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - -
b. Are pressure and priming water levels normal ? --- - - - - --- - - - - - - - - - - - - - - - - - -- - - - - - - - -
c. Is air compressor In good condition ? - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - -
d. Were low points drained during fall and winter Inspections ? - - - - - - - - - - - - - - - - -- - - - - - - - - -
a. Are Quick- opening devices In service ? - - ---- - - - - - - - - - - - - - - - - - -- --- - - - - - -- -
f. Has piping been checked for stoppage within the past ten (10) years ? - - - - - - - - - - - - - - - - - - - - - - --- - -
g. Has piping been checked for proper pitch within the. past five (5) years ? - - - - - - - - - - - - - - - - - - - - - - - - -
h. Have dry valves been trip tested satisfactorily as required ? - --- - - - - - - - - - - - - - - - - - - - - - - - - - - -
1. Are dry valves adequately protected from freezing ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- -
1. Are valve house and heater conditions satisfactory ? - - - - -- - - - - - - - - - - - --- - - - - - - - - - - - - - -
7. SPECIAL SYSTEM (See Section 16)
a. Were valves tested as required ? - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - --- - - - - -
b. Were all heat -responsive systems tested and were the results satisfactory ? - - - - - - - - - - --- -
- - - - - - - - - - -
c. Were supervisory features tested and were the results satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - -
8. ALARMS
a. Is the water motor and gong test satisfactory ? - - - - - - - -- - - - - - - - - - - - - - - - - - - - - -
b. Is the electric alarm test satisfactory ? -- - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - -- - - - - -
c. Is the supervisory alarm service test satisfactory ? Monitoring Co. TO AIZI, Ot /J Ph.:. WA Code: =es�!
9. SPRINKLERS - PIPING
a. Are all sprinkler heads In good condition, not obstructed and free from corrosion or loading ? - - - - - - - - - - - - - - --- ---
b. Are all sprinkler heads less than fifty (50) years old? Head Manufacturer:— Date of head
WHITE- VIKING COPY YELLOW- INVOICE COPY PINK- FIRE DEPARTMENT COPY GOLD: BUILDING COPY
Fire $prinjkler Inspection Report Pag'e:W2
9. SPRINKLER / PIPING (Continued) YES N.A. NO
c. Are extra sprinkler heads readily available?. - - - - - -- I
- - - - - - - - - - - - - - - - - - - - -
U
ress open Iders, and strainers satifactory
Js condition of piping, drain valves, check valves, hangers, pi gel��n prfn
k re ting?.
a. Are all sprin fers'.of proper te miperatiu' ra
i! �97
-.L-Are portable fire extingulshem-In good conditionI.-
1. 1-2 1 -__J
g. Is hand hose on sprinkler systems satisfactory,?
10. Date Dry System Piping last checked for stoppage. ... . . . . . . . . . ... . . . . . . . . . ...
11. Date Dry System Piping last checked for proper pitch - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - -
12. Date Dry Pipe Valve last trip tested .. . . . . . . . . . . . . . . . . . .. . - - - - - - 3-1-0
13. Wet systems: Number Make I Model Year.
14. Dry Systems: Number: Make / Model Year
15. Accelerator: Make I Model Year:
16. Special Systems: Number: —Ty pe:
Make / Model / Year Condition:
17. CONTROL VALVES
a. City Connection Control Valves - - - - - -
b. Tank Control Valves - - - - - - - - -
c. Pump Control Valves --- - - - - - - -
d. Sectional Control Valves - - - - - - - - -
a. System Control Valves.
I& WATER FLOW TEST
a. Water Pressure Source: Ja City, 07ank, E3 FirePump, Water Flow Test taken? 4Z—.I Z4 If not, reason:
Test Pipe Location
Size Test Pipe
Pressure Before
Flow Pressure
Pressure After
19. Explanation of any "No answers: —Pklen 0 #-
20. Recent-chang"jn�b liding-occupan.c�y_pr,!I�!-!��q�
U 1,o n a u I m tri
q 1�_
Z.,
21. Adjustments or corrections made:
F
22. Desira�le Improvements:
k -471A C b, zj
23'.
Has building owne�'/ representative been notified of anydeficiency to th6fire'protection system? OYei 0 No',,Person:..notif led:
If answer Is "No",explaln:
24. Inspector's Signature:— Witness (property. owner / lessee) and date:
WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMLNT COPY GOLD: BUILDING COPY
30
WA.: MI-M-NA-S373NT LEVEL M 602 Wiibmia Way, Longyfzw, WA 93M, 30.'425. 7620
COMPANY:
JOBHO.: DATE: -
A
STREET: PROPERTY MAME LOCATION:
qITY / STATE - �jj"- INSPECTOR:.-