21008 76TH AVE W)IOOB 'Up4h /4jg cA
j
R
&THood and Duct Services, Inc.
6100 12th Ave. S. Phone (206) 726-0940
Seattle,WA 98108 Fax (206) 767-2607
Occupancy Name: . I U- - i U 4-'— L
Occupancy Address: -7 1 po V -XJ
Responsible Person: S (,�D
Building Owner:
COMPLETE Certification Given: REDE] YELLOWD WHITEZI
FIRE PROTECTION CONFIDENCE TESTING RANGEHOOD
High Pressure Hood Cleaning SYSTEM TEST REPORT
Fire Suppression Installation & Service CONFIDENCE TEST21 REPAIRSE]
Fire Extinguisher Sales & Service
Range Hood and Fan Service & Repair
Filter Sales & Service DATE: V12- 614
L7) Ct M C>r\ C1
1A) City, State, Zip:
Phone Numb
Phone Number:
Building Owner Address: — City, State, Zip:
Testers Name (Please Print):— V\D-T�\-e Lk 2 SFD Certification Number: SCP- m-o-2 67C,
System Alarm? Yes No El Central Zation monitoring? Yes [Z No E] Monitoring company name:
Control Pan, fedurer: - - Model Numberf Location of Alarm Panel: rf-t Plu"A
Extinguishing System Manufacturer
Location / Height of Range hood:
300 System? Yes 21 No F 0
U.L. 3 0 Compliant? Yes Z No C] Chemical Type: Wet [Z Dry
Is pressure gauge indicator in operable rang�—?
Y64804No 0
Is there chemical inside of the cylinder?
Yes
No Ej
or
Weigh CO2 or nitrogen cartridge.
NA
-
No visible signs of a system fire or system tampering (if signs check no). Yes
No Ej
Check all piping and conduit. Are all piping and conduit immobilized
with Yes
No F-1
proper hangers and brackets?
Are all protective covers present on nozzles?
Yes [Z
No El
Are all nozzles checked in the proper position?
Yes [Z
No E]
Does system have adequate volume and/or nozzle coverage?
Yes Vj
No []
Are all appliances inside of the hood protection area?
Yes [7/j
No E]
Have fuse links been replaced?
Yes [/-I
No E]
Was system operational from terminal link?
Yes G6
No E]
Was system operational from manual remote?
Yes FZ
No F-1
Was system and micro switch operational?
NA F--1 Yes [7j
No E]
Is system visible and free from obstruction?
Yes [j-6
No E]
Is the inspection and service tag on the cylinder?
Yesz
Non
12 year hydro date of cylinder.
Were hand portable extinguishers properly serviced? NAn
Yes V)
No
Were all cooking surfaces protected? If not, give owner full
Yes V
No El
information.
Was operating procedure verbally given to restaurant personnel?
Yes
No
Was UL 300 compliance explained to owner or manager?
Yes
No
Gas shuts down upon system activation? NA
Yes
No
Electric power shuts down upon system activation? NAEJ
Yes Z
No El
Range hood tied to building alarm panel? NAE1
Yes Z
No F]
Range hood activation signal received at building alarm panel? NAEJ
YesZ
No Ej
Class K extinguisher present?
Yes [Z
No E]
Grease build i group:
Lig —7—M Medium— Heavy, recommend cleaning
Date of last cleaning
Are cleaning intervals within NFPA standards?
Yes F0
Previous Confidence Test Company & Technician —S-04--eu-so - —
—
7
Ulf - -
I-T- 1
—7
11
1
—Cld
C)
ZL
L
T
+
L I
21
re
"Z'3 - '5 PQ K E- W I I-F; 0 0 li-�, r- ov -1 c-k I-:, n
"T Y C 0 A4, r"-V
Customer*r��IIC
Corrections Made: Date Corrected: Corrected By: SFD Certification Number:
This certifies that this fire and life safety system has been pro�erly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code
standards. Discreparic ave Jaw r i� the building Owner/Responsible Person for corrective action.
Signature of Tester: ==A A , 0 1 -A )e4l� Phone # (206) 726-0940
Testing Agency: ___R&T Hood and DQct Services. Inc. MailingAddress: 610012thAve.S..Seaftle,WA98108
The owner is to perform and keep a written record of the following "quick check" fire system inspection to verify the following:
1. The extinguishing system is in its proper location. The extinguishing cylinder is in 6. The nozzle disc caps and their seals are intact, undamaged and tight.
place and has not been removed or tampered with. 7. The inspection tag or certificate is in place and current.
2. The manual pull stations are unobstructed and in clear view and are labeled for 8. If any deficiencies are found, appropriate corrective action shall be taken immediately.
intended use. 9. A record of the monthly inspections is to be kept reflecting the date inspected, inititals of
3. Insure that all tamper seals are intact and that system is in a ready condition. person performing the inspection and any corrections required.
4. Observe system, checking that no obvious physical damage or condition exists
that might prevent operation. AUTHORIZED %,A,
5. The pressure gauge reading on the cylinder shall be in the green operable range. SIGNATURE
FIRE DEPARTMENT COPY
Kevin Zweber
From: Martin Solorio [MartinS@exxelpacific.com]
Sent: Tuesday, January 26, 2016 9:44 AM
To: patdck.lawler@edmondswa.gov; Bjorback, Leif (Leif. Bjorback@edmondswa.gov); Kevin
Zweber; John J. Westfall
Subject: FW: Prestige Care Edmonds Med Gas Room Exhaust
See below.
NUN
I A
CENERAL CONTRACTORS
Martin Solorio
Superintendent
Presfige Care Edmonds
21008 76�h Ave W
Edmonds WA 98026
360 734 2872 Ext. 363
Cell: 360 815 0328
www.exxelpacific.com
This email is to close the circle on the medical gas room ventilation requirements.
The Washington State Department of Health requires the medical gas room to be designed and ventilated per the 1999
NFPA 99. In this version of NFPA 99, the medical gas room shall be vented either naturally or mechanically. Since we
are not on an outside wall, the requirement is mechanical ventilation at I CFM/sq-iare foot. It is understood that newer
Ix,ersions of NFPA 99 have different requirements but not per the code DOH uses.
Thank you,
Randy Hinton, P.E.
R I C E Group, Inc.
Mechanical Consulting Engineers
p. 425.774.3829 x-213
f. 425-672.2084
20201 Cedar Valley Road, Suite 120
Lynnwood, WA 98036
www.rice-group.com
10/23/2015 8:00 am Event History Report Page I of 1
CS# U687020907 Dates 10/20/2015 00:00 to 10/2012015 23:59 Corp Account# All On Test? Y
Site# All Event Class All Reporting Group All Open/Close? N Affiliation All In Service? Y
Date Zone Operator Event Description ornment Additional Info User Com ent
CS# U687020907 Site Name PRESTIGE CARE Add(ess 2:1008:76TH AVE W EDMONDS, WA 98026-7 Alt#
10/20/2015 10:47:46 AHW ONTEST OA-Place on Test �at: 1 jeremy King, gg cs# Expires: 10/20/2015 15:30:00 All
C ��2
Zones
10/2012015 10:52:53 1 E320 CIE320 TR-SNDR/RELAY TRBL
10/20/2015 10:55:10 1 E320 CIR320 RE-SNDR/RELAY TRBL
10120/2015 11:00:08 1 E320 CIE320 TR-SNDRIRELAY TRBL
10/20/2015 11:02:21 1 E320 CIR320 RE-SNDR/RELAY TRBL
10/20/2015 12:02:31 1 E320 CIE320 TR-SNDR/RELAY TRBL
10/20/2015 12:04:28 1 E320 CIR320 RE-SNDR/RELAY TRBL
10/20/2015 12:13:00 14 54 FA -FIRE -SMOKE DET EAST HALL DINNING R,
10/20/2015 12:14:43 14 54 FA -FIRE -SMOKE DET EAST HALL DINNING R
10/20/2015 12:17:33 14 2000 RE -RESTORE EAST HALL DINNING R�
10/20/2015 12:17:37 14 2000 RE -RESTORE EAST HALL DINNING R-
10/20/2015 12:17:42 O/C CIE401 OP -OPEN (LOG-LSL) CONTROL
10/20/2015 13:10:48 11 3709 TR-TRBL ON ZONE DUCT DETECTORS SU
10/20/2015 13:14:58 11 3709 TR-TRBL ON ZONE DUCT DETECTORS SU
10/20/2015 13:16:10 11 2000 RE -RESTORE DUCT DETECTORS SU
10/20/2015 15:09:57 E603 CIE603 IN-RF TRANSMIT TEST zone: 0
CS# U687020907
I'll
NO (S
zoo"
wkx
Page 1 of 1
1113/2015 11:13 am
7(6A-J-- 1�7Z:?p
Event History Report
Page I of 2
CS# First to Last
Dates 10/2912015 00:00 to 10/29/2015 23:59
Corp Account# All On Test? Y
Site# 46717324
Event Class All
Reporting
Group All
Open/Close? N
Affiliation All In Service? Y
Date
Zone
Operator Event
Description
Zone Comment Additional
Info User
Comment
CS# U687020907
Site Name PRESTIGE CARE
Address 21008 76TH AVE W
EDMONDS, WA 98026-7105 A1lt#
10/29/2015 12:37:21 pm
IWA ONTEST
OA-Place on Test
Cat: 1 sean olson with fire prot inc had cs # Expires:
10/29/2015 18:00:00 All Zones
10/29/2015 12:40:23 pm
0
01
US -UNDEFINED SIGNAL
10/29/2015 12:41:08 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET
CONTROL
10/29/2015 12:41:10 pm
0
2000
RE -RESTORE
10129/2015 12:41:14 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET
USER1
10129/2015 12:44:47 pm
9
3123
SU-FIRE SUPERVISORY
KITCHEN HOOD
10/29/2015 12:49:43 pm
9
2000
RE -RESTORE
KITCHEN HOOD
10/29/2015 12:49:46 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET
CONTROL
10/29/2015 12:51:09 pm
9
3123
SU-FIRE SUPERVISORY
KITCHEN HOOD
10/29/2015 12:57:05 pm
9
2000
RE -RESTORE
KITCHEN HOOD
10/29/2015 12:57:09 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET
CONTROL
10/29/2015 12:57:45 pm
2E320
CIE320
TR-SNDR/RELAY TRIBIL
10/29/2015 1:03:56 pm
2
2000
RE -RESTORE
FACP PULL STATION
10/29/2015 1:03:58 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET
CONTROL
10/29/2015 105:45 pm
2
45
FA -FIRE -MANUAL PULL
FACP PULL STATION
10/29/2015 109:13 pm
2
2000
RE -RESTORE
FACP PULL STATION
10/29/2015 109:17 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET
CONTROL
10129/2015 109:19 pm
2
45
FA -FIRE -MANUAL PULL
FACP PULL STATION
10/29/2015 1.10:14 pm
2
2000
RE -RESTORE
FACP PULL STATION
10/29/2015 1-10:18 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET
CONTROL
10/2912015 1 10:20 pm
2
45
FA -FIRE -MANUAL PULL
FACP PULL STATION
10/29/2015 1 10:50 pm
2
2000
RE -RESTORE
FACP PULL STATION
10/29/2015 1.10:52 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET
CONTROL
10/29/2015 1:12:49 pm
2
45
FA -FIRE -MANUAL PULL
FACP PULL STATION
10/29/2015 1:13:25 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET
CONTROL
10/29/2015 1:13:56 pm
2
2000
RE -RESTORE
FACP PULL STATION
10/29/2015 1:13:58 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET
CONTROL
10/29/2015 1:39:09 pm
10
45
FA-FIRE-MANUAIL PULL
RCU PULL STATION
10/29/2015 1:43:37 pm
10
2000
RE -RESTORE
RCU PULL STATION
10/29/2015 1:43:41 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET
CONTROL
10/29/2015 1:44:05 pm
2
45
FA-FIRE-MANUAIL PULL
FACP PULL STATION
10/29/2015 1:52:42 prn
2
2000
RE -RESTORE
FACP PULL STATION
10/29/2015 1:52:46 prn
O/C
96
OP -OPEN (LOG-LSL)
RESET
CONTROL
10/29/2015 1:53:22 prn
E412
CIE412
IN -PANEL DILL SUCCESEE
10/29/2015 1:53:24 prn
E305
CIE305
RE -SYSTEM RESET
10/29/2015 1:54:00 prn
OQ250
CIE320
TR-SNDR/RELAY TRBL
10/29/2015 1:54:36 pm
OQ250
CIR320
RE-SNDR/RELAY TRBL
10/29/2015 1:55:02 prn
2E320
CIE320
TR-SNDR/RELAY TRBL
10/29/2015 2:30:27 pm
10
45
FA -FIRE -MANUAL PULL
RCU PULL STATION
CS# U687020907 Page I of 2
11/312015 11:13 am
Event History Report
CS# First to Last
Dates 10/29/2015 00:00 to 10/29/2015 23:59 Corp Account# All
Site# 46717324
Event Class All
Reporting Group All Open/Close? N Affiliation All
Date
Zone
Operator Event
Description
Zone Comment Additional Info User Comment
CS# U687020907
Site Name
PRESTIGE CARE
Address 2100876THAVEW EDMONDS,WA 98026-7105
10/29/2015 2:35:56 pm
2
45
FA -FIRE -MANUAL PULL
FACP PULL STATION
10/29/2015 2:36:53 pm
2
2000
RE -RESTORE
FACP PULL STATION
10/29/2015 2:36:55 pm
10
2000
RE -RESTORE
RCU PULL STATION
10/29/2015 2:36:57 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET CONTROL
10/29/2015 2:40:21 pm
2
2000
RE -RESTORE
FACP PULL STATION
10/29/2015 2:40:23 pm
10
2000
RE -RESTORE
RCU PULL STATION
10/29/2015 2:40:27 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET CONTROL
10/29/2015 2:40:56 pm
2
45
FA -FIRE -MANUAL PULL
FACP PULL STATION
10/29/2015 2:42:32 prn
2
2000
RE -RESTORE
FACP PULL STATION
10/29/2015 2:42:36 pm
O/C
96
OP -OPEN (LOG-LSL)
RESET CONTROL
10/1 9/2015 3:08:51 pm
E603
CIE603
IN-RF TRANSMIT TEST
zone: 0
10/29/2015 3:24:52 pm
2E320
CIR320
RE-SNDR/RELAY TRBL
10/29/2015,3:33:10 pm
11
3709
TR-TRBL ON ZONE
DUCT DETECTORS SU
10/29/2015 133:12 pm
11
2000
RE -RESTORE
DUCT DETECTORS SU
CS# U6870204'07
On Test? Y
In Service? Y
Alt#
Page 2 of 2
Page 2 of 2
— John J. Wesffall
From: John J. Westfall
Sent: Friday, October 16, 2015 3:15 PM
To: 'Martin Solorio'
Cc: Karl Fitterer; Kevin Zweber; 'Lawler, Patrick'
Subject: Prestige TCO for FIRE
Martin:
Temporary Certificate of Occupancy (TCO PENDING) items require Tuesday 10/20 a.m. inspection. DFIVI Karl
Fitterer 425.754.4262
Some systems NOT APPROVED have been agreed you will not use during temporary and pushed for final
building approval (CO)
When will the glazing that makes up smoke barriers be installed for CORRIDOR office areas?
BLD20071154 Fire Connection/sprinkler supply FINALED
-DDCA not alarm supervised; secured at lid.
BLD20151303 FA Communicator TCO PENDING
BLD20141295 FA System TCO PENDING
-Verify operation of automatic hold opens for fire doors (CORRIDOR doors, any others?)
-install additional horn/strobe CORRIDOR near #405 because of ceiling reduced visibility.
-Install notification Ws) in EAST STAIRWELL.
-Install smoke/CO combos and notifications and TEST in DINING space.
-Rernove all dust covers left on initiators.
-FACP verified connected to generator.
BLD20141320 Auto Sprinkler System TCO PENDING
-Install heads in DINING space.
-Trim head s/remove tape in CLEAN UTILITY (across 217), SNOHOMISH DEN (across 302), Bathroom
#308.
-Hydraulic placards for risers.
-Sign "FDC" sign/graphic on east exterior column near FDC.
-Sign "AUX DRAINS" (UTILITY rooms BASEMENT & KITCHEN)
BLD20140659 Mech (Fire portions)
-Medical gas NOT APPROVED FOR STORAGE/USE
-Post zone signage for controls in hallways
-TCO compressed oxidizer gas storage/use limited to non -permitted quantity of 502 ft3 (2x5'
cylinders)
-Typelhood NOT APPROVED FOR OPERATION
-Verify fan during cooking operations.
-Damper tests (for FD1, BLDG approval separate) APPROVED
-Generator TCO PENDING
-Post "GENSET DISCONNECT" on switch panel near main entry.
BLD20140465 Kitchen Suppression System NOT APPROVED FOR OPERATION
-Acceptance test:
-Verify shunt trip operation of gas and electrical under hood.
-Verify automatic operation from fusible link
-Verify manual operation from pull
-Verify location of Class K extinguisher.
-Verify operation of hood system activates the building fire alarm.
BLD20140457 Skilled Nursing Building
-Elevator NOT APPROVED FOR USE
-Verify operation of elevator recall and fire protection.
-Delayed egress doors: NOT APPROVED FOR USE
-Illumination & keypad control.
-Alarm/power/manual switch control deactivation.
-EXIT signs/emergency pathway TCO PENDING
-final item: repair or replace EXIT sign from PT room.
-Knox Boxes: TCO PENDING
-Provide permanent keys and key cards if necessary.
-Fire Rated Assemblies: TCO PENDING
-Verify FR labeling/closures where required.
-CORRIDOR Doors with gaskets, automatic closing, magnetic hold operation (FA).
-Extinguishers: TCO APPROVED
-Fire Lane markings TCO APPROVED
John 3. Wesffall
Deputy Chief/Fire Marshal
Fire Prevention Services
425-771-0213 Desk
425-775-7721 Fax
425-231-3644 Mobile
KHOHOM"Vol co
F I R E t" *aw_
DIST-ICT
From: Karl Fitterer
Sent: Friday, October 16, 2015 11:47 AM
To: John J. Westfall
Subject: FW: TCO
Sent from my Windows Phone
TE- TiNG AID C.
SERVICES
PROJECT NO: 15-197
DATE: 10/14/2015
TECHNICIAN: CARLOS LUNA
PRESTIGE.CARE, INC. �
21008.76TH AVENUE WEST
EDMONDS, WA 98026
FIRE SMOKE DAMPER
VERIFICATION REPORT
ARCHITECT:
CARLETTI ARCHITECTS P.S.
116 EAST FIR STREET, SUITE A - MOUNT VERNON, WA 98273
MECHANICAL ENGINEER:
RICE GROUPr INC.
20201 CEDAR VALLEY ROAD, SUITE 120 - LYNNWOOD, WA 98036
MECHANICAL CONTRACTOR:
SMITH MECHANICAL, INC.
6146 PORTAL WAY - FERNDALE, WA 98248
*--' )ep
AIMIRL
AADC
TAC SERVICES, LLC
4811 DESMOND STREET
BELLINGHAM, WA 98229
PH: (360) 224-8555
FAX: (360) 464-9973
ADMIN@TES-rANDC(.COM
10/14/2015
Page 1 of 7
Aidal,
FIRE SMOKE DAMPER
VERIFICATION TEST FORM AANC
TE HO A a Cm
SERVICES
PRESTIGE CARE NURSING HOME
EDMONDS, WA
IS-197
CARLOS LUNA
ACCESS
FSD I.D.
FSD-1
LOCATION
HALLWAY
AREA SEPERATED
HALLWAY
DOOR
(Y/N)
NO
TECH
INITIALS
C.L.
WITNESS
INITIALS
C.E.
DATE
10/14/2015
COMMENTS
FSD-2
HALLWAY
HALLWAY
NO
C.L:
C.E.
10/14/2015
FSD-3
HALLWAY
HALLWAY
NO
C.L.
C.E.
10/14/2015
FSD-4
HALLWAY
HALLWAY
NO
C.L.
C.E.
10/14/2015
FSD-5
HALLWAY
102
NO
C.L.
C.E.
10/14/2015
FSD-6
NURSE STATION
134
NO
C.L.
C.E.
10/14/2015
FSD-7
HALLWAY
141
NO
C.L.
C.E.
10/14/2015
FSD-8
210
209
NO
C.L.
C.E.
10/14/2015
FSD-9
HALLWAY
219
NO
C.L.
C.E.
10/14/2015
FSD-10
HALLWAY
220
NO
C.L.
C.E.
10/14/2015
FSD-11
HALLWAY
220 RR
NO
C.L.
C.E.
10/14/2015
FSD-12
HALLWAY
ROOF
NO
C.L.
C.E.
10/14/2015
FSD-13
HALLWAY
HALLWAY
NO
C.L.
C.E.
10/14/2015
FSD-14
HALLWAY
MEDS
NO
C.L.
C.E.
10/14/2015
FSD-15
HALLWAY
309
NO
C.L.
C.E.
10/14/2015
FSD-16
HALLWAY
313
NO
C.L.
C.E.
10/14/2015
FSD-17
HALLWAY
317
NO
C.L.
C.E.
10/14/2015
FSD-18
CLEAN UTILITY
311
YES
C.L.
C.E.
10/14/2015
FSD-19
CLEAN UTILITY
312
NO
C.L.
C.E.
10/14/2015
FSD-20
SOILED UTILITY
310
NO
C.L.
C.E.
10/14/2015
FSD-21
HALLWAY
405
NO
C.L.
C.E.
10/14/2015
FSD-22
HALLWAY
501
NO
C.L.
C.E.
10/14/2015
FSD-23
HALLWAY
502
NO
C.L.
C.E.
10/14/2015
FSD-24
HALLWAY
409
NO
C.L.
C.E.
10/14/2015
FSD-25
CAFt
CAFt
NO
C.L.
C.E.
10/14/2015
FSD-26
CAFt
ACTIVITY OFFICE
NO
C.L.
C.E.
10/14/2015
FSD-27
CAFt
MULTI PURPOSE
NO
C.L.
C.E.
10/14/2015
FSD-28
ACTIVITY DESK
PHYSICAL THERAPY
NO
C.L.
C.E.
10/14/2015
FSD-29
RECEPTION
RESTROOM
NO
C.L.
C.E.
10/14/2015
FSD-30
MARKETING
ROOF
NO
C.L.
C.E.
10/14/2015
FSD-31
MARKETING
ROOF
NO
C.L.
C.E.
10/14/2015
FSD-32
HALLWAY
MANAGER
NO
C.L.
C.E.
10/14/2015
FSD-33
MANAGER
HALLWAY
NO
C.L.
C.E.
10/14/2015
FSD-34
STORAGE
VACUUM
NO
C.L.
C.E.
10/14/2015
FSD-35
HALLWAY
CIRCULATION HALL
NO
C.L.
C.E.
10/14/2015
FORM ID: FSD VERIFICATION FORM
, m- OS LUNA (SIGNATURE ON FILE) / 10/14/2015
i CA-SE-Y EWALD (SIGNATURE ON FILE) / 10/14/2016
10/14/2015
Page 2 of 7
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SERVIMS
PROJECT NO: 15-197
DATE: 10/14/2015
TECHNICIAN: CARLOS LUNA
PRESTIGE CAREJNC.
1,2*lM-gk7i6lT—iH.rrA7V-Erq�tlE,aW,E&T
EDMONDS, WA 98026
FIRE SMOKE DAMPER
VERIFICATION REPORT
ARCHITECT:
CARLETTI ARCHITECTS P.S.
116 EAST FIR STREET, SUITE A - MOUNT VERNON, WA 98273
MECHANICAL ENGINEER:
RICE GROUP, INC.
20201 CEDAR VALLEY ROAD, SUITE 120 - LYNNWOOD, WA 98036
MECHANICAL CONTRACTOR:
SMITH MECHANICAL, INC.
6146 PORTAL WAY - FERNDALE, WA 98248
10/14/2015
Page I of 7
AANC
TAC SERVICES, LLC
4811 DESMOND STREET
BELLINGHAM, WA 98229
PH: (360) 224-8555
FAX: (360) 464-9973
ADMIN@TESTANDC(.COM
4A FC.wp--
Tt
seav
FIRE SMOKE DAMPER
VERIFICATION TEST FORM
AAfirC
ACCESS
FSD I.D.
FSD-1
LOCATION
AY
AREA SEPERATED
HALLWAY
WAY4
DOOR
(Y/N)
NO
No
TECH
INITIALS
C.L.
WITNESS
INITIALS
C.E.
DATE
10/14/2015
COMMENTS
FSD-2
HALLWAY
WAY
HALLWAY
NO
No
C.L.
C.E.
10/14/201S
FSD-3
HALLWAY
LWAY
HALLWAY
No
NO
C.L.
C.E.
10/14/2015
FSD-4
HALLWAY
HALLWAY
LW Y
AtLA
NO
NO
C.L.
C.E.
10/14/2015
FSD-5
HALLWAY
102
NOE
C.L.
C.E.
10/14/2015
FSD-6
NURSE STATION
134
NO
C.L.
C.E.
10/14/2015
FSD-7
HALLWAY
141
NO
C.L.
C.E.
10/14/2015
FSD-8
210
209
NO
C.L._
C.E.
10/14/201S
FSD-9
HALLWAY
219
NO
C.L.
C.E..
10/14/2015
FSD-10
HALLWAY
220
NO
C.L.
C.E.
10/14/2015
FSD-11
HALLWAY
220 RR
NO
C.L.
C.E.
10/14/2015
FSD-12
HALLWAY
ROOF
NO
C.L.
C.E.
10/14/2015
FSD-13
HALLWAY
HALLWAY
NO
C.L._
C.E,
10/14/2015
FSD-14
HALLWAY
MEDS
NO
C.L.
C.E.
10/14/2015
FSD-15
HALLWAY
309
NO
C.L.
C.E.
10/14/2015
FSD-16
HALLWAY
313
NO
C.L
C.E.
10/14/2015
FSD-17
HALLWAY
317
NO
C.L.
C.E.
10/14/2015
FSD-18
CLEAN UTILITY
311
YES
C.L.
C.E.
10/14/2015
FSD-19
CLEAN UTILITY
312
NO
C.L.
C.E.
10/14/2015
FSD-20
SOILED UTILITY
310
NO
---C.L.
C.E.
10/14/2015
FSD-21
HALLWAY
405
NO
C.L.
C.E.
10/14/2015
FSD-22
HALLWAY
501
NO
C.L.
C.E.
10/14/201S
FSD-23
HALLWAY
502
NO
C.L.
C.E.
10/14/2015
FSD-24
HALLWAY
409
—�Ft
NO
C. L
C.E.
10/14/2015
FSD-25
CAFt
NO
C.L.
C.E.
10/14/2015
FSD-26
CAFt
ACTIVITY OFFICE
NO
C.L.
C.E.
10/14/2015
FSD-27
CAFt
MULTIPURPOSE
NO
C.L.
C -. E-.
10/14/2015
FSD-28
ACTIVITY DESK
PHYSICAL THERAPY
NO
C.L.
C.E..
10/14/201S
FSD-29
RECEPTION
RESTROOM
NO
C.L.
C.E.
10/14/2015
FSD-30
MARKETING
ROOF
NO
C.L.
C.E.
10/14/2015
FSD-31
MARKETING
ROOF
NO
C.L.
C.E.
10/'14/2015
FSD-32
HALLWAY
MANAGER
NO
C.L.
C.E.
10/14/2015
FSD-33
MANAGER
HALLWAY
NO
C.L.
C.E.
10/14/2015
FSD-34
STORAGE
VACUUM
NO
C.L.
C.E.
10/14/2015 T
FSD-35
HALLWAY
CIRCULATION HALL
NO
C.L.
C.E.
10/14/2015 1
FORM ID: FSD VERIFICATION FORM
EWCARLOS LUNA (SIGNATURE ON FILE) / 10/14/201S
CASEY EWALD (SIGNATURE ON FILE) / 10/14/2016
10/14/2015
Page 2 of 7
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r
Kevin ZweLe
From:
John J. Westfall
Sent:
Tuesday, October 13, 2015 10:43 AM
To:
Karl Fitterer
Cc:
Kevin Zweber
Subject:
FW: TCO for prestige
Background on Prestige TCO...
From: Martin Solorio [mailto:MartinS@exxelpacific.com]
Sent: Tuesday, October 13, 2015 10:18 AM
To: John 3. Westfall
Cc: Kevin Zweber; '13jorback, Leif
Subject: RE: TCO for prestige
That's correct, delayed egress will not be working but doors will be fully operational.
Yes we will have a 3 rd party inspector looking at those tomorrow.
Thanks.
EM
PACERIC
C. EN ER -AL WNTILACM RS
Martin Solorio
Superintendent
Presfige Care Edmonds
21008 7e Ave W
Edmonds WA 98026
360 734 2872 Ext. 363
Cell: 360 815 0328
www.exxelpacific.com
From: John 1. Westfall [mailto:iwestfallftfiredistrictl.o[g1
Sent: Monday, October 12, 2015 6:55 PM
To: Martin Solorio
Cc: Kevin Zweber; '13jorback, Leif
Subject: RE: TCO for prestige
Alright.
1) 1 understand that for now, the medical gas or Dewar's storage will not be present. Is that correct?
2) Delayed egress features are not installed
3) Damper testing needs be completed for TCO. May I suggest 3 rd party testing given the urgency?
John
From: Martin Solorio [ma ilto: Marti nSCcbexxel pacific. com
Sent: Monday, October 12, 2015 3:50 PM
To: John J. Westfall
Subject: FW: TCO for prestige
Hi John, were you able to look into this?
Thanks.
EM
PACIRC
CEQU. CONTRY.-MRS
Martin Solorio
Superintendent
Prestige Care Edmonds
21008 76"' Ave W
Edmonds WA 98026
360 734 2872 Ext. 363
Cell: 360 815 0328
www.exxelpacific.com
From: Martin Solorio
Sent: Friday, October 09, 2015 8:24 AM
To: 'John 1. Westfall'; Kevin Zweber
Cc: Bjorback, Leif; TJ Mellema (Um@)exxelpacific.com)
Subject: RE: TCO for prestige
John, thank you for your response.
That is correct, TCO is for furniture installation purposes only, there will be no staff, no cooking and it will be just about a
week before we go for Co.
All of the emergency exits will be working properly with all the signage installed but there will be no delayed egress
engaged with the doors, they simply will open when pushing on the crash bars.
The basement is finished but will not have elevator access, the 2 stairwells will be open, no staff will be operating the
laundry room or using the staff lounge, the vertical separations are in place.
At this point and for TCO purposes the Med gas room will be empty with no gas of any type stored or used in the
building, this issue should be resolved one way or another by the time we obtain CO.
Our intention is to have the fire alarm and fire sprinkler systems tested and inspected by your department on Thursday
th th
October 15 , followed by Building's department inspection for TCO on the 16 , with a re -test on Wednesday October
21't once the elevator gets final inspection and the delayed egress system installed and working; finalizing with the
nd
building department's final inspection for CO on October 22
Please let us know as soon as you can if this is acceptable and I will call the inspection request line to schedule the
inspection.
EM
PACIRC
CENRAL CONIILAC"MRS
Martir-Solorio
Sii peri*nte n d e nt
Prestige r�,are Ed4onds
21008 76" Ave W
Edmonds WA 98026
360 734 2872 Ext. 363
Cell: 360 815 0328
www.exxelpacific.com
From: John 3. Westfall rma i Ito: jwestfa I I 0fired istrict 1. orql
Sent: Thursday, October 08, 2015 5:45 PM
To: Martin Solorio; Kevin Zweber
Cc: Bjorback, Leif
Subject: RE: TCO for prestige
Martin:
Is your TCO for purpose of installing FFE, or for staff/resident integration? You're only asking for a week under
temporary?
Typically, fire protection, detection), separations, exit/emergency lighting, hazard mitigations, fire access features (fire
lane & Knoxbox) must be accepted for fire side of TCO sign off. If you're taking staff and residents we will ask for all of
the patient care features such as FA voice evacuation notification and delayed egress when patients are present. When
only staff, as long as the normal exiting is provided and horn/strobe notification.
Are we cooking during this time? Need hood suppression connected to building and alarm.
Leif shared that you may be working unfinished basement. How are the services (laundry, staff lounge, etc ... ) anticipated
to be accommodated during TCO? How will the separations be maintained vertically?
Lastly, please check the email from Kevin Scarlett @ DOH. The medical gas storage questions and solution must be in
place with the hazard present, Cryogenic oxidizer storage vs. compressed gas storage appears to be the medical gas
question to be answered in the immediate. The proposed Dewar's system appears to require additional protections in
place.
John J. Westfaill
Deputy Chief/Fire Marshal
Fire Prevention Services
425-771-0213 Desk
425-775-7721 Fax
425-231-3644 Mobile
A5111
&VOl'townsff
I E 1,
li&crl
jultult T
From: Martin Solorio [mai Ito: Marti nSOexxelpacific.com]
Sent: Thursday, October 08, 2015 7:49 AM
To: John 1. Westfall; Kevin Zweber
Subject: TCO for prestige
We are looking to get TCO on October 16 Ih for the Prestige Project and I have some questions regarding your
rd
inspections. We will go for final CO on October -23
Do we need to have final fire sprinkler and fire alarm inspections done for TCO?
What are the other requirements for TCO?
Our state elevator inspection will be done on October 21", does the elevator need to be operational for TCO?
Ih
The delayed egress system may not be operating before October 16 , is it required to be for TCO?
Let me know when you get a chance.
Thank you.
C ENEIL-U. CONTU."WLS
Martin Solorio
Superintendent
Presbge Care Edmonds
21008 76"' Ave W
Edmonds WA 98026
360 734 2872 Ext. 363
Cell: 360 815 0328
www.exxelpacific.com
Prestige Care Fire Final Checklist: 10/15/15
2 Fir larm
rlif:y notification devices including external bell orstr Ze�?,
ces
door releases
Elevator recal
\Yrify sequence of operation for different alarm states — mode???
Vify address descriptors to be understandable
Ivure FACP circuit has lock -on device on AC panel
VU re FACP is connected to emergency power system
Y
(Vice Evacuation System lFC 907
:Delayed Egress i tem -
mpers and Duct Detectors —special inspection
Oxygen supply system
Ref DOH emails etc.
u tic Spr r
a prinkler
necessity for FDC ignage
'Is��
Lamper switches at FACP
�j �Fau ic Fcalcs label on 9]'
..syste
fy signage on system---%7
test system (notification
seconds)
Comrr(ercial Cooking Type I Hood
$fi-'unt trip shuts off all electrical and gas under hood
Activation from manual pull (located within 10-20 feet of
Activation from fusible link
Class K extinguisher within 30' of hood
All activations of hood activate fire =S'Vsf�em
t Lighting
A qg6
,Zfo c a 'n, distances, directional arrows
\Jdttery backup or emergency power?
� LIA
s �_fZ41A_y
W_ck-
ko"
07
0
Emergenc ��ess Lights
Adeq,Lpte lighting for egress
oryor
emergency power generator
Knox Box
Master keys
FACP and pull station keys
One complete set, two operational sets
e La marking
"fi<a
�essr ss% th
visibility on the 76 AveSide X/
I ZA
W, 6, wal 11 Raw-, d 4"",
In A
'�'4
M
.5VA S"'Okz'p , 5'pe� VU—Y
Reply Reply All Forward
FW: Delayed egress sign
Bjorback, Leif [Leif.Bjorback@edmondswa.gov]
To: Kevin Zweber
Cc: Westfall, John Uohn.westfall@edmondswa.gov]
Thursday, October 22, 201S 1:15 PM
fyi
From: Lawler, Patrick
Sent: Thursday, October 22, 2015 1:12 PM
To: 'Martin Solorio'
Cc: Bjorback, Leif
Subject: RE: Delayed egress sign
I discussed the proposed sign location with Leif, building official. As far as the building code is concerned, we
have no issues with locating the signs adjacent to the -affected doors. The Fire Marshall will have the last say on
the matter though, so I would recommend waiting until Kevin has a chance to see the mock-up on Monday prior
to permanent installation. I would also suggest that "Emergency Egress Only" signs be considered for those
locations.
From: Martin Solorio rmailto:MartinS(�)exxeli)acific.com
Sent: Thursday, October 22, 2015 9:40 AM
To: Zweber, Kevin (Fire District Address); Westfall, John (Fire District Address); Fitterer, Karl (Fire District Address);
Lawler, Patrick; Bjorback, Leif
Subject: CO
We are going to go for CO on October 27th rather than tomorrow.
Thank you.
(i F-\'FXM. CONTRACrORS
Martin Solorio
Superintendent
Prestige Care Edmonds
21008 761h Ave W
Edmonds WA 98026
360 734 2872 Ext. 363
Cell: 360 815 0328
www.exxelpacific.com
Kevin Zweber
From: John J. Westfall
Sent: Tuesday, October 13, 2015 10:39 AM
To: 'Martin Solorio'
Cc: Kevin Zweber;'Biorback, Leif
Subject: RE: TCO for prestige
Great.
Bear with us, there is a lot of demand on our time at this juncture.
John
From: Martin Solorio [mailto:MartinS@exxelpacific.com]
Sent: Tuesday, October 13, 2015 10:18 AM
To: John 1. Westfall
Cc: Kevin Zweber; 'Bjorback, Leif
Subject: RE: TCO for prestige
That's correct, delayed egress will not be working but doors will be fully operational.
Yes we will have a 3 rd party inspector looking at those tomorrow.
Thanks.
EM
PACIRC
CFNERM. CONTRACTORS
Martin Solorio
Superintendent
Presfige Care Edmonds
21008 76�h Ave W
Edmonds WA 98026
360 734 2872 Ext. 363
Cell: 360 815 0328
www.exxelpacific.com
From: John 3. Westfall [mailto:iwestfall@firedistrictl.orQ]
Sent: Monday, October 12, 2015 6:55 PM
To: Martin Solorio
Cc: Kevin Zweber; '13jorback, Leif
Subject: RE: TCO for prestige
Alright.
1) 1 understand that for now, the medical gas or Dewar's storage will not be present. Is that correct?
2) Delayed egress features are not installed
3) Damper testing needs be completed for TCO. May I suggest 3 Id party testing given the urgency?
John
From: Martin Solorio [mailto:MartinSOexxelpacific.com]
Sent: Monday, October 12, 2015 3:50 PIVI
To: John 1. Westfall
Subject: FW: TCO for prestige
Hi John, were you able to look into this?
Thanks.
r7-7 #0
CENEU. CONTIMC17ORS
Mailin Solorio
Superintendent
PresUge Care Edmonds
21008 76�' Ave W
Edmonds WA 98026
360 734 2872 Ext. 363
Cell: 360 815 0328
www.exxelpacific.com
From: Martin Solorio
Sent: Friday, October 09, 2015 8:24 AM
To: 'John 1. Westfall'; Kevin Zweber
Cc: Bjorback, Leif; TJ Mellema (UmC@exxeloacific.com)
Subject: RE: TCO for prestige
John, thank you for your response.
That is correct, TCO is for furniture installation purposes only, there will be no staff, no cooking and it will be just about a
week before we go for Co.
All of the emergency exits will be working properly with all the signage installed but there will be no delayed egress
engaged with the doors, they simply will open when pushing on the crash bars.
The basement is finished but will not have elevator access, the 2 stairwells will be open, no staff will be operating the
laundry room or using the staff lounge, the vertical separations are in place.
At this point and for TCO purposes the Med gas room will be empty with no gas of any type stored or used in the
building, this issue should be resolved one way or another by the time we obtain CO.
Our intention is to have the fire alarm and fire sprinkler systems tested and inspected by your department on Thursday
th th
October 15 , followed by Building's department inspection for TCO on the 16 , with a re -test on Wednesday October
21't once the elevator gets final inspection and the delayed egress system installed and working; finalizing with the
d
building department's final inspection for CO on October 22"
Please let us know as soon as you can if this is acceptable and I will call the inspection request line to schedule the
inspection.
77 �7-- 1 P,
CE.-NMU. CONMACTORS
Martin Solorio
Superintendent
Presfige Care Edmonds
2100876 1h Ave W
Edmonds WA 98026
360 734 2872 Ext. 363
Cell: 360 815 0328
www.exxelpacific.com
From: John 1. Westfall [mailto:jwestfall0firedistrictl.org]
Sent: Thursday, October 08, 2015 5:45 PM
To: Martin Solorio; Kevin Zweber
Cc: Bjorback, Leif
Subject: RE: TCO for prestige
Martin:
Is your TCO for purpose of installing FFE, or for staff/resident integration? You're only asking for a week under
temporary?
Typically, fire protection, detection), separations, exit/emergency lighting, hazard mitigations, fire access features (fire
lane & Knoxbox) must be accepted for fire side of TCO sign off. If you're taking staff and residents we will ask for all of
the patient care features such as FA voice evacuation notification and delayed egress when patients are present. When
only staff, as long as the normal exiting is provided and horn/strobe notification.
Are we cooking during this time? Need hood suppression connected to building and alarm.
Leif shared that you may be working unfinished basement. How are the services (laundry, staff lounge, etc ... ) anticipated
to be accommodated during TCO? How will the separations be maintained vertically?
Lastly, please check the email from Kevin Scarlett @ DOH. The medical gas storage questions and solution must be in
place with the hazard present, Cryogenic oxidizer storage vs. compressed gas storage appears to be the medical gas
question to be answered in the immediate. The proposed Dewar's system appears to require additional protections in
place.
John J. Wesffall
Deputy Chief/Fire Marshal
Fire Prevention Services
425-771-0213 Desk
425-775-7721 Fax
425-231-3644 Mobile
. ANQ�l
FINOROMIS11 Co. wit
From: Martin Solorio [mai Ito: Marti nS@exxel pacific.com]
Sent: Thursday, October 08, 2015 7:49 AM
To: John 1. Westfall; Kevin Zweber
Subject: TCO for prestige
We are looking to get TCO on October 16 th for the Prestige Project and I have some questions regarding your
rd
inspections. We will go for final CO on October 23
Do we need to have final fire sprinkler and fire alarm inspections done for TCO?
What are the other requirements for TCO?
Our state elevator inspection will be done on October 21", does the elevator need to be operational for TCO?
th
The delayed egress system may not be operating before October 16 , is it required to be for TCO?
Let me know when you get a chance.
Thank you.
EM
PACK
(;F-\'FJbkL CONTRACrURS
Martin Solorio
Superintendent
Presfige Care Edmonds
21008 7e' Ave W
Edmonds WA 98026
360 734 2872 Ext. 363
Cell: 360 815 0328
www.exxelpacific.com
-4
John J. Wesffall
I
From: John J. Westfall
Sent: Thursday, October 08, 2015 5:33 PM
To: 'Scarleft, Kevin A (DOH)'; Randy Hinton; David Wilson
Cc: Tj Mellema; Martin Solorio; Paul Rasmussen; Pete; Bjorback, Leif; Kevin Zweber
Subject: RE: 13-625 Prestige Edmonds Med Gas question on 2 hour enclosure 10-7-15
Kevin thanks for the conference with Leif today.
A discussion I had last year with Paul Goto was regarding the "indirect" heated medical gas enclosure. IMC and NFPA 99
seemed at odds for heating medical gas space. The mechanical plans may have been approved allowing building supply
for indirect heating. According to Kevin and NFPA 99, the fuel -fired building system would not work for the oxidizing gas
storage area, that supply must be routed directly from exterior and the typical heating are radiant fixtures local to
medical gas to create a separate space, esp. if we're tripping the H3 using Dewar's. At that time city opted for the more
specific (medical) NFPA 99 requirements, but it may be that mechanical configuration may not work due to this indirect
heating requirement Kevin lists below. Please re -check the configuration for medical gas heating at this location.
lohn I Westfaill
Deputy Chief/Fire Marshal
Fire Prevention Services
425-771-0213 Desk
425-775-7721 Fax
425-231-3644 Mobile
lw� /
BNOWMIZI co Affia
DWF I &W V
.tV
T I
T
From: Scarlett, Kevin A (DOH) [mailto:Kevin.Scariett@DOH.WA.GOV]
Sent: Thursday, October 08, 2015 2:11 PM
To: Randy Hinton; David Wilson
Cc: Tj Mellema; Martin Solorio; Paul Rasmussen; Pete; Bjorback, Leif; John 3. Westfall
Subject: RE: 13-625 Prestige Edmonds Med Gas question on 2 hour enclosure 10-7-15
Randy,
The category of Cryogenic Oxidizing does not apply here. Actually we consider the product from
Dewars the Hazard, not the contents of the compressed tank, therefore a Dewar in a Health Care
Application/Use will always be in it's expansive form. Oxygen Dewars (depending on mfr) will range
from 4500cf to 5500cf of this oxygen expanded gas volume.
The 1 hr room separation requirement in N FPA 99 is overridden by N FPA 1 (1 FC) exempt Table
5003. 1.1 (1) under Oxidizing Gas takes you to an H-3 when you exceed 3000cf. This occupancy Sep
is 2hr from H-3 to 1-2.
Ps - Re: heat sources for this space ... from NFPA 99 ......... other indirect means" includes, electric/oil
fin tube*, radiant panels*, light bulbs*
* no exposed elements (electric resistant elements) and fixture carries a UL listing. Example: fixture
with all electrical elements sealed within the unit as part of the UL listing.
Thank you,
Kevin A. Scarlett, RA, HFDP
Senior Plans Reviewer - Construction Review Services - Hours: M-Th 6:00am - 4:30pm
RA - Registered Architect - Washington State License
HFDP - ASHRAE Certified Healthcare Facility Design Professional
Washington State Department of Health
360-236.2949 Desk/Direct
253.355.6237 Personal Cell
360.236.2944 Main Office -General
Public Health - "Always working for a safer and healthier Washington
http://www.doh.wa.gov/crs
Check project status by going to our website via 'ctrl+click' (you only need to enter the pro*ect number and click
'search'). hftps://fortress.wa.gov/doh/constructionreviewsearch/
77his mc,%vsa1(,4, 11111Y h('0)11fldL'111i0I. If'YOU /I - V MiS111k.". J)ILWSC;101�f�' thCAL71(krand delele thc nies.sage. All me�ysages to and
ftom the Depat-ilnent offlealth mu), he disclosed to the public.
Notice on Interpretations: This correspondence is not a formal interpretation issued pursuant to the applicable licensing regulations,
and does not necessarily represent the official position of the Department of Health. In addition, this correspondence is neither
intended, nor should be relied upon, to provide professional consultation or services.
From: Randy Hinton [mailto:rhintonCdricegroup.coml
Sent: Thursday, October 08, 2015 1:11 PM
To: Scarlett, Kevin A (DOH); David Wilson
Cc: Tj Mellema; Martin Solorio; Paul Rasmussen; Pete; Bjorback, Leif; jwestfallMedistrictI.org
Subject: RE: 13-625 Prestige Edmonds Med Gas question on 2 hour enclosure 10-7-15
Kevin,
Per our conversation (and for my understanding), the IFC states that we can have 90 lbs of cryogenic oxidizer liquid in a
1-hour room if sprinklered. And no applicable maximum for cryogenic oxidizing gas per Table 5003. This is not to
disregard your stance on NFPA 99 but to clarify that the IFC takes a different look at the "state" of the oxygen and in our
case we would be liquid with the Dewars.
Furthermore, the 1999 NFPA 99 for over 3,000 cubic feet says the room must be 1-hour rated (see attached).
I want to make sure that all of the information is on the table. I know you are busy but a quick response will be helpful
in moving forward.
Thank you,
Randy Hinton
425-774-3829
From: Scarlett, Kevin A (DOH) [mailto:Kevin.Scarlett@DOH.WA.GOV
Sent: Thursday, October 08, 2015 12:06 PM
To: David Wilson <david@carlettiarchitects.com>
Cc: Tj Mellema <tim@exxelpacific.com>; Martin Solorio <MartinS@exxelpacific.com>; Paul Rasmussen
<Prasmussen@prestigecare.com>; Pete <peter@carlettiarchitects.com>; Bjorback, Leif
<Leif. Bffiorback@ed mondswa.gov>; Randy Hinton <rhinton@ricegroup.com>; *westfall@firedistrictl.org
Subject: RE: 13-625 Prestige Edmonds Med Gas question on 2 hour enclosure 10-7-15
David,
Yes, If you use (or intend to use) Dewars, the room must be 2hr (this room becomes an H-3
occupancy).
You will need to submit to me (DOH) and Leif (City) for approval.
Please note a few particulars (items you must provide) regardless of what direction you take;
1) all room electrical outlets and switches must be above 5ft.
2) ventilation - the SA & EA for this room must be dedicated and protected to the
exterior (1 hr for 1-2 & 2hr for H-3). Therefore you will need to wrap the supply and
exhaust duct continuous to the exterior. Dampers are not permitted.
3) verify room is heated to above freezing. This is generally done with a small oil/fin
tube or radiant panel, but, it must be dedicated to this room.
The section I was talking with Randy Hinton (Rice Group) about follows here, and doesn't really help
this application much. It is a Code Commentary from NFPA 55 relative to the 20,000cf limit for'room
within the building'.
4 35, uompressea uases ana uryogenic t-tuicis L;oae Uy, requires mar DuiK sysiems De iocarea eirner ouraoors or in a Duliving usea c
)se. Because S. 1.3.3.1.9 requires that locations storing more than 566,335 L (ZO.00�0)_,qf oxygen comp ith NFPA 5 the maximE
jy!W_
on that can be stored inside a health care facility is 566,335 L (20,000 W)i
R is a tendency to use this number as the sole test of a bulk gas installation, which is not really the intent. To protect the operator, any
ded with a stationary tank of liquefied gases should be installed following these rules insofar as Dossible. The hazards are common to
mary liquid installation and are not unique to those aboveT
in this edition are limitations on the sizes of gases other than oxygen and nitrous oxide. Any installation with more than 5L6,335 L (LO,
Your design team is always welcome to contact NFPA for a formal interpretation and direction.
Anyway, as you know, I sit on four NFPA Code Committees and my interaction with these NFPA folks
is somewhat continuous.
That said, specifically re: Dewars, I've already done that .... years ago and updates a couple times
each year (when the issue is encountered) and as recent as this morning talking with the past NFPA
99 Chair (for over a decade) on Med Gas. Dave Mohile said, nope, nothing's changed, a Dewar is
figured at 4500cf to 5500cf depending on mfr. He went on to say the reason NFPA has always used
the expanded volume is the code is the purpose of limiting/guarding against the ability/capacity to
fuel/feed/accelerate a fire.
A somewhat separate issue, but, should be remembered, the tanks tend to 'off gas' a lot, so you will
have more accelerant in the room than with standard H cylinders.
Also, since there is no requirement for piped Med Gas in this Facility, you may de -couple this
room/issue from the main project (Leif agrees). HOWEVER, you will need to contact us both relative
to the particulars of required separate submittals and the current Med Gas system. In short, it can be
done, but we both have requirements for this type of thing and you need to contact us directly to
ascertain the particulars.
I believe you have our contact information, please inform us of your intended direction.
Thank you,
Kevin A. Scarlett, RA, HFDP
Senior Plans Reviewer - Construction Review Services - Hours: M-Th 6:00am - 4:30pm
RA - Registered Architect - Washington State License
HFDP - ASHRAE Certified Healthcare Facility Design Professional
Washington State Department of Health
360.236.2949 Desk/Direct
253.355.6237 Personal Cell
360.236.2944 Main Office -General
Public Health - "Always working for a safer and healthier Washington
hftp://www.doh.wa.gov/crs
Check project status by going to our website via 'ctrl+click' (you only need to enter the proiect number and click
I search'). hftps://fortress.wa.gov/doh/constructionreviewsearch/
Thi-V Mil I'll(! (..W?fld011iU1. 16'011 t-CCeived it h), mistake, please nnlyj- the sender and delcte the MCSSM'C. -111 messages to and
firom the Depurtment qflleallh maj; bedisclosed to the PlthliC.
Notice on Interpretations: This correspondence is not aformal interpretation issued pursuant to the applicable licensing regulations,
and does not necessarily represent the official position of the Department of Health. In addition, this correspondence is neither
intended, nor should be relied upon, to provide professional consultation or services.
From: David Wilson [mailto:david(&cariettiarchitects.com]
Sent: Wednesday, October 07, 2015 4:49 PM
To: Scarlett, Kevin A (DOH)
Cc: Tj Mellema; Martin Solorio; Paul Rasmussen; Pete
Subject: RE: 13-625 Prestige Edmonds Med Gas question on 2 hour enclosure 10-7-15
Kevin,
Just to clarify this is if we have to provide the 2 hour wall. It is our understanding that the Rice Group still feels that the
1 hour wall meets the requirement of the code for this med gas room with the Dewars Tanks. Again it is our
understanding that you were going to forward on some code sections of why you feel that the med gas room needs to
be a 2 hour enclosure. We want to be absolutely sure before we have Prestige go to the expense of providing a 2 hour
room enclosure if the 1 hour enclosure is acceptable.
Thanks for time,
David Wilson
Project Manager
CARLMI
ARcHrTECTS P.S.
ARCHMMRE, INTERIOR DESIGN, & PMNING
www.carleftiarchitects.com
Ph: 360-424-0394 ext. 104
From: Scarlett, Kevin A (DOH) [mailto:Kevin.ScarlettC@DOH.WA.GO
Sent: Wednesday, October 07, 2015 3:49 PM
To: David Wilson
Cc: Tj Mellema; Martin Solorio; Paul Rasmussen
Subject: RE: 13-625 Prestige Edmonds Med Gas question on 2 hour enclosure 10-7-15
David,
Yes this will work. You will need to pay close attention to the wall to ceiling detail and arrange
penetration protection (dampers).
Alsd, this needs to go to Leif at the City ... but, I think he will be pretty quick on this .... we discussed it
this morning.
Thank you,
Kevin A. Scarlett, RA, HFDP
Senior Plans Reviewer - Construction Review Services - Hours: M-Th 6:00am - 4:30pm
RA - Registered Architect - Washington State License
HFDP - ASHRAE Certified Healthcare Facility Design Professional
Washington State Department of Health
360.236.2949 Desk/Direct
253.355.6237 Personal Cell
360.236.2944 Main Office -General
Public Health - "Always working for a safer and healthier Washington"
hftp://www.doh.wa.-gov/crs
Check project status by going to our website via 'ctrl+click' (you only need to enter the project number and click
Isearch'). hftps://fortress.wa.gov/doh/constructionreviewsearch/
This message tmi.i. hL' C0t1fl11011i1J1. I(YOU I-CLVi1Vd it hV 111iStake, /dCUSC 120fili. thL' Sell(ILT Lohl LICIL'It! the HICSS(Il"t.' AII tnesso�gvs it) and
fi,om the Deparitnent qf flealth mti.v , be disclused to the public.
Notice on Interpretations: This correspondence is not oformal interpretation issued pursuant to the applicable licensing regulations,
and does not necessarily represent the official position of the Department of Health. In addition, this correspondence is neither
intended, nor should be relied upon, to provide professional consultation or services.
From: David Wilson [mailto:david@carlettiarchitects.com
Sent: Wednesday, October 07, 2015 2:59 PM
To: Scarlett, Kevin A (DOH)
Cc: Tj Mellema; Martin Solorio; Paul Rasmussen
Subject: 13-625 Prestige Edmonds Med Gas question on 2 hour enclosure 10-7-15
Kevin,
Concerning Prestige Care Edmonds Med Gas:
If we changed the walls to 2 hour per the attached GA file #, and the ceiling of the med gas room to 2 hour per attached
GA File #, and the doors to 2 hour could we keep the "FUTURE" Dewars system and avoid running the 2 hour walls all
the way to the bottom of the roof deck above. Seems like this would meet the code. See attached GA File # options and
sketch of the location of the 2 hour enclosure.
Let us know ASAP if this is an option.
Thanks,
David Wilson
Project Manager
CARLErn
ARCHrrECTS P.S.
AROIMOURF, INTERIOR DESIGN, & MNNING
www.carleffiarchitects.com
Ph: 360-424-0394 ext. 104
John J. Westfall
From:
John J. Wesffall
Sent:
Friday, September 26, 2014 10:27 AM
To:
'Paul Goto'
Cc:
'13jorback, Leif
Subject:
RE: Prestige Care Med Gas
Paul:
I want to let you know Leif and I have had discussion with DOH on prescriptive requirements for medgas system,
specifically, the space heating requirements and supply/exhaust allowances. The city will deferring conflicting
requirements to NFPA 99/101 from IMC/IFC, as they are more specific with your care facility design. Alldepartments
approve of the Mechanical submittal and you should be able to pickup permit from Linda or Kristin.
Thank you,
John
From: Paul Goto [mailto:paulg@ricegroup.com]
Sent: Thursday, September 18, 2014 2: 11 PM
To: John 1. Westfall
Cc: '13jorback, Leif
Subject: RE: Prestige Care Med Gas
No problem. It is good that you are busy.
Let me know if you have any questions. It is a little difficult when different sectors ask for different things.
Thank you,
Paul Goto, E.I.T.
R I C E Group, Inc.
Mechanical Consulting Engineers
p. 425.774.3829 x-203
f. 425.672.2084
20201 Cedar Valley Road, Suite 120
Lynnwood, WA 98036
www.ricegroup.com
From: John J. Westfall [mailto:�westfall@firedistrictl.org]
Sent: Thursday, September 18, 2014 10:39 AM
To: 'paulg@ricegroup.com'
Cc: 'Bjorback, Leif'
Subject: RE: Prestige Care Med Gas
Hi Paul:
We're sorry for delays on this, we have a lot of projects coming due.
We'll be back soon on the items.
John
1
From: Westfall, John [ma i Ito: joh n.westfa 11 ccbed mondswa. go
Sent: Wednesday, September 10, 2014 7:37 AM
To: John J. Westfall
Subject: FW: Prestige Care Med Gas
From: Paul Goto [mailto:r)aulq@ricegroul).com]
Sent: Tuesday, September 09, 2014 5:58 PM
To: Westfall, John; Bjorback, Leif
Subject: RE: Prestige Care Med Gas
Hi John,
I was out of the office this morning, so I apologize for not getting back to you right away.
The "indirect heating" requirement comes from NFPA99 1999 edition which is what the DOH uses for regulations.
Section 4-3.1.1.2 Storage Requirements #10 g. Heating shall be by steam, hot water, or other indirect means. Cylinder
temperatures shall not exceed 130 degrees F.
If we bring in 100% OSA into the room. We would then need to heat the air during the winter because we would
potentially be bringing in 18 degree air. We do not have steam, and the only hot water is for domestic use. You are
correct with the code stating that the supply duct should come from the outside. We have done this in the past and it
has not had an issue. This is our way of getting outside air into the space while still providing the indirect means of
heat.
This may be something that we will need to have a phone conversation about. I want to comply with what you are
looking for, and also with what DOH will be requiring as well.
Thank you,
Paul Goto, E.I.T.
R I C E Group, Inc.
Mechanical Consulting Engineers
p. 425.774.3829 x-203
f. 425.672.2084
20201 Cedar Valley Road, Suite 120
Lynnwood, WA 98036
www.ricegroup.com
From: Westfall, John [mailto:"ohn.westfall@edmondswa.gov]
Sent: Tuesday, September 09, 2014 9:48 AM
To: Bjorback, Leif; 'paulg@ricegroup.com'
Subject: RE: Prestige Care Med Gas
Here's the complete thought, thanks.
From: Westfall, John
Sent: Tuesday, September 09, 2014 9:42 AM
To: Bjorback, Leif
Cc'-' 'paulg@ricegroup.com'
Subject: RE: Prestige Care Med Gas
Paul:
Although oxygen is non-flammable, the presence of oxygen will increase the combustion hazard directly related to
increased concentrations. This is a reason why IFC regulates medical gases, oxygen and oxidizing gases as hazardous
materials that must be treated more carefully than indoor air.
I have two questions:
1) Where does the "indirect heating" requirement come from? This is an interior space is why we can't use
exterior room prescription, but all spaces are heated below and at sides. Oxygen or medical gases will not freeze
in this application and the interior room is not living space.
2) As I read your excerpt from 5306.2.2 below, I've highlighted in yellow below a prescription that is not being met:
that with the supply air coming from the "exterior".
Lastly, Leif and I had been through the justification you make in closing. I trust there will be conditions where the gas
could backfill the interior spaces, I have seen many "never happens" occur.
Our take from fire and building codes is that both supply and vent goes to/comes from the exterior, then is the challenge
where to site the exhaust away from intake and any other intakes above.
Please respond.
John J. Westfall
Fire Marshal
Fire Prevention Services
425-771-0213 Desk
425-775-7721 Fax
425-231-3644 Mobile
SN10HOMI$11 co,
F I 'RD E
DI.S."AFRI'VT
From: Bjorback, Leif
Sent: Monday, September 08, 2014 2:12 PM
To: Westfall, John
Subject: FW: Prestige Care Med Gas
John, you good with this?
From: Paul Goto [mailto:paulqftricegrour).coml
Sent: Monday, September 08, 2014 2: 11 PM
To: Bjorback, Leif
Subject: Prestige Care Med Gas
Leif,
It has been common for us to take a supply duct from the main heating and cooling unit to the medical gas storage
room. This way, we are not adding more equipment to maintain the indirect heating of the room. This is the section
from the 2012 international fire code.
5306.2.2 One -hour interior room.
When an exterior wall cannot be provided for the room, automatic sprinklers shall be installed within the room. The
room shall be exhausted through a duct to the exterior. Supply and exhaust ducts shall be enclosed in a 1-hour-rated
shaft enclosure from the room to the exterior. Approved mechanical ventilation shall comply with the International
Mechanical Code and be provided at a minimum rate of I cubic foot per minute per square foot [0.00508 M3/(S. M2)] Of
the area of the room.
Only oxygen is being stored in this room, and it is not flammable, or toxic. If a 250 Cubic foot tank has a leak and back
pressures the supply duct, the oxygen will have no adverse effects on the people in the hallway or other surrounding
areas. The room is 4.5' by 9' and the ceiling is 8 feet tall. This is 324 cubic feet, so if a tank leaks all of its contents, it will
not fill the room.
Please let me know if you have any other questions.
Thank you,
Paul Goto, E.I.T.
R I C E Group, Inc.
Mechanical Consulting Engineers
p. 425.774.3829 x-203
f. 425.672.2084
20201 Cedar Valley Road, Suite 120
Lynnwood, WA 98036
www.ricep,roup.com
CE9� -0- (��
EPIr-WEERING August4,2014
John Westfall, Fire Marshal
City of Edmonds
1215 th Ave N
Edmonds, WA 98020
RE: BLD2014-04S7CIVILS21008
Project Name: Prestige Care
Project Address: 21008 76 th Ave W
DearJohn,
AUG 0 6 2014
BVILDING DEPARTMENT
CITY OF EDMONDS
Itemized below is our response to the plan review memo dated July 24,2014 for the above referenced
project. Our responses appear In bold.
1. 1 understand that Engineering Division has requested plan specifically for fire supply line and
appurtenances. Fire Prevention Services will like to review the proposal for location and configuration of
FDC, PIV, and DCDA vault.
Refer to C4.1 Sheet.
2. Provide make& model for WA State DOH -approved DCDA.
Provided with OCIDA detail on Sheet C4.2
3. Add COE Engineering details E.7.8 and E.7.8.1:
Details added.
4. Show designated fire lanes on civils &/or site plan. Designated FIRE LANE should continue along the east
side access road continuing only to the main entry doors at the south side of building. Provide yellow
paint on curb face, or 4" bars on asphalt with black FIRE LANE — NO PARKING message alternating every
50'. Fire lane will not continue over storm water vault.
Fire lane depicted on architectural site plan. Note regarding painted curb and fire lane message
added to C4.1 plan In dvil drawings.
5. No detention lid "point" loading requirements in fire lanes due to single story design, use HS-20 "live"
loading for regular traffic loads.
Noted.
If you have any questions or comments regarding the responses, please do not hesitate to call.
Sincerely,
tCG gineering
GreG len, PE SE Principal
'C
Westfall, John
From: Westfall, John
Sent: Tuesday, October 14, 2014 5:08 PM
To: Startzman, Jeanne
Cc: Zweber, Kevin
Subject: RE: Fawcett Records Request Rcv'd 10-13-14
Attachments: 20141014163319.pdf
Request Received: Oct 13, 2014
Request (Summary): Hazmat incidents 21008 76 th Ave W
Jeanne:
The Edmonds Department of Fire Prevention office has address file for 21008 76 th Ave W, an assisted living facility.
2100876 th Ave W: No hazardous material incidents were found in address file information.
I have found two emergency response incident reports in FD1 incident database since 1/1/2007, attached, consisting of 1) natural gas leak and 2)
paint overspray event.
This satisfies all available information requested by attached request.
John I Westfall
Fire Marshal
Fire Prevention Services
425-771-0213 Desk
425-775-7721 Fax
425-231-3644 Mobile
I
SNOHOMISH CO
F I RE
DISTRET
From: Startzman, Jeanne
Sent: Monday, October 13, 2014 11:54 AM
To: Westfall, John
Cc: Zweber, Kevin
Subject: Fawcett Records Request Rcv'd 10-13-14
Hi FDI,
Attached is a records request for hazardous materials incidents at 21008 — 76 th Ave W.
Our response is due October 20th; please let me know if you will need a date extension.
Thanks,
Jeanne S.
Public Disclosure & Records Maintenance Specialist
City of Edmonds 0 425-775-2525 ext. 1244
From: Della Fawcett [mailto:DFawcett(�)landauinc.com]
Sent: Monday, October 13, 2014 9:54 AM
To: Records Requests
Subject: Public Records Request
Hello,
Please find attached my Public Records Request.
Thank you,
Delia Fawcett * Senior Project Geologist
Landau Associates, Inc.
333 SW 5"' Avenue, Suite 700, Portland, OR 97204
(503) 542-1080 * fax (503) 542-1081
dfawcettalandauinc.com * www.landauinc.com
Landau Associates is proudly carbon -neutral through our sustainable practices and financial support of U.S.-based carbon -reduction projects.
NOTICE: This communication may contain privileged or other confidential information. If you have received it in error, please advise the sender by reply email and immediately delete the
message and any attachments without copying or disclosing the contents. Thank you.
I Your Name I Time Spent
,bohn Westfall 160 minutes
7
F_
TOTAL[60 minutes
CITY OF EDMONDS Tracking No.
121 5th Avenue North
Edmonds, WA 98020
425.775.2525 (phone) 425.771.0266 (fax)
Email: prr@edmondswa.gov
(Save completed form to your computer before attaching to email)
REQUEST FOR PUBLIC RECORDS
Date of Request October 13, 2014
Requester Name: Della Fawcett
Requester Address: 333 SW 5th Avenue
Street SuitelApt
700
City State zip
Email Address: Portland, OR 97204
Phone Number: 503-542-1097
Request Made: [] In Person E] In Writing E] Telephone E] Fax R] Email
How would you prefer to be notified when the records are available?
E] In Writing E] Telephone E] Fax F;� Email
DESCRIPTION OF REQUEST:
Be Spec and provide as much detail as possible; include address and owner of property; file name
or number; time period, incident location and date; case number; any other names associated with
your request; etc.):
I am looking for any records regarding fire or hazardous materials incidents at 21008
76th Avenue West, Edmonds, WA.
I agree to pay for any requested copies per the City's adopted fee schedule. Yes R1
Is the information requested a list of individuals to be used for a mailing list for commercial
purposes? Yes [:1 No [Z] If yes, please complete the additional form found on page 3.
"Responses to requests for public records shall be made promptly by agencies, the office of the secretary of the senate, and the
office of the chief clerk of the house of representatives. Within five business days of receiving a public record request, an agency,
the office of the secretary of the senate, or the office of the chief clerk of the house of representatives must respond by either (1)
providing the record; (2) providing an intemet address and link on the agency's web site to the specific records requested, except
that if the requester notifies the agency that he or she cannot access the records through the intemet, then the agency must provide
copies of the record or allow the requester to view copies using an agency computer; (3) acknowledging that the agency, the office
of the secretary of the senate, or the office of the chief clerk of the house of representatives has received the request and providing
a reasonable estimate of the time the agency, the office of the secretary of the senate, or the office of the chief clerk of the house of
representatives will require to respond to the request; or (4) denying the public record request. In acknowledging receipt of a public
record request that is unclear, an agency may ask the requestor to clarify what information the requestor is seeking. ff the requestor
fails to clarify the request, the agency need not respond to it." RCW 42.56.520 (in part)
Page -1-
Incident Report Snohomish County Fire District I
2010-0016631 -000
Basic
Alarm Date and Time
19:44:00 Monday, December 20, 2010
Arrival Time
19:50:00
Controlled Date and Time
Last Unit Cleared Date and Time
19:54:00 Monday, December 20,2010
Response Time
0:06:00
Priority Response
Yes
Completed
Yes
Reviewed
Yes
Fire Department Station
16
Shift
B
Incident Type
745 - Alarm system sounded, no fire - unintentional
Aid Given or Received
N - None
Alarms
I
Action Taken 1
86 - Investigate
Casualties
No
Apparatus - Suppression
I
Personnel - Suppression Personnel
3
Property Use
311 - 24-hour care Nursing homes, 4 or more persons
Location Type
Address
Address
21008 76 AVE W
City, State Zip
Edmonds, WA 98026
District
I
Apparatus - E16
Apparatus ID
E16
Response Time
0:06:00
Apparatus Dispatch Date and Time
19:44:00 Monday, December 20, 2010
En route to scene date and time
19:44:00 Monday, December 20, 20 10
Apparatus Arrival Date and Time
19:50:00 Monday, December 20, 20 10
Apparatus Clear Date and Time
19:54:00 Monday, December 20, 2010
Apparatus priority response
Yes
Number of People
3
Apparatus Use
I
Apparatus Action Taken 1
86 - Investigate
Apparatus Type
I I - Engine
Personnel 1
7909 - Oftedahl, Dennis
Position: CAPT
Personnel 2
8606 - Martin, James
Position: FF/EMT
Personnel 3
0920 - Robinson, Antonio
Position: FF/EMT
Authority
Reported By
7909 - Oftedahl, Dennis
21:44:50 Monday, December 20, 2010
Officer In Charge
7909 - Oftedahl, Dennis
21:45:55 Monday, December 20, 2010
Reviewer
7909 - Oftedahl, Dennis
Page: I Printed: 10/14/2014 16:31:06
Incident Report Snohomish County Fire District 1
2010-0016631 -000
Authority
21:44:56 Monday, December 20, 2010
Narrative Name New Narrative
Narrative Type Incident
Narrative Date 21:42:52 Monday, December 20, 20 10
Author 7909 - Oftedahl, Dennis
Author Rank CAPT
Author Assignment I
Narrative Text E 16 arrived on scene and was met by nursing home staff. A painting company was
painting the physical rehab area. The mist from the paint sprayer set off the alarm. There
was no fire. The system was reset and confirmed by the alarm company. E 16 then
returned.
End of Report
Page: 2 Printed: 10/14/2014 16:31:06
Incident Report
2012-0016728 -000
Snohomish County Fire District I
Basic
Alarm Date and Time
20:51:05 Friday, November 9, 2012
Arrival Time
20:56:48
Controlled Date and Time
Last Unit Cleared Date and Time
21:44:00 Friday, November 9, 2012
Response Time
0:05:43
Priority Response
Yes
Completed
Yes
Reviewed
Yes
Fire Department Station
16
Shift
D
Incident Type
412 - Gas leak (natural gas or LPG)
Initial Dispatch Code
GLI
Aid Given or Received
N - None
Alarms
I
Action Taken 1
86 - Investigate
Action Taken 2
84 - Refer to proper authority
Casualties
No
Apparatus - Suppression
3
Personnel - Suppression Personnel
7
Property Use
311 - 24-hour care Nursing homes, 4 or more persons
Location Type
Address
Address
21008 76 AVE W
City, State Zip
Edmonds, WA 98020
District
I
Map Page
EF206
Apparatus - E16
Apparatus ID
E16
Response Time
0:02:44
Apparatus Dispatch Date and Time
20:51:35 Friday, November 9, 2012
En route to scene date and time
20:54:04 Friday, November 9, 2012
Apparatus Arrival Date and Time
20:56:48 Friday, November 9, 2012
Apparatus Clear Date and Time
21:44:00 Friday, November 9, 2012
Apparatus priority response
Yes
Number of People
3
Apparatus Use
I
Apparatus Action Taken 1
86 - Investigate
Apparatus Action Taken 2
84 - Refer to proper authority
Apparatus Type
I I - Engine
Personnel 1
0808 - Bien, Keith
Position: FF/EMT/I
Personnel 2
0920 - Robinson, Antonio
Position: FF/EMT
Personnel 3
0202 - Dowling, John
Position: CAPTIRR
Apparatus - BC -I 6
Apparatus ID
BC16
Page: I Printed: 10/14/2014 16:34:52
Incident Report
2012-0016728 -000
Snohomish County Fire District I
Response Time
Apparatus Dispatch Date and Time
En route to scene date and time
Apparatus Arrival Date and Time
Apparatus Clear Date and Time
Apparatus priority response
Number of People
Apparatus Use
Apparatus Action Taken I
Apparatus Action Taken 2
Apparatus Type
Personnel I
Apparatus - BC16
0:02:44
20:51:35 Friday, November 9, 2012
20:54:04 Friday, November 9, 2012
20:56:48 Friday, November 9, 2012
21:09:00 Friday, November 9, 2012
Yes
93 - Cancelled en route
84 - Refer to proper authority
9 10 - Battalion Chief unit
8005 - Allison, Steve
Position: BC
Apparatus - E 17
Apparatus ID
E17
Response Time
0:02:56
Apparatus Dispatch Date and Time
20:51:35 Friday, November 9, 2012
En route to scene date and time
20:54:04 Friday, November 9, 2012
Apparatus Arrival Date and Time
20:57:00 Friday, November 9, 2012
Apparatus Clear Date and Time
21:07:00 Friday, November 9, 2012
Apparatus priority response
Yes
Number of People
3
Apparatus Use
I
Apparatus Action Taken 1
93 - Cancelled en route
Apparatus Action Taken 2
84 - Refer to proper authority
Apparatus Type
I I - Engine
Personnel 1
8606 - Martin, James
Position: FF/EMT
Personnel 2
9816 - Hunter, David
Position: CAPT
Personnel 3
9118 - Soucy, Joseph
Position: FF/EMT
Authority
Reported By
0202 - Dowling, John
05:59:11 Saturday, November 10, 2012
Officer In Charge
0202 - Dowling, John
05:59:13 Saturday, November 10, 2012
Reviewer
0202 - Dowling, John
05:59:14 Saturday, November 10, 2012
Narrative Name
Narrative Type
Narrative Date
Author
Author Rank
Narratives
E16
Incident
05:51:45 Saturday, November 10, 2012
0202 - Dowling, John
CAPTIRR
Page: 2 Printed: 10/14/2014 16:34:52
Incident Report
2012-0016728 -000
Snohomish County Fire District I
Narratives
Author Assignment I
Narrative Text (205 1) E 16, along with BC 16 and E 17, responded to the report of a gas leak inside of a
structure. E 16 arrived on scene and made contact with staff who directed our crew back
to the kitchen area. The kitchen area had a light odor of natural gas. E 16 requested a
priority response from PSE. E 16 located a gas stove that had six burners with pilot lights.
Four pilot lights were on and two where out. E 16 secured the gas to this stove and began
natural ventilation. PSE arrived on scene and investigated the the kitchen and found
negligible reading for natural gas. The tech who responded made contact with staff and
advised them that he would "re -light" their stove for them.
End of Report
Page: 3 Printed: 10/14/2014 16:34:52
FACILITY MAINS: SWITCHES, CONTROLS & SHUTOFFS
F
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A 1. Main Water Valve ADA
2. Main Power Panel &
10 Fire Alarm System
3. Main Telephone Panels
4. Automatic Timer - outside
6,0 S Lights
I a 5. Air Compressor for Laundry
6. Laundry Power Panel -
Includes Dishwasher
7. Automatic Timer - Front Sign
17
8. Section Power Panel
9. Kitchen Power Panel
10. Power Panel for Baili_�r &
Water Heater Pumps
15 11. Main Gas Inlet & Met r
12. Section Power Panel
I low.
13. Telephone Section Pane
14. Automatic Timer - Door.
Warning System 1
15. Automatic Timer - Papio Lights
(in bushes)
F_DfVV'0NDs 16. Facility Thermostat
21COO 76TH tV. 17. Telephone Section Pa�el
RRE DOOR 413N. 00O20 18. Section Power Panel
19. Gas Shut-off - Fireplace
FIRE ALARM SO X 11171
lr"2� 1: 1 RE EXIT DOORS
A P% Ra MWT) A-�Gu ISHZP,
Eagle Eye Consulting Engineers, PS
West Coast Code Consultants Company
PO Box 523
01alla, WA 98359
hoytjeter@centurytel.net
206-356-7790
To: Leif Bjorback,
Building Official
City of Edmicinds
Woodinville WA 98072
Re: Prestige Care
Fire Sprinkler Package
2100876 1h Aveniue West
Edmonds, WA 98026
Edmonds Permfit-V-i
EECE#: EDM 14-06
4-1320
?��9LE EYE
NG ENGINEERS
A VV�l Co.st C.d. C.—ftnts C—p—i
Friday, January 2, 2015
The above referenced project is in the process of plan review for compliance with City of
Edmonds ordinances and applicable codes. The following comments,
deficiencies/corrections must be addressed prior to completion of plan review and
subsequent issuance of permits.
Provide revised plans and calculations along with a written response to each of the items
listed below to facilitate a shorter back -check time.
A response to correction must be provided to the citv within 90 days of the date of
this letter or the permit application mav be cancelled without notice.
SCOPE OF REVIEW
The scope of this. review is for the Fire Prevention requirements of this proj ect.
The project was reviewedfor compliance ivith the State of Washington Building Codes.
All features were checked only to the extent allowed by the submittals provided. All
portions of this project are assumed to meet or will meet other departmental requirements,
conditions and concerns before permit approval.
FIRE COMMENTS
1. General Note #5 on sheet FP6 makes reference to NFPA 13R. In looking up the
use of this building on the web it appears that it will be used for more than simply
custodial care and will service persons that are "incapable of self-preservation". As
such it should be considered an 1-2 occupancy in accordance with IBC 308.4. This
EECE Project EDM 14-06
Edmonds Permit BLD2014-1320
Page 2 of 3
would require that the sprinkler system design meet the requirements of a full
NFPA 13 system per IFC 903.2.6. Please address.
2. In accordance with Section'22.1.3 of NFPA 13 the plans should clearly note all fire
separation walls and rated floors as well as the method and means of providing
appropriate fire stopping at piping penetrations of these rated assemblies per IBC
713. Please address.
3. Please note the "clearance" requirements for piping passing through walls and
floors as required by Section 9.3.4 of NFPA 13.
4. Please clarify how hanger rods are to be attached to and supported by the structure
in accordance with Section 9.1 of NFPA 13.
5. No information regarding sway bracing has been provided on the plans. Section
9.3.5.3 requires sway bracing of all feed and cross mains as well as all branch lines
2.5" or larger. Please clarify sway bracing requirements on the plans and provide
supporting calculations in accordance with Section 22.1.3 of NFPA 13, Item 39.
6. Please clarify on the plans how restraint of branch lines less than 2" will be
provided as required by Section 9.3.6 of NFPA 13.
7. The plans specify a volume of 551 gallons for the attic dry pipe system and 120
gallons for the canopy dry pipe system yet a calculation complying with Section
7.2.3 of NFPA 13 has not been provided. Please address.
8. While material data was provided for the air compressors that can be used for the
dry pipe system, the particular compressor that will be used has not been noted.
Please confirm that the air supply source will be available at all times and that it
can meet the 30-minute fill requirement for the dry pipe system as required by
Section 7.2.6.2 of NFPA 13.
9. The plans must clearly note the following water flow test information in
accordance with Section 22.11 of NFPA 13:
a. Static pressure
b. Residual pressure
c. Flow
d. Date of test
e. Name of person/company who perforined the test
10. While the riser diagram on sheet FP6 calls for a spare sprinkler box, please clarify
that a minimum of two spare sprinklers of each type and the appropriate wrenches
shall be provided as noted in Section 6.2.9 of NFPA 13.
11. While sidewall sprinklers are shown at the bottom of the elevator shafts, sprinklers
are not specified at the top of the shaft as required by Section 8.15.5.4 of NFPA
13. Please confirm that the shaft consists of noncombustible construction and that
the elevator car enclosure meets the requirements of ASME A 17. 1.
0
EECE Project EDM 14-06
Edmonds Permit BLD2014-1320
Page 3 of 3
12. The following Tyco material submittals for sprinkler heads were provided, yet
these types of sprinklers have not been specified on the plans. Please clarify.
a. TFP172: TY313 and TY323, quick response, standard coverage sprinklers
b. TFP500: TY3255, TY3155 and TY3355, dry -type sprinklers
13. Please address the following discrepancies in the material data provided for the
sprinklers called out on the plans. Please coordinate.
a. TY3235: The plans specify a 1/2" NTP while TFP5 10 lists V'.
b. TY3335: The plans specify a 1/2" NTP while TFP51 0 lists I".
c. TY318: The plans specify a K-factor of 8.0 and 3/4" NTP while TFP610
lists a K-factor of 5.6 and 1/2" NTP.
14. While the riser diagram on sheet FP6 notes an alarm bell is required, it does not
specify the type of bell as required by Section 22.1.3 of NFPA 13, Item 26, nor has
material data for the alarm been provided.
Additional corrections may be required following receipt of corrections and additional
information as requested.
Your plans may also be reviewed concurrently by other departments within the City of
Edmonds. Changes, clarifications or additional corrections may be required subsequent to
the reviews performed by these other departments.
Should you have any inquiries regarding this letter, please contact Hoyt Jeter at (206) 356-
7790 or by email at chrisk@wc-3.com or Hoyt Jeter.
By: 0-0
Chris Kimball, P.E., S.E.
ICC Fire Plans Examiner
ICC Fire Inspector 1/11