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23326 EDMONDS WAY Fire insp 2017Z33Z(99 �Dmauos "FIRE PREVENTION ServingBrier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT SNOHOMISH CO Mountlake Terrace FIRE Everett, WA 98208 OEDMONDS El BRIER DI 4S. TL 11 T Phone (425) 551-1200 Fax 551-1272 [1 MOUNTLAKE TERRACE [] UNINCORPORATED www.FireDistrictl.org (425) 23326 Edmonds Way Bldg A-G 98020 r FREQUENCY STAT18�6 SHIFr*, Annual 2 LOCATION: Edmcnds Highlands Apts 4257716910 SCHEDULED Jul 2017 BUSINESS NAME: PHONE: DATE DUE � MAILING 23326 Edmonds Way, Bldg A-G, Edmonds, WA 98020 42855 UFIR ADDRESS: Harris, Francis BUSINESS OWNER: HOME PHONE: EMERGENCY-1: Housing Authority/Sno Co HOME PHONE- 4257716910 ' CURRENT KEY ACCESS-2: 20 HOME PHONE: CITY YES NO BUSINESS EMAIL: LICENSE I,- PERSON CONTACTED: r� 0 r4 C J Ji'l- � 0 z)4 4 INITIAL INSPECTION DATE NAME OF INSPECTOR: �IKLSY511=Mb: AS6/15 Partial FA6/151FE7/15 AX Date Last Serviced: &.71-6 HAZARDS FOUND AND LOCATIONS / COMMURICATIO NO Vt V 2- -2, 3 3 4 5 6 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X In our continuing effort to promote fire safety and prevention within the community, your fire department conducts regularly scheduled "Fire Safety Survey Inspections" of all businesses and multi -family occupancies in the Cities covered by Snohomish County Fire District 1. You are to be congratulated on the relative good condition of your occupancy in regards to fire safety. Above you will find the item(s) that were noted during our inspection which require attention to bring them into compliance with the minimum standards adopted by the above jurisdictions. Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions or vi (io n. If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-7)7 , for Mountlake Terrace or Brier, call (425) 744-6231. Z33z(,g 12--omauis w4Y. FIRE PREVENTION ,Sei-,i,it,ig..Briei-,..Ediiioiids, and 12,425 Meridian Ave S INSPECTION REPORT OEDMONDS Mozintlake Terrace Everett, WA 98208 [1 BRIER Phone (425) 551-1200 [1 MOUNTLAKE TERRACE www.FireDistrictl.o�g Fax (425) 551-1272 [1 UNINCORPORATED LOCATION: 23326 Edmonds Way Bldg A-G 98020 BUSINESS NAME: Edmonds Highlands Apts 4257716910 PHONE: MAILING ADDRESS: 23326 Edmonds W, ay, Bldg A-G, Edmonds, WA 08020 FREQUENCY STATION & SHIFT-) Annual I 20-A SCHEDULEDjUl 2015 DATE DUE UFIR 042855 c� , �0( . BUSINESS OWNER: FrangsS HOME PHONE:L('z'�-_ (o 0 0 -7 z (a EMERGENCY-1: Housing Authority/Sno Co HOME PHONE: KEY ACCESS-2: HOME PHONE: NO EMAIL: e_'kn.onks L�_�(C.'Ajsp_ coa &� r-1 0 'V'A_ R PERSON CoNTACTED: INITIAL I SPECTION,DATE NAME OFJ Ojb�ECTOR: 9 ('� I I - �t ( c� etA�_ (I Plpl= Czvq'TPKA-q. AC 774,A D-;4;'-L,CA 7/1A CC 0 -11 A /En 1 0 S? DrAND L CA I IN R F T ONS COMMUNICATIONS a e Lbwe VIC c A 2 3 3 4 4 5 5 6 6 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: EX 'NSION G7ANTEDTO:/ 41NAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: I 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: 9 3 7 3 7 RETURN RECEIPT RECEIVED 6 4 4 18 DATE: DISPOSITION: L�;UERNEEDED Q-"YES 0 NO LETTER NEEDED E] YES El NO 8 FIRE DEPARTMENT COPY Edmonds Highland appartments Karl Fitterer Sent: Wednesday, January 20, 2016 12:13 PM To: edmondshughlands@coastmgt.com I am requesting the latest maintenance records for the Fire Alarm, Fire Extinguishers and the Automatic Sprinkler System at the Edmonds Highland Apartments located at 23326 Edmonds Way. I also would like the location of a lock box entry system at this facility so our fire crews can make access to the fire alarm and sprinkler systems to perform their annual inspections. Thank you for you prompt attention, Karl Fitterer Deputy Fire Marshal Cities of Brier, Edmonds and Mountlake Terrace 425-551-1980 425-754-4262 titAAA FIRE& SAFETY, INC a a a 1— - —, 3013 3RD A VE NORTH (800) 223-3473 SEAME, INA 98109 EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" SPRINKLER - WET SYSTEM Status Given (One System per Report) RED [�] I YELLOW F ] I WHITE JXJ CONFIDENCE TEST I JXJ I REPAIRS I I , Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Responsible P erson FRANCES First & Last Name: Phone Number: Responsible Person Responsible Party Address, City, State, Zip: E—Mail Address Date of Inspection: 06/19/2015 Inspection Annual Frequency/Type: Quartedy 0 Testers Name Seth Sample Nicet Certification S-08260 (Please Print): Number: Identification Building A Riser room outside Number: System Location: Central station monitoring? Yes [I No El Monitoring Monitoring Required? Yes 11 No El Company Name: System Make: Shotgun System Model: NA FIRE CODE VIOLATIONs FOUND: (If additional room is needed, please add a separate sheet) CORRECTIONS MADE: Date Corrected: Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number: 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 Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. A Signature of Tester: Phone # Building Representative (signature) Sprinklers - Wet Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. I General 1. Main Drain apod Inspector's Drain flow test conducted? Yes No El 2. Static pressure: 75 p.s.i. Flow pressure: 50 P. S. i. 3. Number of Sprinkler Heads: 4. 2-inch drain? Other E] Yes Z NoEl 5. Flow switches, supervisory switches and alarm bells tested? N/A El Yes FX-1 NoEl 6. Pressure regulating valves tested? N/A 0 Yes 17 No El 7. Alarm bell operates? N/A El Yes 0 No El 8. System inspected and lubricated? Yes nX No El 9. Valves are sealed or supervised? Yes RX No El 10. Signs are provided on valves? Yes 0 No 0 11. Pumper connections and clapper valves unobstructed and turn freely? Yes 0 No El 12. Sprinkler coverage is acceptable? Yes 9 No El 13. Have the sprip kler heads been replaced or successfully sample test in the Yes El 0 last 50 years? Date of last test: No 14. Proper number of spare sprinkler heads available with appropriate wrenches Yes N El for each? No 15. System left in service? Yes 0 No El 16. System gauges replaced or calibrated within the last 5 years? Yes 0 No El Year changed: 2014 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical Yes Z No El damage? 18. Was debris found in the Fire Department Connection (FDC)? Yes No 19. Was the Fire Department Connection (FDC) back flushed within the last 5 years? Date of last back flush unknown Yes No 20. Was an internal pipe and valve inspection performed within the last 5 years? Date Performed 2014 Yes 0 No 1Z 21. Is the hydraulic nameplate installed and visible on riser. Yes El No M (Ref: NFPA 25 5.2.7) 22. Was a signal received at the Central Station monitoring N/A Yes El N o El company? Sprinklers - Wet Page 2 of 2 AAA FIRE & SAFETY, INC 3013 3RD AVE NORTH (800)223-3473 SEAME, INA 98109 WFOCAAAME.COM EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" SPRINKLER - WET SYSTEM Status Given (One System per Report) RED YELLOW F] I WHITE CONFIDENCE TEST JFX I REPAIRS Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Responsible Person FRANCES First & Last Name: Phone Number: Responsible Person Responsible Party Address, City, State, Zip: E—Mail Address Date of Inspection: 06/19/2015 Inspection Annual FX-1 FrequencyfType: Quartedy El Testers Name Seth Sample Nicet Certification S-08260 (Please Print): Number: Identification Building B Riser room outside Number: System Location: Central station monitoring? Yes D No[@ Monitoring Monitoring Required? Yes 13 NoM Company Name: System Make: Shotgun System Model: NA FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet) CORRECTIONS MADE: Date Corrected: Corrected By: (if addRional room is needed, please add a separate sheet) Nicet Certification Number: 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 Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: C5 C!Y"" Phone # Building Representative (signature) Sprinklers - Wet Page I of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. General 1 . Main Drain an"d Inspector's Drain flow test conducted? Yes R No El 2. Static pressure: 55 p.s.i. Flow pressure: 40 P. S. i. 3. Number of Sprinkler Heads: 4. 2-inch drain? Other [-I Yes 0 No El 5. Flow switches, supervisory switches and alarm bells tested? N/A F-1 Yes 0 NoEl 6. Pressure regulating valves tested? N/A nX Yes El No El 7. Alarm bell operates? N/A El Yes 0 No El 8. System inspected and lubricated? Yes N No 0 9. Valves are sealed or supervised? Yes FX] No El 10. Signs are provided on valves? Yes No 11. Pumper connections and clapper valves unobstructed and turn freely? Yes nX No El 12. Sprinkler coverage is acceptable? Yes No El 13. Have the sp(inkler heads been replaced or successfully sample test in the Yes El No N last 50 years? Date of last test: 14. Proper number of spare sprinkler heads available with appropriate wrenches Yes No El for each? 15. System left in service? Yes 0 No El 16. System gauges replaced or calibrated within the last 5 years? Yes 0 No El Year changed: 2014 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical Yes 0 No El damage? 18. Was debris found in the Fire Department Connection (FDC)? Yes D No 0 19. Was the Fire Department Connection (FDC) back flushed within the last 5 Yes D No 0 years? Date of last back flush unknown 20. Was an internal pipe and valve inspection performed within the last 5 years? Yes El No 0 Date Performed 2014 21. Is the hydraulic. nameplate installed and visible on riser. Yes El No Z (Ref: NFPA 25 5.2.7) 22. Was a signal received at the Central Station monitoring N/A E9 Yes El NoEl company? Sprinklers - Wet Page 2 of 2 AAA FIRE & SAFETY, INC 30133RDAVENORTH (800) Z23-3473 SEA TTLE, INA 98109 EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" SPRINKLER - WET SYSTEM Status Given (One System per Report) RED F] I YELLOW [7] 1 WHITE JXJ CONFIDENCE TEST 0 [ REPAIRS Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Responsible Person FRANCES First & Last Name: Phone Number: Responsible Person Responsible Party Address, City, State, Zip: E—Mail Address Date of Inspection: 06/19/2015 Inspection Annual Frequency[Type: Quarterly El Testers Name Seth Sample Nicet Certification (Please Print): Number: S-08260 Identification Building C Riser room outside Number: System Location: Central station monitoring? Yes 13 No[@ Monitoring Monitoring Required? Yes 13 No19 Company Name: System Make: Shotgun System Model: NA FIRE CODE VIOLATIONs FoUND: (if additional room is needed, please add a separate sheet) CORRECTIONS MADE: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) Nicet Certification Number: - 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 Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: Phone # Building Representative (signature) Sprinklers - Wet Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. General 1. Main Drain a' md Inspector's Drain flow test conducted? 91 Yes 0 No El 2. Static pressure: 60 s.i. Flow pressure: 25 -p P.S.I. 3. Number of Sprinkler Heads: 4. 2-inch drain? Other E] Yes 0 No El 5. Flow switches, supervisory switches and alarm bells tested? N/A E -1 Yes 0 NoEl 6. Pressure regulating valves tested? N/A Eg Yes [I No El 7. Alarm bell operates? N/A El Yes 0 No El 8. System inspected and lubricated? Yes 0 No El 9. Valves are sealed or supervised? Yes nx No El 10. Signs are provided on valves? Yes No 11. Pumper connections and clapper valves unobstructed and turn freely? Yes No 12. Sprinkler coverage is acceptable? Yes 9 No El 13. Have the sprin kler heads been replaced or successfully sample test in the Yes El No FX1 last 50 years 9� Date of last test: 14. Proper number of spare sprinkler heads available with appropriate wrenches Yes 0 No El for each? 15. System left in service? Yes No 16. System gauges replaced or calibrated within the last 5 years? Yes Z No 0 Year changed: 2014 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical Yes S No El damage? 18. Was debris found in the Fire Department Connection (FDC)? Yes El No ED 19. Was the Fire Uepartment Connection (FDC) back flushed within the last 5 years? Date of last back flush unknown Yes El No 0 20. Was an internal pipe and valve inspection performed within the last 5 years? Date Performed 2014 Yes No 21. Is the hydraulit nameplate installed and visible on riser. & Yes El No Z (Ref: NF-,PA 25 5.2.7) 22. Was a signal received at the Central Station monitoring N/A Yes 0 No El company? Sprinklers - Wet Page 2 of 2 AAA FIRE & SAFETY, INC 30133RDAVENORTH (WO) M3473 WFQ0AA4fW.00M SEAME, INA 98109 EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" SPRINKLER - WET SYSTEM Status Given (One System per Report) RED YELLOW [7] 1 WHITE FXJ CONFIDENCE TEST I JXJ I REPAIRS Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Responsible Person FRANCES First & Last Name: Phone Number: Responsible Person Address, City, State, Zip: Responsible Party E—Mail Address Date of Inspection: 06/19/2015 Inspection Annual Frequency/Type: Quarterly El Testers Name Seth Sample (Please Print): Nicet Certification Number: S-08260 Identification Building D Number: Riser room outside System Location: Central station monitoring? Yes No Monitoring Monitoring Required? Yes No Company Name: System Make: Shotgun System Model: NA FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet) CORRECTIONS MADE: Date Corrected: Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number: 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 Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: _C5, a"U4429A tl Phone # Building Representative (signature) Sprinklers - Wet Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. General 1. Main Drain d Inspector's Drain flow test conducted? Yes No 2. Static pressure: 55 s.i. Flow pressure: 40 -p P.S.I. 3. Number of Sprinkler Heads: 4. 2-inch drain? Other E] Yes 0 No El 5. Flow switches, supervisory switches and alarm bells tested? N/A 0 Yes 0 NoEl 6. Pressure regulating valves tested? N/A MX Yes M NoEl 7. Alarm bell operates? N/A Yes NoEl 8. System inspected and lubricated? Yes No M 9. Valves are sealed or supervised? Yes Mx NoEl 10. Signs are provided on valves? Yes 0 No M 11. Pumper connections and clapper valves unobstructed and turn freely? Yes E9 No El 12. Sprinkler coverage is acceptable? Yes No El 13. Have the sprinkler heads been replaced or successfully sample test in the Yes El No 0 last 50 year011",' Date of last test: 14. Proper number of spare sprinkler heads available with appropriate wrenches Yes 0 NoEl for each? 15. System left in service? Yes No M 16. System gauges replaced or calibrated within the last 5 years? Yes N No El Year changed: 2014 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical Yes Z No El damage? 18. Was debris found in the Fire Department Connection (FDC)? Yes No 19. Was the Fire Department Connection (FDC) back flushed within the last 5 Yes No years? Date of last back flush unknown 20. Was an internal pipe and valve inspection performed within the last 5 years? Date Performed 2014 Yes No 21. Is the hydraulij� nameplate installed and visible on riser. Yes El No M (Ref: NFPA 25 5.2.7) 22. Was a signal received at the Central Station monitoring N/A nX Yes El No El company? Sprinklers - Wet Page 2 of 2 lit AAA FIRE & SAFETY, INC a a a 3023 3RD AVE NORTH (800) 223-3473 SEAME, INA 98109 INFOCAAAFRE.COM EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" SPRINKLER - WET SYSTEM Status Given I (One System per Report) RED I YELLOW F] I WHITE LX] CONFIDENCE TEST I FX -] I REPAIRS I F-1 Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Responsible Person FRANCES First & Last Name: Phone Number: Responsible Person Responsible Party Address, City, State, Zip: E—Mail Address Date of Inspection: 06/19/2015 Inspection Annual Frequency/Type: Quarterly El Testers Name Seth Sample Nicet Certification (Please Print): Number: S-08260 Identification Building E Riser room outside Number: System Location: Central station monitoring? Yes 11 No El Monitoring Monitoring Required? Yes 11 No[@ Company Name: System Make: Shotgun System Model: NA FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet) CORRECTIONS MADE: Date Corrected: Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number: - 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 Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: 15-15a4l" Phone # It Building Representative (signature) Sprinklers - Wet Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. I General 1. Main Drain and Inspector's Drain flow test conducted? Yes 0 No El 2. Static pressure: 65 s.i. Flow pressure: 45 -p P.S.I. 3. Number of Sprinkler Heads: 4. 2-inch drain? Other E] Yes Z No El 5. Flow switches, supervisory switches and alarm bells tested? N/A El Yes R NoE-] 6. Pressure regulating valves tested? N/A Z Yes No El 7. Alarm bell operates? N/A El Yes No El 8. System inspected and lubricated? Yes nX No El 9. Valves are sealed or supervised? Yes 0 No El 10. Signs are provided on valves? Yes N No El 11. Pumper connections and clapper valves unobstructed and turn freely? Yes nX No El 12. Sprinkler coverage is acceptable? Yes No El 13. Have the sprinkler heads been replaced or successfully sample test in the Yes El No 0 last 50 years? Date of last test: 14. Proper number of spare sprinkler heads available with appropriate wrenches Yes 0 No El for each? 15. System left in service? Yes No n 16. System gauges replaced or calibrated within the last 5 years? Yes No El Year changed: 2014 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical Yes No El damage? 18. Was debris found in the Fire Department Connection (FDC)? Yes 1:1 No 0 19. Was the Fire Department Connection (FDC) back flushed within the last 5 Yes No years? Date of last back flush unknown 20. Was an internal pipe and valve inspection performed within the last 5 years? Date Performed 2014 Yes 0 No 0 21. Is the hydraulic nameplate installed and visible on riser. Yes El No Z (Ref: NFPA 25 5.2.7) 22. Was a signal received at the Central Station monitoring N/A FX1 Yes El No E] company? Sprinklers - Wet Page 2 of 2 ilk AAA FIRE & SAFETY, INC a a a 30133RDAVENORTH )223-3473 C KFO AAAFIRECOM SEAME, WA 98109 EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" SPRINKLER - WET SYSTEM Status Given (One System per Report) RED [_11 YELLOW F] I WHITE IX CONFIDENCE TEST I FX -11 REPAIRS -771 Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Responsible Person FRANCES First & Last Name: Phone Number: Responsible Person Address, City, State, Zip: Responsible Party E—Mail Address Date of Inspection: 06/19/2015 Inspection Annual Frequency/Type: Quarterly Testers Name Seth Sample (Please Print): Nicet Certification Number: S-08260 Identification Building F Number: Riser room outside System Location: Central station monitoring? Yes No[@ Monitoring Monitoring Required? Yes 11 No El Company Name: System Make: Shotgun System Model: NA FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet) CORRECTIONS MADE: Date Corrected: Corrected By: (if addftional room is needed, please add a separate sheet) Nicet Certification Number: - 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 Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: Phone # Building Representative (signature) Sprinklers - Wet Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. I General 1. Main Drain and Inspector's Drain flow test conducted? Yes 0 No El 2. Static pressure: 75 s.i. Flow pressure: 50 -P P.S.I. 3. Number of Sprinkler Heads: 4. 2-inch drain? Other Yes 0 No El 5. Flow switches, supervisory switches and alarm bells tested? N/A El Yes M NoE] 6. Pressure regulating valves tested? N/A Eg Yes El NoEl 7. Alarm bell operates? N/A El Yes IX7 NoEl 8. System inspected and lubricated? Yes Z No El 9. Valves are sealed or supervised? Yes No El 10. Signs are provided on valves? Yes No El 11. Pumper connections and clapper valves unobstructed and turn freely? Yes Z No El 12. Sprinkler coverage is acceptable? Yes M No El 13. Have the sprinkler heads been replaced or successfully sample test in the Yes El IX R last 50 years,'� Date of last test: No 14. Proper number of spare sprinkler heads available with appropriate wrenches Yes N El for each? No 15. System left in service? Yes RX No El 16. System gauges replaced or calibrated within the last 5 years? Yes N No El Year changed: 2014 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical Yes N damage? NoEl 18. Was debris found in the Fire Department Connection (FDC)? Yes El No Z 19. Was the Fire.Department Connection (FDC) back flushed within the last 5 years? Date of last back flush unknown Yes El No 0 20. Was an internal pipe and valve inspection performed within the last 5 years? Date Performed 2014 Yes No 21. Is the hydraulic nameplate installed and visible on riser. Yes D No 0 (Ref: NFPA 25 5.2.7) 22. Was a signal received at the Central Station monitoring N/A 0 Yes El NoEl company? Sprinklers - Wet Page 2 of 2 -lit AAA FIRE & SAFETY, INC a a a 1�'* —.1 3013 3RD AVE NORTH ,800)223-3473 SEAME, INA 98109 EU 9MAAFMCOM EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" SPRINKLER - WET SYSTEM Status Given (One System per Report) RED-7 I YELLOWFI I WHITE FX] CONFIDENCE TEST IN[ REPAIR Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Responsible Person FRANCES First & Last Name: Phone Number: Responsible Person Responsible Party Address, City, State, Zip: E—Mail Address Date of Inspection: 06/19/2015 Inspection Annual Frequency/Type: Quarterly El Testers Name Seth Sample Nicet Certification S-08260 (Please Print): Number: Identification Building G Riser room outside Number: System Location: Central station monitoring? Yes D No[@ Monitoring Monitoring Required? Yes 11 No El Company Name. - System Make: Shotgun System Model: NA FIRE CODE VIOLATIONs FOUND: (If additional room is needed, please add a separate sheet) CORRECTIONS MADE: Date Corrected: Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number: - 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 Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: Phone # Building Representative (signature) Sprinklers - Wet Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. I General 1. Main Drain and Inspector's Drain flow test conducted? Yes No El 2. Static pressure: 75 p.s.i. Flow pressure: 50 P. S. i. 3. Number of Sprinkler Heads: 4. 2-inch drain? Other Yes 0 No El 5. Flow switches, supervisory switches and alarm bells tested? N/A El Yes Z NoE-] 6. Pressure regulating valves tested? N/A 0 Yes [I No El 7. Alarm bell operates? N/A El Yes 0 No D 8. System inspected and lubricated? Yes nX No El 9. Valves are sealed or supervised? Yes FX] No [:1 10. Signs are provided on valves? Yes No F1 11. Pumper connections and clapper valves unobstructed and turn freely? Yes No El 12. Sprinkler coverage is acceptable? Yes No El 13. Have the sprinkler heads been replaced or successfully sample test in the Yes El last 50 years? Date of last test: No 14. Proper number of spare spdnkler heads available with appropriate wrenches Yes No El for each? 15. System left in service? Yes No [--] 16. System gauges replaced or calibrated within the last 5 years? Yes FX] No El Year changed: 2014 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical Yes No El damage? 18. Was debris found in the Fire Department Connection (FDC)? Yes El No 0 19. Was the Fire Department Connection (FDC) back flushed within the last 5 years? Date of last back flush unknown Yes El No Fx1 20. Was an internal pipe and valve inspection performed within the last 5 years? Date Performed 2014 Yes El No N 21. Is the hydraulic nameplate installed and visible on riser. Yes El No N (Ref: NFPA 25 5.2.7) 22. Was a signal received at the Central Station monitoring N/A Yes El No El company? Sprinklers - Wet Page 2 of 2 AAA FIRE & SAFETY, INC a 11 Ilk 11A.4 $_4 1$ 30133RDAVENORTH (NO) 223-34?3 SEATTLE, INA 98109 1NF0*~FM.00M, EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED—FU YELLOWT—FF WHITE [X CONFIDENCE TEST REPAIRS Sprinkler Monitoring Panel? Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS G Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number - Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E—Mail Address Date of Inspection: Inspection Annual 06/19/2015 Frequency/Type: Quarterly F I Testers Name Seth Sample Nicet 8260-0609-E (Please Print): Number: — Identification Number- S-08260 System Location STAIRWELL Central station monitoring? Yes D No El Monitoring Monitoring Required? Yes 0 No El Company Name: System Make, FIRELITE System Model: MS-2 FIRE CODE VIOLATIONs FOUND.' (If additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number: - 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester Phone # (206) 284-1721 Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall beinspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer mthe Fire Code for inspecting ondte$mnnnuiremcnts. Alarm Svstem Functionali 1. -------Trouble-- -- - -- - `_�I�� QLoQg1Y_qn1bj�t�[Y_ba�kuP? 3. 27�6 volts _ __� _ - 4�' (�dH�ad\2/.21--_volts operating) 27.03 � ` ^ ------' ------------ Yes IXINo _-_- -YeN o Ng�1' _ 7. All b Yes | mber 'oh ___--.......... __- _��No| __ 9. Number of signal circuits _ a�accepted? � 11. All circuits checked��e|ecthca|suoen�s�n? _Yes YesNo ______No ------------ -�' -------------��'------'�l----'N�F� System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 25. Voice Speakers (Voice Clarity) N/A Yes[:] No[:] 26. Visual Alarm,,'Devices N/A Yes[:] NOD 27. Smoke Detectors N/A Yes No N/A Yes No N/A Yes No El 28., Heat Detecfb-rs-, 29. Duct Detectors N/A Yes No 31. Sprinkler Supervisory Switches 32. Manual Pull,�,Stations' 12 N/A Yes No 33. Annunciator(s) N/A Yes No 34. Beam Detectors N/A 0 Yes El No 1:1 35. Automatic Door Unlocks N/A Yes NOE] 36. Automatic Door Release N/A RX Yes No 37. Fire Dampers N/A Yes No Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 39. Phone Jacks N/A Yes No 40. Call -in Signal N/A Yes NOE] Fire Alarm Systems Page 2 of 2 lit AAA FIRE & SAFETY, INC Ran 3013 3RD AVE NORTH 1=1 3.141t3 iff. M SEATTLE, WA 98109 EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) __F_F RED YELLOW _F FT WHITE L CONFIDENCE TEST I LXJ I REPAIRS I Sprinkler Monitoring Panel? Occupancy Address: 23326 EDMONDS WAY Occupancy Name. EDMONDS HIGHLANDS F Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number: Responsible Person. Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E—Mail Address Date of Inspection'. Inspection Annual 06/19/2015 Frequencyrrype: Quarterly F I Testers Name Seth Sample Nicet (Please Print): Number: — 8260-0609-E Identification Number- S-08260 System Location STAIRWELL Central station monitoring? Yes 11 No El Monitoring Monitoring Required? Yes El NoEl Company Name: System Make: FIRELITE System Model: MP-24 FIRE CODE VIOLATIONS FOUND: (if additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) Nicet Certification Number: 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester- Phone # (206) 284-1721 Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm System Functionality -L. Trouble, signal with AC power off? -YesM Syste�m-'op s a pr . ..... � _gLge _pr9ppr!y_pr!..b� y_o@qKqp - ? Yes No 27.40. J��ttery- voltage (no load)__ volts 27.29' 4.' B leage (full -load) volts (signals operating) 5. Charqe circuit voltage 15-34 volts 6. y W-. S �tgm op rat(�s op rly n SW --P-[- -9- --Q- nOby Yes Fx�. No 7. All signal��operate on AC power? -n Yes r o 8. Numbe 6-i qki-g - - -------- - 9. Number of signal circuits 10.� Does alarrq,�!tygerq_T(�et pqoibility standards as accepted? Yes No 11. All circuits checked for electrical supervision? . . . - -.- .. - - ". - - . . 1. . � . - - Yes No I _M_ __pq._(Elevators,. fa ns, . da mpers)? 12. All auxiliary,,qquip ent op�rqt N/A- ...' '�Y s .... N -0 .. -.0 13. Ventilation controls operate? N/AFX�' s o 14. Key to. a -Maie--ri�ls -ore -stations Yes�FX NoEl E. and equipment needed to rest pull- are available at the N/AEI Yes Z NoE]- main panel, e.g. glass rods, and plates; keys and allen wrenches, etc? 16. 00erati in Lstructions- at panel Yes No -:--17. Trouble indicators function properly? Yes No[:]- 18. Remote �A6M%ndafdr-P W�-IsiurGron p Lo �rj P4-/A NoF-1. E-] 19. Elevator Call Down functions properly? N/A N Yes NOH- No 20. Te�t,*rkor( Yes 21. General alarm automatic time delay (minutes) N/A i a =Ie c � -'ive'd � a f�lh 7-��'C6�tra-I-Station monitoring o p ny N A n, NoE]- 23. Other Devices (Specify) Yes 1:1 NoN System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 24. bells, Horns�, Chimes 13 13 N/A Y(�� No [:1 25. Voice Speakers (Voice Clarity) ..... ..... . ... ------- -- -- N/A Yes No 26. Visual Alarm Devices N/A FXJ Yes El No 1:1 27. Smoke Detectors .... .... ... N/A Yes No 28. Heat Detect6rs .. . ......... . .... . .... . .. ..... N/A_N 0 NoO 29. Duct Detectors N/A YesEl No 30. Sprinkler Flow Switches N/A No 31. Sprinkler Supervisory Switches N/A FXJ YesE] No 32. Manual Pull,$tations 5 Yes No 33. Annunciator(s) N/A Yes No 34. Beam Detectors N/A 0 YesEl No 1-1 35. Automatic Door Unlocks N/A Yes No 36. Automatic Door Release N/A Yes No El 37. Fire Dampers N/A Yes No El Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A Yes No 39.. P.honelacks N/A Yes No 40. Call -in Signal N/A Yes NoD Fire Alarm Systems Page 2 of 2 AAA FIRE & SAFETY, INC Ann 30133RDAVENORTH (600) 223-3473 SEATTLE, WA 98109 04T VAAAMEMM EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED FT YELLOWT TT —WHITE L CONFIDENCE TESTITX7 REPAIRS Sprinkler Monitoring Panel? 23326 EDMONDS WAY - EDMONDS HIGHLANDS E Occupancy Address- Occupancy Name. Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number: Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E—Mail Address Annual Date of Inspection: Inspection M 06/19/2015 Frequency[Type: Quarterly F] Testers Name Seth Sample Nicet (Please Print): Number: — 8260-0609-E Identification Number: S-08260 System Location STAIRWELL Central station monitoring? Yes [I NoEl Monitoring Monitoring Required? Yes [I NoEl Company Name - System Make: FCI System Model: SBP FIRE CODE VIOLATIONs FOUND' (If additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number - 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester- Phone# (206) 284-1721 Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm System Functionality 1. Trouble signal with AC power off? Yes No[] _5ystprri.ope�r'tes� p i�ttery Pp�Xgp _L9pgljy 9!IA No 3. Battery voltage (no load) 25.58 volts (fqll I ad) 25.42 t 4. Battery�vp!tage_ .9 volts (sign opera-ing) C�pLrg.� circuit voltage 29.32 volts k..._5ystqT_pp f�� pf9p grly p stand y p !I Yes- 7._._All sigrials.operate on AC power? Yes FX� No . ........... . 8. Number of ihitiatinq circuits: 9. Number of sigjj�l circuits . I .-- � I.- . . 10. Does'alarm,systern meet aud ibility star I ro a s ac cepted? _dq_ _q_ - . Yes - No 11. All circuits checked for electrical sup� rvision? . ...... .... Yes No 12. All auxiliary,^q_qgipaqjjt operates (Elgvat9rsja.ns,,dampers)? _____N/A-Z__- Yes W-1 No EF 13. Ventilation controls o te? N/A Yes[:] No 14. KeV. to wn*eyLvailable?, NLA �No[j 15. Materials and equipment needed to restore pull stations are available at the N/A Yes NoE] main panel, e.g. glass rods, and pj�t� key arjo allen wrenches, etc? 16. Op &tnl� Ci6hs at- panel? _tra in%i Yes ''NoET 17. Trouble indicators function pEoRerly .0 Yes rxi NoEl e-�'o't'e-'A"'n*w-�nc'�i�;�t'r---� _ro _'N/A o- Panels function p 0 --YesE]-'*-- No_] F 19. Elevator Call Down functions p WA -1 Fx YesF No 'NoH_ Test'recordj%sied a�p�!nel? Yes General alarm automatic time delay N/A '.___21. -(minutes)------ 22. Was' a� s i 6 Ha Me iV6d at',Ch� 'ce66ail station monitoring compqny? NIA Z -Yes F_T____7�NoE]_ 23. Other Devices (Specify) Yes El Noz System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 24. Bells H'brns:'Chimes ___ - �!_ - __ - IAI 19 __ -, ' 19 N/AEI Yes N No El 25. Voice Speakers (Voice Clarity) - '__ - - ' --*-*----- - ---*--,-- __ N/A N YesE] NoEl 26. Visual Alarm,Devices N/A 0 YesE] No[ 27. Smoke Detectors N/A N YesE] No F1 N/A 0 Yes El No El 28. Heat Detece6rs,, 29... 9.uct Detectors------------- N/A YesF_1 No El .30. Sprinkler F16W Switches; N/A esFX_1 No 1:1 31. Sprinkler Supervisory Switches N/A Yes No 32. Manual PullStations 9 9 N/A Yes No 33. Annunciator(s) N/A Yes No Beam Detectors N/A Yes No 35. Automatic Door Unlocks N/A Yes No ---------- - 36. Automatic Door Release . . . .... ....... .... N/A Yes No . ......... . ... p_ _ _ . ... _ _ 37. Fire Dampers , _ _ N/A Yes No Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A Yes No 39. Phone lacks N/A 0 YesEj No 0. Call -in Signal N/A 0 Yes [:1 NOE] Fire Alarm Systems Page 2 of 2 lit AAA FIRE & SAFETY, INC 111. a 11 *.d. *-NVI i-t 3013 3RD A VE NORTH (90�) 223�347,3 SEATTLE, WA 98109 EDMONDS FIRE DEPARTMENT "THE NORTHINESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED _FTJ YELLOW [—] I WHITE JXJ CONFIDENCE TEST IN I REPAIRS Sprinkler Monitoring Panel? M Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS D Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number: Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E-Mail Address Date of Inspection'. Inspection Annual 06/19/2015 Frequency/Type: Quarterly F] Testers Name Seth Sample Nicet (Please Print): Number: 8260-0609-E Identification Number: S-08260 System Location STAIRWELL Central station monitoring? Yes U No El Monitoring Monitoring Required? Yes [I No Company Name: System Make: FIRELITE System Model: MP-24 FIRE CODE VIOLATIONs FOUND: (If additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) Nicet Certification Number. - 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. .5, Signature of Tester: Phone # (206) 284-1721 Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm System Functionality 1. Trouble signal with AC power off? Yes NoE] 2., System. operates p[opp��y'qn tery __bqt _kqq_Kgp? Yes MX .... . ..... -3. Battery voltage (no_load).... 25.40 volts 4. B 25.29 volts (signals operating). --- - W-efry-YO-09P M1111 Loa-d)--- 5. Charcle circuit voltage 15.33 volts _6. System oper tes p rly n staqndby ? . a..._ _ropq_ _p__ _pp!AL(�r No El 7. All siqnals operate on AC p9wer? Yes ____No[:]____ ting_circuits ..... .... . . . .. . ....... . ........ . . ... . ... . . ... ... ---- - ---- 9. Number of signal circuits _T rri�t auqjAijiLty ��tandards as ac epted? 10-. Does alanEsy§�e Yes N' 0 11. All circuits checked for electrical supervision? Yes NoF1 12. All auxilia dampers)? - ----!!-a-Fyi .1 .- 1 1. - -.- N/AFXI - _ �- _ __ Yes 13. Ventilation controls operate? N/A Yes '14., Key to Dan N/A. e No 15. Materials and equipment needed to restore pull stations are available at the N/AE] Yes M No[:] main panel, e.g. glass rods and plates; keys and allen wrenches, etc? �77 'instriJ66hs at 0 n I? 16-Op6ratiridt-.- Yes 17. Trouble indicators function p�oper ? Yes.FXI.-,-- NoFj 18., Remotd��"'H" nlunciatd(iPanels n i'npropgrly�_____.______ N Yes No 19. Elevator Call Down functions properly? Yes No[--]- W. -rdst.:r'e`c'6'r' bd6d��k p h6l? -T Yes Fx.- No 0- 21. General alarm automatic time delay (minutes) N/A t the Central Station monitoring cqTp 7ul �e�e a _�!ny?- N/kN Yes [:]7 NoE]. 1 23. Other Devices (Specify) YesEl NoN System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 24. Bells, Hor4, Chimes 13 N/A Yes No 25. Voice Speakers (Voice C I larity) ....... .... .............. N/A Yes No El 26'. Visual Alarm�' Devices ......... . - - F-1- N/A Yes No 27. Smoke Detectors N/A Yes No 28. Heat Detectors . . ... . ......... . .. . -N/A Yes No N/A Yes No 29. Duct Detectors 30. Sprinkler F16w Switches N/A Yes NoEl N/A Yes No 31. Sprinkler Supervisory Switches 32. Manual Pull'Stations 6 6 N/A Yes RX No [:1 33. Annunciator(s) N/A Yes No 34. Beam Detectors N/A Yes No 35. Automatic Door Unlocks ..... .... . . .... . . ............ . . .... . . N/A Yes No 36. Automatic Door Release N/A Yes No E] 37. Fire Dampers N/A Yes No Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A Yes No ---------- 39. Phone Jacks N/A Yes No 40. Call -in Signal N/A Z Yes E] No [3 Fire Alarm Systems Page 2 of 2 lit AAA FIRE & SAFETY, INC a A a 30133RDAVENORTH 'Ma—ey—r.: (m) 223-3473 ,,o*fiAA,m,c,, SEATTLE, WA 98109 EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED —TT YELLOW F—FT—WHITE JXJ CONFIDENCE TEST [X REPAIRS Sprinkler Monitoring Panel? Occupancy Address- 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS C Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number: Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E-Mail Address Date of Inspection: Inspection Annual 06/19/2015 Frequency/Type: Quarterly F I Testers Name Seth Sample Nicet 8260-0609-E (Please Print): Number: - Identification Number: S-08260 System Location STAIRWELL Central station monitoring? Yes D No El Monitoring Monitoring Required? Yes 0 No El Company Name: System Make: ESL System Model: 1500 FIRE CODE VIOLATIONs FOUND: (If additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) Nicet Certification Number: 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. 5� Signature of Tester- Phone # (206) 284-1721 Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm Svstem Functionalit 1. Trouble signal with AC power off? Yes NoF� 2. System, ope@tes,p op ry tter Yes Battery voltage.(no. load)_. 2518- 25.21 volts (signals operating) . ...... - Charge circuit voltag� 27-32 volts . . .... . .... . ......... System or) ra Iyop tqndby er? p:�tes pj9pgr- -�- _- _pQw. . ..... . ... -�-OE Yes. 7. -�—.Wu All signals operate on AC pqwer?_________ Yes Z. NOE] I`m3W-of i-plEtat7in-dr-c—ults g ....... ..... -1 -------- . . .......... 9. Number of siqnal circuits . 10. .. ......... ... . .. .... ------ Does alarpq!jsygeM meet-��LLdib Llity standards -as accepted? Yes 11. All circuits checked for electrical supq!y�i�ion? Yes NOE -1.2.. All.a.u.xiharyrg uipM�pt operpti��q (Eli�vqt rs)? _Qrs, fans,. d mp so N 13. Ventilation controls operate? N/A RX Yes No 11. �Ley So rfel a ilbble?,- p= A N6[:] 15. Materials and equipment needed to restore pull stations are available at the N/A Yes [X-� No[:] main an 1, e.g. glass rods, and plates; keys and allen wrenches, etc? tin'�ijnstri]M I? ,�ra g. tops a , ane --;��e 16.p N'... No El 17. Trouble indicators function prop r ? Yeso NoL] i-�.--k-emot(��An7n,u'6'�i-it,j'r�'-P-anels- " �' i n properly? un /A es NoE] 19. Elevator Call Down functions properly? N/A Yes E] NOE] R TesCrecordTp t pin�bqI.?'.. x 21. General alarm automatic time delay (minutes)—____. N/A H W�akI�A�si Alleec0ivediat �e�RtN StWtibli m6nitorinq_,�;ompAilyZ..________N/kFX� —Yes No[:] NON 23. Other Devices (Specify) Yes System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable sl- 24. Bells, Horn t,Chimes N/A Yes No[:] .... . ...... . 25. Voice Speakers (Voice Clarity) .... ... . N/A Yes No 26. "Visual Alarm ,,�De N/AFx] Yes No N/A Yes No N/A Yes No N/AFXI Yes F� No 27. Smoke Detectors 28. Heat Detectors 29. Duct Detectors Floyv §witchqs N/A Yes No 31. Sprinkler Supervisory Switches N/A Yes No 32. Manual Pull ttations N/A F Yes 0 No N/A-Z No 33. Annu nciator(s) - 34. -Beam Detect , ors N/A nX Yes NO -El 35. Automatic Door Unlocks N/A Z Yes No 36. Automatic Door Release N/A Yes No 37. Fire Dampers N/A Yes No Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A Yes No E] 39. Phone Jacks N/A Yes NOE] 40. Call -in Signal N/A Yes NOD Fire Alarm Systems Page 2 of 2 AAA FIRE & SAFETY, INC ...... 3013 3RD AVE NORTH (M) -73 SEATTLE, WA 98109 ,INFO EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED YELLOW WHITE LA CONFIDENCE TEST IN I REPAIRS Sprinkler Monitoring Panel? M Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS B Responsible Person FRANCES . (425) 771-6910 First & Last Name: Phone Number - Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E—Mail Address Date of Inspection* Inspection Annual 06/19/2015 Frequency/Type: Quarterly F] Testers Name Seth Sample Nicet (Please Print): Number: 8260-0609-E Identification Number: S-08260 System Location STAIRWELL Central station monitoring? Yes D No El Monitoring Monitoring Required? Yes 11 No El Company Name: System Make: FCI System Model: SBP FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number: 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: Phone# (206) 284-1721 Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm System Functionality 1. Trouble sigpal with AC power off? Yes FXI NoE] -1. System opd"ra tes p �pp�Ay�o�battM b4ckqp? ... ---- --- Yes x .. ........ No 3. Battery voltage (no load) 21516- volts ,�.__I�attery.yolt,ag��(fqltlqad) 25.55 volts (signals_ operating) 5. Charge circuit voltagq______,___ 28.94 volts 6. System op 'IF 6tes p e _Lopgrly,p_n sqijdOy,Powg[?-----. No 7. All siqnals operate on AC ppyyer? Yes 8. Number of ihitiatinq circuits, 9. Number of signal circuits 1 0. Doe s a larm� system m ee t audib ilitv- standards, as, accepted? Ye s 11. All circuits checked for electrical supervision? Yes No 12. All auxilia ��qpipM�pt ey�ators, fans, damp��rs)? _9perptqs. N/A Yes' EJ No 13. Ventilation controls operatp? N/A No 0- L4�1 Ke:� t(� aVailable?T,- N/A No[ 15. Materials and equipment needed to restore pull stations are available at the N/AE] Yes N No[:] main panel, e.g. glass rods and at s; keys and allen wrenches, etc? 16. Operatibg�i�Tstruaio*iis af:'anel? Ye's 0 No El- 17. Trouble indicators function prope ? Yes Ix -I No I--]- L 10 _pLpp�rly 18. Remote A-"nnqn' 'i��.'Panelsfun N/A Yes J' NoLj 19. Elevator Call Down functions properly? FX-1 Yes 1:1 No 20.764,re�cdffrdpbstedkp el?� -I" 5. s Fx] NoH, 21. General alarm automatic time delay (minutes) N/A n 2_ :fi� t6h'&al Stati*6". monitoring comp.�ny N/A_N Yes F No 23. Other Devices (Specify) Yes I] NoN System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 24., Bells, Horns'i Chimes 19 N/A'[:] Yes NoE] 25. Voice Speakers (Voice Clarity) N/A Yes No 26 V i su al Alarm Devi ce s N /A Y e s No ..... ... ... 27. Smoke Detectors . ....... .... .. .. ...... . . N/AFXI Yes No [:1 28. Heat Detectors . .......... N/A Yes No 29. Duct Detectors N/A Yes No El- 30. Sprinkler Fl6w Switches N/A No Yqs 31. Sprinkler Supervisory Switches N/A FX� YesE:] No 32. Manual Pull Stations 9 9 N/A Yes No 33. Annunciator(s) . ..... ..... N/A Yes No 34. Beam Detectors . . . . ........ N/AFXI YesE] No [:1 ...... . . ............. 35. Automatic Door Un locks . . . ..... N/A -' - 36. Automatic Door Release --Yes.[:]-,.- ----No[:]-.- N/A nX Yes NoE] 37. Fire Dampers N/A Yes No Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A Yes No 3 - 9. . Pho . ne 1. ]a I cks N/A Yes[:] No'n- 40. Call -in Signal N/A M YesEj NoD Fire Alarm Systems Page 2 of 2 tit AAA FIRE & SAFETY, INC 30133RDAVENORTH -=73 moo~ co, . SEATTLE, WA 98109 EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED YELLOW [] I WHITE X1 L CONFIDENCE TEST I LX] I REPAIRS IF-] Sprinkler Monitoring Panel? M Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS A Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number: Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E—Mail Address Annual Date of Inspection: Inspection IX 06/19/2015 Frequency/Type: Quarterly F] Testers Name Seth Sample Nicet (Please Print): Number: — 8260-0609-E Identification Number'. S-08260 System Location STAIRWELL Central station monitoring? Yes [I No El Monitoring Monitoring Required? Yes No[@ Company Name: System Make: FCI System Model: SBP FIRE CODE VIOLATIONs FOUND: (If additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By - (If additional room is needed, please add a separate sheet) Nicet Certification Number- - 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. .5, Signature of Tester: �7) am (206) 284-1721 Phone # Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm Svstem Functionalit 1. Trouble siqnal with AC power off? Yes -1 .......... Fx NoE] 2. Svstem op rptes M,/ g� _pLop(�rly_.,pp battery ckqp? Yes No -f-da'-tter-y-voltage (no load) 25.72' volts _j. Battery yq1tage. (fq �l load) 25.55 ��olts als operating) _(sigrL 5. Charge circuit voltaaq_ 28.94 volts tes p Yes 6. Svstem o 'rq _Lop _gL1y_9_n stano_oy pp_Wer? -- ------ �om All sign Is operate on AC power? Yes Nom- . . . ..... ... 8. Number ofinit.i�!tingSircuits 9. Number of signal circuits 10. Does alarm�!system meet'audibilitv standards as accepted? .. ........ . 11. All circuits checked for electrical supervision? 12. All auxilia uipTent opera es� (Elevators, fans; dampers ? N/A ___13. Ventilation controls operate? N/A,-nX 14. _Ke y_tq 61 �y4�lable? N/A 15. Materials and equipment needed to restore pull stations are available at the N/A main panel, e.g. glass rods, and plates; keys and allen wrenches, etc? 16. Opf�ratirfg jiant�iq i6ns�tp�neI?*,,. 17. Trouble indicators functio i prope 18. Remote Annunciatbr PanE Is function pop rly L N/A 19. . Elevator Call Down functions properly? nX _.20. Test recor7dpq�ted �Ltppnql? �7_ 21. General alarm automatic time delav (minutes) N/A N o -,YesFXI --------- No. Yes -No Yes No No Yes RX No Yes L;�J___ YesFx Yesn-- Yes F] Olf;received at the Cefitfal Station monitoring corrlp�nyL___ A X Yes 23. Other Devices (Specify) Yes No No No System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 24. Bells, Horns,'j," Chimes 31 31 N/A Yes nX No 25. Voice Speakers (Voice Clarity) N/A YesFj No . . ... ... ..... ......... .. 26. Visual Alarm Devices N/A Yes No 27. Smoke Detectors.---- N/A Yes No N/A Yes No 28.'Heat Detectors 29. Duct Detectors N/A Yes No Sprinkler F1'p'w Switches, _N/A- Yes No 31. Sprinkler Supervisory Switches N/A Yes No 32. Manual Pull Stations 15 N/A Yes No 33. Annunciator(s) N/A Yes No 34. Beam Detectors . .... . .......... N/A nX Yes No El 35. Automatic Door Unlocks N/A Yes No 36. Automatic Door Release'.- N/A Yes No 37. Fire Dampers . . ... ..... N/A Z YesE] No Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 38. Phone Sets N/AFX1 Yes [:1 No E] 39. Phone Jacks N/A Yes No 40. Call -in Signal N/A Z _YesE:1 No 1:1 Fire Alarm Systems Page 2 of 2 Fire & Safety, Inc. titAAA 3013 3rd Avenue North Seattle, WA 98109-1602 Phone: 206.284.1721 Fax: 206.284.2176 Email: accounting@aaafire.com fine * $"$TV wc�*- Bill To: EDMONDS HIGHLANDS 23326 EDMONDS WAY EDMONDS, WA 98026 Account#: Invoice #: Date: Service Address: EDMONDS HIGHLANDS 23326 EDMONDS WAY EDMONDS, WA 98026 Invoice 34584 627993 07/07/2015 og' *Mj, Rick Dolph NET 15 07/07/2015 MEOW 0 1.00 MOBILE SERVICE FEE 60.00 60.00 25.00 5# ABC FIRE EXT SERVICE PER NFPA 10 6.00 150.00 1.00 HAZMATFEE 5.00 5.00 215.00 Intl g 0.00 V4, 0.00 215.00 Account#: 34584 Visa/Mastercard/Amex #: Expiration: Signature: Invoice: 627993 Name on Card: Amount Paid: $ litAAA FIRE & SAFETY, INC. a a 11 30133RDAVENORTH (800) 223-3473 INFO&AAAFRECOM SEAME, WA 98109 EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED I YELLOW F] I WHITE X CONFIDENCE TEST I LX] REPAIRS Sprinkler Monitoring Panel? N Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS A Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number - Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E—Mail Address Inspection Annual Date of Inspection: 06/19/2015 Frequency/Type: Quarterly F-1 Testers Name Seth Sample Nicet (Please Print): Number: — 8260-0609-E Identification Number: S-08260 System Location STAIRWELL Central station monitoring? Yes 11 NoS Monitoring Monitoring Required? Yes D No [F] Company Name: System Make: FCI System Model: SBP FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected- Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number- - 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. -s (206) 284-1721 Signature of Tester: Phone # Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm System Functionality 1. Trouble signal with AC power off? 2. System operates properly on battery backup? I Battery voltage (no load) 25.72 volts 4. Battery voltage (full load) 25.55 volts (signals operating) 5. Charge circuit voltage 28.94 volts 6. System operates properly on standby power? 7. All signals operate on AC power? 8. Number of initiating circuits 9. Number of signal circuits 10. Does alarm system meet audibility standards as accepted? 11. All circuits checked for electrical supervision? 12. All auxiliary equipment operates (Elevators, fans, dampers)? 13. Ventilation controls operate? 14. Key to panel available? 15. Materials and equipment needed to restore pull stations are available at the main panel, e.g. glass rods, and plates; keys and allen wrenches, etc? 16. Operating instructions at panel? 17. Trouble indicators function properly? 18. Remote Annunciator Panels function properly? 19. Elevator Call Down function ' s properly? 20. Test record posted at panel? 21. General alarm automatic time delay _ (minutes) 22. Was a signal received at the Central Station monitoring company? 23. Other Devices (Specify) N/A N/A N/A N/AE] Yes YesNX No NoH Yes No [:1 Yes NoR Yes N Yes nX Yes Yes Yesm Yes nX No No No No No[--] NoEl Yes 0 No [:] Yes nX No[:] N/A Yes No[-] N/A Yes No YesZ NoH N/A N/A Yes No Yes No System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 24. Bells, Horns, Chimes 31 31 N/A Yes No 25. Voice Speakers (Voice Clarity) N/A Yes No[:] 26. Visual Alarm Devices N/A Yes NO[-] 27. Smoke Detectors N/A Yes No [:] 28. Heat Detectors N/A nX Yes No El 29. Duct Detectors N/A 0 Yes No D 30. Sprinkler Flow Switches 1 1 N/A Ej Yes 0 No 31. Sprinkler Supervisory Switches N/A Yes No 32. Manual Pull Stations 15 15 N/A Yes No 33. Annunciator(s) N/A Yes No 34. Beam Detectors N/A Yes No 35. Automatic Door Unlocks N/A Yes No 36. Automatic Door Release N/A Yes E] No E] 37. Fire Dampers N/A Yes [:] No [:] Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A Z YesE:1 No [:1 39. Phone Jacks N/A Z Yes No [-] 40. Call -in Signal N/A Eg Yes NOD Fire Alarm Systems Page 2 of 2 tit AAA FIRE & SAFETY, INC A. a A.. 30133RDAVENORTH (800) 223-3,473 SEAME, WA 98109 INFOIDAAAFRECOM EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED YELLOW _F FT —WHITE UX CONFIDENCE TEST REPAIRS Sprinkler Monitoring Panel? 23326 EDMONDS WAY - EDMONDS HIGHLANDS B Occupancy Address: Occupancy Name. Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number: Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E—Mail Address Date of Inspection: Inspection Annual 06/19/2015 Frequency/Type: Quarterly H Testers Name Seth Sample Nicet (Please Print): Number: — 8260-0609-E Identification Number: S-08260 System Location STAIRWELL Central station monitoring? Yes 11 No Monitoring Monitoring Required? Yes D No[@ Company Name. - System Make- FCI SBP System Model: FIRE CODE VIOLATIONS FOUND: (If additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number: - 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. -s (206) 284-1721 Signature of Tester: Phone # Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm Svstem Functionali 1. Trouble signal with AC power off? Yes RX No 2. System operates properly on battery backup? Yes F;�-/I NoH 3. Battery voltage (no load) 26.26 volts 4. Battery voltage (full load) 25.55 volts (signals operating) 5. Charge circuit voltage 28.94 volts 6. System operates properly on standby power? Yes No 7. All signals operate on AC power? Yes No 8. Number of initiating circuits 9. Number of signal circuits 10. Does alarm system meet audibility standards as accepted? Yes No 11. All circuits checked for electrical supervision? Yes No 12. All auxiliary equipment operates (Elevators, fans, dampers)? N/A Yes No 13. Ventilation controls operate? N/A YesE] No 14. Key to pane(available? N/AE] Yes M%/ 1^1 NoEl 15. Materials and equipment needed to restore pull stations are available at the N/AE:] Yes Z No[:] main panel, e.g. glass rods, and plates; keys and alien wrenches, etc? 16. Operating i41tructions at panel? Yes No 17. Trouble indic ' ators function properly? Yes No 18. Remote Annunciator Panels function properly? N/A Yes No[:] 19. Elevator Call Down functions properly? N/A Yes No 20. Test record posted at panel? Yes NoH 21. General alarm automatic time delay (minutes) N/A 22. Was a signalireceived at the Central Station monitoring company? N/A Yes No 23. Other Devices (Specify) Yes NoZ System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 24. Bells, Horns, Chimes 19 19 N/AEI Yes 0 No [:1 25. Voice Speakers (Voice Clarity) N/A Yes [:1 No 26. Visual Alarm Devices N/A Yes No 27. Smoke Detectors N/A MX Yes No 28. Heat Detectors N/A RX Yes No 29. Duct Detectors N/A Yes No 30. Sprinkler Flow Switches 1 1 N/A Yes No 31. Sprinkler Supervisory Switches N/A Yes No 32. Manual Pull Stations 9 9 N/A Yes No 33. Annunciator(s) N/A Yes NoE:1 34. Beam Detectors N/A 0 Yes No El 35. Automatic Door Unlocks N/A Yes No 36. Automatic Door Release N/A Yes No 37. Fire Dampers N/A Yes No Communication Equipment Total Number of Units in Buildinq Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A YesF� No 39. Phone lacks N/A Yes [:] No 40. Call -in Signal N/A Yes El NoD I Fire Alarm Systems Page 2 of 2 AAA FIRE & SAFETY, INC 30133RDAVENORTH (8GO) 223-3473 SEAME, WA 98109 INFOO,AAAFRE.COM, EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED YELLOW FTT WHITE CONFIDENCE TEST IN I REPAIRS Sprinkler Monitoring Panel? M Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS C Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number: Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E—Mail Address Date of Inspection'. Inspection Annual z 06/19/2015 Frequency/Type: Quarterly H Testers Name Seth Sample Nicet (Please Print): Number: — 8260-0609-E Identification Number- S-08260 System Location STAIRWELL Central station monitoring? Yes 13 NoEl Monitoring Monitoring Required? Yes 11 NoS Company Name: System Make: ESIL System Model: 1500 FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number: - 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: Phone # (206) 284-1721 Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm System Functionality 1. Trouble signal with AC power off? 2. System operates properly on battery backup? 3. Battery voltage (no load) 25.38 volts 4. Battery voltage (full load) 25.21 volts (signals operating) 5. Charge circuit voltage 27.32 volts 6. System operates properly on standby power? 7. All signals operate on AC power? 8. Number of initiating circuits 9. Number of signal circuits 10. Does alarm system meet audibility standards as accepted? 11. All circuits checked for electrical supervision? 12. All auxiliary equipment operates (Elevators, fans, dampers)? 13. Ventilation controls operate? 14. Key to panel available? 15. Materials and equipment needed to restore pull stations are available at the main panel, e.g. glass rods, and plates; keys and alien wrenches, etc? .16. Operating instructions at panel? 17. Trouble indicators function properly? 18. Remote Annunciator Panels function properly? 19. Elevator Call Down functions properly? 20. Test record posted at panel? 21. General alarm automatic time delay (minutes) 22. Was a signal received at the Central Station monitoring company? 23. Other Devices (Specify) N/A N/A N/A N/A Yes Yes :X:] No NoH Yes No [:] Yes NoFj Yes Yes Yes YesEl Yes Yes No No No E] No 1:1 No[:] No[:] Yes 0 No Yes FXj No N/A Yes No[:] N/A Yes No Yes NoH N/A N/A YesE:] No Yes F-I No System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 24. Bells, Horns, Chimes N/A Yes 0 No 25. Voice Speakers (Voice Clarity) N/A FXI Yes [:1 NoE:1 26. Visual Alarm Devices N/A Yes [:1 No [:1 27. Smoke Detectors N/A Yes No 28. Heat Detectors N/A Yes No 29. Duct Detectors N/A Yes No 30. Sprinkler Flow Switches N/A Yes No 31. Sprinkler Supervisory Switches N/A Yes No 32. Manual Pull Stations N/A Yes No 33. Annunciator(s) N/A Yes No 34. Beam Detectors N/A Z YesEj NoE:] 35. Automatic Door Unlocks N/A Yes No 36. Automatic Door Release N/A Yes No 37. Fire Dampers N/A Yes No Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A Yes No 39. Phone lacks N/A Yes No E] 40. Call -in Signal N/A Z YesE] NoD Fire Alarm Systems Page 2 of 2 AAA FiRE & SAFETY, INC 3013 3RD AVE NORTH (800) 223.3473 SEAME, WA 98109 INFOCAAAFRECOM EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED YELLOWF] I WHITE LA CONFIDENCE TEST [A I REPAIRS Sprinkler Monitoring Panel? M Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS D Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number: Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E—Mail Address Date of Inspection: Inspection Annual 06/19/2015 Frequency/Type: Quarterly H Testers Name Seth Sample Nicet (Please Print): Number: — 8260-0609-E Identification Number: S-08260 System Location STAIRWELL Central station monitoring? Yes 11 No El Monitoring Monitoring Required? Yes 11 NoEl Company Name: System Make: FIRELITE System Model: MP-24 FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) Nicet Certification Number: - 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester Phone # (206) 284-1721 Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm Svstem Functionali 1. Trouble signal with AC power off? 2. System operates properly on battery backup? 3. Battery voltage (no load) 25.40 volts 4. Battery voltage (full load) 25.29 - volts (signals operating) 5. Charge circuit voltage 15.33 volts 6. System operates properly on standby power? 7. All signals operate on AC power? 8. Number of initiating circuits 1 9. Number of signal circuits 1 10. Does alarm system meet audibility standards as accepted? 11. All circuits checked for electrical supervision? 12. All auxiliary equipment operates (Elevators, fans, dampers)? 13. Ventilation controls operate? 14. Key to panel �available? 15. Materials and equipment needed to restore pull stations are available at the main panel, e.g. glass rods, and plates; keys and allen wrenches, etc? 16. Operating instructions at panel? 17. Trouble indicators function properly? 18. Remote Annu'hciator Panels function properly? 19. Elevator Call Down functions properly? 20. Test record posted at panel? 21. General alarm automatic time delay _ (minutes) 22. Was a signal r�eceivecl at the Central Station monitoring company? 23. Other Devices (Specify) N/A N/A N/AE] N/A [:] Yes P9 No" Yes LXJ No Yes NoEl Yes NoF� Yes Yes Yes Yes E] Yes M Yes nX No 1:1 No E] NoEl No 1:1 No[:] NoE] Yes No Yes No N/A Z Yes NoEj N/A Yes No Yes NoH N/A N/A Yes No Yes No System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 24. Bells, Horns, Chimes 13 13 N/A Yes No 25. Voice Speakers (Voice Clarity) N/A Yes No 26. Visual Alarm Devices N/A Yes No[:] 27. Smoke Detectors N/A Yes No 28. Heat Detectors N/A Yes No 29. Duct Detectors N/A Z Yes [:1 No El 30. Sprinkler Flow Switches 1 1 N/A Ej Yes Z No [:] 31. Sprinkler Supervisory Switches N/A Z Yes NoE] 32. Manual Pull Stations 6 6 N/A Yes No 33. Annunciator(s) N/A Yes No 34. Beam Detectors N/A RX Yes No 35. Automatic Door Unlocks N/A Yes No 36. Automatic Door Release N/A Yes No 37. Fire Dampers N/A Yes No Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A Yes [:1 No 39. Phone lacks N/A YesE] No 40. Call -in Signal N/A Z Yes [:] NOD Fire Alarm Systems Page 2 of 2 AAA FiRE & SAFETY, INC 3013 3RD AVE NORTH (800) 223-3473 SEATTLE, WA 98109 INF00AAAFRECOM EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED—FTYELLOW _F FT WHITE CONFIDENCE TEST X I REPAIRS Sprinkler Monitoring Panel? 0 Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS E Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number: Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E—Mail Address Date of Inspection: Inspection Annual 06/19/2015 Frequency/Type: Quarterly Testers Name Seth Sample Nicet (Please Print): Number: — 8260-0609-E Identification Number- S-08260 System Location STAIRWELL Central station monitoring? Yes 11 NoEl Monitoring Monitoring Required? Yes D NoEl Company Name: System Make: FCI System Model: SBP FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number: 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. .57 (206) 284-1721 Signature of Tester: Phone # Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm Svstem Functionali 1. Trouble signal with AC power off? YesFX] No 2. System operStes properly on battery backup? Yes NoH 3. Battery voltage (no load) 25-58 volts 4. Battery voltage (full load) 25.42 volts (signals operating) 5. Charge circuit voltage 29.32 volts 6. System operates properly on standby power? Yes 1,�\j No 7. All signals operate on AC power? Yes No 8. Number of initiating circuits 9. Number of signal circuits 10. Does alarm system meet audibility standards as accepted? Yes NoE] 11. All circuits checked for electrical supervision? Yes No 12. All auxiliary equipment operates (Elevators, fans, dampers)? N/A Yes No 13. Ventilation controls operate? N/A Yes No 14. Key to panel N/A Yes No[:] 15. Materials and equipment needed to restore pull stations are available at the N/A YesFXj No[:] main panel, e.g. glass rods, and plates; keys and allen wrenches, etc? 16. Operating in4ructions at panel? Yes FXJ NoE] 17. Trouble indicators function properly? Yes No 18.1 Remote AnnO-Piciator Panels function properly? N/A Yes No[:] 19. Elevator Call Down functions properly? N/A Yes No 20. Test record p�qsted at panel? Yes NoH 21. General alarm automatic time delay - (minutes) N/A 22. Was a signal"riLeceived at the Central Station monitoring company? N/A Yes No[:] 23. Other Devices (Specify) Yes NoZ System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 24. Bells, Horns, Chimes 19 19 N/A Yes No 25. Voice Speakers (Voice Clarity) N/A Yes No 26. Visual Alarm Devices N/A FXJ Yes No[:] 27. Smoke Detectors N/A 0 Yes No [-] 28. Heat Detectors N/A 0 Yes No El 29. Duct Detectors N/A 0 Yes No El 30. Sprinkler Flow Switches 1 1 N/A Yes No 31. Sprinkler Supervisory Switches N/A YesE] No 32. Manual Pull Stations 9 9 N/A Yes No 33. Annunciator(s) N/A Yes No 34. Beam Detectors N/A Z Yeso No El 35. Automatic Door Unlocks N/A FX-j Yes No 36. Automatic Door Release N/A FX� Yes No 1 37. Fire Dampers N/A Z Yes NoE:1 Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A YesEl No [I 39. Phone lacks N/A Yes No 40. Call -in Signal N/A Yes No Fire Alarm Systems Page 2 of 2 titAAA FIRE & SAFETY, INC 3013 3RD AVE NORTH (800) 223-3473 SEAME, INA 98109 INFOCAAAFRE.COM EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED J-P YELLOW _F FT —WHITE CONFIDENCE TEST ILA I REPAIRS I Sprinkler Monitoring Panel? 0 Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS F Responsible Person FRANCES (425) 771-6910 First & Last Name: Phone Number: Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E—Mail Address Inspection Annual Date of Inspection: 06/19/2015 Frequencyrrype: Quarterly H Testers Name Seth Sample Nicet (Please Print): Number: — 8260-0609-E Identification Number: S-08260 System Location STAIRWELL Central station monitoring? Yes 11 NoEl Monitoring Monitoring Required? Yes D NoEl Company Name. - System Make: FIRELITE System Model: MP-24 FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number: - 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. 15, IS (206) 284-1721 Signature of Tester Phone # Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm System Functionality 1. Trouble signal with AC power off? 2. System oper�ates properly on battery backup? 3. Battery voltage (no load) 27.40 volts 4. Battery voltage (full load) 27.29 volts (signals operating) 5. Charge circuit voltage 15.34 volts 6. System operates properly on standby power? 7. All signals operate on AC power? 8. Number of initiating circuits 9. Number of signal circuits 10. Does alarm system meet audibility standards as accepted? 11. All circuits checked for electrical supervision? 12. All auxiliary equipment operates (Elevators, fans, dampers)? 13. Ventilation controls. operate? 14. Key to panell�tavailable? 15. Materials and equipment needed to restore pull stations are available at the main panel, e.g. glass rods, and plates; keys and alien wrenches, etc? 16. Operating insIf"Tucti.ons at panel? 17. Trouble indicators function properly? 18. Remote Ann ,416ciator PaInels function properly? 19. Elevator Call Down functions properly? 20. Test record ilosted at panel? 21. General alarm automatic time delay - (minutes) 22. Was a signallfec6ivecl at the Central Station monitoring company? 23. Other Devices (Specify) N/A N/A N/A N/A Yes Yes Yes Yes Yes Yes Yes Yes Yes RX Yes Z No NoH No No No No No NoEl No[:] No[] Yes No [:] Yes No [j N/A Yes No[:] N/A Yes No YesZ NoH N/A N/A Yes No Yes No System Devices Total Number of Units in Buqq�� Total Number Units Tested Test Results Acceptable 24. Bells, Horns, Chimes 13 13 N/A Yes No 25. Voice Speakers (Voice Clarity) N/A Yes No[:] 26. Visual Alarm Devices N/A Yes No 27. Smoke Detectors N/A Yes No 28. Heat Detectors N/A Yes No 29. Duct Detectors N/A Yes No 30. Sprinkler Flow Switches 1 N/A E] Yes Eg No 31. Sprinkler Supervisory Switches N/A Yes No 32. Manual Pull Stations 5 N/A Yes No 33. Annunciator(s) N/A Yes No 34. Beam Detectors N/A 0 Yes El No El 35. Automatic Door Unlocks N/A Yes No 36. Automatic Door Release N/A Yes No 37. Fire Dampers N/A Yes No Communication Equipment Total Number of Units in Building Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A Yes No 39. Phone lacks N/A Yes No 40. Call -in Signal N/A 0 YesE] NoD Fire Alarm Systems Page 2 of 2 tit AAA FIRE & SAFETY, INC 3013 3RD AVE NORTH (800) Z23-3473 SEATTLE, WA 98109 INF09DAAAFRE.COM EDMONDS FIRE DEPARTMENT "THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION" FIRE ALARM SYSTEM Status Given (One System per Report) RED YELLOW [] I WHITE CONFIDENCE TEST I LXJ I REPAIRS I L] Sprinkler Monitoring Panel? 0 23326 EDMONDS WAY - EDMONDS HIGHLANDS G Occupancy Address: Occupancy Name. Responsible Person FRANCES (425) 771-6910 First & Last Name'. Phone Number: Responsible Person Responsible Party EDMONDSHIGHLANDS@COA Address, City, State, Zip: E-Mail Address Date of Inspection: Inspection Annual 06/19/2015 Frequencyrrype: Quarterly Testers Name Seth Sample Nicet (Please Print): Number: - 8260-0609-E Identification Number- S-08260 System Location STAIRWELL Central station monitoring? Yes 11 NoE] Monitoring Monitoring Required? Yes 11 No El Company Name: System Make'. FIRELITE System Model: MS-2 FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet) NO ACCESS TO RESIDENTIAL UNITS, ONLY COMMON AREAS TESTED CORRECTIONS MADE: Date Corrected: - Corrected By: (if additional room is needed, please add a separate sheet) Nicet Certification Number: - 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: a �� Phone # (206) 284-1721 IV Building Representative (signature) Fire Alarm Systems Page 1 of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Fire Code for inspecting and testing requirements. Alarm Svstem Functionali 1. Trouble signal with AC power off? Yes No 2. System operates properly on battery backup? Yes 1XI NoH I Battery voltage (no load) 27.35 volts 4. Battery volt$ge (full load) 27.21 - volts (signals operating) 5. Charge circuit voltage 27.03 volts 6. System oper�ahes properly on standby power? Yes No 7. All signals operate on AC power? Yes nX No 8. Number of initiating circuits 1 9. Number of signal circuits 10. Does alarm system meet audibility standards as accepted? Yes No 11. All circuits checked for electrical supervision? Yes nX No 12. All auxiliary equipment operates (Elevators, fans, dampers)? N/A Yes No 13. Ventilation controls operate? N/A Yes No 14. Key to pain�jlavailable? N/A Yes��,nx No i -- 15. Materials and equipment needed to restore pull stations are available at the N/A Yes No main panel, e.g. glass rods, and plates; keys and allen wrenches, etc? 16. Operating inItructions at panel? Yes No E] 17. Trouble indicators function properly? Yes No El 18. Remote An6driciator Panels function properly? N/A M Yes No[:] 19. Elevator Call Down functions properly? N/A Z YesE] No 20. Test record',*:p _bsted at panel? Yes NOH General alarm automatic time delay - (minutes) N/A 22. Was a signAlkeceived at the Central Station monitoring company? N/A Yes No 23. Other Devices (Specify) Yes NO System Devices Total Number of Units in Building Total Number Units Tested Test Results Acceptable 24. Bells, Horns, Chimes 19 19 N/A Yes No 25. Voice Speakers (Voice Clarity) N/A Yes No 26. Visual Alarm, Devices N/A Yes Ej NO[-] 27. Smoke Detectors N/A FXI Yes No 28. Heat Detecto-rs N/A Yes No 29. Duct Detectors N/A Yes No 30. Sprinkler FloW Switches 1 1 N/A Yes No 31. Sprinkler Supervisory Switches N/A Yes No 32. Manual Pull ttations 12 12 N/A Yes No 33. Annunciator(s) N/A Yes No 34. Beam Detectors N/A nX Yes No 35. Automatic Door Unlocks N/A Yes No 36. Automatic Door Release N/A Eg Yes No 1 37. Fire Dampers N/A Eg Yes No Communication Equipment Total Number of Units in Buildinq Total Number Units Tested Test Results Acceptable 38. Phone Sets N/A 0 Yes NOE] 39. Phone Jacks N/A Z Yes NOE] 40. Call -in Signal N/A 0 Yes El NOD I Fire Alarm Systems Page 2 of 2 FIRE PREVENTION J Se' I Briet'*,� lEdinonds, and SNOHOMISH C4." 12425 Ivieridian Ave S INSPECTION REPORT .. ..... Mountlake Terrace FI-E Everett, WA 98208 EIEDMONDS 0 BRIER Twww.FireDistrictl.org Phone (425) 551-1200 0 MOUNTLAKE TERRACE 0 UNINCORPORATED Fax (425) 551-1272 FREQUENCY STATION & SHIFF"*-' LOCATION: 23326 Edmands Way Rldg A-G 9=0 y I 2D-D BUSINESS NAME: Edmonds I lighlarkils Apbz PHONE: 425-71W71C SCHEDULED DATE DUE II' JUI 2 14 MAILING UFIR ii, ADDRESS: 2-a2b Edmormi. Way, Bldg A-Ci, EdiTmindii, WA -08020 BUSINESS OWNER: HOME PHONE: frig EMERGENCY-1: I la Lrz i VAN A Lyk rin Cc HOME PHONE: 420716911) CURRENT - H9ME P�IrNE: KEY ACCESS-2: A��C��OL'.N CITY YES NO BUSINESS EMAIL: &__71f L,,A t) S LICENSE PERSON CONTACTED: b"*'F�: es INITIAL INSPECTION DATE NAME OF INSPECTOR: VV L I -J 12- C) Iz F I HE SYS I EMS, AS 7113 FA 13 FE 3113 FD Lk Baw I q p / Iq A) ,,� I '1711tJ40 71 HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS ' 0 F 0 DA) 2 5 p "V) L �-f 6 0 X1 7 Y*Z- 1) 2- VAL-u E 2AS02- ALL I-) I L 0 1,%) 3 3 a I I— 1 01 VU /A IL 4 (L A V) 6H 'r 4 5 4 ti- A-) 0 L� U I- 1- -5 -7 /1 -r A) E, r-- 0 5 4 6 6 �)j )Lo I/)(, c) 0 F f- E V-2 6 D 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X I st RE -INSPECTION DATE DUE: [Al PERSON CONTACTED: INSPECTOR: DATE: VIO IONS 1 15 2 6 3 4 .8 LETTERNEEDED [] YES NO 2nd RE -INSPECTION DATE DUE: EXTENSION GRANTEDTO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON C014TACTED: PERSON CONTACTED: 1 '11NPECTOR: INSPECTOR: 2 DATE: DATE: 3 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 2 6 DATE: CODE SECTION, 5 3 7 RETURN RECEIPT RECEIVED 6 4 18 ANO DATE: DISPOSITION: LETTERNEEDED [] YE _:S :0 F 8 FIRE DEPARTMENT COPY 3013 3rd AVE NORTH SEATTLE, WA 98109 ILIA. 1(206) 284-1721 (800) 223-FIRE (206) 284-1769 FAX FIRE & SAFM Nc. AAA.FIRE.COM. - U CZqffJ6J7J U FIRE DEPARTMENT Testi Z ....Conridence ng. QV.QT1PX4 INVOICE # `06' ///! ACCOUNT-# 1�45� i — DATE Address- X_ C.) Zip Code , 71 Occupied.as: -OCT 3 0 2014 Building Gwffer. Ph.# _711 -6 V/D Address: City: Zip Code: L le—) Date of Inspection: Type of Igspectio : Annu Other I I/W ?-- Tester's Name (PLEASE' PRINT) A�e) SFD Certification # DRY SYSTEM 1. Trip test (dry trip) conducted: System tripped in seconds kAII flow switches, supervisory switches & alarm bells tested 3. Alarm Bell operates: 4;� Flow tests conducted: Static Pressure psi Flow pressure psi 2 inch drain? 5. Systems inspected and lub j ed refills 6. Air compressor - Is em in 30 minutes 7. Systems drained a restores to normal operations 8. Were the heat a ation devices tested on pre -action and deluge systems? WET SYSTEM I Flow test conducted: Static Pressure TO psi Flow Pressure psi 2 inch drain? 2. Flow switches, supervisory switches & alarm bells, tested Alarrn bell operates: 4. Systems inspected and lubricated: 5�' Pressurd regulating valves tested: GENERAL 1. Central Station Monitoring? Name of Company A-Zli .2. Location of Sprinkler: IJ Basement Hallways As Designed Others 3. Pumper connections and clapper valves unobstructed 4 -Sprinkler heads less than 50 years old heads are available 6.: �:'S: ems left in service yst 'are sealed.or supervised - tw -Signs.are provided on valves 9- *City Static Water-Tressure LID psi :,9 PROBLEMS�TOUND MADF- FA _4T bate corrected THIS --IS �7 (OCERTIFY THAT T -,:��:�,,,�,S:i6i4,A�TUkE�OF-TES By Yes No Yes No N/A. Yes No N/A. Yes No Yes No Yes No Yes No Yes No Yes No N/A Yes IN 0 Yes No Other Yes No N/A N/A Yes No N/A -74 Yes No N/A Yes No Yes No IV"*A Yes :]�I'No Yes Yes _]900 T-es R o ;'fes =No HAS BEEN PROPERLY TESTED AND INSPECTED FOR RELIABILITY TO COVER SFD LICENSE# Form # 8304 3013 3rd AVE NORTH -1721 SEATrLE, WA 98109 (206)284 (800) 223-FIRE 284-1769 FAX (206) FIRE & SAFM INC. AAA.FIRE.COM Address Occupied as: t'�, Buflding..Gv�.k FIRE DEPARTMENT ...Confidence lestin Address: City: Date -of Inspection: Type of lr)spect*o yw Testet'S Name (PLEASE PRINT) bf:k a2gl& INVOICE # C�l 6' ACCOUNT DATE '7Z, IL 41 Zip Code: Other SFD Certification # DRY SYSTEM I . Trip test (dry trip) conducted: System tripped in seconds 2. Wl flow switches, supervisory switches & alarm bells tested .3. Alarm Bell operates: 4. Flow tests conducted: Static Pressure psi Flow pressure psi 2 inch drain? 5. Systems inspected and lubr* ed 6 is - m in 30 minutes 6. Air compressor re ills 7. Systems drained a restores to normal operations 8. Were the heat a ation devices tested on pre -action and deluge systems? WET SYSTEM 1. Flow test conducted: Static Pressure psi Flow Pressure psi 2 inch drain? 2. Flow switches, supervisory switches & alarm bells, tested 3. Alarm bell operates: 4. Systems inspected and lubricated: 5� Pressure regulating valves tested: GENERAL L. !Central Station Monitoring? Name of Company AT,/j/ -Location of Sprinkler: -IJ .:2. Basement Hallways As Designed Others 3.: Pumper connections and clapper valves unobstructed 4.' .-Sprinkler heads less than 50 years old 5. --,�;Spare�sprinkler heads are available �:6. Systems -left in service 7. -Valves are sealed or supervised 8.!* --Signs are provided on valves �9.' 'City Static Water Pressure psi PROBLEMS�' OUND: CORRE . C ANS MADE: IPN4T f� Yes No Yes No N/A Yes No N/A Yes No Yes No Yes No Yes No Yes No Yes No N/A Yes No Othey//'*' Yes Yes No No N/A Yes No N/A Yes No N/A —74 Yes No N/A Yes N o Yes No Yes : 2'"No Yes 0 :Z (I � Yes No Yes �No Yes =No By, 3YSTEM HAS. BEEN PROPERLY TESTED AND INSPECTED FOR RELIABILITY TO COVER SFDLICENSE# Ila Fonn #. 8304 3013 3rd AVE NORTH SEATTLE, WA 98109 (206) 284-1721 (800) 223-FIRE .(206) 284-1769 FAX & SAFETY WC. AAA.FIRE.COM ^—^ r% . I Address Occupied.as: Building gwftr.*. Address: Date -of Inspection: FIREDEPARTMENT Confidencelestinz AUTI 0MA"'ITIC SIP-Rl�IN,,K',,�',LE,�R.�.'SYSI ig 2, Type of Tester's Name (PLEASE PRINT) a Ph. # City: INVOICE # S�l (y // '� ACCOUNT4 DATE Zip Code Zip Code: Other SFD Certification # DRY SYSTEM I ..Trip test (dry trip) conducted: :System tripped in seconds 2. �,All flow switches, supervisory switches & alarm bells tested �3. Alarm Bell operates: 4.- Flow tests conducted: Static Pressure psi Flow pressure psi 2 inch drain? 5. Systems inspected and lubr* ed . - Is e in 30 minutes fi 6. Air compressor re ills 7. Systems drained a restores to non-nal operations 8. Were the heat a ation devices tested on pre -action and deluge systerns? WET SYSTEM , . "'..oe 0 1 1. Flow test conducted: Static Pressure 6P psi Flow Pressure psi 2 inch drain? 2. Flow switches, supervisory switches & alarm bells, tested 3. Alarrn bell operates: 4. Systems inspected and lubricated: 5;' Pressure regulating valves tested: GENERAL f. Central Station Monitoring? Name of Company I-OeAl alil --,,Location of Sprinkler: Basement Hallways As Designed Others Pumper connections and clapper valves unobstructed 4e� �Sprinkler heads -less than 50 years old 11:71 % "on 5 ,-,Spare sprinkler heads are available I A 6.1 Systems left in service -Valves�are sealed�or supervised 7 S. �.`S44ns are provided on val ves AIN �9 -Pressure psi City Static Water Vnr . V AQ�_Pr)Plmn- - 'A&SIX: CO MADE: 7-HI&4& TO CERTIFY THAT LISTED -IN TH ��'SIGNATURE'1017 TEST 0. Yes No Yes No N/A Yes No N/A Yes No Yes No Yes No Yes No Yes No Yes No N/A Yes VIN o Yes No Other Yes Yes No No N/A N/A Yes No N/A 74 Yes No N/A V Yes No Yes No Yes =//No Yes "o Yes 17N No ;��s :2'Noo By. — SYSTEM HAS:BEEN PROPERLY TESTED AND INSPECTED FOR RELIABILITY TO COVER '�7 SFD LICENSE # 04 Oa Form #:8304 3013 3rd AVE NORTH SEATTLE, WA 98109 ,(206) 284-1721 (800) 223-FIRE 1769 FAX jig (206)284 FIRE A SAFETY INQ AAA.FIRE.COM Address Occupied.as: Building: Gwner, ?f-v�p Address: Date -of Inspection: //Cv I 'I " Type of Tester's Name (PLEASE PRINT) 0 FIRE DEPARTMENT -ConfWence Testin 9:. INVOICE # ACCOUNT # DATE t/ City: Zip Code: Other SFD Certification # DRY SYSTEM Trip test (dry trip) conducted: System tripped in seconds 2. WI flow switches, supervisory switches & alarm bells tested 3. Alarm Bell operates: ..4; Flow tests conducted: Static Pressure psi n s ac 'e t te s s u d p er or sw ps s e tc c h 0 e n s ds & a ar n e es te Flow pressure psi 2 inch drain? e d 5. Systems inspected and lubr' ed 1 6. Air compressor refills em in 30 minutes .7. Systems drained a restores to non-nal operations a 8. Were the heat a ation devices tested on pre -action and deluge systems? WET SYSTEM I Flow test conducted: Static Pressure 9ro psi Flow Pressure ('00 psi 2 inch drain? 2.- Flow switches, supervisory switches & alarm bells, tested 3. Alarm bell operates: .4.. Systems inspected and lubricated: 5:� Pressure regulating valves tested: Yes No Yes No N/A Yes No N/A Yes No Yes No Yes No Yes No Yes No Yes No N/A Yes _/"No Yes No Other Yes No N/A Yes No N/A Yes No N/A —7'4 Yes No N/A GENERAL- 1. , —Central Station Monitoring? Yes No Name of Company xT,/j/ 2. ',Location of Sprinkler: 1_j Basement Hallways As Designed Others Yes No I(V :.�-3.� Pumper connections and clapper valves unobstructed :4.: 'Sprinkler heads -.less than 50 years old Yes No heads are available 5 0 p :� Z111 _Systems .-left in service es 7.1 :-Valves- are sealed.,or supervised Yes RN00 _2� 8. . *-Signs are provided on valves Yes =No 9.,` - City Static Watpr,Pressure psi PROBLEMS--.FO'UND.-- Alvd 14 :-�COkREQTA NSMADE: 3013 3rd AVE NORTH SEATTLE, WA 98109 (206) 284-1721 (800) 223-FIRE (206) 284-1769 FAX FIRE & SAFM INt AAA.FIRE.COM. Address Occupied as: Building Gvmteer. Address: Date of Inspection: ClaffJeWW FIRE DEPARUMENT i q,:� Type of Tester's Name (PLEASE PRINT) Confi4enceles.i Ph. # City: INVOICE # F ZV ACCOUNT.# DATE Zip Code Zip Code: Other SFD Certification # DRY SYSTEM 1. Trip test (dry trip) conducted: Yes — No System tripped in seconds 2. �.All flow switches, supervisory switches & alarm bells tested Yes — No — N/A 3. Alarm Bell operates: Yes — No — N/A 4; Flow tests conducted: Static Pressure psi Yes — No Flow pressure psi 2 inch drain? Yes No 5. Systems inspected and lubr' ed Yes No 6. Air compressor refills em in 30 minutes Yes No 7. . Systems drained a restores to normal operations Yes No 8. Were the heat a ation devices tested on pre -action and deluge systems? Yes No N/A WET SYSTEM I Flow test conducted- Yes V11 No Static I psi )ressure Flow Pressure psi 2 inch drain? Yes her --A,- 2. Flow switches, supervisory switches & alarm bells, tested Yes No N/A 3. Alarm bell operates: Yes No N/A 4. Systems inspected and lubricated: Yes No N/A 5�' Pressure regulating valves tested: Yes No N/A GENERAL 1. - Cen tral Station Monitoring? Yes No Name of Company 2. Location of Sprinkler: Basement Hallways As Designed Others �3.' Pumper connections and clapper valves unobstructed Yes No AZA /N 4.- -Sprinkler heads less than 50 years old Yes 0 .:5.� .,,Spare- sprinkler heads are available Yes NO 6... Systems left in service 7.:. --Valves.are sealed: or supervised es No tA Y 8.� *S' s are provided on valves Ign Yes =No 9 City Static Water Pressure psi P '-I ROBLEMS::ZOUND� '�6k�E�Tit.NS MADE: 3013 3rd AVE NORTH SEATTLE, WA 98109 (206) 284-1721 (800) 223-FIRE (206) 284-1769 FAX FIRE & SAFETY INC. AAA.FIRE.COM. Address Occupied as: Building Qwqflter.&� /-7,/, Address: Date of Inspection: Z 4C� CAMAM FIRE DEPARTMENT i q, Type of I Tester's Name (PLEASE PRINT) Conridencelesting INVOICE # ACCOUNT.# DATE City:___ Zip Code: Other SFD Certification # DRY SYSTEM I Trip test (dry trip) conducted: System tripped in seconds Wl flow switches, supervisory switches & alarm bells tested 3-� Alarm Bell operates: 4; Flow tests conducted: Static Pressure Dsi Flow pressure r)si 2 inch drain? 5. Systems inspected and lubr' 'ed 6. Air compressor re Zillsem in 30 minutes f Systems drained a restores to normal operations 8. Were the heat a ation devices tested on pre -action and deluge systems? WET SYSTEM 1. Flow test conducted: Static Pressure 110 psi Flow Pressure psi 2 inch drain? 2. Flow switches, supervisory switches & alarm bells, tested 3. Alarm bell operates: 4. Systems inspected and lubricated: 5. Pressure regulating valves tested: Yes No Yes No N/A Yes No N/A Yes No Yes Yes Yes Yes Yes Yes No No No No No /No Iffla Yes No Other N/A Yes, Yes No No N/A Yes No N/A —74 Yes No N/A GENERAL 1. Central Station Momtoring9 Yes - No Name of Company .2. Location of Sprinkler: IJ Basement Hallways As Designed Others -3.- Pumper connections and clapper valves unobstructed Yes No AZA 4-. Sprinkler headsiless than 50 years old Yes No -5.'--. Spare -.sprinkler heads are available Yes NO -.6. Systems -left in service 0 y 7. :-Valves are sealed -or supervised Yes No Yes .8. -Signsare provided on valves Yes =No -.�,9. 'City Static Water. Pressure LID psi ad 00 PRART,FMR��FCWNDw � � I _ & I rK lei! 91i 1plljgj%fx� —1, - orm W-141 NS':MADE: Fom #, 8304 3013 3rd AVE NORTH SEATrLE, WA 98109 (206) 284-1721 A. R (800) 223-FIRE N (206) 284-1769 FAX FIRE & SAFM INC AAA.FIRE.COM Address Occupied as: Building Owfler. Address: - U CjZTJe)1_) 3 FIRE DEPARTMENT Date of Inspection: //Cv I 'I , Type of Tester's Name (PLEASE PRINT) UI Con ence Testin fid INVOICE # 0 6' ACCOUNT # City: - Zip Code: Other SFD Certification # DRY SYSTEM 1. Trip test (dry trip) conducted: Yes — No System tripped in seconds 2. IWI flow switches, supervisory switches & alarm bells tested� Yes — No — N/A. 3. Alarm Bell operates: Yes — No — N/A. 4. Flow tests conducted: c te Static Pressure psi p S i Yes — No Flow pressure psi ps 2 inch drain? Yes — No 5. ed Systems inspected and lub ed Yes — No 6. Air compressor refills em in 30 minutes Yes* — No 7. Systems drained a restores to normal operations Yes — No 8. Were the heat a ation devices tested on pre -action and deluge systems? Yes — No N/A WET.SYSTEM 1. . Flow test conducted: Yes 4ZNo Static Pressure psi Flow Pressure psi 2 inch drain? Yes No Other 2. Flow switches, supervisory switches & alarm bells, tested Yes No N/A 3. Alarm bell operates: Yes No N/A 4. Systems inspected and lubricated: Yes No N/A 5. Pressure regulating valves tested: Yes No N/A GENERAL I . Central Station Monitoring? Yes No U1Name of Company 2. Location of Sprinkler: Basement Hallways As Designed Others 3. Pumper connections and clapper valves unobstructed Yes N o Yes 4. -Sprinkler heads less than 50 years old :]: No -5. Spare sprinkler heads are available Yes NO 6.- Systems left in service Yes :Y'l 0 0— :7. Valves are sealed or supervised es �N 8. - -Signs are provided on valves Yes =No 9. City Static Water Pressure (1�0 psi 4 'MADE: F Vlea li 11941M 176=- KW AMAIL PAK' Date corr . ected By, z i, :-THIS-11S TO CERTIFY THAT THE SPRINYXER SYSTEM HAS BEEN PROPERLY TESTED AND INSPECTED FOR RELIABILITY TO COVER ,EMS LISTEDIN THI _,:,TTHE ITt OFIESTE SFD LICENSE 4. fwl TUR&OFIESTE Fom #: 8304 AAA Fire and Safety M./yOZI&RE DEPARTMENT INVOICE 4 3 0 13 3*d Ave. No. Confidence Tesiing A C C 0 U N T 4 Seattle, WA. 98109 DATE (800) .223-.3473 FIRIE ALARM Address CIty 6-,d1-fi41 zip Occupied as Building Owner- 6/ Phc(he 171 Address city Zip Date of Inspection Type of inspection Anngpi Tester's Name, Michelle Huber Control Panel Model # SFD Certificate # SCIP-H-04401 No. of Initiating Circuits No. of Signal Z!�ircuits Battery Voltag J-7. 0 Battery Voltage under Load C& I —(signals operating) Charge Voltage_ J-11 1 Trouble signal with A/C power off (� S-) N 0. N/A 2. System operates satisfactorily on standby power (M�) N 0 N/A 3. All auxiliary equipment operates (elevators, fans, dampers, -etc.) --,,��N 0 J(N /A� 4. All signals operate on A/C power 0 N/A y N 1 5. All notification appliances checked for proper operation 0 N/A 6. All circuits checked for electrical supervision NO N/A 7. Control panel checks per manufacturer's instructions F 's N 0 NJA- 8. Central station or remote connection YES NO 9. Name of monitoring company 1.ma,/ 10. Key to panel available (Y EV N 0 N/A Type OF Equip # Devices Tested Satisfactory YES NO NIA Total # Devices Bells, Homs, Chimes X I Voice -Alarm Speaker Visual"Alarm Devices --Trodbtd, Indicators Switches .-Flow- Supervisory Switches :Srn6k6`-De-te*ctors Heat Detectors Manual Pull Stations .Ventilation Control Ops. 'Central -Station Annunciators Elevator Call Down Fire— and -'Smoke Damper Phone, Jacks DoorUnlocks (fail safe) oor" elease Chemical Release Other Problems found .CorrLictions Made: -.,,,Date Cor'rected S, igna Liur(. ''W; IN Electrical License FRJBERMJ9j' I KB , AAA Fire and Safety V-,i) FIRE DEPARTMENT INVOICE 4 ,d 17 1 _-Ft- / j 3013 3 Ave. No. Confidence Te#ing ACCOUNT9 Seattle, WA. 98109 DATE (800).223-.3473 FIRIE ALARM Address Ity C, 6�dlvjajj Zip Occupied as 1�s -L Building Ownef Phone# I LWAU Address city Zip Date of Inspection Type of inspection Annjjg I Tester's Name: Michelle Huber Control Panel Model # 77-N SFD Certificate # SCP-H-04401 No. of Initiating Circuifs No. of Signal Circuits Battery Voltage_ --- Battery Voltage under Load a42,Y (sijnals operating) Charge Voltage 7-9 1., Trouble signal with A/C power off 6/ S-) N 0 N/A 2. System operates satisfactorily on standby power NO NJA 3. All auxiliary equipment operates (elevators, fans, dampers, -etc.) NO YN /A 4. All signals operate on A/C power NO N/A 5. Ali notification appliances checked for proper operation NO ErrN N/A 6. All circuits checked for electrical supervision NO N/A 7. Control panel checks per manufacturer's instructions Q NIA 8. Central station or remote connection YES NO �_V_A 9. Name of monitoring company 10. Kev.to r)anel available (Y ES) N 0 N/A Type OF Equip # Devices Tested Satisfactory Total # Devices YES NO N/A l3qUS5 . floms, Chimes Vbice.Alarm Speake .-V. am evices 4SU4 D 1',-Tioubl' , Indicators :,S46�yi§ . ory. Switches :Smoke'-betectors -H6"&ectors P - Stations aniial-, Ul n i i fii.aon Control Ops. dl'Stdtion 'iindiators EleV t , Down er anaSrhoke:Damper 0 0 a. ks 0'r filocks (fail safe) Q, lease Release er fOUnd !�rdble`rns orr6ctidns -Made: Date: C . 6ftected I Electrical License H-UBERMJ9'IIKB AAA Fire and Safety FIRE DEPARTNIENT EITVOICE 9 ,d 3013 3 'Ave. No. Confidence Tes#ng ACCOUNT4 Seattle, WA. 98109 DATE (800) .223-.3473 FIRE AILARM Address 0 C iy Zip Occupied as Building Owne-r Or) re-E Phore# Address city Zip Date of Inspection Type of inspection Aurtual Tester's Name: Michelle Huber Control Panel Model # &ATjl�7_ Spn Certificate -04401 I # SCP-H No. of Initiating Circuits No. of Signal Circuits Battery Voltage I, Battery Voltage under Load (sijnals operating) Charge Voltage I., Trouble signal with A/C power off 61 E SO N 0 N/A 2. System operates satisfactorily on standby power 0 N/A 3. All auxiliary equipment operates (elevators, fans, darnpers,-etc.) —KI N J�— N 0 �LIA 4. All signals operate on A/C power 'ZZE-9 NO N/A 5. All notification appliances checked for proper operation NO N/A 1 6. All circuits checked for electrical supervision NO N/A PN 7. Control panel checks per manufacturer's instructions 0 WA_ 8. 9. Central station or remote connection Name YES NO Nj�, of monitoring company 10. Key.to panel available (�'(E_S) NO N/A .Type OF Equip # Devices Tested Satisfacto!y YES NO N/A Total # Devices .Bells.l.'Horns, Chimes b ice 1,�. arm peaker V V- fAl S V1 I S�at�_-A-larih Devices A J�90f61ndicators 'Flbwl-�S.�Vitches _s4peryisdry Switches :',�SRQW)�tectors jj6"��ctors Stations :._.Wntflation Control Ops. ,-)C�iifiar-Staiion unciators. -,gr vatof. Call- Down ii�*&Smoke Damper -�,E ,Pfi6ii6,ja6ks _066i,Ulnlocks (fail safe) Release -:Q-herni*ca1 Release .R f oLind ---------- on.s.Made: �rrected. BV: Electrical License H-[JBERMJ9')IKB I AAA Fire and Safety 3013 3,d 'Ave. No. Seattle, WA. 98109 (800) .223-.3473 '1 2 Address �/M/ FIRE DEPARTMENT INVOICE 4 12�21 zj. Confidence Tes#ng ACCOUNT# _7e I�X� 61 DATE FIRE AILARM Zip Occupied as �*,dMtMCIS 6�� &IS (,/ I — Building Owner al) (.,�,P3, 61 Phone# NXL-)EL&W Address 4 . city Zip Date of Inspection Type of inspection Annyaj Tester's Name: Michelle Huber Control Panel 101YIP/11 I Model # SFD Certificate # SCP-H-04 01 1 No. of Initiating Circuits No. of Signal Circuits Battery Volta e M.7 Battery Voltage under Load (signals operating) Charge Voltage 1.,, Trouble signal with A/C power off (� S,) N 0. N/A 2. System operates satisfactorily on standby power 61_7_E;) NO UV6 3. All auxiliary equipment operates (elevators, fans, dampers, -etc.) NO :LN L)� 4. All signals operate on A/C power N 0 N/A 5. All notification appliances checked for proper operation S N 0 N/A 6. All circuits checked for electrical supervision NO Ay, N/A 7. Control panel checks per manufacturer's instructions �113.1 NO �LIL_ 8. Central station or remote connection YES NO LA 9. Name of monitoring company 10. Key to panel available (Y�� NO N/A Type OF Equip # Devices Tested SatisfactorV YES NO N/A Total # Devices 1W.1"S',,-Homs, Chimes -Voiic�eAlarm Speaker ,Visuat, Alairn Devices X -Trouble.1hdicators F16v..$witches A _8' i i - S - hes upervis-ory: witc sm , oke -D6tectors :He ' at D&6ctors Manual-Ptill Stations --.VeniilAii9n- Control Ops. 'Central Station Annunciators .Ef6vat6r-Call. Down 'i,Fire;and_ S*moke::Dainper iP'hbn'6jac'ks ocks (fail safe) �-D,66r,,Release Cli6mical -- el -ease Other Prdblems fOUnd _-'--.-.Cofre6tion"s, Made: _UBEP �!,S�Oat4.. ��UJ4 (4W Electrical License H MJ9']KB AAA Fire and Safety 30133d-Ave.No. Seattle, WA. 98109 (800).223-.3473 Address FIRE DEPARTMENT Confidence Testing FIRIE ALARM INVOICE 9 401 Z) ACCOUNT# DATE 6cdl Zip Occupied as Building Owner Phone# (-%Z-)VL49/0 Address city Zip Date of Inspection Type of inspection Annual Tester's Name: Michelle Huber Control Panel Model # e SFD Certificate # SCP-H-04401 No. of Initiating Circuits !Y No. of Signal Circuits c�_, Battery Voltage Battery Voltage under Load (si , nals operating) Charge Voltage 697.07 9 1 . 4 Trouble signal with A/C power off 2. System operates satisfactorily on standby power 3. All auxiliary equipment operates (elevators, fans, dampers, -etc.) 4. All signals operate on A/C power 5. All. notification appliances checked for proper operation 6. All circuits checked for electrical supervision 7. Control panel checks per manufacturer's instructions 8. Central station or remote connection 9. Name of monitoring company 10. Key.to panel available' 6(E S) N 0 N/A Type OF Equip # Devices Tested Satisfactory YES NO N/A Total # Devices M.ls,-.._Horns, Chimes Voice --Alarm Speaker visuat�,-'Alarrn Devices --Trouble-jndicators ��. ". i_ T,l ow.."gWiiches ervisbry. Switches .Sm_�'�ok06tectors :j1eat-,D6t6ctors .`M��.Pull Stations X `�filition: Control Ops. , ation 6 I.St" -Ann ciators 'glevat 6 r Call Down �F i r e,-atid-Smoke Damper fte.,--- , c Pbo- 6-Ja ks ..:06.or.-Unlocks (fail safe) Dobr.Release Chemical Release Other -A Lind _,-CorrectionsWade: D a tes. C6rre,cted By: Electrical License HUBER-N4J9' )I KB '. AAA Fire and Safety 3013) 3,d 'Ave. No. Seattle, WA. 98109 (800) .223-.3473 Address Occupied as Building Owrtef rR Address Date of Inspection Control Panel )W No. of Initiating Circuits Battery Voltage under Load FiRr,, DEPARTMENT INVOICE Confidence Testing ACCOUNT4 DATE FIRE AILARM CijV zip Phone 77P W)U city Zip Type of inspection Annual Tester's Name: Michelle Huber Model # j2JU— SFD Certificate # SCIP-H-04401 No. of Signal Circuits r-Q, BatteryVoltage (sijnals operating) ChargeVoltage_ C22h 1_ Trouble signal with A/C power off 2. 11 System operates satisfactorily on standby power. 3. All auxiliary equipment operates (elevators, fans, dampers, -etc.) 4. All signals operate on A/C power 5. All notification appliances checked for proper operation 6. All circuits checked for electrical supervision 7. Control panel'checks per manufacturer's instructions 8. Central station or remote connection 9. Name of monitoring company Zbmj, 10. Kev to nanel available ('YES) NO N/A Type OF Equip # Devices Tested Satisfactory YES4, NO N/A Total # Devices Bells, Horns, Chimes -VoiceAlarm. Speaker Visilal'Alarm Devices Trou'blo'.Indicators FloN;v:,Switches Supervisory Switches Smoke Detectors Heat,Detectors Manual Pull Stations h2 -Ye ntilafion Control Ops. .--Central � Station ciators Elevator Call- Down Fire;'and- Smoke Damper Phone. Jacks -Door Unlocks (fail safe) - .0or elease Chemical Release Other Problems_Lound 120- 'ry . Corie6iions:-Made: D�te,Coerected_ By: Electrical License FRJBERMJ9')IKB 4 AA.4 Fire and Safety FIRE DEP"TMENT WVOICE 4 ,d ' 5—& 61 30133 Ave.No. Confidence Tesflng ACCOUNT4 7elX.�-61 Seattle, WA. 98109 FERE AIL . ARM DATE 11q (800) .223-.3473 I -? � Address 6�6n,�&j city ��Idl_fiel zip W,310 Occupied as �*,'6&220WS 1:� . /- I - - Building Owner Phone# 6�-`L)ELWW Address city Zip Date of Inspection 7 ,ZJIAI Type of inspection Annual Tester's Name: Michelle Huber I / )—, SFD Certificate # SCP-H-04401 Control Panel Model # A7 No. of Initiating Circuits No. of Signal Circuits Battery Voltage i7l 8 Battery Voltage under Load (si4nals operating) Charge Voltage Q /. 1.,1 Trouble signal with A/C power off E NO N/A 2. System operates satisfactorily on standby power NO NZ6 3. All auxiliary equipment operates (elevators, fans, dampers, -etc.) NO ]LN /Z) 4. All signals operate on A/C power NO N/A 5. All notification appliances checked for proper operation NO N/A 6. All circuits checked for electrical supervision NO N/A 7. Control panel*checks per manufacturer's instructions P, NO N/A 8. Central station or remote connection YES NO N/A 9. Name of monitoring company lfiea) "ZA 10 Kpv tn n;;npl ivnil;;hIp NES) NO N/A Type OF Equip M.ls�_Horns, Chimes Voice -Alarm Speaker # Devices Tested Satisfactory YES NO N/A X Total # Devices Visuat"Alarm- Devices Trouble". Indicators Flow, Switches :;54pe'ey.'isory Sv�ritches :Sii�ok6�Dete*ctors -fie' at' Detectors Manual -Pull- Stations oq -V . _6rifil�fio ' n.Cbntrol Ops. -Central'-Station Aiihunciators 11'evat-of.call-Down Flre,'�dd z Smoke Darnper Phone. -Jacks _D6or,Qiilocks (fail safe) b6or.Release C1116", �]:Release P-r'6b er�s foLind orrections-,-Made: ,;--_,Q,at6,Couected ME Electrical License HUBERMJ93lKB Aftmi V FIRE PREVENTION &`.V4�Brir, Edmonds 12425 Meridian Ave S INSPECTION REPORT SNOHOMISH CO. Mountlake Terrace, and TIRE' Everett, WA 98208 OEDMONDS '0 BRIER the Town of W6odway DISTRI-ET Phone (425) 551-1200 0 WOODWAY 0 MOUNTLAKE TERRACE www.FireDistrict].org Fax (425) 551-1272 0 UNINCORPORATED FREQUENCY STATION & _S_H1_F_T'**' LOCATION: 233216' I�E qmon6m' ay Bld A-G 365 20 C t". BUSINESS NAME: Edmonds Highlands Apts PHONE: 425771g64Q- SCHEDULED DATE DUE 07/0-1/13 MAILING 233?6 Edmofids Way LIFIR 428 7055 ADDRESS: Edmonds 98026 BUSINESS OWNER: . Housing Authority/Sno Co HOME PHONE: A25J.7-1691 0 ACTIVE EMERGENCY-1: Werner-Glidridi HOME PHONE: 4257716910' CURRENT KEY ACCESS-2: Kehler, Steve HOME PHONE 4252908449 CITY XES NO BUSINESS LICENSE PERSON CONTACTED: 5- INITIAL INSPECTION DATE NAME OF INSPECTOR: -3 3 v,, I 9F FIRE AS 8/4FA 8"�(ql BX FEY/ 13 CVQ-=&AC- 'n ANKIIIA1 I U HAZARDS FOUND AND LOCATIONS C86M6NICATIONS 2 2 3 4 4 5 5 6 6 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION DATE DUE. 2nd RE -INSPECTION DATE DUE. ;1FA To L 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 L TER SENT CITATION ISSUED NUMBER: -2 6 2 6 DATE: CODE SECTION: 5 3 7 3 7 RETURN RECEIPT RECEIVED A 14 18 4 18 IDATE: DfSPO SIT,1��N, LETTER NEEDED [] YES El NO LETTER NEEDED [-] YES El NO 8 FIRE -DEPARTMENT COPY ps 3013 3rd AVE NORTH SEATTLE, WA 98109 til (206) 284-1721 (800) 223-FIRE RAN (206) 284-1769 FAX AAA.FIRE.COM 9 5 Address 0 5A49 Occupied as: Building dwiter: JQA. *1 FIRE DEPARTMENT OICE # Confidence Testing ACCOUNT # 4 AUTOMATIC SPRINKLER SYSTEM DATE 711-q&3 Address: Date of Inspection: 7LI q 113 Type of 1pspecti( I I Tester's Name (PLEASE PRINT)U—. ga" I in. i City: Ph. # City: Zip Code 49&9Q& IWAHMM Zip Code: Other SFD Certification # 5:35/- / T 100W7 DRY SYSTEM 1. Trip test (dry trip) conducted: Yes — No System tripped in seconds 2. All flow switches, supervisory switches & alarm bells tested Yes N/A. 3. Alarm Bell operates: es — No N/A. 4. Flow tests conducted: Static Pressure psi Yes — No Flow pressure Psi 2 inch drain? Yes No 5. Systems inspected and I ated Yes — No 6. Air compresso s system in 30 minutes Yes — No 7. Syste rained and restores to normal operations Yes — No 8. ere the heat actuation devices tested on pre -action and deluge systems? Yes — No N/A WET SYSTEM 1. Flow test conducted: Yes V/No Static Pressure Ips psi Flow Pressure 50 P§i 2 inch drain? AAAFI.T1., Yes No Other Cate of C- "�J- Yes No N/A 2. How switches, supervisory switches & alarm bells, tested\� 3. Alarm bell operates: es No N/A No N/A 4. Systems inspected and lubricated: .9 s 5. Pressure regulating valves tested: No N/A GENERAL 1. Central Station Monitoring? No Name of Company AIA -lid throuV 2. Location of Sprinkler: Basement Hallways As Designed Others—r 3kd 3. Pumper connections and clapper valves unobstructed Yes No 4. Sprinkler heads less than 50 years old Yes No 5. Spare sprinkler heads are available Yes Nov- 6. Systems left in service Yes No 7. Valves are sealed or supervised&�,� Ozout Yes 0 1,N 8. Signs are provided on valves Yes — No -itv Static Water Pressure 0 psi PROBLEMS FOUND- 0 H 4 1 FD E dij WUIAd *AWAA,&.k hiaJC 'Ald 7:��Z IZPa,�ZQ 19 &9& &JZY0&,r C N� ORRE- S MADE: M, Date corrected By THIS IS TO CERTIFY THAT T S I ER SYSTEM HAS BEEN PROPERLY TESTED AND INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THI SIGNATURE OF TESTER SFD LICENSE # Form #:8304 3013 3rd AVE NORTH SEATTLE, WA 98109 ikk (206) 284-1721 (800) 223-FIRE Ann (206) 284-1769 FAX FFE A SAFETY W- - A A A MDC fli-NNA Address Occupiec Building FIRE DEPARTMENT INVOICE # 143 1 '� Confidence Testing ACCOUNT # 67 AUTOMATIC SPRINKLER SYSTEM DATE 5zlqb_;� Address: City: Zip Code: Date of Inspection: Type of I bon: Annual Other Tester's Name (PLEASE PRINT) T i3butp-7R, &2L SFD Certification # .63v- / r loo56 -f DRY SYSTEM 1. Trip test (dry trip) conducted: System tripped in seconds 2. All flow switches, supervisory switches & alarm bells tested 3. Alarm Bell operates: 4. Flow tests conducted: Static Pressure psi ure psi Flow pressure psi 'r 2 inch drain? 9 5. Systems inspected and lubrnicated 6. Air compressor refills syste minutes 7. Systems drained and ores to normal operations p _ cti u tio vic s t s:m1 on pre -action and deluge systems? 8. Were the he uation devices te te re a WET SYSTEM 1. Flow test conducted: Static Pressure psi Flow Pressure go psi 2 inch drain? 2. How switches, supervisory switches & alarm bells, tested 3. Alarm bell operates: 4. Systems inspected and lubricated: 5. Pressure regulating valves tested: GENERAL 1. Central Station Monitoring? Name of Company IJA 2. Location of Sprinkler: Basement Hallways As Desi2ned Others 3. Pumper connections and clapper valves unobstructed 4. Sprinkler heads less than 50 years old 5. Spare sprinkler heads are available 6. Systems left in service P"a"ed 7. Valves are sealed or supervised 8. Signs are provided on valves 9. City Static Water Pressure — -10 psi _-_ �, P., ", 7_7111 1711, Yes No Yes. N/A 0 >&_�;�N N/A Yes No Yes No Yes No Yes No Yes No Yes No N/A Yes /No Yes No Other Yes :�' No N/A Yes No N/A Yes _l� No N/A — Yes No N/A Ve Yes No Yes No Yes No Yes No Yes V/1"No Yes No V7_ Yes No Date corrected By V L , 4 1 1-i THIS IS TO CERTIFY THAT THE SPRINKLER SYSTEM HAS BEEN PROPERLY TESTED AND INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED INTHIS rRO T- SIGNATURE OF TESTE I SFD LICENSE # Forin #: 8304 3013 3rd AVE NORTH SEATTLE, WA 98109 (206) 284-1721 (800) 223-FIRE (206) 284-1769 FAX `E ' wE" w- * AAA.FIRE.COM Address Ab�59U Occupied as: 07 et: Building E)wn�;9N Address: &007dS FIRE DEPARTMENT INVOICE # I'Ll Confidence Testing ACCOUNT # -iLQ25V AUTOMATIC SPRINKLER SYSTEM DATE City: ?d,0022C/,3 Zip Code 9'G�L City: Zip Code: Date of Inspection: 71 I'f 1/0 Type of ns ct nnual Other ne Tester's Name (PLEASE PRINT SFD Certification # 6331 - T & DRY SYSTEM 1. Trip test (dry trip) conducted: Y No System tripped in seconds 2. All flow switches, supervisory switches & alarm bells tested Yes — No — N/A 3. Alarm Bell operates: Yes — No — N/A 4. Flow tests conducted: Static Pressure psi Yes — No How pressure psi 2 inch drain? Yes No 5. Systems inspected ubricated Yes — No 6. Air compres refills system in 30 minutes Yes — No 7. Syste rained and restores to non-nal operations Yes — No 8. ere the heat actuation devices tested on pre -action and deluge systems? Yes — No N/A WET SYSTEM 1. Flow test conducted: Yes No Static Pressure psi How Pressure psi 2 inch drain? Yes No Othe/ 2. Flow switches, supervisory switches & alarm bells, tested Yes No — N/A 3. Alarm bell operates: Yes; No N/A 4. Systems inspected and lubricated: Yes No — N/A 5. Pressure regulating valves tested: Yes No — N/AV'pe GENERAL 1. Central Station Monitoring? Yes No—z Name of Company MA 2. Location of Sprinkler: Basement Hallways As Designed Others 3. Pumper connections and clapper valves unobstructed Yes No 4. Sprinkler heads less than 50 years old No A_A;on AXC ,,,j Yes 5. Spare sprinkler heads are available r**- Yes No 6. Systems left in service Yes No 7. Valves are sealed or supervised *&Cb& Yes No 8. Signs are provided on valves Yes No 9. City Static Water Pressure psi Date corrected By THIS IS TO CERTIFY THAT THE SPRINKLER SYSTEM HAS BEEN PROPERLY TESTED AND INSPECT] THE ITEMS LISTED IN�� SIGNATURE OF TESTE SFD LICENSE # FOR RELIABILITY TO COVER Form #: 8304 3013 3rd AVE NORTH FIRE DEPARTMENT INVOICE # SEATTLE, WA 98109 (206) 284-1721 Confidence Testing ACCOUNT # (800) 223-FIRE (206) 284-1769 FAX AUTOMATIC SPRINKLER SYSTEM DATE 7h (?k,;� FM & SAFM W- AAA.FIRE.COM g 7 Address 19 3�3z City: &Wdn'j-'s Zip Code 9?0 Occupied as: &&. z5viv V Building QW= Ph. # V�5— 17/ — 6916 Address: City: Zip Code: Date of Inspection: Type of Inspection: Annual Other Tester's Name (PLEASE PRINT) SFD Certification # 535,1- /T /00-5D4 DRY SYSTEM 1. Trip test (dry trip) conducted: System tripped in seconds 2. All flow switches, supervisory switches & alarm bells tested 3. Alarm Bell operates: 4. Flow tests conducted: Static Pressure psi 'a" u' Flow pressure psi 9 2 inch drain? 1 5. Systems inspected and lubric rl 6. Air compressor ystem in 30 minutes 7. Syste amed and restores to normal operations e r t t ctu tio vi s t 0 p _ cti re the heat actuation devices tes:ted on pre -action and deluge systems? WET SYSTEM I . Flow test conducted: Static Pressure -75 psi Flow Pressure 35 psi 2 inch drain? 2. Flow switches, supervisory switches & alarm bells, tested 3. Alarm bell operates: 4. Systems inspected and lubricated: 5. Pressure regulating valves tested: Yes No Yes No �UA Yes Yes No Yes No. Yes No Yes No Yes No Yes No N/A Yes No Yes No Other Yes No N/A Yes Yes No No N/A N/A Yes No N/A 7 GENERAL 1. Central Station Monitoring? Yes — No —V/" Name of Company NA 2. Location of Sprinkler: Basement Hallways As Designed Others &dk "\-w 3. Pumper connections and clapper valves unobstructed Yes No 4. Sprinkler heads less than 50 years old --7,- ..,d) Yes No 5. Spare sprinkler heads are available rS—eaj1z&) � 6* � nm - Yes No V 6. Systems left in service Yes No 7. Valves are sealed or supervised &,�VA 01tout Yes No 8. Signs are provided on valves Yes 7� No 9. City Static Water Pressure 167 psi 5 IPI �-rOel Date corrected By 0 q0(y THIS IS TO CERTIFY THAT THE SPRINKLER SYSTEM HAS BEEN PROPERLY TESTED AND INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS� SIGNATURE OF TESTER 71/ — SFD LICENSE # Form #: 8304 HE3013 3rd AVE NORTH SEATTLE, WA 98109 (206) 284-1721 (800) 223-FIRE Ann (206) 284-1769 FAX ME & SAFEry W- - A A A UMU fNf-%Al Address Occupiec Building FIRE DEPARTMENT INVOICE # Confidence Testing ACCOUNT # AUTOMATIC SPRINKLER SYSTEM DATE 7 11-9 Address: City: — Date of Inspection: Type of Inspection: Annual Tester's Name (PLEASE PRINT)T. 83_A1i&/(YjAJkt_c_ Zip Code: Other SFD Certification # DRY SYSTEM I . Trip test (dry trip) conducted: System tripped in seconds 2. All flow switches, supervisory switches & alarrn bells tested 3. Alarm Bell operates: 4. Flow tests conducted: Static Pressure psi Flow pressure 2 inch drain? 5. Systems inspe and lubricated 6. Air c essor refills system in 30 minutes 7 stems drained and restores to normal operations 8. Were the heat actuation devices tested on pre -action and deluge systems? WET SYSTEM 1. Flow test conducted: Static Pressure psi Flow Pressure psi 2 inch drain? 2. Flow switches, supervisory switches & alarm bells, tested 3. Alarm bell operates: 4. Systems inspected and lubricated: 5. Pressure regulating valves tested: GENERAL 1. Central Station Monitoring? tJA Name of Company 2. Location of Sprinkler: Basement Hallways As Designed 3. Pumper connections and clapper valves unobstructed 4. Sprinkler heads less than 50 years old 5. Spare sprinkler heads are available Yes No Yes No — N/A. Yes No N/A. Yes No Yes No Yes No Yes No Yes No Yes No N/A Yes /No Yes No Yes No Yes V No Yes No Yes No Yes No Others Yes No Ye s No Yes No V_ XT ystems e n sery ce a V 7. Valves are sealed or supervised CLW.A- 91OUi_ 06201 Yes No V11 L�_ 8. Signs are provided on valves Yes No 9. City Static W40r11ressq_re 7,151" psi MADE: Date corrected By Other N/A N/A N/A N/A THIS IS TO CERTIFY THAT THE SPRINKLER SYSTEM HAS BEEN PROPFRVTESTED AND INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS R.7EP SIGNATURE OF TESTER SFD LICENSE # Form #: 8304 3rd AVE NORTH kkk3013 SEATTLE, WA 98109 (206) 284-1721 Ann (800) 223-FIRE (206) 284-1769 FAX "* 'E" w- * AAA.FtfZF-COM Address 07 53. 2 & Occupied as: — Building Ow.m.: FIRE DEPARTMENT Confidence Testing City: ral Ph. # i/LI-5 - 7//— INVOICE # 14S'19 ACCOUNT # DATE Zip Code 9 Address: City: Zip Code: Date of Inspection: J9113 Annual Other Tester's Name (PLEASE PRINT) SFD Certification# 5,33-1-Ir-1003-07- DRY SYSTEM 1. Trip test (dry trip) conducted: System tripped in seconds 2. All flow switches, supervisory switches & alarm bells tested 3. Alarm Bell operates: 4. Flow tests conducted: Static Pressure psi Flow pressure psi 2 inch drain? 5. Systems inspected an ricated 6. Air compresso i Is system in 30 minutes 7. Syste amed and restores to normal operations 8. e the heat actuation devices tested on pre -action and deluge systems? 1. Flow test conducted: Static Pressure psi Flow Pressure 150 psi 2 inch drain? 2. Flow switches, supervisory switches & alann bells, tested 3. Alann bell operates: 4. Systems inspected and lubricated: 5. Pressure regulating valves tested: GENERAL 1. Central Station Monitoring? Name of Company 2. Location of Sprinkler: Basement Hallways As Desi2ned 3 4 5 6 7 8 9 Yes Yes No N/A, Yes No N/A Yes No Yes No Yes No Yes No Yes No Yes No N/A Yes V, No Yes No Other Yes No N/A Yes No N/A Ye s No N/A Yes No N/A Yes — No —Az Others_z_;�d Yes ANO Yes V"' No Yes��7 No U.-I Systems left in service les — 1,10 Valves are sealed or supervised Yes - k�:&o Signs are provided on valves Yes No City Static Water Pressure psi IM 17)-<il dJ.1-0- Pumper connections and clapper valves unobstructed Sprinkler heads less than 50 years old Spare sprinkler heads are available �VCOIUO� MADE: Date corrected By THIS IS TO CERTIFY THAT THE SPRINKLER SYSTEM HAS BEEN PROPERLYTfSTED AND INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN TH71STO SIGNATURE OF TESTER SFD LICENSE # Fom #: 8304 k pp 3013 3rd AVE N ORTH FIRE DEPARTMENT INVOICE # _j SEATTLE, WA 98109 k (206) 284-1721 Confidence Testing ACCOUNT # (800) 2,23-FIRE (206) 284-1769 FAX AUTOMATIC SPRINKLER SYSTEM DATE 7 AAA.FIRE.COM h Address A -3 �_3,9 (P e & Yin q &s&N . citv: &dM01_VS Zip Code (0 Occupied as: &-mn-d-S, Aldo /.&- 77/- 6'710 Building fhr":& &4121W U Ph # Address: City: Zip Code: Date of Inspection: Type ofInspection: Annual Other Tester's Name (PLEASE PRINT) SFD Certification-# 533 1- 1 T_ 1003-0?- DRY SYSTEM 1. Trip test (dry trip) conducted: Yes No System tripped in seconds 2. All flow switches, supervisory switches & alarm bells tested Ye 0 N/A 3. Alarm Bell operates: Yes No — N/A 4. Flow tests conducted: Static Pressure psi Yes No Flow pressure psi 2 inch drain? Yes No 5. Systems inspected and I ted Yes No 6. Air compressor s system in 30 minutes Yes — No 7. Syste ined and restores to normal operations Yes — No 8. re the heat actuation devices tested on pre -action and deluge systems? Yes — No — N/A WET SYSTEM 1. Flow test conducted: Static Pressure MO psi Flow Pressure ig5o psi 2 inch drain? 2. Flow switches, supervisory switches & alarm bells, tested 3. Alarm bell operates: 4. Systems inspected and lubricated: 5. Pressure regulating valves tested: GENERAL 1. Central Station Monitoring? Name of Company /\JA 2. Location of Sprinkler: Basement Hallways As Designed 3. Pumper connections and clapper valves unobstructed 4. Sprinkler heads less than 50 years old 5. Spare sprinkler heads are available &O-0-Lb-& 6. Systems left in service 7. Valves are sealed or supervised e�� &At-f pad,40cbd 8. Signs are provided on valves 9. City Static Water Pressure psi Yes No Yes No Other Yes No N/A Yes No N/A Yes No N/A Yes No N/A Yes No Others j P�� " Yes No Yes No Yes No Ye s No Yes N No Yes _V No Date corrected By THIS IS TO CERTIFY THAT THE SPRINKLfi"YSTEM HAS BEEN PROPERLY TESTED AND INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS R SIGNATURE OF TESTER SFD LICENSE # Fom #: 8304 AAA Fire and 'Safety 3013 3 d Ave. No. Seattle, WA. 98109 (800),223-.3473 FIRE DEPARTM[ENT INVOICE Confidence Testing ACCOUNT# FM ALARM DATE Occupied -as &=qvay Aka.Azdazhg'� 4W-L� Ac Building QwFi r Phor�e Address City Date of Inspection Type of inspection Annual Control Panel Mod e I # -3k-9—r No. of Initiating Circuits No. of Signal Circuits Battery Voltage under Load �signals operating) Zip Tester's Name: Michelle Huber SFD Certificate # SCIP-1-11-04401 I Battery Voltage 'harge Voltage eWa. 1 . Trouble signal with A/C power off - 2. System operates satisfactorily on standby power 3. All auxiliary equipment operates (elevators, fans, dampers, etc.) 4. All signals operate on A/C power 5. All notification appliances checked for proper operation 6. All circuits checked for electrical supervision 7. Control panel c ' hecks per manufacturer's instructions 8. Central station or remote connection AM 9. Name of monitoring company in wm%, tn nnnial nxiniinhliz .1� (YESI NO N/A Type OF Equip #Devices Tested Satisfacto!y YE§ NO NIA Total # Devices ---T Bells, Homs, Chimes;] 13 Voice Alarm Speaker Visual Alarm Devices Trouble Indicators Flow Switches Supervisory Switches Smoke Detectors Heat Detectors Manual Pull Stations Ventilation Control Ops. Central Station Annunciators Elevator Call Down Fire and Smoke Damper Phone Jacks Door Unlocks (fall safe) Door Release Chemical Release Other ProblernsLound Corrections Made: Date Corrected Signatu re- YVdk-Ajl Electrical License HUBERT\4J931KB AAA Fire and 'Safety 3013'3'd Ave. No. Seattle, WA. 98109 (800).223-.3473 Address Pdmo&SFIRE DEPARTMENT 11,WOICE # Confidence Testing ACCOUNT# FIRE ALARM DA TE 96ME MOO' M � Occupied as _ 11,1 4-�? ' j , - - - - jg.1 Building ew4wl Plio e#9' 77 Address city Zip Date of Inspection Type of inspection Annual Tester's Name: Midhelle Huber Model # SFD Certificate # SQP-H-04401 Control Panel FIP No. of Initiating Circuits OIL No. of Signal Circuits Battery Voltage 110 Battery Voltage under Load a&-. --- �signals operating) Charge Voltage _ Qj�, 1 . Trouble signal with A/C power off - 2. System operates satisfactorily on standby power 3. All auxiliary e*quipment operates (elevators, fans, dampers, etc.) 4. All signals operate on A/C power 5. All notification appliances checked for proper operation 6. All circuits checked for electrical supervision 7. Control panel c ' hecks per manufacturer's instructions 8. Central station or remote connection 9. Name of monitoring company /jig ir) V +r% nnal n%iniinhip (SQ _RO N/A I ype OF Equip # Devices Tested Satisfacto!1 YES NO NIA Total # Devices Bells, Homs, Chimes y J Voice Alarm Speaker Visual Alarm Devices Trouble Indicators Flow Switches Supervisory Switches Smoke Detectors Heat Detectors Manual Pull Stations Ventilation Control Ops. Central Station Annunciators Elevator Call Down Fire and Smoke Damper Phone Jacks Door Unlocks (fail safe) Door Release Chemical Release Other - Problems_tounl Corrections Made: Date Corrected In Sign Electrical License l-jUl3ERMJ93IKB AAA Fire and Safety FIRE DEPARTMENT ITWOICE # 3013.3 d Ave. No. Confidence Testing ACCOUNT# 0 Seattie, WA. 98109 FM ALARM DATE (800).223-.3473 Address Ci-ty ZID 1?4W4212 occupied as ell, IL ---- -71-6970 Building GWM 4 Phonb Address city Zip Date of Inspection Type of inspection Annual Tester's Name: Michelle Huber Control Panel - L Model # SFD Certificate # SCIP-H-044011 No. of Initiating Circuits No. of Signal Circuits Baftery'Voltaqp Battery Voltage under Load ignals operating) Charge Voltage 9&.-1 1 . Trouble signal with A/C power off 2. System operates satisfactorily on standby power 3. All auxiliary equipment operates (elevators, fans, dampers, etc.) 4. All signals operate on A/C power 5. All notification appliances checked for proper operation 6. All circuits checked for electrical supervision 7. Control panel c ' hecks per manufacturer's instructions 8. Central station or remote connection 9. Name of monitoring company in V + -.ina1!nwni1nh1P �0---N-o N/A Type OF Equip # Devices Tested Satisfacto!3t YES NO N/A Total # Devices Bells, Horns, Chimes Voice Alarm Speaker Visual Alarm Devices Trouble Indicators Flow Switches Supervisory Switches Smoke Detectors Heat Detectors Manual Pull Stations Ventilation Control Ops. Central Station Annunciators Elevator Call Down Fire and Smoke Damper Phone Jacks Door Unlocks (fail safe) Door Release al Release 0�tiujlc ,[Chemi er Problems_Lound Corrections Made'. Date Corrected 13 si : Electrical License HUBERI\4J931KB AAA Fire and 'Safety 3013 3 d Ave. No. Seattle, WA. 98109 (800).223--3473 Address U/77 FIRE DEPARTMENT Confidence Testing FIRE ALARM INVOICE # ACCOUNT# DATE Z i 9 CMI: " I N!V11 Occupied as_ A4j I U/" -V Building Ph6ne IV- � — Address city — Zip Date of Inspection -1 Type of inspection_Annuai Tester's Name: Michelle Huber Control Panel Model # InPI;?19 # SCIR-1-1-04401 2YSFD Certificate No. of Initiating Circuits No. of Signal Circbits I — Battery Voltage J 7, Battery Voltage under Load 0`4 ;ignals operating) Charge Voltage D-7. 1 1 . Trouble signal with A/C power off - 2. System operates satisfactorily on standby power 3. All auxiliary equipment operates (elevators, fans, dampers, 4. All signals operate on A/C power 5. All notification appliances checked for proper operation 6. All circuits checked for electrical supervision 7. Control panel checks per manufacturer's instructions 8. Central station or remote connection 9. Name of monitoring company IUA 4 - - I (Y'a NO N/A 67CV NO NL8 etc.) Y E,9 N 0 UA-' NO N/A NO , N/A NO N/A &ED N-CL N/A YF�q -609 N/A (YES-/ NO N/A r—y uycxll�—K Satisfacto!3t YES NO NIA Total # Devices Type OF Equip # Devices Tested Bells, Horns, Chimes Voice Alarm Speaker Visual Alarm Devices V11, Trouble Indicators Flow Switches Supervisory Switches Smoke Detectors Heat Detectors Manual Pull Stations Ventilation Control Ops. Central Station Annunciators Elevator Call Down Fire and Smoke Damper Phone Jacks Door Unlocks (fall safe) Door Release Chemical Release Other Problems found ale, Corrections Made: Date Corrected Signature: Electrical License HUBERMJ931KI3 AAA Fire andSafety FIRE DEPARTMENT INVOICE # 3013^3 d Ave. No. Confidence Testing ACCOUNT# Seattle, WA. 98109 DATE (800).223-.3473 FIRE ALARM 2P � 9a. A-j t1,7,0'rid 0 1A III Citv zi 9 Address Li P Occupied as P6one# Building Qwper� 7-- 9-5-771- �;� Address - city Zip Date of Inspection '1/1 17/13 Type of inspection Annual Tester's Name: Michelle Huber Control Panel Model # ]3� SFD Certificate # SCIP-1-11-04401 No. of Initiating Circuits No. of Signal Circuits Battery Voltage, Battery Voltag3e under Load �*O (signals operating) Charge Voltage 1 , Trouble signal with A/C power off - 2. System operates satisfactorily on standby power 3. All auxiliary equipment operates (elevators, fans, dampers, etc.) 4. All signals operate on A/C power 5. All notification appliances checked for proper operation 6. All circuits checked for electrical supervision 7. Control panel c ' hecks per manufacturer's instructions 8. Central station or remote connection 9. Name of monitoring company IVA .4 n - - - - I ntin;1-nKIm A'1� VESJ NO N/A I--Y U VCR[ 1�-1 Type OF Equip # Devices Tested Satisfactory YE5 NO NIA Total # Devices Bells, Horns, Chimes Cf Voice Alarm Speaker Visual Alarrn Devices Trouble Indicators Flow Switches Supervisory Switches Smoke Detectors Heat Detectors Manual Pull Stations Ventilation Control Ops. Central Station Annunciators Elevator Call Down Fire and Smoke Damper Phone Jacks Door Unlocks(fail safe) oor lease Chemical Release Other Problems found Corr-ections Made: Date Corrected By: Signature Electrical License 14UBERMJ931KIB AAA Fire and 'Safety ZdAlOn&FIRE DEPARTMENT 11WOICE # AW 3013^3' Ave. No. Confidence Testing ACCOUNT# W-3 Seattle, WA. 98109 DATE (800).223-.3473 FIRE ALARM Address g?),59L-2d --9 zip Occupied as -2-�(VnMU3 AffZ41Uar&U c2u&sf E T-010 Building Owmer I Address city Zip Date of inspection Type of inspection Annual Tester's Name: Michelle Huber Control Panel Model # SFD Certificate # SCP-H-04401 No. of lnitiatin( Circuits No. of Signal Circuits Battery Voltage.24. _7 Battery Voltage under Load �signals operating) Charge Voltage 1 . Trouble signal with A/C power off 2. System operates satisfactorily on standby power 3. All auxiliary e�uipment operates (elevators, fans, dampers, etc.) 4. All signals operate on A/C power 5. All notification appliances checked for proper operation 6. All circuits checked for electrical supervision 7. Control panel c ' hecks per manufacturer's instructions 8. Central station or remote connection 9. Name of monitoring company �J A -i n V + I nwnilnhla Qr M E- NO N/A Satisfactory YES NO NIA Total # Devices Type OF Equip # Devices Tested Bells, Homs, Chimes Voice Alarm Speaker Visual Alarm Devices Trouble Indicators Flow Switches -Supervisory Switches Smoke Detectors Heat Detectors Manual Pul Ventilation Control Central Station Annunciators Elevator Call Down Fire and Smoke Darn�e—r Phone Jacks D(To—rUnlocks (fall safe) oor Release Chemical Release Other - Problems found Corrections Made: Date Corrected Signature Electrical License 14UBERMJ931K-B Fire Safety FIRE DEPARTME NT INVOICE # MOM' AAA and 3013'3" Ave. No. Seattle, WA. 98109 Confidence Testing ACCOUNT# --7/q /1'3 DATE 7 FIRE ALARM (800).223-.3473 C I t Zip 4790;vo Address y Occupied as A', -a & Building-4Nvmr EW Phriiie;f Address 30 1 city Zip Date of Inspectio 1/ q1j -�i Panel d1ir, Type of inspection Annual Tester's Name: Michelle Huber Model # ��FD Certificate # SCIP-H-04401 Control No. of Initiating Circuits - No. of Signal 6ircuifs / — Battery Voltage B-attery Voltage under Load M. -;E- �signals operating) Charge Voltage c27. 3 1 . Trouble signal with A/C power off 2. System operates satisfactorily on standby power 3. All auxiliary equipment operates (elevators, fans, dampers, etc.) 4. All signals operate on A/C power 5. All notification appliances checked for proper operation 6. All circuits checked for electrical supervision 7. Control panel c ' hecks per manufacturer's instructions 8. Central station or remote connection 9. Name of monitoring company 4 n V + nifnil'ahl'o CES) NO N/A Type OF Equip # Devices Tested Satisfacto YES NO N/A Total # Devices Homs, Chimes -Bells, Voice Alarm Speaker Visual Alarm Devices 7 Trouble Indicators Flow Switches Supervisory Switches Smoke Detectors Heat Detectors Manual Pull Stations Ventilation Control Ops. Central Station Annunciators Elevator Call Down Fire and Smoke Phone Jacks Door Unlocks (fail safe) Door Release Chemical Release Other - Problerns_fgund Pal2d h"&Z�a Corrections Made: Date Corrected M3 Sign Electrical License HUBERMJ931KB FIRE PREVENTION 'd '424�5.MeridianAves mon s, INSPECTION REPORT -SNOHOMISH CO. Ed" I '6 T E�erett, WA 98208 un �rrciceand 0 BRIER 0 EDMONDS FIREthe Town of Woodway Phone (425) 551-1200 0 WOODWAY ST1 11 0 MOUNTLAKE TERRACE h Fax (425) 551-1272 0 UNINCORPORATED ICI www.FireDistrictl.org FREQUENCY I STAT%N &dHIFF**' LOCATION: 23326 Edmonds Way Bid A-G 365 BUSINESS NAME: Edmonds Highlands Apts PHONE: 4257719610 SCHEDULED 07/0-1/12 DATE DUE 0 MAILING 23326 Edmonds Way UFIR 1, 428 7055 ADDRESS: Edmonds 93026 J BUSINESS OWNER: Housing Authority/Sno Co HOME PHONE: 4257716910 ACTIVE EMERGENCY-1: Werner, Glenda 4257716910 HOME PHONE: CURRENT YES KEY ACCESS-2: Kehler, Steve HOME PHONE: 4252908449 CITY NO BUSINE twowsiv PERSON CONTACTED: c-, INITIAL INSPECTION DATE NAME OF INSPECTOR: 6 FIRE AS 8/11 FA 8/ LKIJx F 24 �U A HAZARDS FOUND AND LOCAT N c/_z 2 2 3 3 4 4 5 5 6 6 7 7 I AGREE TO C�15RECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X lstRE�-I S CTI3_N7'_ PPE DATE hupo D!� 2nd RE -INSPECTION DATE DUE: EXTENSION '4 GRANTED TO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON 4r— 1CONTACTED: PERSON CONTACTED: PERSON CONTACTED: 1 INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: DATE: 3 VIOLATIONS 1 5 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 2 6 2 6 DATE: CODE SECTION: 5 3 7 3 7 RETURN RECEIPT RECEIVED 6 4 18 4 8 DATE: DISPOSITION: 7 LETTER NEEDED [] YES NO LETTER NEEDED [] YES NO 8 FIRE DEPARTMENT COPY AAA FIRE & SAFETY, INC 30133RDAVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report V-1, ACCT# INV# 109743 SPRINKLERS WET Certification Given CONFIDENCE TEST X REPAIRS RED YELLOW WHITE Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Building Owner: EDMONDS, WA 98026 BLDG. "A" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Building Owner Address: Date of Inspection: 08/13/12 Inspection Annual Frequency/ Type: Testers Name 5331-IT-100507 (Please Pdnt): BAUER/HUBER SFD Cert No: SCP- H-04401 Central Station Yes No X Monitoring LOCAL ONLY Monitoring? Company Name: Primary Component: System Make: 1" RISER System Model: SHOTGUN PROBLEms FOUND: (if additional room is needed, please add a separate sheet) UNIT A304 MISSING ESCUSSION IN HALL HEAD, MASTER BEDROOM HEAD COVERED W, ITH DECOR TENANT HAS, SCARVES COVERING CEILING, UNABLE TO VIEW HEAD. Corrections Made Date Corrected: Corrected By: (it additional room is needed, please add a separate sheet) SFD Certification Num ADVISED FRANCES HARRIS OF UNIT A304 ISSUES NOTE: 5 YR INTERNAL PIPE INSPECTION OVER DUE NOTE: SPRINKLERS LOCATED ON 3"LFLR ONLY This certifies that this fire and life safety system has been properly inspected for reliability to Items listed in this report and is consistent with Seattle Fire Department Fire Code standards, discrepancies'are noted and have been reported to the building Owner/Manager for correctiv ch.n 50" VC." Signature of Tester: Phone: Testing Agency: 8?q�� &AAT-ETY—, TNC- Mailing Address: 3013 Vu AVE N SEATTLE, WA 98109 Building Representative: (Signature) Pagel of2 N The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Seattle Fire Department Fire Code for inspecting and testing requirements. General I Flow test conducted? Yes X No Staticpressure: 75 PSI Flow pressure: 50 PSI Number of Sprinkler Heads: 90 2-inch drain? Other Yes NoX Flow switches, supervisory switches and alarm bells tested? N/A Yes X No Pressure regulating valves tested? N/A X Yes No Alarm bell operates? N/A Yes X No System inspected and lubricated? Yes X No Valves are sealed or supervised? Yes X No Signs are provided on valves? Yes X No Pumper connections and clapper valves unobstructed and turn freely? N/A X Yes No Wet type sprinkler heads replaced or successfully sample tested in last 50 Yes X No years? Sprinkler coverage is acceptable? Yes X No Have the sprinkler heads been replaced or successfully sample test in the last Yes X No 50 years? Proper number of spare sprinkler heads available? Yes X No System left in service? Yes X No System gauges replaced or calibrated within the last 5 years? Yes X No Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes X No Was debris.found in the Fire Department Connection (FDC)? Y., e s NoX Was (FDC) back flushed / Intern pipe exam with -in the last 5 years? Yes No X Was an internal pipe and valve inspection performed within the last 5 years? Yes NoX Date Performed Was a signal received at the central station / monitoring company? N/A X Yes No Sprinkler wrench available for each type of sprinkler? Yes X No Page 2 of 2 AAA FIRE & SAFETY, INC 30133RDAVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCT# INV# 109743 SPRINKLERS WET Certification Given CONFIDENCE TEST X REPAIRS RED YELLOW I I I WHITE Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Building Owner: EDMONDS, WA 98026 BLDG."B" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Building Owner Address: Date of Inspection: 08/13/12 Inspection Annual Frequency/ Type: Testers Name 5331-IT-100507 (Please Print): BAUER/HUBER SFD Cert No: SCP- H-04401 Central Station Yes No X Monitoring LOCAL ONLY Monitoring? Company Name: Primary Component: System Make: 1 J3 ER System Model: SHOTGUN '�J� PROBLEms FOUND: ((f additional room is needed, please add a separate sheet) xicale of Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) SFD Certification Numb NOTE: 5 YR INTERNAL PIPE INSPECTION OVER DUE NOTE: SPRINKLERS LOCATED ON 3 RD FLR ONLY —*4d-fhroU%" 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 buildin,@,Owner/Manager for corrective action. Signature of Tester: Phone: (206) 284-1721 Testing Agency: -' �AAA IRE 9—SA—FETY, INC Mailing Address: 3013 3"LAVE N SEATT�K, WA 98109 Building Representative: (Signature) Page I of 2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Seattle Fire Department Fire Code for inspecting and testing requirements. General Flow test conducted? Yes X No Static pressure: 55 PSI Flow pressure: 40 PSI Number of Sprinkler Heads: 52 2-inch drain? Other Yes NoX Flow switches, supervisory switches and alarm bells tested? N/A Yes X No Pressure regulating valves tested? N/A X Yes No Alarm bell operates? N/A Yes X No System inspected and lubricated? Yes X No Valves are sealed or supervised? Yes X No Signs are provided on valves? Yes X No Pumper connections and clapper valves unobstructed and turn freely? N/A X Yes No Wet type sprinkler heads replaced or successfully sample tested in last 50 Yes X No years? Sprinkler coverage is acceptable? Yes X No Have the sprinkler heads been replaced or successfully sample test in the last Yes X No 50 years? Proper number of spare sprinkler heads available? Yes X No System left in service? Yes X No System gauges replaced or calibrated within the last 5 years? Yes X No Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes X No Was debris found in the Fire Department Connection (FDC)? Yes NoX Was (FDC) back flushed / Intern pipe exam with -in the last 5 years? Yes NoX Was an internal pipe and valve inspection performed within the last 5 years? Yes NoX Date Performed Was a signal received at the central station / monitoring company? N/A X Yes No I Sprinkler wrench available for each type of sprinkler'? Yes X No Page 2 of 2 AAA FIRE & SAFETY, INC 30133RDAVE N SEATrLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCT# INV# 109743 SPRINKLERS WET Certification Given CONFIDENCE TEST X REPAIRS RED YELLOW I I WHrTE I x Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Building Owner: EDMONDS, WA 98026 BLDG. "C" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Building Owner Address: Date of Inspection: 08/13/12 Inspection Annual Frequency/ Type: Testers Name 5331-IT-100507 (Please Print): BAUER/HUBER SFD Cert No: SCP- H-04401 Central Station Yes No X Monitoring LOCAL ONLY Monitoring? Company Name: Primary Component: System Make: 1" RISER System Model: SHOTGUN PROBLEms FOUND: (if additional room is needed, please add a separate sheet) ;'/�4AK X— Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) SFD Certification Num�. 40 1 h: 6 NOTE: 5 YR INTERNAL PIPE INSPECTION DUE .S r RD NOTE: SPRINKLERS LOCATED ON 3 FLR ONLY ",OUIR-h D,,:'M'oc' 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 Seaftle Fire Department Fire Code standards, and that discrepancies are noted andAave been reported to the building Owner/Manager for corrective action. Signature of Tester: Zz� Phone: (206) 284-1721 Testing Agency: PAA fFIRE & SAFETY, INC Mailing Address: 3013 3"u AVE N SEATTLE, WA 98109 Building Representative: (Signature) Pagel of2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Seattle Fire Department Fire Code for inspecting and testing requirements. General Flow test conducted? Yes X No Static pressure: 75 PSI Flow pressure: 30 PSI Number of Sprinkler Heads: 42 2-inch drain? Other Yes NoX Flow switches, supervisory switches and alarm bells tested? N/A Yes X No Pressure regulating valves tested? N/A X Yes No Alarm bell operates? N/A Yes X No System inspected and lubricated? Yes X No Valves are sealed or supervised? Yes X No Signs are provided on valves? Yes X No Pumper connections and clapper valves unobstructed and turn freely? N/A X Yes No Wet type sprinkler heads replaced or successfully sample tested in last 50 Yes X No years? Sprinkler coverage is acceptable? Yes X No Have the sprinkler heads been replaced or successfully sample test in the last Yes X No 50 years? Proper number of spare sprinkler heads available? Yes X No System left in service? Yes X No System gauges replaced or calibrated within the last 5 years? Yes X No Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes X No Was debris found in the Fire Department Connection (FDC)? Yes NoX Was (FDC) back flushed / Intern pipe exam with -in the last 5 years? Yes NoX Was an internal pipe and valve inspection performed within the last 5 years? Yes No X Date Performed Was a signal received at the central station / monitoring company? N/A X Yes No I Sprinkler wrench available for each type of sprinkler? Yes X No Page 2 of 2 AAA FIRE & SAFETY, INC 30133RDAVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCT# INV# 109743 SPRINKLERS WET Certification Given CONFIDENCE TEST X REPAIRS RED YELLOW I I WHrTE I x Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Building Owner: EDMONDS, WA 98026 BLDG. "D" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Building Owner Address: Date of Inspection: 08/13/12 Inspection Annual Frequency/ Type: Testers Name 5331-IT-100507 (Please Print): BAUER/HUBER SFD Cert No: SCP- H-04401 Central Station Yes No X Monitoring LOCAL ONLY Monitoring? Company Name: Primary Component: System Make: System Model: SHOTGUN PROBLEms FOUND: (If additional room is needed, please add a separate sheet) V Inc. Corrections Made Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) SFID Certification Number-V", Um"I NOTE: 5 YR INTERNAL PIPE INSPECTION DUE NOTE: SPRINKLERS LOCATED ON 3 R" FLR ONLY 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 corrective action. Signature of Tester: aw� Phone: (206) 284-1721 Testing Agency: A,6�4FIRL & SAFETY, INC Mailing Address: 3013 Vu AVE N SEATTLE, WA 98109 Building Representative: (Signature) Pagel ot`2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Seattle Fire Department Fire Code for inspecting and testing requirements. General Flow test conducted? Yes X No Static pressure: 55 PSI Flow pressure: 20 PSI Number of Sprinkler Heads: 42 2-inch drain? Other Yes NoX Flow switches, supervisory switches and alarm bells tested? N/A Yes X No Pressure regulating valves tested? N/A X Yes No Alarm bell operates? N/A Yes X No System inspected and lubricated? Yes X No Valves are sealed or supervised? Yes X No Signs are provided on valves? Yes X No Pumper connections and clapper valves unobstructed and turn freely? N/A X Yes No Wet type sprinkler heads replaced or successfully sample tested in last 50 Yes X No years? Sprinkler coverage is acceptable? Yes X No Have the sprinkler heads been replaced or successfully sample test in the last Yes X No 50 years? Proper number of spare sprinkler heads available? Yes X No System left in service? Yes X No System gauges replaced or calibrated within the last 5 years? Yes X No Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes X No Was debris found in the Fire Department Connection (FDC)? Yes NoX Was (FDC) back flushed / Intern pipe exam with -in the last 5 years? Yes NoX Was an internal pipe and valve inspection performed within the last 5 years? Yes No X Date Performed Was a signal received at the central station / monitoring company? N/A X Yes No Sprinkler wrench available for each type of sprinkler? Yes X No Page 2 of 2 AAA FIRE & SAFETY, INC 30133RDAVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCT# INV# 109743 SPRINKLERS WET Certification Given CONFIDENCE TEST x REPAIRS RED YELLOW I I WHrTE I x Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Building Owner: EDMONDS, WA 98026 BLDG."E" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Building Owner Address: Date of Inspection: 08/13/12 Inspection Annual Frequency/ Type: Testers Name 5331-IT-100507 (Please Print): BAUER/HUBER SFD Cert No: SCP- H-04401 Central Station Yes No X Monitoring LOCAL ONLY Monitoring? Company Name: Primary Component: System Make: 1" RISER System Model: SHOTGUN PROBLEms FOUND,: (if additional room is needed, please add a separate sheet) rN%-.M11r Ti Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) SFD Certification Numbe NOTE: 5 YR INTERNAL PIPE INSPECTION DUE NOTE: SPRINKLERS LOCATED ON 3 Ro FLR ONLY This certifies that this fire and life safety system has been properly inspected for reliability to �ovpr Th$ 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 corrective action. Signature of Tester: M6�� Phone: (206) 284-1721 Testing Agency: AAAF-IRE &SAFETY, INC Mailing Address: 3013 3"'u AVE N SEATTLE, WA 98109 Building Representative: (Signature) Pagel of2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Seattle Fire Department Fire Code for inspecting and testing requirements. General Flow test conducted? Yes X No Static pressure: 265 PSI Flow pressure: 240 PSI Number of Sprinkler Heads: 56 2-inch drain? Other Yes NoX Flow switches, supervisory switches and alarm bells tested? N/A Yes X No Pressure regulating valves tested? N/A X Yes No Alarm bell operates? N/A Yes X No System inspected and lubricated? Yes X No Valves are sealed or supervised? Yes X No Signs are provided on valves? Yes X No Pumper connections and clapper valves unobstructed and turn freely? N/A X Yes No Wet type sprinkler heads replaced or successfully sample tested in last 50 Yes X No years? Sprinkler coverage is acceptable? Yes X No Have the sprinkler heads been replaced or successfully sample test in the last Yes X No 50 years? Proper number of spare sprinkler heads available? Yes X No System left in service? Yes X No System gauges, replaced or calibrated within the last 5 years? Yes X No Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes X No Was debris found in the Fire Department Connection (FDC)? Yes NoX Was (FDC) back flushed / Intern pipe exam with -in the last 5 years? Yes NoX Was an internal pipe and valve inspection performed within the last 5 years? Yes NoX Date Performed Was a signal received at the central station / monitoring company? N/A X Yes No Sprinkler wrench available for each type of sprinkler? Yes X No Page 2 of 2 AAA FIRE & SAFETY, INC 30133RDAVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCT# INV# 109743 SPRINKLERS WET Certification Given CONFIDENCE TEST x REPAIRS RED YELLOW I I WHITE I x Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Building Owner: EDMONDS, WA 98026 BLDG. 7" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Building Owner Address: Date of Inspection: 08/13/12 Inspection Annual Frequency/ Type: Testers Name 5331-IT-100507 (Please Print): BAUER/HUBER SFD Cert No: SCP- H-04401 Central Station Yes No X Monitoring LOCAL ONLY Monitoring? Company Name: Primary Component: System Make: 1" RISER System Model: SHOTGUN PROBLEms FouND. (if additional room is needed, please add a separate sheet) V�' V, C' "h" Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) SFD Certification NumbeJ6_r NOTE: 5 YR INTERNAL PIPE INSPECTION DUE NOTE: SPRINKLERS LOCATED ON 3 Ro FLR ONLY This certifies that this fire and life safety system has been properly inspected for reliability to covdF"h 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 corrective action. Signature of Tester: 6-14c? Phone: (206) 284-1721 Testing Agency: AAA1 FIRE & SAFETY, INC Mailing Address: 30133 .. J AVE N SEATTLE, WA 98109 Building Representative: (Signature) Pagel of2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Seattle Fire Department Fire Code for inspecting and testing requirements. General I Flow test conducted? Yes X No Static pressure: 70 PSI Flow pressure: 45 PSI Number of Sprinkler Heads: 36 2-inch drain? Other Yes No X Flow switches, supervisory switches and alarm bells tested? N/A Yes X No Pressure regulating valves tested? N/A X Yes No Alarm bell operates? N/A Yes X No System inspected and lubricated? Yes X No Valves are sealed or supervised? Yes X No Signs are provided on valves? Yes X No Pumper connections and clapper valves unobstructed and turn freely? N/A X Yes No Wet type sprinkler heads replaced or successfully sample tested in last 50 Yes X No years? Sprinkler coverage is acceptable? Yes X No Have the sprinkler heads been replaced or successfully sample test in the last Yes X No 50 years? Proper number of spare sprinkler heads available? Yes X No System left in service? Yes X No System gauges replaced or calibrated within the last 5 years? Yes X No Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes X No Was debris found in the Fire Department Connection (FDC)? Yes NoX Was (FDC) back flushed / Intern pipe exam With -in the last 5 years? Yes NoX Was an internal pipe and valve inspection performed within the last 5 years? Yes NoX Date Performed Was a signal received at the central station / monitoring company? N/A X Yes No I Sprinkler wrench available for each type of sprinkler? Yes X No Page 2 of 2 AAA FIRE & SAFETY, INC 30133RDAVE N SEATFLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCT# INV# 109743 SPRINKLERS WET Certification Given CONFIDENCE TEST X REPAIRS RED YELLOW I I WHrTE I x Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS Building Owner: EDMONDS, WA 98026 BLDG. "G" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Building Owner Address: Date of Inspection: 08/13/12 Inspection Annual Frequency/ Type: Testers Name 5331-IT-100507 (Please Print): BAUER/HUBER SFD Cert No: SCP- H-04401 Central Station Yes No X Monitoring LOCAL ONLY Monitoring? Company Name: Primary Component: System Make: "'ER System Model: SHOTGUN PROBLEms FOUND: (if additional room is needed, please add a separate sheet) hr 'bp C c r ti fj,' Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) SFD Certification NumI5 NOTE: 5 YR INTERNAL PIPE INSPECTION DUE n sprit, NOTE: SPRINKLERS LOCATED ON 3 R" FLR ONLY 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 corrective action. Signature of Tester:4,40 Phone: (206) 284-1721 Testing Agency: ��V FIRE & SAFETY, INC Mailing Address: 30133 .. J AVE N SEATTLE, WA 98109 Building Representative: (Signature) Pagel ot`2 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Seattle Fire Department Fire Code for inspecting and testing requirements. General Flow test conducted? Yes X No Static pressure: 70 PSI Flow pressure: 56 PSI Number of Sprinkler Heads: 54 2-inch drain? Other Yes NoX Flow switches, supervisory switches and alarm bells tested? N/A Yes X No Pressure regulating valves tested? N/A X Yes No Alarm bell operates? N/A Yes X No System inspected and lubricated? Yes X No Valves are sealed or supervised? Yes X No Signs are provided on valves? Yes X No Pumper connections and clapper valves unobstructed and turn freely? N/A X Yes No Wet type spdnkler heads replaced or successfully sample tested in last 50 Yes X No years? Sprinkler coverage is acceptable? Yes X No Have the sprinkler heads been replaced or successfully sample test in the last Yes X No 50 years? Proper number of spare sprinkler heads available? Yes X No System left in"service? Yes X No System gauges replaced or calibrated within the last 5 years? Yes X No Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes X No Was debris found in the Fire Department Connection (FDC)? Yes NoX Was (FDC) back flushed / Intern pipe exam with -in the last 5 years? Yes NoX Was an intemal pipe and valve inspection performed within the last 5 years? Yes No X Date Performed Was a signal received at the central station / monitoring company? N/A x Yes No Sprinkler wrench available for each type of sprinkler? Yes X No Page 2 of 2 AAA FIRE & SAFETY, 30133 RD AVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCT# INV# 109743 FIRE ALARM SYSTEM Certification Given (One System per Report) RED YELLOW WHITE X CONFIDENCE TEST FX I REPAIRS I Occupancy Address: 23326 EDMONDS WAY Occupancy Name: - EDMONDS HIGHLANDS EDMONDS, WA 98026 BLDG. "A" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Inspection Building Owner Address: Frequency[Type: ANNUAL Date of Inspection: AUG. 13, 2012 Testers Name SFD Certification (Please Print): Michelle Huber Number: SCP — H-04401 Central Station Yes No X Monitoring Monitoring? Company Name: LOCAL ONLY Primary Component: Facp System Make: FQI System Model: SBP2 System Location: Identification STAIRWELL Number: PRoBLEms FoUND: (If additional room is needed, please add a separate sheet) CORREMONS MADE: Date Corrected: Corrected By: Michelle Huber (If additional room is needed, please add a separate shed) SFD Certification Number: H-04401 NOTE: ONLY 3 RD FLOOR HAS SPRINKLERS, ALL UNITS HAVE 1 MINI HORN. ACCESSED 3 RD FLR ONLY, LISTENED TO HORNS THROUGH UNIT DOORS 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 corrective action. Signature of Tester: il—�j Phone # 206-284-1721 Testing Agency: \-�FME & SAFETY, INC Mailing Address: 30133 RD AVE N SEATTLE, WA 98109 Building Representative CTF- 0 1 Pagel of2 Alarm Svstem Functionali Trouble signal with AC power off? Yes X No System operates properly on battery backup? Yes X No Battery voltage (no load) 26.7volts Battery voltage (full load) 24.8 volts (signals operating) Charge circuit voltage -263—volts System operates properly on standby power? Yes X No All signals operate on AC power? Yes X No Number of initiating circuits 4 Number of signal circuits I Does alarm system meet audibility standards? Yes X No All circuits checked for electrical supervision? Yes X No All auxiliary equipment operates (Elevators, fans, dampers)? N/A X Yes No Ventilation controls operate? N/A X Yes No Key to panel available? Yes X No Operating instructions at panel? Yes X No Trouble indicators function properly? Yes X No Remote Annunciator Panels function properly? N/A X Yes No Elevator Call Down functions properly? N/A X Yes No Test record posted at panel? Yes X No General alarm automatic time delay — (minutes) N/A X was a signal received at the Central Station monitoring company? N/A X Yes No Other Devices (Specify) Yes No Total Number of Total Number System Devices Units in Building Units Tested Test Results Acceptable 1. Bells, Horns, Chimes 31 31 N/A Yes X No 2. Voice Speakers (Voice Clarity) N/A Yes No 3. Smoke Detectors N/A Yes No 4. Heat Detectors N/A Yes No 5. Duct Detectors N/A Yes No 6. Sprinkler Flow Switches 1 1 N/A Yes X No 7. Sprinkler Supervisory Switches N/A Yes No 8. Visual Alarm Devices 1 1 N/A Yes X No 9. Manual Pull Stations 18 18 N/A Yes X No 10. Annunciator(s) N/A Yes No 11. Beam Detectors N/A Yes No 12. Automatic Door Unlocks N/A Yes No Automatic Door Release N/A Yes No -13. Total Number of Total Number Units Communication Equipment Units in Buildinq Tested Test Results Acceptable 14. Phone Sets N/A Yes No 15. Phone Jacks N/A Yes No 16. Call -in Signal N/A Yes No CTF- 01 Page 2 of 2 MA FIRE & SAFEW, 30133 RD AVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCr# INV# 109743 FIRE ALARM SYSTEM Certification Given (One System per Report) RED YELLOW WHrrE X CONFIDENCETESTJ X I REPAIRS I Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS EDMONDS, WA 98026 BLDG. "B" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Building Owner Address: Inspection Frequency/Type: ANNUAL Date of Inspection: AUG. 13, 2012 Testers Name SFD Certification (Please Print): Michelle Huber Number: SCP — H-04401 Central Station Yes No X Monitoring Monitoring? Company Name: LOCAL ONLY Primary Component: Facp System Make: FCI System Model: SBP2 System Location: Identification STAIRWELL Number: ftosiugms FoUND: (If additional room is needed, please add a separate sheet) CORRECnONS MADE: Date Corrected: Corrected By: Michelle Huber (If additional room is needed, please add a separate shed) SFD Certification Number: H-04401 NOTE: ONLY 3 RD FLOOR HAS SPRINKLERS, ALL UNITS HAVE 1 MINI HORN. ACCESSED 3 RD FLR ONLY, LISTENED TO HORNS THROUGH UNIT DOORS This certifies that this fire and life safety system has been properly inspected for reliability tD 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 report d to the building Owner/Manager for corrective action. Signature of Tester: rq&J-XL "I",/ Phone # 206-284-1721 Testing Agency: '--�E & SAFIETY, INC Mailing Address: 30133 RD AVE N sEATrLE. WA 8109 Building Representative CTF- 0 1 Pagel of2 Alarm Svstem Functionali Trouble signal with AC power off? Yes X No System operates properly on battery backup? Yes X No Battery voltage (no load) 26.4volts Battery voltage (full load) _Z5.5 volts (signals operating) Charge circuit voltage _26.7 volts System operates properly on standby power? Yes X No All signals operate on AC power? Yes X No Number of initiating circuits 2 Number of signal circuits 1 Does alarm system meet audibility standards? Yes X No All circuits checked for electrical supervision? Yes X No All auxiliary equipment operates (Elevators, fans, dampers)? N/A X Yes No Ventilation controls operate? N/A X Yes No Key to panel available? Yes X No Operating instructions at panel? Yes X No Trouble indicators function properly? Yes X No Remote Annunciator Panels function properly? N/A X Yes No Elevator Call Down functions properly? N/A X Yes No Test record posted at panel? Yes X No General alarm automatic time delay - (minutes) N/A X was a signal received at the Central Station monitoring company? N/A X Yes No Other Devices (Specify) Yes No Total Number of Total Number System Devices Units in Building Units Tested Test Results Acceptable 1. Bells, Horns, Chimes 19 19 N/A Yes X No 2. Voice Speakers (Voice Clarity) N/A Yes No 3. Smoke Detectors N/A Yes No 4. Heat Detectors N/A Yes No S. Duct Detectors N/A Yes No 6. Sprinkler Flow Switches 1 1 N/A Yes X No 7. Sprinkler Supervisory Switches N/A Yes No 8. Visual Alarm Devices I I N/A Yes X No 9. Manual Pull Stations 9 9 N/A Yes X No 10. Annunciator(s) N/A Yes No 11. Beam Deit�ldors N/A Yes No 12. Automatic Door Unlocks N/A Yes No 13. Automatic Door Release N/A Yes No Total Number of Total Number Units .Communication Equipment Units in Building Tested Test Results Acceptable 14. Phone Sets N/A Yes No 15. Phone Jacks N/A Yes No 16. Call -in Signal N/A Yes No CTF- 01 Page 2 of 2 AAA FIRE & SAFEW, 30133 RD AVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCT# INV# 109743 RRE ALARM SYSTEM Certification Given (One System per Report) RED YELLOW WHrTE X CONFIDENCE TEST FX I REPAIiTS Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS EDMONDS, WA 98026 BLDG. "C" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Inspection Building Owner Address: Frequency/Type: ANNUAL Date of Inspection: AUG. 13, 2012 Testers Name SFD Certification (Please Print): Michelle Huber Number: SCP — H-04401 Central Station Yes No X Monitoring Monitoring? Company Name: LOCAL ONLY Primary Component: Facp System Make: ESL System Model: 1500 System Location: Identification STAIRWELL Number: Pgopgms FoUND: (If additional room is needed, please add a separate sheet) CORREMONS MADE: Date Corrected: Corrected By: Michelle Huber (If additional room is needed, please'add a separate sheet) SFD Certification Number: H-04401 NOTE: ONLY 3RD FLOOR HAS SPRINKLERS, ALL UNITS HAVE 1 MINI HORN. ACCESSED 3RD FLR ONLY, LISTENED TO HORNS THROUGH UNIT DOORS This certifies that this fire and life safety system has been properly inspected for reliability tr) cover the Items listed in this report and is consistent with Seattle Fire Department Fire Code standards, and that discrepancies are noted and have.,bezreArted,,to the building Owner/Manager for corrective action. Signature of Tester: A 4,9 Phone # 206-284-1721 Testing Agency: A'j��IKE & SAFETY, INC Mailing Address: 3013 3RD AVE N SEATTLE, WA 98109 Building Representative CTF- 01 Pagel of2 Alarm Svstem Functionali Trouble signal with AC power off? Yes X No System operates properly on battery backup? Yes X No Battery voltage (no load) 26.3volts Battery voltage (full load) _L5.8 volts (signals operating) Charge circuit voltage 26.7 volts System operates properly on standby power? Yes X No All signals operate on AC power? Yes X No Number of initiating circuits 2 Number of signal circuits .1 Does alarm system meet audibility standards? Yes X No All circuits checked for electrical supervision? Yes X No All auxiliary equipment operates (Elevators, fans, dampers)? N/A X Yes No Ventilation controls operate? N/A X Yes No Key to panel available? Yes X No Operating instructions at panel? Yes X No Trouble indicators function properly? Yes X No Remote Annunciator Panels function properly? N/A X Yes No Elevator Call Down functions properly? N/A X Yes No Test record posted at panel? Yes X No General alarm automatic time delay - (minutes) N/A X Was a siqnal received at the Central Station monitoring company? N/A X Yes No Other Devices (Specify) Yes No Total Number of Total Number System Devices Units in Building Units Tested Test Results Acceptable 1 . Bells, Horns, Chimes 13 13 N/A Yes X No 2. Voice Speakers (Voice Clarity) N/A Yes No 3. Smoke Detectors N/A Yes No 4. Heat Detectors N/A Yes No 5. Duct Detectors N/A Yes No 6. . Sprinkler Flow Switches 1 1 N/A Yes X No 7. Sprinkler Supervisory Switches N/A Yes No 8. Visual Alarm Devices I I N/A Yes X No 9. Manual Pull Stations 9 9 N/A Yes X No 10. Annunciator(s) N/A Yes No 11. Beam Dd-tectors N/A Yes No 12. Automatic Door Unlocks N/A Yes No Automatic Door Release N/A Yes No -13. Total Number of Total Number Units Communication Equipment Units in Building Tested Test Results Acceptable 14. Phone Sets N/A Yes No 15. Phone Jacks N/A Yes No 16. Call -in Signal N/A Yes No CTF- 01 Page 2 of 2 AM FIRE & SAFETY, 30133RDAVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCT# INV# 109743 FIRE ALARM SYSTEM Certification Given (One System per Report) RED 7-1�113W WHrTE X CONFIDENCE TEST FX I REPZ� Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS EDMONDS, WA 98026 BLDG. "D" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Inspection Building Owner Address: Frequency/Type: ANNUAL Date of Inspection: AUG. 13, 2012 Testers Name SFD Certification (Please Pont): Michelle Huber Number: SCP — H-04401 Central Station Yes No X Monitoring Monitoring? Company Name: LOCAL ONLY Primary Component: Facp System Make: EIRELITE System Model: NP-24 System Location: Identification STAIRWELL Number: PROBLEms FoUND: (If additional room is needed, please add a separate sheet) CORRECTIONS MADE: Date Corrected: Corrected By: Michelle Huber (If additional room is needed, please add a separate shed) SFD Certification Number: H-04401 NOTE: ONLY 3 RD FLOOR HAS SPRINKLERS, ALL UNITS HAVE 1 MINI HORN. ACCESSED 3 RD FLR ONLY, LISTENED TO HORNS THROUGH UNIT DOORS 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 fpv� beeq reported to the building Owner/Manager for corrective acbon. //71 Signature of Tester: Af/ fft .-q A V4- Phone # 206-284-1721 Testing Agency: %'��AA F%E & SAFETY, INC Mailing Address: 30133 RD AVE N SEATTLE, WA 98109 Building Representative CTF- 01 Pagel U2 Alarm System Functionality Trouble signal with AC power off7 Yes X No System operates properly on battery backup? Yes X No Battery voltage (no load) 26.7volts Battery voltage (full load) 26.4 volts (signals operating) Charge circuit voltage 27.3 volts System operates properly on standby power? Yes X No All signals operate on AC power? Yes X No Number of initiating circuits 2 Number of signal circuits 1 Does alarm system meet audibility standards? Yes X No All circuits checked for electrical supervision? Yes X No All auxiliary equipment operates (Elevators, fans, dampers)? N/A X Yes No Ventilation controls operate? N/A X Yes No Key to panel available? Yes X No Operating instructions at panel? Yes X No Trouble indicators function properly? Yes X No Remote Annunciator Panels function properly? N/A X Yes No Elevator Call Down functions properly? N/A X Yes No Test record posted at panel? Yes X No General alarm automatic time delay - (minutes) N/A X Was a siqnal received at the Central Station monitoring company? N/A X Yes No Other Devices (Specify) Yes No Total Number of Total Number System Devices Units in Building Units Tested Test Results Acceptable 1 - Bells, Horns, Chimes 13 13 N/A Yes X No 2. Voice Speakers (Voice Clarity) N/A Yes No I Smoke Detectors N/A Yes No 4. Heat Detectors N/A Yes No 5. Duct Detectors N/A Yes No 6. Sprinkler Flow Switches 1 1 N/A Yes X No 7. Sprinkler Supervisory Switches N/A Yes No 8. Visual Alarm Devices I I N/A Yes X No 9. Manual Pull Stations 6 6 N/A Yes X No 10. Annunciator(s) N/A Yes No 11. Beam Detectors N/A Yes No 12. Automatic Door Unlocks N/A Yes No Automatic Door Release N/A Yes No -13. Total Number of Total Number Units Communication Equipment Units in Building Tested Test Results Acceptable 14. Phone Sets N/A Yes No 15. Phone Jacks N/A Yes No 16. Call -in Signal N/A Yes No CTF- 01 Page 2 of 2 AM FIRE & SAFEW, 30133RDAVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCr# INV# 109743 FIRE ALARM SYSTEM Certification Given (One System per Report) RED YELLOW WHrTE X CONFIDENCE TEST FX I REPAIRS I Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS EDMONDS, WA 98026 BLDG. "E" Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Inspection Building Owner Address: Frequency/Type: ANNUAL Date of Inspection: AUG. 13, 2012 Testers Name SFD Certification (Please Print): Michelle Huber Number: SCP — H-04401 Central Station Yes No X Monitoring Monitoring? Company Name: LOCAL ONLY Primary Component: Facp System Make: FCI System Model: SBP2 System Location: Identification STAIRWELL Number: PROBLEms FoUND: (If additional room is needed, please add a separate sheet) PANEL BATTERIES OUTDATED CORREC'nONS MADE: Date Corrected: 08/13/12 Corrected By: Michelle Huber (If additional room is needed, please add a separate shed) SFD Certification Number: H-04401 REPLACED PANEL BATTERIES (12 VOLT 7 AMP) NOTE: ONLY 3 RD FLOOR HAS SPRINKLERS, ALL UNITS HAVE 1 MINI HORN. ACCESSED 3 RD FLR ONLY, LISTENED TO HORNS THROUGH UNIT DOORS 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 Se attle Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: Phone # 206-284-1721 Testing Agency: (AAAAE & SAFEry, INC Mailing Address: 30133 RD AVE N SEATTLE, WA 98109 Building Representative CTF- 01 Page] of2 Alarm Svstem Functionali Trouble signal with AC power off2 Yes X No System operates properly on battery backup? Yes X No Battery voltage (no load) 25.7volts Battery voltage (full load) 24.9 volts (signals operating) Charge circuit voltage 25.9 volts System operates properly on standby power? Yes X No All signals operate on AC power? Yes X No Number of initiating circuits 2 Number of signal circuits 1 Does alarm system meet audibility standards? Yes X No All circuits checked for electrical supervision? Yes X No All auxiliary equipment operates (Elevators, fans, dampers)? N/A X Yes No Ventilation controls operate? N/A X Yes No Key to panel available? Yes X No Operating instructions at panel? Yes X No Trouble indicators function properly? Yes X No Remote Annunciator Panels function properly? N/A X Yes No Elevator Call Down functions properly? N/A X Yes No Test record posted at panel? Yes X No General alarm automatic time delay - (minutes) N/A X was a signal received at the Central Station monitoring company? N/A X Yes No Other Devices (Specify) Yes No Total Number of Total Number System Devices Units in Building Units Tested Test Results Acceptable 1 . Bells, Horns, Chimes 25 25 N/A Yes X No 2. Voice Speakers (Voice Clarity) N/A Yes No 3. Smoke Detectors N/A Yes No 4. Heat Detectors N/A Yes No 5. Duct Detectors N/A Yes No 6. Sprinkler Flow Switches 1 1 N/A Yes X No 7. Sprinkler Supervisory Switches N/A Yes No 8. Visual Alarm Devices I I N/A Yes X No 9. Manual Pull Stations 9 9 N/A Yes X No 10. Annunciator(s) N/A Yes No 11. Beam D& tectors N/A Yes No 12. Automatic Door Unlocks N/A Yes No Automatic Door Release N/A Yes No -13. Total Number of Total Number Units Communication Equipment Units in Building Tested Test Results Acceptable 14. Phone Sets N/A Yes No 15. Phone lacks N/A Yes No 16. Call -in Signal N/A Yes No CTF- 01 Page 2 of 2 AAA FIRE & SAFETY, 30133RDAVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-28+1769 EDMONDS Fire Department Confidence Test Report ACCT# INV# 109743 FIRE ALARM SYSTEM Certification Given (One System per Report) RED YELLOW WHITE X CONFIDENCETESTJ X I REPAIRS I Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS EDMONDS, WA 98026 BLDG. "F' Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Inspection Building Owner Address: Frequency/Type: ANNUAL - Date of Inspection: AUG. 13, 2012 Testers Name SFD Certification (Please PHnt): Michelle Huber Number: SCP — H-04401 Central Station Yes No X Monitoring Monitoring? Company Name: LOCAL ONLY Primary Component: Facp System Make: FIRELITE System Model: MP-24 System Location: Identification STAIRWELL Number: Pgopgms FoUND: (If additional room is needed, please add a separate sheet) CORREMONS MADE: Date Corrected: Corrected By: Michelle Huber (If additional room is needed, please add a separate shed) SFD Certification Number: H-04401 NOTE: ONLY 3 RD FLOOR HAS SPRINKLERS, ALL UNITS HAVE I MINI HORN. ACCESSED 3 RD FLR ONLY, LISTENED TO HORNS THROUGH UNIT DOORS 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 rpported to the building Owner/Manager for corrective action. Signature of Tester: I -A Phone # 206-284-1721 Testing Agency: E &SAFETY, INC Mailing Address: 30133 RD AVE N SEATTLE, wA 98iog Building Representative CTF- 01 Pagel of2 Alarm System Functionality Trouble signal with AC power off? Yes X No System operates properly on battery backup? Yes X No Battery voltage (no load) 26.9 volts Battery voltage (full load) 26.7 volts (signals operating) Charge circuit voltage 27.2 volts System operates properly on standby power? Yes X No All signals operate on AC power? Yes X No Number of initiating circuits 2 Number of signal circuits 1 Does alarm system meet audibility standards? Yes X No All circuits checked for electrical supervision? All auxiliary equipment operates (Elevators, fans, dampers)? N/A X Yes X Yes No No Ventilation controls operate? N/A X Yes No Key to panel available? Yes X No Operating instructions at panel? Yes X No Trouble indicators function properly? Yes X No Remote Annunciator Panels function properly? N/A X Yes No Elevator Call Down functions properly? N/A X Yes No Test record posted at panel? Yes X No General alarm automatic time delay - (minutes) N/A X was a signal received at the Central Station monitoring company? N/A X Yes No Other Devices (Specify) Yes No Total Number of Total Number System Devices Units in Building Units Tested Test Results Acceptable 1 . Bells, Horns, Chimes 13 13 N/A Yes X No 2. Voice Speakers (Voice Clarity) N/A Yes No 3. Smoke Detectors N/A Yes No 4. Heat Detectors N/A Yes No 5. Duct Detectors N/A Yes No 6. Sprinkler Flow Switches 1 1 N/A Yes X No 7. Sprinkler Supervisory Switches N/A Yes No 8. Visual Alarm Devices 1 1 NIA Yes X No 9. Manual Pull Stations 6 6 N/A Yes X No 10. Annunciator(s) N/A Yes No 11. Beam Detectors N/A Yes No 12. Automatic Door Unlocks N/A Yes No Automatic Door Release N/A Yes No -13. Total Number of Total Number Units Communication Equipment Units in Building Tested Test Results Acceptable 14. Phone Sets N/A Yes No 15. Phone Jacks N/A Yes No 16. Call -in Signal N/A Yes No CTF- 01 Page 2 of 2 AM FIRE & SAFETY, 3013 3RD AVE N SEATTLE, WA 98109 PH: 206-284-1721 FX: 206-284-1769 EDMONDS Fire Department Confidence Test Report ACCT# INV# 109743 FIRE ALARM YSTEM Certification Given (One System per Report) RED YELLOW WHITE X CONFIDENCE TEST FX I REPAIRS I Occupancy Address: 23326 EDMONDS WAY Occupancy Name: EDMONDS HIGHLANDS EDMONDS, WA 98026 BLDG. 11U1 Responsible Person: FRANCES HARRIS Phone Number: 425-771-6910 Inspection Building Owner Address: Frequency/Type: ANNUAL Date of Inspection: AUG. 13, 2012 Testers Name SFD Certification (Please Print): Michelle Huber Number: SCP - H-04401 Central Station Yes No X Monitoring Monitoring? Company Name: LOCAL ONLY Primary Component: Facp System Make: FIRELITE System Model: MS-2 System Location: Identification STAIRWELL Number: PROBLEms FoUND: (If additional room is needed, please add a separate sheet) CORREMONS MADE: Date Corrected: Corrected By: Michelle Huber (If additional room is needed, please add a separate sheet) SFD Certification Number: H-04401 NOTE: ONLY 3RD FLOOR HAS SPRINKLERS, ALL UNrrS HAVE 1 MINI HORN. ACCESSED 3RD FLR ONLY, LISTENED TO HORNS THROUGH UNIT DOORS 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 bWrj reported to th building Owner/Manager for corrective action. Signature of Tester: A �- I , - Phone 206-284-1721 Testing Agency: �IR & SAFETY, INC Mailing Address: 30133 RD AVE N SEATTLE, WA 98109 Building Representative CTF- 0 1 Page] U2 Alarm System Functionality Trouble signal with AC power off7 Yes X No System operates properly on battery backup? Yes X No Battery voltage (no load) 27.0 volts Battery voltage (full load) 26.4 volts (signals operating) Charge circuit voltage 27.3 volts System operates properly on standby power? Yes X No All signals operate on AC power? Yes X No Number of initiating circuits 2 Number of signal circuits 1 Does alarm system meet audibility standards? Yes X No All circuits checked for electrical supervision? Yes X No All auxiliary equipment operates (Elevators, fans, dampers)? N/A X Yes No Ventilation controls operate? N/A X Yes No Key to panel available? Yes X No Operating instructions at panel? Yes X No Trouble indicators function properly? Yes X No Remote Annunciator Panels function properly? N/A X Yes No Elevator Call Down functions properly? N/A X Yes No Test record posted at panel? Yes X No General alarm automatic time delay - (minutes) N/A X Was a signal received at the Central Station monitoring company? N/A X Yes No Other Devices (Specify) Yes No Total Number of Total Number System Devices Units in Building Units Tested Test Results Acceptable 1. Bells, Horns, Chimes 19 19 N/A Yes X No 2. Voice Speakers (Voice Clarity) N/A Yes No 3. Smoke Detectors N/A Yes No 4. Heat Detectors N/A Yes No 5. Duct Detectors N/A Yes No 6. Sprinkler Flow Switches 1 1 N/A Yes X No 7. Sprinkler Supervisory Switches N/A Yes No 8. Visual Alarm Devices 1 1 N/A Yes X No 9. Manual Pull Stations 12 12 N/A Yes X No 10. Annunciator(s) N/A Yes No 11. Beam Detectors N/A Yes No 12. Automatic Door Unlocks N/A Yes No 13. Automatic Door Release N/A Yes No Total Number of Total Number Units Communication Equipment Units in Building Tested Test Results Acceptable 14. Phone Sets N/A Yes No 15. Phone Jacks N/A Yes No 16. Call -in Signal N/A Yes No CTF- 01 Page 2 of 2 John J. Wesffall From: Michael J. Smith Sent: Tuesday, October 30, 2012 9:17 AM To: Brett W. Kuhn Cc: John J. Westfall Subject: RE: Oven Fire at Edmonds Highlands I will look into the knox issue. Also read your report in sunpro. Eventually this will be a no smoking and no deep frying complex. From: Brett W. Kuhn Sent: Tuesday, October 30, 2012 8:59 AM To: John J. Westfall; Michael 1. Smith Cc: Patrick M. Hepler; Leslie H - ynes;-Station 20 Crew; Andrew Polak; Jesse McCormick; Melissa Reimer Subject: Oven Fire af, �Edmi�cls--Highlancls,---) 13ood morning Marshal Westfall and Inspector Smith, We had a small incident at the Edmonds Highlands worth mentioning last night. In unit #C101 there was a small stove fire that started while deep frying in a small pot of boiling oil. It had boiled over and got into the drip pan underneath the burners. One of the residents had used two dry chem extinguishers. Fire was out upon arrival. Although the fire damage was minimal, the whole apartment had been filled with light smoke. The renters have no rental insurance. Sandra Bright (425) 931-9104 is the renter. On a completely separate issue, but still worth noting. We went to the Korean Church at 8505 240th ST. A person who was going to use the gymnasium was attempting to find the light switch and pulled the fire alarm pull station instead. Our Knox box keys off of E20 would not open either of the Knox boxes (main entry or SW corner by the I'D connection). When you get time could you look into this? Thank you gentleman, Srett 11—Rho, Captain/ Rescue Station #20 (425) 551-1920 bkuhnCcDfiredistrictl.orR FIRE DISTRICT OV EI)Af PHONE: (425) 771-0220 - FAX: (425) 771-0221 CITY OF EDMONDS 121 5TH AVENUE NORTH - EDMONDS, WA 98020 STATUS: ISSUED 4/16/2012 Expiration Date: 4/16/2013 Parcel No: 00555300100300 -Mit #: BLD20120271 Project Address; 23326 EDMONDS WAY,- EDMONDS PIR1111PERT7 0 EDMONDS HIGHLANDS - AAA FIRE & SAFETY INC AAA FIRE & SAFETY INC AUTHORITY OF SNO CO HOUSING 3013 3Rd Ave N 3013 3Rd Ave N 12625 4TH AVE W # 200 Seattle, WA 98109 Seattle, WA 98109 EVERETT, WA 98204 (206) 284-1721 (206) 284-1721 LICENSE #: AAAFIS114ODS EXP71/15/2013 J161,11 DES('k',IPTI,'$)V REPLACE FIRE PANEL IN BUILDING G WITH SIMILAR PANEL VALUATION: $0.00 PERMIT TYPE: Commercial PERMIT GROUP: 79 - Fire Alarm GRADING: N CYDS, 0 TYPE OF CONSTRUCTION: RETAINING WALL ROCKERYi N OCCUPANT GROUP: OCCUPANT LOAD� FENCE: N ( 0 X 0 FT.) CODE: 09 OTHER N ------- OTHER DESC: ZONE NUMBER OF STORIES: 0 VESTED DATE: NUMBER OF DWELLING UNITS: 0 LOT #: EXISTING AREA BASEMENT: 0 1 ST FLOOR 0 2ND FLOOR: 0 PROPOSED AREA �E�MENT 0 1 ST FLO3_R 0 2ND FLOOR: 0 13RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0 13RD FLOOR� 0 GARAGE: 0 DECK 0 OTHER: 0 FRONT SETBACK SIDE SETBACK REARSETBACK REQUIRED: PROPOSED: �REQUIRED: PROPOSED� 7�UIRED: PROPOSED: HEIGHT ALLOWED:O PROPOSED:O I REQLARED: PROPOSED: SETBACK NOTES: I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HISIHER DEPUTY AND ALL�FEES ARE PAID. Signature Print Name Date By Date ATTENTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC 109/ IBC 110/ IRC 110, FIRE COPY = ONLINE = APPLICANT = ASSESSOR = OTHER STATUS: ISSUED BLD20120271 CONDITIONS • Final approval on a project or final occupancy approval must be granted by the Building Official prior to use or occupancy of the building or structure. Check the job card for all required City inspections including final project approval and final occupancy inspections. • Any request for alternate design, modification, variance or other administrative deviation (hereinafter "variance") from 0 adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified, Processing fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable. • Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision of city code or state law does not approve any items not to code specification. • Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits of ECC Chapter 5.30 only during the hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120. • Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of whatever nature, arising directly or indirectly from the issuance for this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any requirements of any City ordinance nor limit in any way the City s ability to enforce any ordinance provision. INSPECTIONS THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6) I BUILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 775-7720 1 I PUBLIC WORKS (425) 771-0235 1 PRE-TREATMENT (425) 672-5755 1 RECYCLING (425) 275-4801 1 When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection being reauested. Contact Name and Phone Number, Date Prefereed, and whether Von prefer morning or afternoon. . F-Fire Alarm System Acceptance DF-5221 1:132 e A2-250 MS-2(E) 2-Zone Fire Alarm Control Panels Fire-LIWALWMS by Honeywell I@u0mmmaFa u3tG aff'u @&w7d General The Fireel-ite MS-2 and MS-2E Fire Alarm Control Panels (FACPs) bring the latest in microprocessor technology to con- ventional fire controls. The MS-2 Is compatible with the 13"m smoke detectors from System Sensor with drift compensation, maintenance alert, and freeze warning. Automatic synchronize - bon of audiotvisual devices with three selections for manufac- turer protocol. The Notification Appliance Circuit (NAC) protocol can silence audible devices while strobes continue to flash, using a single pair of wires. The MS-2 Is compatible with conventional input devices such as two- and four -wire smoke detectors, pull stations, waterflow devices, tamper switches and other normally -open contact devices. Refer to the FireoLite Device Compatibility Document PN 15384 for a complete list of compatible devices. Note: Unless indicated otherwise, the term `MS-2"refers to both MS-2 and MS-2E models. Features • Two Style B (Class B) Initiating Device Circuits (IDCs). • One Style Y (Class B) NAC. • 24 VDC. • 13TO Technology features: — Drift compensation automatically adjusts detector sensitiv- ity and increases resistance to false alarms caused by dust accumulation. — Maintenance Alert LEDs (per zone) warn of excessive dirt accumulation, preventing false alarms (meets NFPA 72 requirements). — Detector sensitivity is automatically measured by the detector, which automatically adjusts Its sensitivity back to the factory settings when it becomes more sensitive due to contaminants settling in the chamber. — Wireless handheld sensitivity meter eliminates the need for voltmeters, magnets, and a physical connection to the detector. The reader displays sensitivity in terms of percent per foot obscuration and provides text status indication. — Supervisory LED (per zone) provides warning if a detector senses temperature approaching freezing. — Special test protocol and LED Indication allows quick test of all detectors without need for a ladder. • NAC synchronization features: — Synchronization of standard ANSI audible signals as required by NFPA 72. — Synchronization of ADA compliant strobes per NFPA 72. — Selectable for System Sensor, Wheelock, and Gentex protocols. — Selective Silence for manual silence of horns while strobes continue to flash on the same NAC. — Alarm verification selectable for each zone. — Disable switches provided per zone. NAC programmable for., — Silence Inhibit — Auto Silence — Strobe Synchronization — Selective Silence (horn -strobe mute) — Temporal or Steady signal — Silenceable or Nonsilenceable • Silent or audible Walk Test operation mode commanded from the front keypad, with automatic return -to -normal after one hour of inactivity. • Each zone may be programmed for supervisory or fire; each zone has separate red and yellow LEDs. • Disable switches provided for each zone. • Form-C Alarm and Trouble relays. • 3.0 amps total usable current. • Piezo sounder for alarm, trouble, supervisory and mainte- nance. Control buttons: — ACK (Acknowledge) — Alarm Silence — Reset — Walk Test — Zone Enable/Disable (one per zone) o LED Indicators: — Fire Alarm (one per zone) — Supervisory (one per zone) — Trouble (one per zone) — Maintenance (one per zone) — AC Power — NAC Disable — Zone Disable — NAC Fault — System Trouble DF-52211:B2-12/21/11 —Page I of 2 - Power Trouble - Walk Test - Alarm Silence - Earth Fault (on circuit board) - Battery Fault (on circuit board) - Charger Fault (on circuit board) Optional dress panel. Operation Activation of a compatible smoke detector or any normally -open fire alarm initiating device activates audible and visual signaling devices, illuminates an indicating LED, sounds the piezo sounder at the FACP activates the FACP alarm relay and oper- ates an optional module used to notify a remote station or initi- ate an auxiliary control function. Specifications AC POWER - TB8 • MS-2:120VAC,50/60Hz,2.3A. • MS-2E:240VAC,50Hz,1.15A. • Wire Size: Minimum 14 AWG (2.0 mm2) with 600 V insulation. BA TTER Y (SEALED LEAD -ACID ONL Y) - J8 • Maximum charging circuit: normal flat charge 27.6 VCD @ 0.8 A. • Maximum battery charger capacity: 18.0 AH battery (two 7.0 AH batteries can be housed in the FACP cabinet. Larger batteries require a separate battery box such as the Fireol-ite BB-17F). INITIA77NG DEVICE CIRCUIT - T93 • Alarm zones 1 & 2. • Power -limited circuitry. • Operation: all zones Style B (Class B). • Normal operating voltage: nominal 20 VDC. • Alarm current 15 mA minimum. • Short-circuit current: 40 mA maximum. • Maximum loop resistance: 100 ohms. • End -of -line resistor: 4.7K ohm, 1/2 watt (P/N 71252). • Standby current: 4 mA. • Compatible devices: refer to the FireoLite Device Compatibil- ity Document PN 15384 for a complete list of compatible devices. NOTIFICATION APPLIANCE CIRCUIT - T92 * One NAC. • Power -limited circuitry. • Normal operating voltage: nominal 24 VDC. • Maximum signalling current 2.5 A total with standard trans- former. • End -of -line resistor: 4.7K ohm, 1h watt (P/N 71252). • Compatible devices: refer to the Fire-Lite Device Compatibil- ity Document PN 15384 for a complete list of compatible devices. FORM-C RELA YS * Trouble Relay TB5 (fail-safe). • Alarm Relay TB6. • Relay contact ratings: 2.0 A @ 30 VDC (resistive). AUXILIARY OUTPUT. RESETYABLE POWER - TBI • Operating voltage: nominal 24 VDC. • Maximum available current: 500 mA - appropriate for pow- ering four -wire smoke detectors (see notes). • Power -limited circuitry. Notes: 1) Refer to the FireoLite Device Compatibility Document PN 15384 for a complete list of compatible devices. 2) Total current for resettable power and one NAC must not exceed 3.0 A for MS-2. CABINET DIMENSIONS Door: 15.34Z' (38.97 cm) high x 14.66T' (37.28 cm) wide x 0.376'(0.95 cm) deep. Backbox: 15.OP' (38.10 cm) high x 14.5" (36.83 cm) wide x 3.U' (7.62 cm) deep. BACKBOKMOUNTING The cabinet can be surface mounted. The door is removable during installation by opening and lifting it off the hinges. The cabinet mounts using two key slots at the top of the backbox and two additional 0.25" diameter holes at the bottom. Listings and Approvals • UL Listed: S624. • MEA: 297-01-E. • CSFM: 7165-0075:200. Ordering Information MS-2: Two -zone conventional FACP. 120 VAC, 50/60 Hz, 2.3 A. MS-2E: Same as above with 240 VAC, 50 Hz, 1. 15 A operation. BB-17F: Battery box, required to house two batteries greater than 7 AH to a maximum of 18 AH. DPMS214: Optional dress panel. MS-2RB: MS-2(E) replacement board. TR-1-R: Optional trim ring for semi -flush mounting. 4XTMF: Transmitter Module provides a supervised output for a local energy municipal box transmitter in addition to alarm and trouble reverse polarity. A 4-zone version of this panel is also available. See DF-52266. Fire-LiteOD Alarms Is a registered trademark of Honeywell Intemationall Inc. 02011 by Honeywell Intemationall Inc. All rights reserved. Unauthorized use of this document Is strictly prohibited. This document is not intended to be used for installation purposes. IS09001We try to keep our product information up-to-date and accurate. We cannot cover all specific applications or anticipate all requirements. I liimmgl All specifications are subject to change without notice. COMITY SYSTEMS Made In the U.S. A. For more Information, contact Fire-Lite Alarms. Phone: (800) 627-3473, FAX: (877) 699-4105. www.firelite.com Page 2 of 2 - DF-52211:82 - 12121 /11 'el .0 3112" (40- Fire One, Inc. '000",( 107 Washington Blvd Algona, WA 98001 (206) 575-0311 FAX (253) 7354976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprinkler Test Report C..- � 4" I CONFIDENCE TEST I LN I REPAIRS I Li I Occupancy Name: Occupancy Address: Building Owner: Responsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder Phone Number: 8-11-11 Inspection Type: Annual [D George Holtmeyer 15091TO61510 Location of System: Dog House Front of Bldg 2 Design Density 0.00/ft (example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) El Central station monitoring? Yes El No E Monitoring company name: N/A Control panel manufacturer: FCI Model Number: SPB-4 Problems Found:.(If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: (If additional room is needed, please add a separate sheet) Corrected By: 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner[Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mailing Address: 107 Washington Blvd Algona, WA 98001 Building Representative (Signature) The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Flow test conducted? Static pressure: psi 60 Flow pressure: psi 50 Yes E- No E] 2-inch drain? Other Yes EI No El Flow switches, supervisory switches and alarm bells tested? N/A El Yes 0 No D Alarm bell operates? N/A El Yes ED No E3 System inspected and lubricated? 'j��_es_s_uiei�� ""g-7�*-v-a-lv-es".fe-sied*?"*, N/A ED Yes El Yes El No El No,E] Valves are sealed or supervised? Locked Yes El No El j7- 7, Signs ardprovided on va ves,. Yes No -E1 Pumper connections and clapper valves unobstructed and turn freely? Wet type.-pprinkler heads r laced or:successfully, sample tested in last -50 years?. ep Sprinkler coverage is acceptable? Yes El Yes,E,-, Yes E No El -No F� NoE] Proper number of spare spfinkler heads available? System left in service? Yes ED- Yes E No'E] No El System gauges replaced orcalibrated every 5 years? 2008 Yes S No D Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes E No El Was.debri,§'found in the Fire Department Connection (FDC)? Yes Was an internal pipe and valve inspection performed every 5 years? Yes El No El Sprinklerwrench available for each type of sprinkler? Yes CD No 0' Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206)575-0311 FAX(253)735-4976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprin1der Test Report B I CONFIDENCE TEST I LLI I REPAIRS I Li I Occupancy Name: Edmonds Highlands Apts Occupancy Address: 23510 Edmonds Way Edmonds, WA 98020 Building Owner: Same Phone Number: Responsible Person: Beth Balder Phone Number: Date of Inspection: .8-11-11 Inspection Type: Annual ED Testers Name (Please Print): George Holtmeyer 15091TO61510 Location of System: Dog House Rear of Bldg 2 Design Density 0.00/ft (example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) F1 Central station monitoring? Yes El No ED Monitoring company name: N/A Control panel manufacturer: FCI Model Number: SPB-4 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: (If additional room is needed, please add a separate sheet) Corrected By: 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mailing Address: 107 Washington Blvd Algona, WA 98001 Building Representative (Signature) The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Flow test. conducted? Static pressure: psi Flow pressure: psi 45 Wo-- Yes ED' No,E]. -2-inch drain? Other Yes El No D Flow switches, supervisory switches and alarm bells tested? N/A Yes [D No El ... ......... Alarm bell operates? N/A El Yes ED --i�o 0 System inspected and lubricated? --- - --- - ---- . ......... ---- - ----- Pressure regulating valves, tested-?- N/A 0 Yes El YesEl�-- No El No'[]' Valves are sealed or supervised? Lo cke d Yes El No El g s are S. n provided,on valve 9 Yes 10',111 NoEl Pumper connections and clapper valves un ed and turn freely9 Wet type spnnKier,-heads replaced,or,succes'sfully sample'tested in last 50 years? Sprinkler coverage is accept Proper.number o�-_sp�Fe�R�nkler`hea&s available? Yes El �'.YeslD�-'I- Yes Yes.[D No El NoR- El No El System left in service? Yes 2 No El System gauges replaced or calibrated every 5 years? Yes S No El Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes ED No El Was debris found in the Fife Department Connection (FDC)? 'Yes [I No El Was an internal pipe and valve inspection performed every 5 years? Yes FI No El Sprinkler wrench'available for ea6h'type of sprinkler? Yes ED No El Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206)575-0311 FAX(253)7354976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprinkler Test Report C I CONFIDENCE TEST 1 1411 1 REPAIRS I Li I Occupancy Name: Occupancy Address: Building Owner: Responsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder Phone Number: 8-11-11 Inspection Type: Annual ED George Holtmeyer 1509IT061510 Location of System: Dog House Rear of Bldg 2 Design Density 0.00/ft (example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) Central station monitoring? Yes 0 No E Monitoring company name: N/A Control panel manufacturer: ESL Model Number: 1500 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: (If additional room is needed, please add a separate sheet) Corrected By: This certifies that this fire and life safety system has been properly inspected for reliability to cover the items fisted in this report and is consistent with Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mailing Address: 107 WashinLyton Blvd Algona, WA 98001 BuRding Representative (Signature) a The items on the checklists below shall be inspected and tested. This fist does not constitute all of the required inspecting and testing of the fire and life safety system. Flow �test� co'nducted?' Static pressure: psi 60 Flow pressure: psi 45 Yes ID NoEl:-,,�- I --I - I . . t' -.11111 1 : 2-inch drain9l Other Flow switches, supervisory switches and alarm bells tested? Yes D Yes ED N 0 No El Alarm bell operates? N/A- Ye s Iz ..System inspected and lubricated? Pressure regulatitw valves teste., N/A -'Z Yes El Yes [3 No El -No Valves are sealed or supervised? Locked Yes El No 0 Signs are piro'v'i*ded�dn valves? Yes JE No,D Pumper connections and clapper valves unobstructed and turn freely? Wet type sorinkler'heads replaced or successfully sample tested in last 50 years? Yes El Yes Z No El No E3 - -------- -- Sprinkler coverage is acceptable? Proper number of spare spri�kler he "ads available? Yes Z YesID No 0 No 0 . ... ... ... System left in service? Yes Z No D System gaug6s-xoplaced or calibrated � every 5 years? Sprinkler heads free of corrosion', paint, obstructions and/or physical damage? -1, Yes 'E Yes ED -N 'Z 0 No El Was debris found in the Fire Department Connection (FDC)?. Yes.E] No-E] Was an internal pipe and valve inspection performed every 5 years? Yes El No D Sprinkler wrench available for eachtype of sprinkler? Yes.0 No El Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206)575-0311 FAX(253)7354976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprinkler Test Report CC I CONFIDENCE TEST I L61 I REPAIRS I Li I Occupancy Name: Occupancy Address: Building Owner: Responsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder Phone Number: 8-11-11 Inspection Type: Annual ED George Holtmeyer 15091TO61510 Location of System: Dog House Front of Bldg Design Density 0.00/ft (example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) El Central station monitoring? Yes El No 0 Monitoring company name: N/A Control panel manufacturer: Firelite Model Number: MP 12/24 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet). 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mafling Address: 107 Washington Blvd Algona, WA 98001 Bui1ding Representative (Signature) The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Flow' 'test conducted? Yes[D No f Static pressure: psi 55 Flow pressure: psi 35 2-inclb drain? Yes El N60 Flow switches, supervisory switches and alarm bells tested? N/A El Yes ED No El Alarffi.-bell operates? N/A Yes,[D NoE], System inspected and lubricated? Pre s- § ure regul�ting valve's,46sted? N/,A7 Yes El Yes �El No El No "El Valves are sealed or supervised? Locked Yes El No El .Sii�,�are provided on valves? Yes',[D NoO' Pumper connections and clapper valves unobstructed and turn freely? . . . ......... _�&,� . ....... Wet,ty,pe sprinkler replaced o'r,:succ�iiidI,y,** p e tested in last,50 ears? Yes El Yes,'[D - No El No�M Sprinkler coverage is acceptable? Proper number of spare sprinkler heads,available? Yes ED YesID No 0 No 0 System left in service? Yes ED No F1 System jauges replaced ovcalibrated:every 5 years? 2008 YeSIED N60 Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes [D No El Was �debri s found in the Fire Department Connection (FDC)? Was an internal pipe and valve inspection performed every 5 years? Yes,E] Yes El NoO No El Sprinkler wrench available -for each type of sprinkler? Yes ED No 0 i -i� Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206) 575-0311 FAX (253) 7354976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprinkler Test Report E I CONFIDENCE TEST I i6l I I REPAMS I Li I Occupancy Name: Occupancy Address: Building Owner: Responsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder Phone Number: 8-11-11 Inspection Type: Annual ED George Holtmeyer 15091TO61510 Location of System: Dog House West of Bldg 2 Design Density 0.00/ft (example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) [:1 Central station monitoring? Yes El No E Monitoring company name: N/A Control panel manufacturer: FCI Model Number: SPB-4 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: (If additional room is needed, please add a separate sheet) Corrected By: 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mailing Address: 107 Washington Blvd Algona, WA 98001 Buflding Representative (Signature) The items on the checklists below shaH be inspected and tested. This Hst does not constitute all of the required inspecting and testing of the fire and fife safety system. F16W'Iesi'conducted? Static pressure: psi 55 Flow pressure: psi 40 1-inA rlrnin9 0 TI Ye's ED N' - --------- Oth,-r V.-Q r I MA M Flow switches, supervisory switches and alarm bells tested? Kii� Yes No F1 - — -------- - - - -------- e . ..... . ...... &/A- E I _Y-e s-[- ------- ....... .... .. System inspected and lubricated? Yes El No El .. ........ .......... ......... .. - ------- Pressure regulating valves tested? N/A ........ ED Yes *E]'. No El _Va_Ives are sealed o r s u p er v i sed? Loe ked Yes El No 0 Signs are provided on valves? ........... ..... ....... ... ..... . . . . Yes S . -- --- No EI Pumper connections and clapper valves unobstructed and turn freely? --- ------ Yes El No El ........ .... ...... Wet type sprinkler heads replaced or successfully sample tested in last 50 years? Yes Sprinkler coverage is acceptable? Yes 0 No 0 ..... ... .. ....... ... ... �,Proper number of spare sprinkler heads available? Yes ED No El System left in service? Yes No F� System gauges replaced or calibrated every 5 years? 2008 Yes 0 No El . ... ...... . .............. ... . . . Sprinkler heads free of corrosion, paint, obstructions and/or physical (fa�m_a*_g_e*_?__ ... . . ..... Y .... es_*[D, "Was debris found in the Fire Department Connection (FDC)? -wasi Yes El No El a--n—i nt e- rn-a-1-p- i-p-e- an* d" -valv e, -i n s'p' ec-t-io n _p` erf-o''ri n- e-d-, 'ev e-r- y 5 ars- ?_ V _e s- * E T N o E-1 ,Sprinkler wrench -available for each type of.sprinkler? .Yes Z_ No_,�, i il Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206) 575-0311 FAX (253) 7354976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprinkler Test Report ra I CONFIDENCE TEST I LL1 I REPAIRS I L-1 I Occupancy Name: Occupancy Address: Building Owner: Responsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder Phone Number: 8-11-11 Inspection Type: Annual ED George Holtmeyer 15091TO61510 Location of System: 2 Design Density 0.00/ft (example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) El Central station monitoring? Yes El No 0 Monitoring company name: N/A Control panel manufacturer: Firelite Model Number: MP 12/24 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) This certifies that this fire and fife safety system has been properly inspected for reliability to cover the items listed in this report and is consistent with Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mailing Address: 107 Washington Blvd Algona, WA 98001 Buflding Representative (Signature) The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. F-10''W'test conducted? Yes',[D No El Static pressure: psi .60 Flow pressure: psi 45 2 in Other. -'ffi ch draffi? Yes:0 No,E] Flow switches, supervisory switches and alarm bells tested? N/A 0 Yes ED No El Alarin bell operates.? N/A El Yes'[D No El System inspected and lubricated? �7—'---7 ------- 7 - ------------- N/A 'Z Yes El — ---------- - s Ye �'E] No El No,[:] Valves are sealed or supervised? Locked Yes El No EI Signs are provided on valves? Pumper connections and clapper valves unobstructed and turn freely? Wet type sprinkler heads replaced or successfully sample tested in last 50 years? Yes,[D Yes r-I Yes [D No El No El No D Sprinkler coverage is acceptable? Proper number �of spare-spnaiwhiai Yes S Y es�.. No El -0 System left in service? Yes El No El System pa�jg laced �or calibrated every,5,years? 2008 e�Tph_ ........... .......... Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes ID Yes E No:0 No L1 Was debris found in the'Fire Department Connection (FDC)? Yes -EI No El Was an internal pipe and valve inspection performed every 5 years? Yes El No El Spfink] er wrench available for ea6h'type of sp finkler? Yes ED No El Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206)575-0311 FAX(253)735-4976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) I CONFIDENCE TEST REPAIRS Occupancy Name: Occupancy Address: Building Owner: Responsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder Phone Number: 8-11-11 Inspection Type: Annual George Holtmeyer 15091TO61510 Location of System: Dog House East Side of Bldg 2 Design Density 0.00/ft (example .495/2000 sq. ft):. Wet- Automatic Sprinkler Test Report G 425-771-6910 Quarterly (High Rise Only) [:] Central station monitoring? Yes El No [D Monitoring company name: N/A Control panel manufacturer: FCI Model Number: SPB4 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: (If additional room is needed, please add a separate sheet) Corrected By: 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mailing Address: 107 Washinzton Blvd Al2ona, WA 98001 Building Representative (Signature) The items on the checklists below shall be inspected and tested. This'list does not constitute all of the required inspecting and testing of the fire and life safety system. Flow lest conducted?,t-,-'-,---I Yes,:E],�,: No,E] Static pressure: psi 60 Flow pressure: psi 50 7�!� 1 11 .24nch drain? 6ther . �S— . - Cl Yes No El Flow switches, supervisory switches and alarm bells tested? N/A Alarm bell operates? N/A El Yes S No D 140 System inspected and lubric�ie? -------- --- --- ---- Pressure re.gulaii�i v ves-test�d? N/A S' Yes El -Yes,E] No D No 0 Valves are sealed or supervised? Locked Yes D No El Signs are provided -on vdIV6s?-. Yes 0: No El Pumper connections and clapper valves unobstructed and turn freely? Wet t-'—sp—nn—kler heads' -,'replaced or successfully sample t'- ed,in-last 50 years? .ype est Yes El ''Yes''El No El No El Sprinkler coverage is acceptable? Proper number,o spge:.Lpn er heads available? Yes ED Yes, -El No El No El System left in service? Yes ED No D Systern,gauges re aced, 'Alibrated.ever 5 vears? 2 pI or c Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? -Ye§:[D:"".' Yes ED No 1- No El Was debris found �in the f ire D6partment Connection (FDC)?' YesO No El Was an internal pipe �iid--�alve inspection performed"every 5 years? Yes D No El Sprinkler wrench available,for each'type of sprinkler? Yes ID No El Fire One, Inc. (206) 575- 0311 Office (253) 735-4976 Fax 107 Wa�hington Blvd. BREMERTON (360) 478-0428 Algona, WA 98001 FIREOI*099KW Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Phone#: 425-771-6910 Occupied As: Apartment Comple.x Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg A Inspection by: George Holtmeyer Cert #: SCP-H01 311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: Monthly E] Quarterly E] Semi -Annual Annual[D Other 2. Type of system: Addressable El Conventional Other El 3. Local Fire Department: Monitored? Yes El No El 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? Yes No Monitoring Account: N/A 6. No. of Initiating Circuits: 4 No. of Signaling Circuits: 1 BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 25.3 8. Battery Voltage Under Load w/Signal Devices Operating 25.0 9. Change Circuit Voltage 26.5 CONTROL PANEL CHECKS SATISFACTORY CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off 0, 0 ..E] 11. All Circuits Operate Satisfactory on Standby (Battery) Power [D El El 12. All Circuits Operate Satisfactory on AC Power 13. All Circuits Checked for Electrical Supervision 14. Control Panel Checks Made Per Manufacturers Instructions ED El El 15. All auxiliary Equipment Operates El E] ED 16. Alarm Delay Function (if installed) Operates Properly El E] 11 17. Panel Key Available 1z El El 18. Operating Instructions at Panel S E] El 19. Test/Service Record at Fire Alarm Control Panel ED E] El PAGE 1 OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EOUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes No N/A Control Panel FCI SPB4 1 El El 1 Communicators N/A Annunciators N/A Master Alarm Box N/A Supervisory Trouble Indicators 2 [D E) 2 Smoke Detectors Duct Detectors Beam Detectors Heat Detectors El El Manual Pull Stations 18 18. Audible Devices 31 31 31 Visual Devices Audio/Visual Devices E] El E Public Address System E] E Fireman Phones Elevator Recall — Phase I - Phase 11 Auto Door Release Fail Safe Door Unlock Ventilation Controls Generators Sprinkler Flow Switches 19 El I Sprinkler Tamper Switches E] El I Sprinkler Supervisory Switches Electric Alarm Bell/Motor Gong Other THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: Batteries over 5 yearrs old 24v-7AH Glass rods in pull stations by 204 and 304 are missing Pull station by A107 inop. Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fire One, Inc. (206) 575- 0311 Office (253) 735-4976 Fax 107 Washington Blvd. BREMERTON (360) 478-0428 Algona, WA 98001 FIREOI*099KW Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Occupied As: Apartment Complex Phone #: 425-771-6910 Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg B Inspection by: George Holtmeyer Cert #: SCP-HO1311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: MonthlyE] Quarterly F1 Semi -Annual E] Annual E Other. F� 2. Type of system: Addressable E] Conventional Other 3. Local Fire Department: Monitored? Yes F] No 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? Yes El No Ej Monitoring Account: N/A 6. No. of Initiating Circuits: 2 No. of Signaling Circuits: 1 BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 22.5 8. Battery Voltage Under Load w/Signal Devices Operating 22.5 9. Change Circuit Voltage 26.8 CONTROLPANELCHECKS SATISFACTORY CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off 0 1:1 1:1 11. All Circuits Operate Satisfactory on Standby (Battery) Power El El ED 12. All Circuits Operate Satisfactory on AC Power ED 11 El 13. All Circuits Checked for Electrical Supervision .0— El 1:1 14. Control Panel Checks Made Per Manufacturers Instructions 15. All auxiliary Equipment Operates 16. Alarm Delay Function (if installed) Operates Properly 17. Panel Key Available 18. Operating Instructions at Panel 19. Test/Service Record at Fire Alarm Control Panel PAGE 1 OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes No N/A Control Panel FCI SPB-4 - 1 El 1:1 1 Communicators NIA El El 0 Annunciators N/A Master Alarm Box N/A Supervisory N/A Trouble Indicators 2 El El 2 Smoke Detectors El El El Duct Detectors El El El Bem Detectors El El Heat Detectors El El Manual Pull Stations 9 9 Audible Devices 19 19 Visual Devices El 1 Audio/Visual Devices E] El Public Address System E] N Fireman Phones Elevator Recall — Phase I - Phase 11 Auto Door Release Fail Safe Door Unlock Ventilation Controls E] 1:1 0 Generators Sprinkler Flow Switches Sprinkler Tamper Switches Sprinkler Supervisory Switches Electric Alarm Bell/Motor Gong El El 1 Other THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: No access to B204 Batteries dropped to 22.7 with AC disconnected. Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fire One, Inc. (206) 575- 0311 Office (253) 735-4976 Fax 107 Washington Blvd. BREMERTON (360) 478-0428 Algona, WA 98001 FIREOI*099KW Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Phone #: 425-771-6910 Occupied As: Apartment Complex Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg C Inspection by: George Holtmeyer Cert #: SCP-H01 311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: MonthlyE] QuarterlyEl Semi -Annual Annual[D Other F] 2. Type of system: Addressable El Conventional Other 3. Local Fire Department: Monitored? Yes No E] 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? Yes No Monitoring Account: N/A 6. No. of Initiating Circuits: 1 No. of Signaling Circuits: 1 BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 25.2 8. Battery Voltage Under Load w/Signal Devices Operating 25.0 9. Change Circuit Voltage 25.8 CONTROLPANELCHECKS SATISFACTORY CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off ED El El 11. All Circuits Operate Satisfactory on Standby (Battery) Power ED El El 12. All Circuits Operate Satisfactory on AC Power ED El 1:1 13. All Circuits Checked for Electrical Supervision ED 0 El 14. Control Panel Checks Made Per Manufacturers Instructions ED El E] 15. All auxiliary Equipment Operates 11 [1 ED 16. Alarm Delay Function (if installed) Operates Properly 1:1 El E 17. Panel Key Available ED D D 18. Operating Instructions at Panel E 1:1 1:1 19. Test/Service Record at Fire Alarm Control Panel E E] 1:1 PAGE 1 OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes No N/A Control Panel ESL 1500 1 El El 1 Communicators N/A 1:1 El E Annunciators N/A Master Alarm Box N/A Supervisory N/A Trouble Indicators 2 1:1 El 2 Smoke Detectors Duct Detectors El I Beam Detectors El El Heat Detectors 1:1 =- Manual Pull Stations 9 E] 9 Audible Devices 12 12 Visual Devices 1 0 El 1 Audio/Visual Devices El I Public Address System Fireman Phones Elevator Recall — Phase I - Phase 11 EJ ED Auto Door Release Fail Safe Door Unlock Ventilation Controls Generators Sprinkler Flow Switches 1:1 El 1 Sprinkler Tamper Switches Sprinkler Supervisory Switches 0 E Electric Alarm Bell/Motor Gong E El 1:1 Other L1 0 1 THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 1� V Fire One, Inc. (206) 575- 0311 Office (253) 735-4976 Fax 107 Washington Blvd. BREMERTON (360) 478-0428 Algona, WA 98001 FIREOI*099KW Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Occupied As: Apartment Complex Phone #: 425-771-6910 Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg D Inspection by: George Holtmeyer Cert #: SCP-H01 311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: Monthly [] Quarterly Semi -Annual E] Annual[] Other F-1 2. Type of system: Addressable E] Conventional Other 3. Local Fire Department: Monitored? Yes No El 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? Yes E] No E] Monitoring Account: N/A 6. No. of Initiating Circuits: 2 No. of Signaling Circuits: 1 BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 25.6 8. Battery Voltage Under Load w/Signal Devices Operating 25.4 9. Change Circuit Voltage 27.6 CONTROLPANELCHECKS SATISFACTORY CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off 0 El El 11. All Circuits Operate Satisfactory on Standby (Battery) Power ED El E:1 12. All Circuits Operate Satisfactory on AC Power ED [1 1:1 13. All Circuits Checked for Electrical Supervision ED 1:1 1:1 14. Control Panel Checks Made Per Manufacturers Instructions ED 0 1:1 15. All auxiliary Equipment Operates 1:1 E] 0 16. Alarm Delay Function (if installed) Operates Properly 1:1 1:1 11 17. Panel Key Available IE E] 1:1 18. Operating Instructions at Panel S El E] 19. Test/Service Record at Fire Alarm Control Panel E 1:1 1:1 PAGE 1 OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EOUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes No N/A Control Panel Firelite MP 12/24 1 El Ej 1 Communicators NIA E] El S Annunciators N/A Master Alarm Box N/A Supervisory N/A Trouble Indicators 2 El 2 Smoke Detectors El El El Duct Detectors Beam Detectors Heat Detectors Manual Pull Stations 6 El —6 Audible Devices 13 13 Visual Devices 1 1 Audio/Visual Devices Public Address System E] E Fireman Phones 1:1 2 - Elevator Recall — Phase 1 0 1:1 - Phase 11 Auto Door Release El Fail Safe Door Unlock El El Ventilation Controls Generators Sprinkler Flow Switches ED El 1 Sprinkler Tamper Switches = —0 Sprinkler Supervisory Switches El Electric Alarm Bell/Motor Gong Other Ej 0 THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: Batteries are over 5 years old 12v 7AH No access to D303 Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fire One, Inc. (206) 575- 0311 Office (253) 7354976 Fax 107 Washington Blvd. Algona, WA 98001 FIREOI*099KW BREMERTON (360) 478-0428 Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Phone #: 425-771-6910 Occupied As: Apartment Complex Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg E Inspection by: George Holtmeyer Cert #: SCP-HO1311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: Monthly E] Quarterly El Semi -Annual E] Annual[D Other F-1 2. Type of system: Addressable El Conventional Other El 3. Local Fire Department: Monitored? Yes E] No F� 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? Yes F] No F Monitoring Account: N/A 6. No. of Initiating Circuits: 2 No. of Signaling Circuits: 1 BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 25.5 8. Battery Voltage Under Load w/Signal Devices Operating 25.2 9. Change Circuit Voltage 26.6 CONTROLPANELCHECKS SATISFACTORY CHECK NOTES Yes No I N/A 10. Trouble Signal w/AC Power Off 0 El El 11. All Circuits Operate Satisfactory on Standby (Battery) Power ED El El 12. All Circuits Operate Satisfactory on AC Power ED 1:1 El 13. All Circuits Checked for Electrical Supervision 14. Control Panel Checks Made Per Manufacturers Instructions 15. All auxiliary Equipment Operates El 1:1 ED 16. Alarm Delay Function (if installed) Operates Properly 1:1 1:1 ED 17. Panel Key Available ED 1:1 El 18. Operating Instructions at Panel ID 1:1 E] 19. Test/Service Record at Fire Alarm Control Panel ED PAGE 1 OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes No N/A Control Panel FCI SPR-4 E El El 1 Communicators Annunciators Master Alarm Box El E Supervisory Trouble Indicators 2 El 2 Smoke Detectors Duct Detectors Beam Detectors Heat Detectors El Manual Pull Stations 9 [A El 9 Audible Devices 19 19 Visual Devices I Audio/Visual Devices Public Address System Fireman Phones Elevator Recall — Phase I - Phase 11 Auto Door Release El Fail Safe Door Unlock El El [9 Ventilation Controls [E] Generators Sprinkler Flow Switches 1 1 Sprinkler Tamper Switches El El E Sprinkler Supervisory Switches Electric Alarm Bell/Motor Gong 1 El 1 Other THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies - Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fire One, Inc. (206) 575- 0311 Office (253) 7354976 Fax 107 Washington Blvd. Algona, WA 98001 FIREOI*099KW BREMERTON (360) 478-0428 Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Occupied As: Apartment Complex Phone 425-771-6910 Address: 23510 Edmonds Way City: Edmonds County: King - Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg F Inspection by: George Holtmeyer Cert #: SCP-HO1311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: Monthly 0 QuarterlyEl Semi -Annual Annual[D Other F� 2. Type of system: Addressable El Conventional ED Other El 3. Local Fire Department: Monitored? Yes F1 No [I 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? Yes [_1 No Monitoring Account: N/A 6. No. of Initiating Circuits: No. of Signaling Circuits: BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 23.8 8. Battery Voltage Under Load w/Signal Devices Operating 9. Change Circuit Voltage 26.7 CONTROLPANELCHECKS SATISFACTORY CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off 11. All Circuits Operate Satisfactory on Standby (Battery) Power ED El El, 12. All Circuits Operate Satisfactory on AC Power ED E] 11 13. All Circuits Checked for Electrical Supervision 0- El El 14. Control Panel Checks Made Per Manufacturers Instructions 11 15. All auxiliary Equipment Operates ED 16. Alarm Delay Function (if installed) Operates Properly 17. Panel Key Available 18. Operating Instructions at Panel 0 E] E] 19. Test/Service Record at Fire Alarm Control Panel 11 1:1 1:1 PAGE 1 OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes I No N/A Control Panel Firelite MP 12/24 1 Communicators Annunciators -EJ Master Alarm Box , -0 Supervisory 0 0 Trouble Indicators 2 1:1 El 2 Smoke Detectors Duct Detectors Beam Detectors Heat Detectors 1:1 E] E] Manual Pull Stations 6 E] 1:1 6 Audible Devices 19 1:1 19 Visual Devices 1 ID El 1:1 1 Audio/Visual Devices 1:1 El Public Address System El El 0 Fireman Phones Elevator Recall — Phase I - Phase 11 Auto Door Release 1:1 El E Fail Safe Door Unlock 1:1 El 0 Ventilation Controls El El E Generators 1:1 1:1 1:1 Sprinkler Flow Switches 1 ED El Sprinkler Tamper Switches El El 0 Sprinkler Supervisory Switches El Electric Alarm Bell/Motor Gong 1 0 El El Other LJ W El I THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: Batteries dropped below 24 volts with AC power disconnected 24v 4AH Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fire One, Inc0 (206) 575- 0311 Office (253) 735-4976 Fax 101 Washington Blvd. BREMERTON (360) 478-0428 Algona, WA 98001 FIREOI*099KW Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Phone #: 425-771-6910 Occupied As: Apartment Complex Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 -...,:,I-.,Telephone: 425-771-6910 Building Designation (if more than one building): Bldg G Inspection by: George Holtmeyer Cert #: SCP-HO1311 Date of Inspection: 8-11-11 Low Vol. Lic. #: -------------------------------------------------------------------------------------- 1. Type of Test: Monthly E] Quarterly F1 Semi -Annual E] Annual [D Other F� 2. Type of system: Addressable El Conventional Other El 3. Local Fire Department: Monitored? Yes 0 No El 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? Yes E] No Ej Monitoring Account: N/A 6. No. of Initiating Circuits: No. of Signaling Circuits: BATTERY.TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 25.3 8. Battery Voltage Under Load w/Signal Devices Operating 25.2 9. Change Circuit Voltage 26.7 CONTROLPANELCHECKS SATISFACTORY CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off 1:1 El 1:1 11. All Circuits Operate Satisfactory on Standby (Battery), Power El F1 El 12. All Circuits Operate Satisfactory on AC Power 13. All Circuits Checked for Electrical Supervision 14. Control Panel Checks Made Per Manufacturers Instructions 1:1 1:1 E] 15. All auxiliary Equipment Operates 11 E] E] 16. Alarm Delay Function (if installed) Operates Properly E] E] El 17. Panel Key Available El E]I El 18. Operating Instructions at Panel 1:1 11 1:1 19. Test/Service Record at Fire Alarm Control Panel 1:1 1:1 El PAGE 1 OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes I No N/A Control Panel FCI SPB-4 1 El El 1 Communicators El E] 0 Annunciators Master Alarm Box Supervisory Trouble Indicators 2 El 2 Smoke Detectors El Duct Detectors 11 El Beam Detectors Heat Detectors Manual Pull Stations 12 El —12 Audible Devices 19 19 Visual Devices 1 E] I Audio/Visual Devices -== M Public Address System El Fireman Phones IEJ Elevator Recall — Phase I El El - Phase 11 Auto Door Release Fail Safe Door Unlock Ventilation Controls El F] M Generators El 1:1 El Sprinkler Flow Switches Sprinkler Tamper Switches El Sprinkler Supervisory Switches Electric Alarm Bell/Motor Gong E El 1 Other El 0 THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fire One. Inc. Fire Protection Service/Sales 107 Washington Blvd Algona, Wa 98001 Seattle: (206) 575-0311 * Bremerton (360) 478-0428 TO Edmonds Fire Department 121 5th Avenue North Edmonds, WA 98020 Letter of Transmittal Date 8/16/2011 jJob No. Attention RE: Test Rer)orts I REPAIRS NOT DONE I WE ARE SENDING YOU El Attached El Under separate cover via the following items: El Shop Drawings 13 Prints El Plans El Test Forms El Specifications El Copy of Letter El Change Order El Other COPIES DATE NO. DESCRIPTION 14 08/11/11 23326 Edmonds Way/ Edmonds Highlands THESE ARE TRANSMITTED as checked below. El For Approval El For Your Use 13 As Requested El For Review And Comment REMARKS COPY TO: File (Office), Property or Management Co. SIGNED: Edmonds Fire Department If enclosures are not as noted, kindly notify us at once. FiOe One, Inc. (206) 575- 0311 Office (253) 735-4976 Fax 107 Washington Blvd. BREMERTON (360) 478-0428 Algona, WA 98001 FIREOI*099KW Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Occupied As: Apartment Complex Phone #: 425-771-6910 Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020' Telephone: 425-771-6910 Building Designation (if more than one building): 'Bldg A Inspection by: George Holtmeyer Cert #: SCP-HO1311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: Monthly El QuarterlyEl Semi -Annual E] Annual[D Other 2. Type of system: Addressable El Conventional Other 3. Local Fire Department: Monitored? YesE] NoE] 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? Yes [I No F-1 Monitoring Account: N/A 6. No. of Initiating Circuits: 4 No. of Signaling Circuits: 1 BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 25.3 8. Battery Voltage Under Load w/Signal Devices Operating 25.0 9. Change Circuit V oltage 26.5 CONTROLPANELCHECKS SATISFACTORY CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off ED El D 11. All Circuits Operate Satisfactory on Standby (Battery) Power [D Ej 12. All Circuits Operate Satisfactory on AC Power ED El 1:1 13. All Circuits Checked for Electrical Supervision Z El El 14. Control Panel Checks Made Per Manufacturers Instructions ED El El 15. All au)dliary Equipment Operates ED 16. Alarm Delay Function (if installed) Operates Properly 17. Panel Key Available 18. Operating Instructions at Panel S D El 19. TestlService Record at Fire Alarm Control Panel PAGE 1 OF 2 Name & Address of Facilky: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes No N/A Control Panel FCI SPB-4 1 0 1:1 1:1 1 Communicators N/A El I El Annunciators N/A El I E] Master Alarm Box N/A Li Supervisory Trouble Indicators 2 2 Smoke Detectors = = I Duct Detectors El El El Beam Detectors Heat Detectors El Manual Pull Stations 18 18 Audible Device& 31 31 31 Visual Devices 1 1 Audio/Visual Devices Public Address System Fireman Phones Elevator Recall — Phase I - Phase 11 Auto Door Release Fail Safe Door Unlock Li Ventilation Controls Generators Sprinkler Flow Switches i Sprinkler Tamper Switches Sprinkler Supervisory Switches Electric Alarm Bell/Motor Gong 1 1 Other 7 Li THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: Batteries over 5 yearrs old 24v-7AH Glass rods in pull stations by 204 and 304 are missing Pull station by Al 07 inop. Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fir'e One, Inc. (206) 575- 0311 Office (253) 735-4976 Fax 107 Washington Blvd. BREMERTON (360) 478-0428 Algona, WA 98001 FIREOI*099KW Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Occupied As: Apartment Complex Phone #: 425-77166910 Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg B Inspection by: George Holtmeyer Cert #: SCP-HO1311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: Monthly El Quarterly El Semi -Annual El AnnualS Other El 2. Type of system: Addressable El Conventional Other 3. Local Fire Department: Monitored? Yes No 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? YesE] No [j Monitoring Account: N/A 6. No. of Initiating Circuits: 2 No. of Signaling Circuits: 1 BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 22.5 8. Battery Voltage Under Load w/Signal Devices Operating 22.5 9. Change.Circuit.Voltage 26.8 CONTROL PANEL CHECKS - SATISFACTORY CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off 19 El El 11. All Circuits Operate Satisfactory on Standby (Battery) Power El El ED 12. All Circuits Operate Satisfactory on AC Power 0 1:1 1:1 13. All Circuits Checked for Electrical Supervision ED El 1:1 14. Control Panel Checks Made Per Manufacturers Instructions 0 El E3 15. All au)dliary Equipment Operates 1-3 11 ED 16. Alarm Delay Function (if installed) Operates Properly 1:1 13 ED 17. Panel Key Available S 1:1 El 18. Operating Instructions at Panel ED 11 11 19. TesttService Record at Fire Alarm Control Panel 19 El 11 PAGE I OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes I No N/A Control Panel FCI SPB-4 1 01 1:1 El 1 Communicators N/A El El Annunciators N/A Master Alarm Box N/A Supervisory N/A El El Trouble Indicators 2 El 2 Smoke Detectors -0. El El 11 Duct Detectors Beam Detectors Heat Detectors Manual Pull Stafions 9 El 9 Audible Devices 19 Ej 1 19 Visual Devices 1 Audio/Visual Devices Public Address System Fireman Phones Elevator Recall — Phase I - Phase 11 Auto Door Release Fail Safe Door Unlock Ventilation Controls Generators Sprinkler Flow Switches Q El El 1 Sprinkler Tamper Switches Sprinkler Supervisory Switches Electric Alarm Bell/Motor Gong 1 Li 1 1 Other Li I THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCESTANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: No access to B204 Batteries dropped to 22.7 with AC disconnected. Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 FiOe One, Inc. (206) 575- 0311 Office (253) 735-4976 Fax 107 Washington Blvd. Algona, WA 98001 FIREOI*099KW BREMERTON (360) 478-0428 Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Occupied As: Apartment Complex Phone #: 425-771-6910 Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg Inspection by: George Holtmeyer Cert #: SCP-HO1311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: MonthlyE] Quarterly -E] Semi -Annual El Annual 0 Other F1 2. Type of system: Addressable Conventional ED Other 3. Local Fire Department Monitored? Yes E] No E] 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? Yes E] - No E] Monitoring Account: N/A 6. No. of Initiating Circuits: 1 No. of Signaling Circuits: 1 BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 25.2 8. Battery Voltage Under Load w/Signal Devices Operating 25.0 9. Change Circuit Voltage 25.8 CONTROLPANELCHECKS SATISFACTORY CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off 11. All Circuits Operate Satisfactory on Standby (Battery) Power 12. All Circuits Operate Satisfactory on AC Power 0 El 13. All Circuits Checked for Electrical Supervision ED El 1:1 14. Control Panel Checks Made Per Manufacturers Instructions ID 1:1 1:1 15. All auxiliary Equipment Operates D El 11 16. Alarm Delay Function (if installed) Operates Properly El 0 ED 17. Panel Key Available ED E] El 18. Operating Instructions at Panel ED El El 19. TestlService Record at Fire Alarm Control Panel 10 El 01 PAGE 1 OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes No N/A Control Panel ESL 1500 1 E] Communicators N/A Annunciators N/A Master Alarm Box N/A El ED Supervisory N/A 0 El 0 Trouble Indicators 2 Smoke Detectors Ell Duct Detectors Beam Detectors Heat Detectors El I El Manual Pull Stations 9 Li 9 Audible Devices 12 E] 12 Visual Devices Li 1 Audio/Visual Devices Public Address System 13 L1 Fireman Phones Elevator Recall — Phase I - Phase 11 Auto Door Release Fail Safe Door Unlock 1:1 1 El Ventilation Controls Generators Sprinkler Flow Switches Sprinkler Tamper Switches Sprinkler Supervisory Switches Electric Alarm Bell/Motor Gong Other I Li I THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: Geo[ge Holtmeyer Discrepancies: Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fir'e One, Inc. (206) 575- 0311 Office (253) 7354976 Fax 107 Washington Blvd. -0428 Algona, WA 98001 BREMERTON (360) 478 FIREOI*099KW Building Owner/Representative: Beth Bald er Phone #: 425-771-6910 Name of Facility: Edmonds Highlands Apts Occupied As: Apartment Complex Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg D Inspection by: George Holtmeyer Cert #: SCP-HO1311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: Monthly Quarterly Semi -Annual Annual(D Other F-1 2. Type of.system: Addressable Conventional. Other El 3. Local Fire Department: Monitored? Yes E] No 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? Yes No E] Monitoring Account: NIA 6. No. of Initiating Circuits: 2 No. of Signaling Circuits: 1 BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 25.6 8. Battery Voltage Under L66d w/Signal Devices Operating 25.4 9. Change Circuit Voltage —r27.6 SATISFACTORY CONTROL PANEL CHECKS CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off ED El 13 11. All Circuits Operate Satisfactory on Standby (Battery) Power ED El :[I 12. All Circuits Operate Satisfactory on Ad Power" 13. All Circuits Checked for Electrical Supervision 10 El El 14. Control Panel Checks Made Per Manufacturers Instructions ED El 11 15. All auxiliary Equipment Operates El El ED 16. Alarm Delay Function (if installed) Operates Properly El El S 17. Panel Key Available ED 11 El 18. Operating Instructions at Panel ED El 11 19. Test/Service Record at Fire Alarm Control Panel ED El 11 PAGE 1 OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes I No N/A Control Panel Firelite MP 12124 1 0 1 El Q 1 Communicators N/A 11 0 1 Annunciators N/A El 1 0 Master Alarm Box N/A El I El Supervisory N/A E3 El ED Trouble Indicators 2 2 Smoke Detectors El Duct Detectors Beam Detectors Heat Detectors Manual Pull Stations 6 —6 Audible Devices 13 13 Visual Devices 1 1 AudioNisual Devices Public Address System Fireman Phones Elevator Recall — Phase I - Phase 11 El Auto Door Release Fail Safe Door Unlock Ventilation Controls Generators E] El 1:1 Sprinkler Flow Switches El 1 Sprinkler Tamper Switches Sprinkler Supervisory Switches Electric Alarm Bell/Motor Gong Other 1 0 1 z 1 0 1 THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: Batteries are over 5 years old 12v 7AH No access to D303 Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fire One, Inc. (206) 575- 0311 Office (253) 735-4976 Fax 107 Washington Blvd. Algona, WA 98001 FIREOI*099KW BREMERTON (360) 478-0428 Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Occupied As: Apartment Complex Phone 425-771-6910 Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg E Inspection by: George Holtmeyer Cert #: SCP-HO1311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: Monthly QuarterlyEl Semi -Annual Annual[D Other F� 2. Type of system: Addressabl.e Conventional 0 Other El 3. Local Fire Department: Monitored? Yes No 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received at. Monitoring Agency? Yes No E] Monitoring Account: N/A 6. No. of Initiating Circuits: 2 No. of Signaling Circuits: 1 BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 25.5 8. Battery Voltage Under Load w/Signal Devices Operating 25.2 9. Change Circuit Voltage 26.6 CONTROL PANEL CHECKS SATISFACTORY CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off ID El El 11. All Circuits Operate Satisfactory on Standby (Battery) Power ED El 1:1 12. All Circuits Operate Satisfactory on AC Power 13. All Circuits Checked for Electrical Supervision 14. Control Panel Checks Made Per Manufacturers Instructions 15. AJI auxiliary Equipment Operates 16. Alarm Delay Function (if installed) Operates Properly 17. Panel Key Available 0 0 El 18. Operating Instructions at Panel 11 11 11 19. TesttService Record at Fire Alarm Control Panel 0 D El PAGE 1 OF 2 Name & Address of Facilfty: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes I No N/A Control Panel FCI SPR-4 1 1 Ll El 1 Communicators E] 1:1 Annunciators 13 Master Alarm Box Supervisory Trouble Indicators 2 El =-2 Smoke Detectors -0. F1 I El LJ Duct Detectors El 1 0 Beam Detectors Li Heat Detectors Manual Pull Stations 9 -0- -EF 9 Audible Devices 19 19 Visual Devices 1 1 Audio/Visual Devices Public Address System El El Fireman Phones Elevator Recall — Phase I - Phase 11 Auto Door Release Fail Safe Door Unlock Ventilation Controls Generators Sprinkler Flow Switches 1 El 1 Sprinkler Tamper Switches Sprinkler Supervisory Switches Electric Alarm Bell/Motor Gong Other I Li 1 0 Li THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fite One, Inc. (206) 575- 0311 Office (253) 735-4976 Fax 107 Washington Blvd. BREMERTON (360) 478-0428 Algona, WA 98001 FIRE01*099KW Building Owner/Representative: Beth BaIder Name of Facility: Edmonds Highlands Apts Occupied As Apartment Complex Phone #: 425-771-6910 Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg F Inspection by: George Holtmeyer Cert #: SCP-HO1311 Date of Inspection: B-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1. Type of Test: MonthlyE] Quarterly El Semi -Annual Annual Other F� 2. Type of system: Addressable El Conventional Other 3. Local Fire Department: Monitored? Yes No 4. Monitoring Agency: N/A Telephone: N/A 5. Test Received At. Monitoring Ageindy? Yes El No [I Monitoring Account: N/A 6. No. of Initiating Circuits: No. of Signaling Circuits: BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 23.8 8. Battery Voltage Under Load w/Signal Devices Operating 9. Change Circuit Voltage —r26.7 CONTROLPANELCHECKS SATISFACTORY CHECK NOTES Yes 10. Trouble Signal w/AC Power Off ID El E, El 11. All Circuits Operate Satisfactory on Standby (Battery) Power 12. All Circuits Operate Satisfactory on AC Power 0 UN/A El 11 13. All Circuits Checked for Electrical Supervision 14. Control Panel Checks Made Per Manufacturers Instructions 0 El 11 15. All auxiliary Equipment Operates El 1:1 ED 16. Alarm Delay Function (if installed) Operates Properly 11 El ED 17. Panel Key Available 11 El ED 18. Operating Instructions at Panel 19. Test/Service Record at Fire Alarm Control Panel PAGE 1 OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes No N/A Control Panel Firelite MP 12/24 1 El Communicators Annunciators Master Alarm Box El Supervisory -cr- Trouble Indicators 2 El 2 Smoke Detectors Duct Detectors Li Beam Detectors El 1 1:1 Heat Detectors El 1 1:1 Manual Pull Stations 6 6 Audible Devices 19 19 Visual Devices 1 Audio/Visual Devices Public Address System Fireman Phones Elevator Recall — Phase I - Phase 11 Auto Door Release Fail Safe Door Unlock - Ventilation Controls Generators Sprinkler Flow Switches 1 19 El 1:1 Sprinkler Tamper Switches Sprinkler Supervisory Switches Electric Alarm Bell/Motor Gong I Other THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: Batteries dropped below 24 volts with AC power disconnected 24v 4AH Corrections Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fire One, Inc. (206) 575- 0311 Office (253) 735-4976 Fax 107 Washington Blvd. BREMERTON (360) 478-0428 Algona, WA 98001 FIREOI*099KW Building Owner/Representative: Beth Balder Name of Facility: Edmonds Highlands Apts Occupied As: Apartment Complex Phone #: 425-771-6910 Address: 23510 Edmonds Way City: Edmonds County: King Zip: 98020 Telephone: 425-771-6910 Building Designation (if more than one building): Bldg G Inspection by: George Holtmeyer Cert #: SCP-HO1311 Date of Inspection: 8-11-11 Low Vol. Lic. #: --------------------------------------------------------------------------------------- 1.- Type of Test: Monthly El Quarterly [I Semi -Annual El Annual 0 Other 2. Type of system: Addressable 1:1 Conventional Other 3. Local Fire Department: Monitored? Yes No 4. Monitoring Agency: N/A Telephone: N/A 5. Test ReceiVed bt. Monitoring Agency? YesE] No Monitoring Account: N/A 6. No. of Initiating Circuits: No. of Signaling Circuits: BATTERY TEST DURATION: #1 #2 #3 #4 NOTES 7. Static Battery Voltage 25.3 8. Battery Voltage Under Load w/Signall Devices Operating 25.2 9. Change Circuit Voltage 26.7 CONTROL PANEL CHECKS SATISFACTORY CHECK NOTES Yes No N/A 10. Trouble Signal w/AC Power Off 11 El 11 11. All Circuits Operate Satisfactory on Standby (Battery) Power El 11 El 12. All Circuits Operate Satisfactory on AC Power 0 El El 13. All Circuits Checked for Electrical Supervision El 11 El 14. Control Panel Checks Made Per Manufacturers Instructions 0 11 El 15. All au)dliary Equipment Operates 11 El El 16. Alarm Delay Function (if installed) Operates Properly El El 11 17. Panel Key Available El El F1 18. Operating Instructions at Panel I] El El 19. Test/Service Record at Fire Alarm Control Panel El El El PAGE 1 OF 2 Name & Address of Facility: Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Date: 8-11 -11 EQUIPMENT TESTED TYPE OF EQUIPMENT MANUFACTURING & MODEL # NUMBER OF UNITS TESTED SATISFACTORY CHECK NUMBER OF UNITS IN BLDG Yes No N/A Control Panel FCI SPB-4 Communicators Annunciators Master Alarm Box Supervisory Trouble Indicators 2 2 Smoke Detectors Duct Detectors L1 Beam Detectors El I El Heat Detectors El I El Manual Pull Stations 12 1 [:]-- 12 Audible Devices 19 1 Li 0 19 Visual Devices 1 1:1 1 Audio/Visual Devices L1 El 0 Public Address System Fireman Phones Elevator Recall — Phase I Li 0 Phase 11 El Auto Door Release Fail Safe Door Unlock Ventilation Controls Generators Sprinkler Flow Switches Sprinkler Tamper Switches Sprinkler Supervisory Switches M 7T Electric Alarm Bell/Motor Gong 0 El Other EJ I N El THIS IS TO CERIFY THAT THIS FIRE ALARM SYSTEM HAS BEEN PROPERLY INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT AND IS CONSISTENT WITH FIRE ALARM MAINTENANCE STANDARDS. Signature of Owner or Representative: Signature of Fire Alarm Representative: George Holtmeyer Discrepancies: Correctons Made: Date Corrected: By: Cert # PAGE 2 OF 2 Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206) 575-0311 FAX (253) 735-4976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprinkler Test Report 4" I CONFIDENCE TEST I LN . I REPAIRS I Li . I Occupancy Name: Occupancy Address: Building Owner: Responsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder Phone Number: 8-11-11 Inspection Type: Annual ED George Holtmeyer 15091TO61510 Location of System: Dog House Front of Bldg 2 Design Density 0.00/ft (example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) El Central station monitoring? Yes D No ED Monitoring company name: N/A Control panel manufacturer: FC1 Model Number: SPB-4 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: (If additional room is needed, please add a separate sheet) Corrected By: This certifies that this fire and fife safety system.has been properly inspected for reliability to cover the items listed in this report and is consistent with Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mailing Address: 107 Washindon Blvd Al2ona, WA 98001 Building Representative (Signature) The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing'of the fire and fife safety system. �evO,7,g Static pressure: psi 60 Flow pressure: psi 50 Flow switches, supervisory switches and alarm bells tested? N/A Yes ED No El l""' "ll' 11 -:- � -N-, 7-.-,-T 1:�� - .—I', azm4be System inspected and lubricated? Yes El 'y 9, 7 1 �17 7y- yesAest -r No D Valves are sealed or supervised? Locked Yes El No El IM ::0 d6d Pumper connections and clapper valves unobstructed and turn freely? Y e s D No D ess I.Sarfibld ? "'full' p6.*.` er'li IT, succ test P Y Sprinkler coverage is acceptable? Yes ED 7-7 enum &r,..-6. fifikl ly �p _.erj.9--, No El 777 System left in service? Yes ED No D -�S'§�hj lacbd"" iddlibj;�a6d,& K��`!`5m- y a. -,gaggesxep *rt ar qK P P. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes 0 No C DI `Y W. �.: No Was an internal pipe and valve inspection performed every 5 years? Yes 0 - -:�. No El . . . . . . . . . . ep Fire One, Inc. Wet- Automatic Sprin1der 107 Washington Blvd Test Report Algona, WA 98001 (206) 575-0311 FAX (253) 7354976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) B I CONFIDENCE TEST I LN I REPAIRS I U I I Occupancy Name: Occupancy Address: Building Owner: Responsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder Phone Number: 8-11-11 Inspection Type: Annual ED George Holtmeyer 15091TO61510 Location of System: Dog House Rear of Bldg 2 Design Density 0.00/ft �example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) El Central station monitoring? Yes No Monitoring company name: N/A Control -vanel manufacturer: FCI Model Number: SPB4 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: (If additional room is needed,.please add a separate sheet) Corrected By: 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311, Testing Agency: Fire One, Inc Mailing Address: 1 07 Washington Blvd Algona, WA 98001 Building Representative (Signature) The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. w. AesP56fid- d NoU— Static pressure: psi 60 Flow pressure: psi 45 'MC e �N '-E3 Flow switches, supervisory switches and alarm bells tested? N/A LJ Yes 0 No El System inspected and lubrica ted? Yes El No 11 'qv Valves are sealed or supervised? Locked Yes 0 No 11 �on vi V . . . . . . . . . . . . . . . Pumper connections and clapper valves unobstructed and turn freely.? Yes E] No [3 el RUM Sprinkler coverage is acceptable? Yes No M q.inumberW S' 77�X pare's !I ea( -aval System left in service? Yes ED No El Ip2M—e f Mdi�ffie Was an internal pipe and valve inspection p ed every 5 years? Yes El No 0 lerwren. A,avail E] Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206) 575-0311 FAX (253) 7354976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprinkler Test Report A I CONFIDENCE TEST I ILI I REPAMS I U I Occupancy Name: Occupancy Address: Building Owner: Responsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder Phone Number: 8-11-11 Inspection Type: Annual ED George Holtmeyer 1509IT061510 Location of System: Dog House Rear of Bldg 2 Design Density 0.00/ft (example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) El Central station monitoring? Yes 0 No ED Monitoring company name: N/A Control panel manufacturer: ESL Model Number: 1500 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: (If additional room is needed, please add a separate sheet) Corrected BY: This certifies that this fire and life safety system has been properly inspected for reliability to cover the items fisted in this report and is consistent with Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mailing Address: 107 Washinidon Blvd Ah!ona, WA 98001 Building Representative (Signature) The items on the checklists below shall be inspected and tested. This fist does not constitute all of the required inspecting and testing of the fire and fife safety system. T .'con Static pressure: psi 60 Flow pressure: psi 45 Offi C ..... . . . . . . Flow switches, supervisory switches and a —]a bells tested? N/A El Yes [D No N1 Al� No, —a�-, System inspected and lubricated? Yes El No El 7 7-7 7:777 Tessure Te 0; -V Y&E] '�`No Valves are sealed or supervised? Locked Yes El No El S1, Pumper connections and clapper valves unobstructed and turn freely? Yes F1 No E3 i��der� eacisiidbl&W--,dr";'SuccessfLdlv,§A�i ted.-h-jAst30-,years !-, —SP -p u. 1 NOU, Sprinkler coverage is acceptable? Yes ED No El . . . . . . . ...... ...... purn er- e per, arp�sp N 4j- System left in service? Yes ED No D tern -gauges -,.r -'ac Pi ,,els o. Sprinkler heads free of corrosion, paint, obstructions and/or physical dairnage? Yes ED No ns.f6und e- .tmdnfC6nnec' 7, I�w p�r �es7,4:0 'y -NOO� Was an internal pipe and valve inspection performed every 5 years? Yes El No El Ier wren -$prink ch� yAlable�fir--6doh.type'.of sprinkI -Y ?No -0 Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206) 575-0311 FAX (253) 735-4976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprinkler Test Report 10 I CONFIDENCE TEST I LN I REPAIRS I Li I Occupancy Name: Occupancy Address: Building Owner: Resp onsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder I Phone Number: 8-11-11 Inspection Type: Annual ED George Holtmeyer 15091TO61510 Location of System: Dog House. Front of Bldg 2 Design Density 0.00/ft (example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) Central station monitoring? Yes El No ED Monitoring company name: N/A Control-pAjqel manufacturer: Firelite Model Number: MP 12/24 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311, Testing Agency: Fire One, Inc Mailing Address: 107 Washington Blvd Al2ona, WA 98001 Buflding Representative (Signature) The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Static pressure: psi 55 Flow pressure: psi 35 -�mc Yes x .-er- N Flow switches, supervisory swit - ches and alarm bells -tested? N/A Yes 0 No El ec 00 System inspected and lubricated? Yes El No 0 ves; f6sied y 34" Valves are sealed or supervised? Locked Yes El No El V No Pumper.connections and clapper valves unobstructed and turn freely" Yes El No 0 s er hedds--rer) acec ars.. 00nk] F W i�� e s ish 11 y s a r. YqP Y 7TS ff Sprinkler coverage is acceptable? Yes ED er. 'of vare.sib er - e :ava en No El -7 System left in service? Yes ED No El -5 9 IY -gAu -.'.reblac;d bf-'-6�dili zVeryt, years..,- ystem UTis e es.0,. Sprinkler heads free of-corro-sion, paint, obstructions and/or physical damage? _77-77 7 Yes No EJ ge- al --onneci Was an internal pipe and valve inspection performed every 5 years? Yes El. No [I ler -wrench �avaflAbld,f6i.:6a6h`.4iV6 bf, I -nkIerT,_,:.. rim- ff, NoM� Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206)'575-0311 FAX(253)735-4976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprinkler Test Report E I CONFIDENCE TEST I LN I REPAM I U I Occupancy Name: Edmonds Highlands Apts Occupancy Address:' 23510 Edmonds Way Edmonds, WA 98020 Building Owner: Same Phone Number: Responsible Person: Beth Balder Phone Number: Date of Inspection: 8-11-11 Inspection Type: Annual ED Testers Name (Please Print): George Holtmeyer 15091TO61510 Location of System: Dog House West of Bldg 2 Design Density 0.00/ft (example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) El Central station monitoring? Yes El No 0 Monitoring company name: N/A Control panel manufacturer: FCI Model Number: SPB4 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) 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 Fire Department Fire Code standards, and that discrepancies -are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mailing Address: 107 Washineton Blvd Algona, WA 98001 Building Representative (Signature) The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. 0 t Static pressure: psi 55 Flow pressure: psi 40 Flow switches, supervisory switches and alarm bells tested? N/A El Yes [D No E] arm, atEs) E' System and lubricated? Yes El No El -inspected . . . . . . . . . . v ves�� Valves are sealed or supervised? Locked Yes El No 0 LIS �'��&d Pumper connections and clapper valves unobstructed and turn freely? Yes El No 0 -or,,success e,- Aetdstedf, iai§t,*5.0'_.'y.-.dgi9?" ac,,. 77 �.N Sprinkler coverage is acceptable? Yes ED No El en aN 7N&EF System left in service? Yes S No 0 . . . . . . . . . . . . k s1z 0 years,20 4 Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes No bYhi4_6 th&.Fiie': `; J7 j o ........... Was an internal pipe and valve inspection performed every 5 years? Yes El No 0 Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206)575-0311 FAX(253)735-4976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprinkler Test Report F I CONFIDENCE TEST 1 2SI 1 REPAIRS I Li I Occupancy Name: Occupancy Address: Building Owner: Responsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder Phone Number: 8-11-11" Inspection Type: Annual ED George Holtmeyer 15091TO61510 Location of System: 2 Design Density 0.00/ft (example .495/2000 sq. ft): 425-771-6910 Quarterly (High Rise Only) Central station monitoring? Yes No Monitoring company name: N/A Contrpl pqnel -manufacturer: Firelite Model Number: MIP 12/24 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: (If additional room is needed, please add a separate sheet) Corrected By - This certifies that this fire and fife safety system has been properly inspected for reliabifity to cover the items fisted in this report and is consistent with Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mailing Address: 107 Washington Blvd Algona, WA 98001 Building Representative (Signature) V The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. 'Ys, OE Static pressure: psi 60 Flow pressure: psi 45 WIMI Flow switches, supervisory switches and alarm bells tested? N/A No El X System inspected and lubricated? Yes [3 No El sureye gw�tmg 'y �Z - .01, 1 Valves are sealed or supervised? Locked Yes El No El igns-are , prpyided,'A�4- @Mbs'T' Pumper connections and clapper- valves unobstructed and turn freely.? Yes El No D er ac F-success er. qo� y �S Sprinkler coverage is acceptable? Yes ED No El '&�,n of' art, e 01 - System left in service? Yes No e �or e es.,, K-T I. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes [D No El W. �Y' In, iti�adt6 edi6ni(FOC)i -No Was an internal pipe and valve inspection performed every 5 years? Yes El No El Fire One, Inc. Wet- Automatic Sprinkler 107 Washington Blvd Test Report Algona, WA 98001 (206) 575-0311 FAX (253) 735-4976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) G I CONFEDENCE TEST I LLJ I REPAIRS I Li I Occupancy Name: Occupancy Address: Building Owner: Responsible Person: Date of Inspection: Testers Name (Please Print): Edmonds Highlands Apts 23510 Edmonds Way Edmonds, WA 98020 Same Phone Number: Beth Balder Phone Number: 8-11-11 Inspection Type: Annual ED George Holtmeyer 15091TO61510 Location of System: Dog House East Side of Bldg 2 Design Density 0.00/ft (example .495/2000 sq. ft):. 425-771-6910 Quarterly (High Rise Only) El Central station monitoring? Yes El No ED Monitoring company name: N/A Control p4pel manufacturer: FCI Model Number: SPB4 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) This certifies that this fire and fife safety system has been properly inspected for reliability to cover the items fisted in this report and is consistent with Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: George Holtmeyer Phone # 206-575-0311 Testing Agency: Fire One, Inc Mailing Address: 107 Washington Blvd Algona, WA 98001 Buflding Representative (Signature) The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. N� est,tffid �N 7Y -a7 i, KP Static pressure: psi 60 Flow pressure: psi 50 . . . . . . . . . . Flow switches, supervisory -switches and alarm bells tested? N/A Z No El System inspected and lubricated? Yes [3 No El t.ze -V 77"1 7: Valves are sealed or supervised? Locked Yes El No El `6: Pumper connections and clapper valves unobstructed and turn freely? Yes [3 No El e, J er,hea-id e s-,,rqpIa,__ "Or%s s -S -Z., Sprinkler coverage is acceptable? Yes ED No-E] ii6rAVefofs_pa&� hbld?"'I 77 er, e 4av es 0, System left in service? Yes S No El SS Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes ED No D e_ ion' Was an internal pipe and valve inspection performed every 5 years? Yes D No El -�fink-IWZ�cb--a 9_IIab_IIe'Ifi6p-egbhiypi .9 7Fes" CITY OFEDMONDS 121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215 FIRE DEPARTMENT LOCATION: 23326 Edmonds Way BUSINESS NAME: Edmonds Highlands Apts MAILING 23326 Edmonds Way FIRE PREVENTION SAFETY SURVEY Bid A-G PHONE: 4257719610 Edmonds 98026 BUSINESS OWNER: Housing Authority/Sno Co HOMEPHONE: 4257716910 EMERGENCY-11: . Wemer, Glenda HOMEPHONE: 4257716910 KEY ACCESS-2: Kehler, Steve HOME PHONE: 425290BU9 FREQUENCY STATION & SHIFT 365 20 D SCHEDULED DATE DUE 0- 07101/10 LIFIR 1' 428 7055 ACTIVE INITIAL INSPECTION DATE PERSON CONTACTED: I;rl I�H kllpl 'S NAME OF INSPECTOR: ,//5 �Tll,c s; j 0 141, Vr, 0 7 FIRE AS 8/07 FA-M I'D LIcBx FE 37 )51' SYSTEMS: 9A ANNUAL HAZARDS FOUND ANDACATIONS COMMUNICATIONS ENTER CODE ONLY ONCE 0 VIOLATION CODE M441ke 4,4 1 r rzr---7A- c, e) 2 2 3 3 4 4 5 5 6 6 7 7 8 8 Ist RE -INSPECTION 2nd RE-I[NSPECTION EXTENSION FINAL RE -INSPECTION VIOLATIONS DATE DUE: 1 DATE DUE: PERSON 0 GRANTED TO: DATE DUE: CITED: PERSON PERSON CONTACTED: CONTACTED: CONTACTED: 1 A INSPECTOR: INSPE6013: INSPECTOR: 2 DATE: ke DATE: DATE: 3 VIOLATIONS VIOLATIONS PRE -CITATION CITATION ISSUED 1 5 1 5 LETTER SENT NUMBER: 4 CODE 2 6 2 6 DATE: SECTION: 5 RETURN RECEIPT 6 2- RECEIVED DISPOSITION: 4 8 4 8 LETTER NEEDED C] Y�S No DATE 7 8 t.,LETTERNEEDED C] YES NO FIRE DEPARTMENT COPY 1 3 Fire One. Inc. Fire Protection Service/Sales 107 Washington Blvd Algona, Wa 98001 Seattle: (206) 575-0311 * Bremerton (360) 478-0428 TO Edmonds Fire Department 121 5th Avenue North Edmonds, WA 98020 WE ARE SENDING YOU 11 Shop Drawings El Copy of Letter Letter of Transmittal Date 8/31/2010 jJob No. Attention RE: Test Reports El Attached El under separate cover via_ the following items: D Prints El Plans El Test Forms 0 Specifications E3 Change Order El Other COPIES DATE NO. DESCRIPTION 14 08/26/10 23326 Edmonds Way/ Edmonds Highlands THESE ARE TRANSMITTED as checked below. El For Approval REMARKS El For Your Use 0 As Requested El For Review And Comment COPY TO: File (Office), Property or Management Co. SIGNED: Edmonds Fire Department If enclosures are not as noted, kindly notify us at once. 107 WkSENGTON BLVD ALGONA. Wk,990DI (206) 575-0311 FAX M3)7354976 BREMmTON (360) 478-0428 FAX (360) 782-2594 (One . System per Report) I'dDNFEDENCE. TEST - ' I - Occupancy'NILme: Occupancy Addmss: Building Owner: gesponsible Person:.. jDate of Inspection: Testers Name (Please Print): ="YAW Phone Num,ber'. Phone Nnmber-. A�Unjff Inspection Type: LA),cation of -System: centmi station monitoring? yes No Monhoring rOmPanY name: Control panel mamufactrw- Model Number Problems Fo (If additional room is needed, plem add a sepm-zte sheet) ot'l G 6k 0 Qu"riy (korh Rise Only) -Vo-4(2 gv CorrectedBr.. Corrections M2de: Date Corrected: (if additional room i needed, pl6ase add a separate sheet) uAl)-5 mv- This cerfifies that tds fire and life Safety 9VI5 and is consistent -with Fire Depa=en ri v Ce building Owner/NUnager for co -8 01 Sig,nature of Te&-ter-. Tegffin Agency: Fire One, Inc Mailing. Addresm. 107 Washin.0 Buildin- ep (Siguature). ReDresentative I 1'as been properly insP.ecte -for reflability to cover th ' e 1�ms EsUd in this rel ftandardsalipd that discrepancies am noted and haveieen mported to the Phone N 206-575-611 The items on the checklists below shall be insPected and tested. This list does not congurute AL" ul ww, , Y-- --r--o tesdug of the fire and life safety SydenL Alarm System Fitnctiona# Trouble signal with AC power off? Yes ia Yes g No INOCI System operates properly on battery backup? Battery voltagd (no load) 2S. I 8volts 41 9?Voits (sig�als opmfiln) Battery voltage (full load) -volts Charge circuitv'oltage C� 's Yes No System operates properly on standb� power?,, Yes D A U.signals operate'on AC power? .No[]. Number of initiating cirbuits Number of signal circuits . Does alarm jystgm meet audibility standards7. Yeso. No All circuits checked for electrical supervision? N/A93 Yes[].*. No[]. All auxiliaTy equipment operates (Elevators, fans, dampers)? . N/A.0 Yes No[] Ventilation controls operate? Yes NoD Key to panel available? . I YeSA NOO Operating inst uctions at panel? *indicators Yes No[]* T rouble function properly? . N/A Yes[] No Remote Annunciator Panels:ftmc tion properly? . N/A Yes:[] No E levator Call Down fimctions properly? YesS No [I Test record posted at panel? N/AK Greneral al-grm automatic time delay (minutes), Yes NoR Other Devices (SDecify) System Devices Total Number of Units in Buil(ling Total.Number Units T6&� Test Results Acceptable 1.* Bells, Horns, Chimes N/A 0 Yes [I No 0 2. Voice Speakers (Voice Clarity) N/A R Yes 0 No 0 3. Sn�pke;.Dctectors N/A 91 Yes (3 No [I 4. Heat Detectors N/A F3 Yes'El No 0 S. Duct Detectors N/A;Q Yes 0, No 0 6.- SpHnIder Flow Switches N/A 0 Yes JZ NoD 7. Sprinkler Supervisory Switches NIA M Yes [I No 0 8. Visual Alarm Devices N/A 4 Yes 0 No 0 9. Manual Pull Stations NIA El Yes IN No 0: 10. -'Automatic Door Unlocks N . /A : Yes 0-. NoO 11. - Automatic Door Release N/A- Yes Q. No 0 12. Bearn Detectors' N/A Et Yes* Ej NoO - Communicztion Equipment Total Number of b Total Num. er Test Results Units in Building Units Tested ' Acceptable 12. Pho n*e Sets N/A 0 Yes 0 No 0 13. Phone Jar -la N/A 13 Yes D No 0. 14.* Call -in Signal N/A Yes Z No [I a as %., %F8.5,W�'ID 1 07 WASENGTON 33LVD ALGONA. WA-98001 (206) 575-0311 FAX C-53) 735-4976 BREh4MTON (360) 478-0428 FAX (360) 782-2594 (one System per Report) 'CONMENCE 7EST occupancy'Name: 0�cupancy Address: Building Owner: Responsible Person: jDate, of Inspection: �94�� RIIC�6c-1 LAW I*)--',*> ' 12-122. 1 2 �Moz_ GJA' ISCZ_0... 4tzs-73) -6,�_10 C—bM(*405 HS (-JA LAN phone Nnuk.ber. phone Number-* F3-z6- (0 InspectionType: Quariedy (figh Rise Only) Testers Name (Pleffie Print): L.Catio'n of System.. 5 rA-T- Central station mmit0ring?' yes No Monitor . jug company name Control . pane.l. manafacturer. Model Number Problems Foun (If addffional room is needed, please add a separate sheet) T6 105. LOC.&, _!a"4Y 515p—"L - Correctea Br. Corr'ections Made: Date Corrected: (If addWonal room needed, pl6ase add a separate sheet) This certifies that tIds . fim and life safety system blu been' properly inspected -for reliability to. cover th ' e hau Igted ia this rel ancies am noted and haveben reported to the Chat discrep and is consistent -with fim Departrnent Fi ar building Owner/Manager for co 206-575-611 Signature of Tester-. ]Phone # Testing Agency: Fire, One, Inc M2ifin- Address: 107 Washington R A tern IL 98001' Building (signature) Revresentative The Items on the checklists below shall be insoected and tested. This h9t does nOt CGns=Tz ul Lu,- testing of the fire and Iffe safety system. Alirm System Fancti.onafiq Trouble signal vhffi AC power off? Ye Yes No No 0 System operates properly on battery bkkup? Battery voltage (no load) 4LLSVolts 2,y. Vvoits (signals qma*) Battery voltage (fiffi load) Charge circuit voltage &�v . olts, Yes;& y n p System operates proprrl'o standb� 4wer? Yes.&'. No Allsi siN operate�onAC power? gn Number of initiating circuits Number of sign* circuits . Yes;&. ;'No[3' Does alarm system meet audibility standards?. Yeso(, 'N'O,[3 All circuits checked for electrical supervision? dampers)? /A yes[].*. No[].. All auxiliary eqiipment operates (Elevators, fans, N/A Yes NO[] Ventilation controls YesR NOD Key- to panel available? . yes;0 NoO Operating irot uctions af'panel? I 'indicators Yesg NO.[] Trouble fimetion. properly? N/A Yes No Remote Annunciator Panels fimction properly? N/A yes:[] NO Elevator Call Down fimctions properly? Yes No Test record posted at panel? . N/A, General alarm automatic time delay (minutes), YeSj& NoEl ,'Other Devices (Specify) Sysftm De -Aces Total Number of Units in Building Total Number Units T69ted Test Results Acceptable L' Bells, Horns, Chimes JAL N/A D Yes 9 * No 0 2. Voice Speakers (Voice Clarity) Nhk A yes 0 No D 3. Smpke,Detectors N/A,6 Yes 0 No D 4. 'Heat Detectors N/A Yes 0 No 5. Duct Detectors N/A Yes 0. No D 6. Sprinkler Flow Switches N/A 0 Yes ik No 0 7. Sprinkler Supervisory Switches N/A ja Yes [I No [I 8. Visual Alarm Devices N/A ET Yes 13 No 0 9. . Manual. Pull Stations N/A 0 Yes R No 0. 10. 'Automatic Door Unlocks N/Ag. Yes [3 No 0 11. Autoniatic Door Release NIAA Yes 0. No 0 12. Beam Detectors N/A §L Yes' [I No[J Communication Equipment Total Number of Total Number Test Results Units in Building Units Tested Acceptable 12. Phone Sets N/A 9 Yes D No D 13. Phone Jacks N/A 13 Yes 0 No [I. 14. Call -in Sigmal N . /A 0 Yes 9 . No D 107 WAsHINGTOW BLVD ALGONA. WA-98001 (2D6) s75-0311 FAX (253) 735-4976 - BREhmTON (360) 478-D428 FAX (360) 792-2584 (one System per Repo.rt) CONFIDENCE 7EST REPAM occupancy'Name: ilni VA occupancy Addresr. Building Owner: 6D YA 0 A rj5_ H5&k LA -No Phone Number*. Phone Number. - Responsible Persaw.. r iDat*e of Inspect . i0a.' (_92 Inspection Type: Q'uarteriy (Egh Rise Only)E] WY -ATesters Name (Please Print):, &W - - ------ ---- Location of Sysiew, Central stabon mmitoring? Yes El No Monitoring comp=3� name Control . panel ma.mufacturc . r. model Number. Problems Founck (If additionO room is needed, please add a sepmzte sheet) Wq(5 LOC-64— , i 6,00 Cor1r'ections Mad Date Corrected: Correctea Br. (If addi . tional room needed, pl�ase add a sepwate sheet) This certifies that Ws fire and life safety system and is consistent -with Fire Department Fir��j building Owner/Manager for corrective I Sig'nature of Tester-. Testing A gencyl- Fire One- IDC Nlailing kddress:. 107 Washin.u—to Baildina Signature) ReDresentative .4 properlyinsp. d -for reliability to. ;over the i�zw Ikted iia this report dj;—R-n-� that discrepancies are noted and have �eez mported to the EV Phone # 206-575-511 The items on the cbecklists below shall be inspected and testecL This iigt aoes noL cuub—u- tefffin Of the GM Rnd life safety systent. Alarm System FunctionRWY Trouble signal with AC power off? System operates properly on. battery backup? Battery voltage (no load) Battery voltage (fall load) Charge.ci.rcuitvoltage System operates properly on standby power?. All.signals operate� on AC power? Number of initiating circuits Number of signal cirmiti . Does alarm system meet audibility standards?. All circuits checked for electrical 'ervisidn? SUP All auxiliary eqii . pment operates (Elevators, fans� dampers)? Ventilation controls opmmte? Key- to panel available? Operating instractions. at panel? Trouble. indicators function properly? Remote Annunciator Panels function properly? Elevator Call Dowm functions properly? Test record posted at panel? General alarm automatic time delay (minutes). -Other Devices (Specify) YesS No Lj YeR4, No 2L- &Y 61 t s anals- 21--oavoits (sig N/A;9 N/A NIA R. N/AK- Yis A - NoLJ-.. YeSA, - - NoE] ;'No[]' Y�sa- - 'N'0.0 Yes No Yes 0. No[] Yes g 'No Yesa Yesg No Yes No Y S: e El No 11 Yes;K No [I NI�L [I Yes Noz - System De-tices Total Number of TotalNumber Test R.esults I Horns, Chimes Units in Building IL Units TesW N/A [I Acceptable Yes)& No [3 Bells, 2. Voice Speakers (Voice Clarity) N/A Yes 0 No 0 3. Srn�pke Detctqrs N/A 54 Yes [3 No El 4. Heat Detectors N/A JR Yes 0 No 0 5. Duct Detectors N/A EL Yes 0 No 0 6. Sprinkler Flow S-Aitches N/A 0 Yes)5 NDO 7. Sprinkler Supm-visory Switches N/A 5& Yes [3 No El 8. Visual Alarm Devices N/A JZ Yes D No [I 9. Manual Pull Stations N/A 0 Yes JZ NoO 10. 'Automatic Door Unlocks N , /A q Yes 0- No 0 11. Automatic Door Release N/A 14. Yes El.'� No D 12. Rearn Detectors N/A S Yes'Ej No(3- Communication Equipment Total Numb er of Total Number Test Results Units in Building Units Tested Acceptable 12. Phone Sets N/A Z Yes D No D 13. Phone Jacks N/A 13 Yes 0 No [I 14. CaH-in Signal N/A 13 Yes 9 No D a as %; LVxV%;#q *ago%.#& 107 WASI-ENGTON BLVD ALGONA. WA 98001 (206) s7s-0311 FAX (253) 735-4976 BREm:ERTON (360) 478-0428 FAX (360) 792-2584 (One System per Ripart) 'CbNFIODENCIE TEST occupancy'Natne: occupancy Addmsc I . 7 Building Owner-. T�esponsible Perwn: jDate of inspection: .Zgslz WAY Phone Number..* Inspection Type: ease Testers Name (PI Print): A Location Of Syst= Cent -al stabon monitoring? yes No Monitoring company name: Model Number Control panel manufacturer . ProblemsFoun (if additional room is needed, please add a sepmate sheet) RI WA 9802-' Quartedy fth Rise 0n1Y) 13 Corrections Made: Date Corrected: ---------- Corrected Br. (If addi . tional room is needed, pl�ase add a separate sheet) This certifies that this fire and life sa sysl "�t'y 'e and is C'Onsistent -with fire Depa nt Fj� building owner/lYhriager for co x signature. of Te&-ter-- V Testing Aggency: F"ire One- 107 Washin, ng Addresm. Buildina (Signature) Revresentative, properly inspected for reliability to. cover the bms Ested i1i this rel ind that discrepancies are noted and have ieez mported tD the Phone # 206-5754311 The items on the cheeklists below shall be inspected and teste& This fin Does nOt CUILNULULr- SLAI %#A _T_ _r testing of the fire and Hfe sRfety systeuL Alarm System FanctionalitY Trouble signal vAth AC power off? System operates properly on battery backup7 Battery voltage (no load) Battery vol�tage (�L load) charge cir.cuit;voltage System operates properly on standby power?. All.signals operate on AC power? Nunber of initiating circuits N-umbeir of signal circuits Does alarm system meet audibility standards?. AM circuits checked for electrical supervision? AM aukiliary eq�npment opm-ates (Mevators, fans, dampers)? Ventilation controls opmate? Key -to panel,avEflable? Operating instnutions af panel? Trouble indicators fimetion properly? Remote Annunciator Panels function properly? Elevator Call Down functions properly? Test record posted at panel? Creneral ala= automatic time delay (minutes), -Other Devices (Svecify) Te7sJ NO [I 0 YeS6 NOE]. I -TA Volts .Z�JVOjts (sigriah* qeratinb - -2-14 � 0 volts N/A N/A Nl.�,o . N/A: td' No Ye&3, . . yes,S: .,No[]. Yes;g YeSS N . o.[] Yes Yes No[] Yes,9 'NoD Yes& Not] Yeso No,[] Yes[] No[] e: No[] Y s[] YeSE No [I NXQ Yes[] No,9 I.' System De -vices Bells, Horns, Chimes Total Number of Units in Buildinj� TotalNumber Unit T�sted Test Re sults Acceptable _N/A 0 Yes& No 0 2. Voice Speakers (Voice Clarity) N/A 0 Yes 0 No 0 3. Smoke.Detectors N/A Yes (3 No El 4. Heat Detectors N/A Yes D No [I 5. Duct Detectors N/A 8 Yes 0 'No 0 6. Sprinkler Flow SAritches N/A 0 Yes 19 No [I 7. Sprinkler Supe;rvisory Switches N/A 4 Yes [I No [3 8. Visual Alann Devices N/A 0 Yes 3 No 13 9. M'a''nual PuIl Stations N/A El Yes 4- NDO 10. 'Automatic Door Unlocks N . /A Yes 0- 1400 11. Auioniatic Door Release'. N/A Yes 0'. No 0 12. 13'eamDetectors' NIA ja Yes 0 NOD Communication Equipment Total Number of b Total Num. er Test Results Units in Bnildinz Units Tested Acceptable 12. Phone Sets N/A 13 Yes 13 No 13 13. Phone Jacks N/A 13 Yes [I No 0. 14. Call -in Signal N/A [I Yes 9 - No 0 IF Raw L914409 '81"We 107 WAsjjNGTON BLVD ALGONA, WA� 98001 (206)575-0311 FAX ('-153)735-4976 BREI,MMN (360) 478-0428 FAX (360) 782-2584 (One System per Repo.rt) 'CbNTMENCE 7EST UPAW occupancyName: q WXY -ID610,6 occupancy Addiress: 5 bone Number. ]Building Owner. Respon*sible Permn: Phone Numben Date of Inspect . iow, Inspection Type: Annual Testers Name (Ple2se Prin*, Location of System: �TA-.'Pf LW 6 1 k -Centmi station monitoring? Yes No'S Monitoring company name: Control panel manufacturer. Model Number Problems Foun (if additional room is needed, please, add a SePmmte Shed) W 47Z �- �-Gcl�Q Quart efly (Eigh Rise Only) ON LW 6EP-z' - Cor+ections Made: Date Corrected: ----------- Corrected Br. (If addi . tional room.s needed, pl6ase add a separate sheet) rly inspected -for reliability to cover the 1�ms EgW in this report -"'I This certifies that this fire and life ety Zgleln b eh proper"Y ' sp . ecw" "u' r-r . safety and is C'onsistent -with Fire Department F n ards, and that discrepancies a re noted and have ieen reported to the building owner/Manager for co�rect�' e a P one Phone # 206-575-S11 Signature of Te&ter-. h Testing Aggeucyt- FF-ire One, Inc Nwlinff Address: 107 Washinvotoulmv) Akmna. WA 98001 Building (Signature) 1 Representative The items on the checklists below shall be inspected and teste& TILis list does not constitute RD or rat rcy . LA VU LLLbjJ&6"% ""m testing of the fire and We safety system. Ahm System FanctionRUtY Trouble signal with AC power off? Ye$N Yes 9.— No Lj No System operates properly on battery backup? Battery voltage (no load) 61ts em �2E fing) g_qVojts (sig�24"q Battery voltage (hL load) 'voltage Volts Charge.circuit No[]-.. System operates properly- on standby power? All.signds operate on AC power? Number of initMng cir*ts Number of signA cirmifti . No[] Does alarm system meet audibility standards?. Y�sg, No AM circuits checked for -6lectiLcal supervision? NIA;R Yes[].*. No[].. All auxiliary eqiipment operates (Elevators, fans, dampers)? NIAC Yes D No[] Ventilation controls Operate? - Yes�R No Key- to panelavailable? YeS9 N00 Operating instractions at'panel? Yetg No Trouble midicatorsfimcdon properly? Yes No P,emote Annunciator Panels function properly? Nhk Yes:[] No Elevator Call Down functions properly? yes;E� No Test record posted at panel? Nlk Greneral alarm automatic time delay (minutes). Yes NoR Other Devices (Specify) System DevAces Total Number of TotaNumber Test Results Acceptable I.- Bells, Horns, Chimes Units in Building ICi Units TesW N/A 0 Ye�,6— No [3 2. Voice Speakers (Voice Clarity) NIA Yes D No 0 3. Smoke.Detectors N/A Yes D No 0 4. 'Heat Detectors N/A Yes D No 0 5. Duct Detectors NIAA Yes 0 . No 0 6. Sprinkler Flow SAitches 1�/A 0 YesX NDO 7. Sprinkler Supervisory Switches N/A X Yes 0 No 0 S. Visual Alarm Devices N/A 0 Yesg No 0 9. 'Manual PuU Stations N/A [I Yes�Z No 0: 10. Automatic Door Unlocks N/AA Yes [3- No 0 11. -Automatic Door Release N/A Yes 0. No 0 12. Bearn Detectors' NIAX Y6s'El No [1. Communicadon Equipment Total Number of Total Number Test Results Units in Building T Units Tested its Acce b 12. Phone Sets N/A 2 Yes 0 No D 13. Phone Jacks N/A 13 Yes 0 No 0. 14. Call -in Signal N/A 0 Yes [D No 0 107 WAsH[rNGTON BLVD ALGMA. WA 98001 (206) 575-0311 FAX (253) 735-4976 - BREjvMT0?4 (360) 479-0428 FAX (360) 782-2584 (One System per Report) -CbNFIDENCE MST REPAIRS Occupancy �NRMC: &19en6140 WA� M&4 _42,5W14 Occupancy Adictress: phone Num'ber: Building Owner. gesponsible, Person: LA R C—t Pbone Numben artarly Rise only)- El jDate of Impaction: Inspection Type:. AARuAl Qu Testers Name (Please Print): Lbcation Of System: - Cent -al stE6on Monitoring? Yes E] No Monitoring compan5l nanre: Model Number Control panel ma.nafacturm Problems Founch (If additional -room is needed, plem'add a separ-2te shed) Corrections Made: Date Corrected: Corrected Br. (If additional room i needed, pl6ase add a separate sheet) pecte -for reliability to.cover the 1�ms Efted iii this report This certifies that &b fim and life —asafety By een properly ins d 7t ancies are noted and haveieu reported to the and is consistent v&h Fire Department Fi s ndards, and that discrep I v IL building Owner/Manage r for correctiv n. r 06-575-611 Signature of Tes;ter Testing Agency: Fire One, Inc Mailing Address; 107 Washin.ortom Blvd on WA 98001' (Signature) ReDresentative The items on the cbecklists below shall be inspected and tes= TIUS INE a(m IIUL 6ULW"&"_ testing of the fire and life safety syrtem. Alanm System FunctionaftO Trouble signal with AC power off? Ye YeA No No System operate&properly on battery backup? LI(evolts Battery voltage (no load) ILivoits (sigialsaprafini) Battery voltage (full load) :16 volts 0 Charge circuitv'oltage No System operates properly on statft' ower?. p YesX: .."NO0. All si on AC power? gnals operate Number of initiating circuits Number of signal circuits . Yes.g. No[] Does alarm �ytem meet audibil#y. standards?. Ye4;9; N' o[I All circuits checked for electrical supervision? Yes NoQ.. A-11 auxiliary equipment opm-ates'(Elevators, fans, dampers)? NIAK Yes No[] Ve�tilatip n* controlsoperate? Yega. No Key-t.o panel available? YesR No[] Operating instruetiops at panel? YeS91 No.[]'. Trouble indicators function properly? Yes No Remote Annunciator Panels function properly? N/.k Yes:f No Elevator Call Dowm fimetions properly? Yes& No Test record posted at panel? . WAR General On= automatic time delay .(minutes). Yes NoZ -Other Devices (Specify) Total Number of Units in Builffing To�&I.Number Units TesW Teg R.esultB Acceptable System De -Aces 13 — JOL N/A [I YesS No 0 NIA )A Yes [I No 0 N/A A Yes (3 No 0 N/AA Yes 0 No 0 N/A W e ' Y sO. No D N/A 0 Yes;s� No [I NIAA Yes 0 No [I N/A 0 YesH_ No 0 N/A [3 Yes�M No [I' N./A^ Yes 0- No 0 NIA-2� Yes 0'. No 0 N/A O'Yes 0 NoO - 1.' Bells, Horns, Chimes 2. Voice Speakers (Voice Clarity) 3. Sn�oke.Detectors 4. Heat Detectors 5. Duct Detectors 6. Sprinkler Flow Svitches 7. SprinZer Supervisory Switches 8. Visual Alarm Devices 9. Manual Pull Stations 10. 'Automatic Door Unlocks 11. Automatic Door Release 12. Bearn Detectors Communication Equipment Total Number of . er Total Nu mb Test Results Units in Building Units Tested Acc 12. Phone Sets N/A Z Yes D No 0 13. Phone Jacla N/A Z Yes [I No 0. 14. Call -in Signal N . /A D Yes Z . No D 107 WASHINGTON BLVD ALGONA. WA, 98001 (2D6) 575-0311 FAX (--)S3) 735-4976 BPJUMTON (360) 479-0428 FAX (360) 792-2594 (one System per R6port) -CbNFIODENC'E 7EST 75� -, I � I* C67 OccupancYNsLme: eDMANM' A-L= I:X- 0MU pancy Address: Phone Number. ]Building Owner. lip - phone Number.. gesponsible Person: Inspection Type: Annual. Quarteriy Mcgh Rise Only)EI jDate of Inspection: _16- 0 Testers Narne, (Plewei Print): r- e I LAmsdion of System: - 5 ,� Cental stabon monitoring? yes No Monholing compan3r name: Cont-ol panel ma.nufachrrer Model Number ProblemsFoun .(If additional room is needed, please add a separTle shed) L.00,AL- ev4z_�- 5 6 F_ _Z_ - CorrecteaBr. Cor,rections M2de: Ditte Corrected: (If addi . tional room i needed, pl6ase add a separate sheet) This certifies that tids fim and life safety gyste b and is congistent-withfim Department Fj "Cti, building Owner/Manager for co IL S' ' ature. of T e&-ter-. Testing Aggency-. Fire On I .hin rvwiing Address; 107 Washin.- Bailding (Signi.dure) Revresentative prop rly inspe,zted -for reliability to.r-over th ' e i�ru Ested iD this rej ds, and that discrepandes are noted and haveiem reported to the # 206-575-611 The items on the. cherklisIs below shall be insPected and tested. This list dm no, ronsurum all testing of the fire and life safety system. Alw= System ]FuncdonaliO Trouble signal vhth AC power off? System operates properly on battery bazkup7 Battery voltage (no load) Battery voltage (full -load) Charge circuit Voltage System operates properl� on standby power? A.11 signals operate on AC power? Number of initiating circuits Number of signal circuit� Does alarm system meet audibilitY standards? A-11 circuits checked for electrical supervigon? AD I auxiliary eq7jpment operates (Elevators, fans, dampers)? Ventilation controls operate? Key- to panelavailable? Operating instructions at*panel? Trouble indicators function properly? Remote Annunciator Panels function properly? Elevator Call Downfimations properly? Test record posted at panel? General alarm automatic time delay .(minutes), I -Other Devices (Specify) YesH No Lj Yess No [I q6761ts 16,7 Volts N/A;K N/A N/A4, N/Ag - Yes No Yes6'.- ..No[I Ye sa,* ;'No[]' Yes9- No [I Yes No[] Yes[] -No[] Yesa No [I Yesg,.. NoO Yes No Yes[] No[] Yes.[] No[] YesO No NIA Yes N09 - System De -Aces Total Number of Units in Building Total.Number Unift Tested Test R,esulb Accep#We I.' Bells, Horns, Chimes Aap,%- &-tot e N/A 0 Yes 0 No 0 2. Voice Speakers (Voice Clarity) N/A X Yes D No 0 N1AAq Yes D No [I 3. Sm�pke Detectors 4. Heat Detect6rs N/A)q Yes 0 No 0 5. Duct Detectors N/A 5( Yes 0 'No 0 6. Sprinkler Flow Switches N/A 0 Yes 0; No 0 7. Sprinkler Supervisory Switches . N/AB�Yes D No 0. 8. Visual Alqrm Devices -NIA 0 Yes;!F, No 0 9. Manual Pull Stations N/A 0. Yes a No 0. 10. Automatic Door Unlocks .................. N/A 9, Yes [3- No [I 11. Automatic Door Release N/A.,Q. Yes 0. No 0 12. Beam Detectors N/AgI Yes'[! No 0 Communicafion Equipment Total Number of Total Number Test Results Units in Building Units Teda Acceptable 12. Phone Sets N/A 13 Yes D No 0 13. Phone Jacks N/A Z Yes El No i 14. Call -in Signal N/A 0 Yes 3 . No D Fire One, Inc. 107 Washington Blvd Algona, WA* 98001 (206)575-03lj FAX(253)735-4976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprin1der Test Report CONFIDENCE TEST REPAIRS EJ Occupancy Name: Occupancy Address..'13 410 Building Owner: Phone Number: Responsible Person: -Fr"jc,.e,5. Phone Number: Date of Inspection: Inspection Type: Annual Quarterly (Fligh Rise Only) E] Testpr&NaMe (Please Print): G 9- o r4,e, T H o ltm e I -11�- e) I -1�- �, 0 t" 15 1 n %J I Location of System: 117a 14 c2 (Ase Design Density 0.00/ft (example .495/2000 sq. ft): 15 Central station monitoring? Yes El No Monitoring company nam-z: A) 1A e-- lne Control panel manufacturer: F Model Number: 39 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. .0 Si -nature of Tester. eD Testing Agency: t5 Mailing Address: 07 Washinc-rton Blvd Phone # 206-575-0311 Building Representative (Signature),' 47 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Static pressure: psi Flow pressure: psi # lilt, A U., M—W-11 I. Flow s-writches, supervisory switches and alarm bells tested? N/A El Yes, 'S, No El M"zit ft, _T IN- Oft 4.0 a �4 System inspected and lubricated? Yes 9 No I OrN A" - Valves are sealed or supervised? Yes g No El Or IN, 111141 lik Pumper connections and clapper valves unobstructed. and tum freely?. Yes El No [:1 Sprinkler coverage is accep le? Yes a No D Mal, IrvT 17 P 'ZOM i1a "IM I System left in service? Yes No N_ *—'M"q' WW" FIN.' i Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes-O No El "N. -M =pipe Xan- 9 !saan inie—nial f> V4�_ Yes No Fire One, Inc. 107 Washington Blvd Algona, WA 98001 (206)575-0311 FAX(253)735-4976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) Wet- Automatic Sprin1der Test Report I CONFIDENCE TEST 7-1�ip-AIRS 11 . . I Occupancy Name:, A-d M142 ARIZ z-r / (v n i cx yy cy,;) 10 1 'i - -4Mf Occupancy Address23332 MOLJ 5 LQM6� AE -2 Building Owner: -e-, Phone Number: r'06 Responsible Person: I raw t-,e- c;. Phone Number: Date of Inspection: A Inspection *Type: Annual Quarterly (ffigh Rise Only) F1 Testers Name Wlease Print): r-> P-0 r 0 hyn Lync 1C. <�6 q -M 7- 6f- I 11�- 16 -1 Location of System: 0 US e, Design Density 0.00/ft (example .495/2000 sq. ft): Central station monito ' ring? Yes El No C9 Monitoring company name: Control panel manufacturer. ;Y-e- L+e- Model Number: 2 Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: Corrected By: (If additionalToom is needed, please add a separate sheet) 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 Fire Department Fire Code standards, and th t discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: Phone # 206-575-0311 Testing Agency: ire On-, 141 Mailing Address: Washington Blvd Algona. WA Building Representative 2:) 1 t!) (Signature),' The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and lesting of the fire and life safety system. M M-0 N", RHi glV�4 " — 6" M' 1", " I I - 1 1- OR 1 Static pressure: Flow pressure: Psi I - - U." R I Mi, P M-W is-mia 1,-;iv i-II I ORION i Flow svAtches, supervisory switches and alarm bells tested? N/A Yes 10 No D ON= 21-M 2M 1 X� Ww. I M"--; MINS - III System inspected and lubricated? Yes No 57" 0111IR MMM".� 1, Bill, 21i� 0, RON' _7 Valves are sealed or supervised? Yes Of No E] " rg m P"M 1 —10 Pumper connections and clapper valves unobstructed and turn freely?, Yes F-1 No lw MR50 gsg g.�gdn';E%19 M ± I, n M.- M MMEMMA- 44 '101,il 111"§"�i �- 00 0' Sprinkler coverage is acceptable? Yes 9 No 1191-11, IN'" I ISIM-1 ROM F System left in service? Yes 0 No E] -A V0,0M.— 04 M, Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes'K — — No D M gg',%. i R 21 mr'; �4=E'j " i M .. 11 . ..'. " �- 01", MEMO Was an internal pipe and valve inspection performed every 5 years? gzsa' ff! Mp L o The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. 9- t 6 61 C. 71" ii, M i, MA =010, !s _0 Flow pressure: psi Static pressure: psi iT No i;;;.o J�w .2 - IMI No J lip 01-4114., - �v IN', 1.0 - MM I` My , Valves are sealed or supervised? Yes No El 550 2 CAR Pumper connections and clapper valves unobstructed and turn freely?. Yes El 1, No le"IMIAMM 1257ffi-,`� R—M, gi I T'F� M 1 FOR IN 5 3M4R=7r —Ma"RE Sprinkler coverage is acceptable? 'Yes 0 No E3 - WE -u, i""M 111" Ow �Iffl System left in service? Yes R No El ONE.,-M. ORION,., NO =$IMMM 1 12 OAZ ;4 WAP,RNli 1 ON-, " M rvwi R f,4,, `q," Sprinkler heads free of corrosion, paint� obstructions and/or physical damage? Yes No 5-11 Mw R; a mg x [re I i I �) - 3� Tmurwfm - , 1 11 - x- - �,I - z M, IMOML - , 'A -?,543, N Was an internal pipe and valve inspection performed every 5 years? Yes No I R-55M, 0 j WM M-0 R MR, MHRAI I- ", I -, , P , - R"IR." , 4 K Fite One, Inc. 107 Washington Blvd Algona, WA 98001 (206)575-031l FAX(253)735-4976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) CONFI . DENCE TEST z TREPAIRS MIA NAMN- IMTOW-M, I Wet- Automatic Sprinkler Test Report Building Owner: Z CLM to- Phone Numbe r: Responsible Person: Phone Number: Date of Inspection:. 8-26- 10 Inspection Type:* Annual Z Quarterly ffigh Rise Only) El Testers Name (Please Print). V Location of System: Design Density 0.00/ft (example .495/2000 sq. ft): Central station monitoring? Yes El No Monitoring company n e: 4 1 1A Controlpanel manufacturer: Fire-d4a, Model Number: Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Sianature of Tester. Phone # 206-575-0311 401 Testing Agency: Fire Oneqnc. t5 t� Mailing Address: 107 Washino—ton Blvd 42onaZA'98001 Building Representative (Signature) The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and 'testing of the fire and life safety system. Op" $0 Static pressure: psi Flow pressure: psi 114, AM R5M ME I Mild V� 11 M., 1 - 1,"'NERS �UM` 'No Flow svAtches, supervisory switches and alarm bells tested? N/A Yes _014 a M 1� � MIR, 011' M 481 M.", L ON MINN I Ell System inspected and lubricated? Yeso No A _.0 W, W in Inn, POR Valves are sealed or supervised? Yesj9 No [I Pumper connections and. clapper valves unobstructed. and turn freely?. Yes 101 NoO. ;;7—OU 010, MARM �� FA 1�1 Sprinkler coverage is acceptable? Yes No F-1 I ME System left in service? Yes CZ No E.]. I'M Sprinkler heads free of corTosion, paint� obstructions and/or physical damage? Yes No RL RIO, I MI 01' 11 "�ffll 11 - 11111 Qn� 1 '110 t t T E Was an internal pipe and valve inspection performed every 5 years? "I Pt r wwvj-�,g gr!�r�,L %J; g Q IN M Firie One, Inc. Wet- Automatic Sprinkler 107 Washington Blvd Test Report Algona, WA 98001 (206)575-0311 FAX(253)7354976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) CONFIDENCE TEST z TWP7AIRS 'Al Iticc,ipancj,,molt.1w—Aw-smmmw—w--rliw'o-lxlkw,L�E A 117111EN1,12 rUp_ VMMM TWNPI. = FATLuA I= Building Owner: Sam e- Phone Number: Responsible Person: - 16�k-A A) C-,P- S Phone umber: Date of Inspection: 19-26-410 Inspection Type: Annual R Quarterly Pgh Rise Only) Testers Narne (Please Print): 6e_OCQP� T 1401'tme'4"e'r Jr. Location of System: Design Density 0.00/ft (example .495/2000 sq. ft): Central station monitoring? Yes No.K Monitoring company narne:. Control panel manufacturer: Model Number: Problems Found: (If additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: Phone# 206-575-0311 Testing Agency: Fire One, Mailing Address: 107 Washin--ton Blvd A1,gona,yA M001 Building Representative (Signature) The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life. safety system. The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and 'te**sting of the fire and life safety system. Static pressure: psi Flow pressure: psi M PROMMIRTIP14. Flow svAtches, supervisory switches and alarm bells tested?. Ale "I" I M''Al ga M, System inspected and lubricated? gg j mg-� "IMM'', Valves are sealed or supervised? -.4 ';gg r-, gq V Sprinkler coverage is acceptable? System left in service? Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? i. Mmi'EM00- A X-4 A ROM 39 ON Was an internal pipe and valve inspection performed every 5 years? PI . Fali E '111 07 Yes El - No D Fii� One. Inc. 107 Washington Blvd Algona, WA 98001 (206)575-0311 FAX(253)735-4976 BREMERTON (360) 478-0428 FAX (360) 782-2584 (One System per Report) CONFIDENCE TEST z Ti�ip-AIRS Occupancy Name:, EArnovJ -s H;qh towks 6 14 Occupancy Address EJmotjAs Wet- Automatic Sprinkler Test Report Building Owner: Phone Number: Responsible . Person: q2-67 -7-71 4 2 1 Z) Phone Number: Date of Inspection: 2-6 1 Inspection Type: Annual 19. Quarterly ffigh Rise Only) TestersNaj-pe leasp V- i�OC7 �L oil Location of System: Design Density 0.00/ft (example .495/2000 sq. ft): Central station monitoring? Yes F1 No 1�f— Monitoring company name: Control panel manufacturer: F. Model Number: Problems Found: (If additional room is needed, please add a separate� sheet) Corrections Made: Date'Corrected: Corrected By: (If additional room is needed, please add a separate sheet) 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 Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective action. Signature of Tester: ED Testing Agency: Fire One, Inc Mailing Address: 107 Washin Building, Representative (Signature), 2!� tD n Blvd Algona—W Phone # 206-575-0311 The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. 14 - �Elvl Ni Fff-- g%,y I 10MR 141 MI. N*%&-Ijw�-41?�`,. - 0 "1 Owl 1-0� I Static pressure: psi Flow pressure: psi mi F-- I M RIV, �M M 01.11 2. " I , I I M Flow switches, supervisory switches and alarm bells tested? N/A Yes 29 No El — - -- ------- System inspected and lubricated? Yes 5? No Valves are sealed or supervised? Yes'& No [I 111-M, IN AMM rM R Pumper connections and clapper valves unobstructed. and turn freely?. Yes EJ No 0 ,gii*-Ml. N �jg7,g�, M 4 Ati tM cam, 12� RMEW mu,�4 --------- ---- - ,7, j�, A"g,§ "n Sprinkler coverage is acceptable? Yes No i4urt C11, a" 21111 Live-, 'v"r-d I - � - m I. -P System left in service? Yes No ------------ W;7� MbM 1-n M M& ON' M ON177i jil, Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? Yes-R No M 51, "g. r4- 1 010 --- --- � ffl)M� �g - Was an internal pipe and valve inspection performed every 5 years? Yes D No EJ CITY OF EDMONDS GARY HAAKENSON MAYOR 121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0215 - FAX (425) 775-7721 FIRE DEPARTMENT Established 1904 www.edmondsfire.org "r? C. 18913 December 20, 2007 Alisa C. Clein 1123 - 5h Avenue S. #2 Edmonds, WA 98020 Subject: Request for Public Records Incident Date - February 29, 2004 Incident Location - Edmonds Highlands Apartments 23510 Edmonds Way, #308 Incident Type - Fire Dear Ms. Clein: We have located the report that you requested regarding the above -referenced incident. Advance payment of $12.25* is required. Please make your check payable to the Edmonds Fire Department and mail your check to the Edmonds Fire Department at the address listed above. Copies are not made until payment is received. We will contact you within five business days after receipt of payment to let you know the documents are available and determine if you would like them mailed or prefer to pick them up. cerely, inne Startzman (startzmanOci.edmonds.wa.us) mutive Assistant N&Fji-r J e] M Tr5s ME I �e s ff,5 I �l "Ltsc 0 U:FireAdmin:Publiclnfo:2007:Clein3 Incorporated August 11, 1890 Sister City - Hekinan, Japan 2 3 S-I C) L' " CITY OF EDMONDS GARY HAAKENSON MAYOR 121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0215 - FAX (425) 775-7721 FIRE DEPARTMENT Established 1904 www.edmondsfire.org -fq C. 1 sc) 1) December 11, 2007 Alisa C. Clein 1123 - 5h Avenue S. #2 Edmonds, WA 98020 Subject: Request for Public Records Incident Date Provided - October, 2003 Incident Location - Edmonds Highlands Apartments Incident Type - Fire Dear Ms. Clein: An initial search of our October, 2003 incident reports has, so far, not revealed the fire incident report you are requesting. We are continuing to search. Due to the uncertainty of the incident date and address provided, however, additional time is required. We will contact you no later than the first week of January 1, 2008 with the results of our efforts, In the meantime, if you are able to be provide further detail such as the exact date and street address, please contact us. Sincerely, Jeanne Startzman (startzmana-ci.edmonds.wa.us) Executive Assistant 'wCOFF::�ire�KATr,"sh7a%IkV,VAs.,ff 9110P .__L- U:FireAdmin:F'ublicInfo:2007:Clein2 Incorporated August 11, 1890 Si.qtp.r Citty - Hp.kinan Janan I i Westfall, John From: Sent: To: Subject: Jeanne: I've searched my 23510 Edmonds Way month in archive, on EDMONDS WAY. Sorry, John Westfall, John Wednesday, December 05, 2007 6:17 PM Startzman, Jeanne FW: Public Records Request fire record copies and screened all the CAD information for I find no call during Oct 2003. If David goes through the I suggest he look for any of the HIGHLANDS building addresses ----- Original Message ----- From: Westfall, John Sent: Wednesday, December 05, 2007 9:19 AM To: 1ALISA C. CLEINI Cc: Startzman, Jeanne Subject: RE: Public Records Request Lisa: Thank you for that information -it is a tremendous help. I'll commence the search. John Westfall Edmonds Fire Marshal (425) 771-0213 ----- Original Message ----- From: ALISA C. CLEIN [mailto Sent: Tuesday, December 04, To: Westfall, John Subject: Re: Public Records Hi John! :aclein@u.washington.edul 2007 10:08 PM Request I just got my daughter to email me back and she said that according to her blog, the fire happened in October 2003. The blog had no date, but was logged by paragraph (if that makes any sense, she was pretty young at the time.) But now we have the month and the year, will that help? It is the best that we can do hear. Can I help you go through the papers? I know that it will go a lot more fster. If you decide you would like some help, call me at home this week, I between studies so I have some time (425.967.353B). Thanks for everything! Lisa On Tue, 4 Dec 2007, Westfall, John wrote: • Alisa: • Just a reminder that we need more specific date for fire @ 23510 • Edmonds Way to help you locate and obtain the fire incident report • All our reports are filed by date. Lsffall, John From: ALISA C. CLEIN [aclein@u.washington.edu] Sent: Tuesday, December 04, 2007 10:08 PM To: Wesffall, John Subject: Re: Public Records Request H i John! I just got my daughter to email me back and she said that according to her blog, the fire happened in October 2003. The blog had no date, but was logged by paragraph (if that makes any sense, she was pretty young at the time.) But now we have the month and the year, will that help? It is the best that we can do hear. Can I help you go through the papers? I know that it will go a lot more fster. If you decide you would like some help, call me at home this week, I between studies so I have some time (425.967.3538). Thanks for everything! Lisa On Tue, 4 Dec 2007, Westfall, John wrote: > Alisa: > Just a reminder that we need more specific date for fire @ 23510 > Edmonds Way to help you locate and obtain the fire incident report > All our reports are filed by date. > Thank you for your assistance, 0 3 -*Z?I( * John Westfall 0'3 —1 Y31 * Edmonds Fire Marshal * 425 771-0213 CD/ > 7 U 2.0/ 511 0 C7—,?o 1 �VGStfall, John From: Westfall, John Sent: Wednesday, December 05, 2007 9:25 AM To: 'ALISA C. CLEIN' Subject: RE: Public Records Request Alisa: Thank you. I did receive that information and will look for your incident. Jeanne Startzman will be in contact with you when it is found. John ----- Original Message ----- Prom: ALISA C. CLEIN [mailto:aclein@u.washington.eduI Sent: Wednesday, December 05, 2007 8:56 AM To: Westfall, John Subject: Re: Public Records Request Hi John, I was checking my email and I thought I emailed you yesterday to let you know that Katie had checked her blog and it was in October of 2003 that we had the fire. Does that help? She could not find a more specific date. Thanks so much, Alisa Clein On Tue, 4 Dec 2007, Westfall, John wrote: • Alisa: • Just a reminder that we need more specific date for fire @ 23510 • Edmonds Way to help you locate and obtain the fire incident report • All our reports are filed by date. > Thank you for your assistance, * John Westfall * Edmonds Fire Marshal * 425 771-0213 1 i, Wesffall, John From: Westfall, John Sent: Tuesday, December 04, 2007 12:12 PIVI To: 'aclein@u.washington.edu' Cc: Startzman, Jeanne Subject: Public Records Request Alisa: Just a reminder that we need more specific date for fire @ 23510 Edmonds Way to help you locate and obtain the fire incident report . All our reports are filed by date. Thank you for your assistance, John Westfall Edmonds Fire Marshal 425 771-0213 R-equest for Public Records -Edmonds FD Page I of I Westfall, John From: Alisa Clein [aclein@u.washington.edu] Sent: Tuesday, November 27, 2007 10:55 AM To: Westfall, John Subject: RE: Request for Public Records -Edmonds FID Hi John, No problem, I'll be talking to my daughter tonight and will have that information to you in the next day or so. I do know that I moved out because of the damage to my apartment from the water and the incredible drug/gang problem there and from what I understand, it is still going on. Since they have initiated a lawsuit against me, the complex has gone through two different management companies! Nobody seems to be in charge and I think they ought to demolish that place and start over, it's disgusting! I'll be in touch. Many thanks, Alisa From: Westfall, John [mailto:Westfall@ci.edmonds.wa.usI Sent: Tuesday, November 27, 2007 10:12 AM To: aclein@u.washington.edu Cc: Startzman, Jeanne Subject: Request for Public Records -Edmonds FID Alisa: Thank you for a specific date -this will be extremely beneficial and reduce the amount of time required to locate. We have gone to an automated incident reporting system beginning in 2005, unfortunately your incident occurs prior to this time. With the date, we will locate the record and let you know what fees will apply. Thank you for your assistance. John Westfall Edmonds Fire Marshal 425 771-0213 11/27/2007 iMot-TIRS r m mmm Fire Incident Report Edmonds Fire Department Incident Number: EF06001447 Exposure: 0 Incident,Date: 5/1/2006 Jurisdictional Station 20 Location Type: Street address Address: 111111111111111WA304 Cit�: Edmonds State: WA Zip: 98026 Incident Type: Service Call, other Shift: B Alarms; 1 Grid: EF055 Aid Type: None Alarm Time: 18:21:15 5/1/2006 Arrival Time: 18:29:50 5/1/2006 Last Unit Cleared Time: 18:34:06 5/1/2006 Actions Taken: Investigate HazMat Released: None Property Value: 0 Contents Value: 0 Property Loss: 0 Contents Loss: 0 Fire Service Deaths: 0 Civilian Deaths: 0 Fire Service Injuries: 0 Civilian Injuries: 0 Detector: 0ificer In Charge: TODD ANDERSON Assignment: Command Mixed Property Use: Not mixed use Property Use: 1 or 2 family dwelling or .,% 1 1-1*- VVC.ITIRS. Fire Incident Report Edmonds Fire. Department Person('s) Involved Role: Patient Name: Ronda Keith Phone Number: 4256700725 Address: 23510 EDMONDS WAY *A304 Edmonds, WA 98026 Apparatus and Personnel Apparatus ID Personnel ID('s) E16 EF0117 EF1126 EF1540 EF2376 E17 EF0032 EF1425 EF2400 1-N A I VVCPFIRS- Fire Incident Report Edmonds Fire Department Incident Number: EF06001447 Exposure: 0 incident Date: 5/1/2006 Narrative E17 arrived on scene to find an wall heater that was reported by resident as sparking. E17 found no fire and secured power to the heater. Maintenace from the complex were notified. E17 went in service. Lt TODD ANDERSON Ila 0 5/01/06 18:58:00 PRINT REQUESTED BY TERMINAL EFPC23 Incident History for: #EF06001447 Case Numbers: $EF06001658 $S206007778 Received 05/01/06 18:19:42 By SCPC04 SC721 Entered 05/01/06 18:20:03' By SCPC04 SC721 D . ispatched 05/01/06 18:21:15 BY SCPC01 SC748 Enroute 05/01/06 18:26:30 0-Inc c cnc r) Closed 05/01/06 18:34:06 Initial Type: APPLIA Initial Alarm Level: 1 Final Alarm Level: 1 Final. Type: APPLIA (APPLIANCE FIRE) Pri: 2 Dispo: Police BLK: E003 Fire BLK: EF055 Map Page: 474H-2 Group: EF1 Beat: EF20 Sr Loc: 23510 EDMONDS WY #A304 EDM -- EDMONDS HIGHLANDS high xst: 236 ST SW (V) Loc Info: Name: KEITH, RONDA /1820 (SC721 ENTRY /1820 SUPP /1820 CHANGE /1821 (SC748 DISP E16 /1821 $ASNCAS E16 /1821 ASST TAC21 /1821 $ASNCAS TAC21 /1822 AIQ TAC21 /1822 ASST E17 /1822 ASST TAC21 /1822 AOR E16 /1822 AIQ TAC21 /1826 ENROUT E17 /1829 ONSCNE E17 /1834 AOR E17 /1834 CLOSE E17 Addr: 23510 EDMONDS WY #A304 Phone: 4256700725 ,APPLIANCE FIRE - HEATER SPARKING AND SMOKE TXT: HEATER IS GLOWING - RP WAS VACUUMING HEATER AND IT STARTED TO SPARK NAM: KRUEGER JOSHUA S - - > KEITH, RONDA #EF0117 OFTEDAHL,DENNIS #EF1126 SOUCY,JOSEPH HAZMAT TECH #EF2376 BEARDSLEY, DOUG-PARAMEDIC #EF1540 TURNER, AMY - RESCUE TECH $EF06001658 $S206007778 #EF1425 ANDERSON, TODD #EF2400 ANDERSON, BLAKE #EF0032 FISCHER, M - HAZMAT TECH FOR 2 MINS INVESTIGATING