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401 HOWELL WAY (2)4r -v �ISZIIOM' ISH Co. 401' HUW4f-L KA-17 Serving Brier, Ldinonds, and 12425 Meridian Ave S Mountlake Terrace. Everett, WA 98208 Phone (425) 551-1200 www.FireDistrictl.org Fax (425) 551-1272 LOCATION: 401 Howell Way 98020 BUSINESS NAME: Edmonds Autobody MAILING 401 Howell Way, Edmonds, WA 98020 ADDRESS: BUSINESS OWNER: Taylor, Robert, EMERGENCY-1: KEY ACCESS-2: EMAIL: PERSON CONTACTED: Rc� e)Q-1 "r JLJ NAME OF INSPECTOR,_ 0,-.ZnL-xj i Date Last Serviced: 4257717109 PHONE: fIRE PREVENTION INSPECTION REPORT )(0 EDMONDS .0 BRIER 0 MOUNTLAKE TERRACE [I UNINCORPORATED 5P&,CWfNCY STTfy SHIFT SCHEDULED Sep 2016 DATE DUE UFIR HOME PHONE-4-�5-71 Z - ()7�551 HOME PHONE: CURRENT HOME PHONE: CITY YES NO BUSINESS \ 17,1' LICENSE AD El INITIAL INSPECTION DATE '� / -Z -, -I � SNOHOMISH CO. Serving Brier, Edmonds, and Mountlake Terrace www.FireDistrictl.org LOCATION: 401 Howell Way 98020 BUSINESS NAME: Edmonds Autobody MAILING ADDRESS: 401 Howell Way, Edmonds, WA 98020 BUSIN ESS OWNER: Taylor, Robert EMERGENCY-1: KEY ACCESS-2: PERSON CONTACTED:&u, /c, Z��Clk— f NAME OF INSPECTOR: FIRE SYSTEMS: AS 9/13 FE 113 Spray Booth'� nntp I nqt Rprvinprl- lo FIRE -PREVENTION 12425 MeridianAve S INSPECTION REPORT Everett, WA 98208 0 EDMONDS OBRIER Phone (425) 551-1200 0 MOUNTLAKE TERRACE [3 UNINCORPORATED Fax (425) 551-1272 FREQUENCY STATION 1, SHI�Fj 2015 17-A I SCHEDULED PHONE: 4257717109 DATE DUE � Sep 2015 UFIR 1' 513 +Ie�PHONEzg! 711--*2 cl-?r 7 HOME PHONE: "'CURRENT HOME PHONE: CITY YES NO BUSINESS LICENSE PE INITIAL INS 7, TION DATE / C� YO HAZARDS FOUND AND LOCATIONS /COMMUNICATIONS 2 /'�' 4�kP_ 2 3 4 4 5 5 6 6 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X In our continuing effort to promote fire safety and prevention within the community, your fire department conducts regularly scheduled "Fire Safety Survey Inspections" of all.businesses and multi -family occupancies in the Cities covered by Snohomish County Fire District 1. You are to be congratulated on the relative good condition of your occupancy in regards to fire safety. Above you will find the item(s) that were noted during, our inspection which require attention to bring them into compliance with the minimum standards adopted by the above jurisdictions. Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions or violation. If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-7720; for Mountlake Terrace or Brier, call (425) 744-6231. rA Snohomish County Fire District #1 Confidence Test Report 23422 57" Ave SE Woodinville WA 98072 425-956-3434 Office 425-956-3723 Fax LIC# BRIMSFS918KO SPRINKLER -DRY SYSTEM F_ Certification Given (One System per Report) = YELLOW WHITE CONFIDENCE TEST 0 1 REPAIRS Occupancy Address: 401 Howell Way Occupancy Name: Edmonds Center Bldg Responsible Person First & Last Name: Wilson Investments Phone Number: 543-7441 Responsible Person Address, City, State, Zip: Responsible Party E—Mail Address Date of Inspection: 9/17/15 Inspection Annual Frequency/Type: Testers Name (Please Print): Matt Deckard SFD Certification Number: SCP — d07231 Central station monitoring? Yes 0 No 13 Monitoring Monitoring Required? Yes 0 No 0 Company Name: NW Alarms System Make: Grinnell System Model: E-2 System Size: 4 System Location: Back of Bldg Identification Number: 1 PROBLEIVIs FOUND: (if additional room is needed, please add a separate sheet) Due for 5yr (gauges x2,internal pipe, FDC) CORRECTIONS MADE: ' Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) SFD Certification Number: SCP - 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: Phone # Testing Agency: Mailing Address: Building Representative (signature) Sprinklers - Dry Page 1 of 2 a. 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 Snohomish County Fire District Fire Code for inspecting and testing requirements. General 1. Trip test conducted? Yes 2. System tripped in 16 seconds. 3. Flow test conducted? Yes 4. Static pressure: 115 psi Flow pressure: 100 psi 5. Number of Sprinkler Heads? 100+ 6. 2-inch drain? Other Yes RI 7. Flow switches, supervisory switches and alarm bells tested? N/A Yes 8. Alarm bell operates? N/A Yes 9. Air compressor refills system in 30 minutes or less? Yes 10. Heat actuation devices tested on pre -action and deluge N/A Yes �YZZKM I Ib - 11. System inspected and lubricated? 12. Valves are sea -led or supervised? 13. Signs are provided on valves? 14. Pumper conn6ctions and clapper valves unobstructed and turn freely? 15. Sprinkler heads replaced or successfully sample tested in last 10 years? 16. Sprinkler coverage is acceptable? 17. Proper number of spare sprinkler heads available with appropriate wrench for each? 18. System left in service? 19. System gauges replaced or calibrated within the last 5 years? 20. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? 21. System drained and restored to normal operation? 22. Was debris found in the Fire Department Connection (FDC)? 23. Was the Fire Department Connection (FDC) back flushed in the last 5 years? 14 Wne n ci nni r raiwati nt thn rianfrml Cfnfinn rn^nH-r% i Yes 0 Yes Yes Yes Yes Yes No M 170VE-i No 13 No No No No 13 No 13 No No No No No Yes RI No Yes RI No Yes 13 No Yes No 13 Yes No Yes No Yes 13 N/A C3 Yes 21 company? 25. Was an internal pipe and valve inspection performed within the last 5 years? Date Performed No No Yes M No RI .4 Sprinklers - Dry Page 2 of 2 rrimffrano Snohomish County Fire District #1 Confidence Test Report 2342257 th Ave SE Woodinville WA 98072 425-956-3434 Office 425-956-3723 Fax LIC# BRIMSFS918KO SPRINKLER - WET SYSTEM Certification Given (One System per Report) YELLOW 2 1 WHITE C3 CONFIDENCE TEST 0 1 REPAIRS C3 Occupancy Address: 401 Howell Way Occupancy Name: Edmonds Center Bldg Responsible Person First & Last Name: Wilson Investments Phone Number: 543-7441 Responsible Person Responsible Party Address, City, State, Zip: E—Mail Address Date of Inspection: Inspection Annual 9/17/15 Frequency/Type: Testers Name SFD Certification (Please Print): Matt Deckard Number: SCP — D07231 Central station monitoring? Yes 0 No C3 Monitoring Monitoring Required? Yes C3 No 0 Company Name: NW Alarm System Make: Grinnell System Model: A System Size: 8 System Location: Back side of Bldg Identification Number: 1 PROBLEms FOUND: (if additional room is needed, please add a separate sheet) Due for 5yr (gauges x2, internal pipe, FDC) CORRECTIONS MADE: Date Corrected: Corrected By: (If additional room is needed, please add a separate sheet) SFD Certification Number: SCP - 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: Phone # PIZ Testing Agency: Mailing Address: Building Representative (signature) Sprinklers - Wet Page 1 of 2 4- 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 Snohomish County Fire District Fire Code for inspecting and testing requirements. General 1. Flow test conducted? Yes No 2. Static pressure: 115p.s.i. Flow pressure: 100 p.s.i. 3. Number of Sprinkler Heads: —100+ 4. 2-inch drain? Other Yes No 5. Flow switches, supervisory switches and alarm bells tested? N/A Yes No [I 6. Pressure regulating valves tested? N/A Yes No M 7. Alarm bell operates? N/A Yes No 8. System inspected and lubricated? Yes No 9. Valves are sealed or supervised? Yes No 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 No 13. Have the sprinkl-_Or heads been replaced or successfully sample test in the last 50 years? Yes No 14. Proper number of spare sprinkler heads available with appropriate wrenches Yes for each? No 15. System left in service? Yes No 16. System gauges replaced or calibrated within the last 5 years? Yes No 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical Yes damage? No 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? Yes No 20. Was an internal pipe and valve inspection performed within the last 5 years? Yes No Date Performed 21. Was a signal reqpived at the Central Station monitoring N/A U Yes 2 No 0 company? Sprinklers - Wet Page 2 of 2 111.11r___ 1\ Snohomish County Fire District #1 rimlarone Confidence Test Report PO Box 6683 Bellevue WA 98008 425-956-3434 Office LIC# BRIMSFS918KO 425-956-3723 Fax SPRINKLER - WET SYSTEM Certification Given (One System per Report) YELLOW C3 I WHITE 0 CONFIDENCE TEST 0 1 REPAIRS Occupancy Address: 401 Howell Way Occupancy Name: Edmonds Center Bldg Responsible Person First & Last Name: Wilson Investments Phone Number: 543-7441 Responsible Person Address, City, State, Zip: Responsible Party E—Mail Address Date of Inspection: 9/4/13 Inspection Annual Frequency/Type: Testers Name (Please Print): Tim Gehlhausen SFD Certification Number: SCP — G04398 Central station monitoring? Yes lZ No C3 Monitoring Monitoring Required? Yes C3 No IZ Company Name: NW Alarm System Make: Grinnell System Model: A System Size: 8 System Location: Back side of Bldg Identification Number: 1 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) SFD Certification Number: SCP - 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: Phone # Testing Agency: Mailing Address: 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 Seattle Fire Department Fire Code for inspecting and testing requirements. General 1. Flow test conducted? Yes No 2. Static pressure: 106 p.s.i. Flow pressure: 98 p.s.i. 3. Number of Sprinkler Heads: 4. 2-inch drain? Other Yes No C3 5. Flow switches, supervisory switches and alarm bells tested? N/A Yes No 0 6. Pressure regulating valves tested? N /A Yes No 7. Alarm bell operates? N/A Yes No 8. System inspected and lubricated? Yes No 9. Valves are sealed or supervised? Yes No 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 No 13. Have the sprinkl6r heads been replaced or successfully sample test in the Yes 0 NoC3 last 50 years? 14. Proper number of spare sprinkler heads available with appropriate wrenches Yes No for each? 15. System left in service? Yes No 16. System gauges replaced or calibrated within the last 5 years? Yes No 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? i Yes No 18. Was debris found in the Fire Department Connection (FDC)? Yes No 21 19. Was the Fire Department Connection (FDC) back flushed within the last 5 Yes No years? I 20. Was an internal pipe and valve inspection performed within the last 5 years? Yes No Date Performed 21. Was a signal received at the Central Station monitoring N/A LJ Yes RI No 0 company? Sprinklers - Wet Page 2 of 2 PO Box 6683 Bellevue WA 98008 425-956-3434 Office LIC# BRIMSFS918KO 425-956-3723 Fax Snohomish County Fire District #1 Confidence Test Report SPRINKLER - DRY SYSTEM Certification Given (One System per Report) 70 M YELLOW C3 F wHITE 2 CONFIDENCE TEST 10 1 REPAIRS Occupancy Address: 401 Howell Way Occupancy Name: Edmonds Center Bldg Responsible Person First & Last Name: Wilson Investments Phone Number: 543-7441 Responsible Person Address, City, State, Zip: Responsible Party E—Mail Address Date of Inspection: 9/4/13 Inspection Annual Frequency/Type: Testers Name (Please Print): Geh1hausen SFD Certification Number: SCP — G04398 Central station monitoring? Yes 13 No 0 Monitoring Monitoring Required? Yes C3 No 0 Company Name: System Make: Grinnell System Model: E-2 System Size: 4 System Location: Back of Bldg Identification Number: 1 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) SFD Certification Number: SCP - 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: Phone # Testing Agency: Mailing Address: Building Representative (signature) Sprinklers - Dry 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 Seattle Fire Department Fire Code for inspecting and testing requirements. General 1. Trip test conducted? Yes 2. System tripped in 20 seconds. 3. Flow test conducte d? Yes 4. Static pressure: 114 psi Flow pressure: 101 psi 5. Number of Sprinkler Heads? 6. 2-inch drain? Other C3 Yes 7. Flow switches, supervisory switches and alarm bells tested? N/A Yes 8. Alarm bell operates? N/A Yes 9. Air compressor refills system in 30 minutes or less? Yes 10. Heat actuatioh devices tested on pre -action and deluge N/A Yes byb= I Ib r 11. System inspected and lubricated? Yes 12. Valves are se6led or supervised? Yes 13. Signs are provided on valves? Yes 14. Pumper conn i'dions and clapper valves unobstructed and turn freely? Yes 15. Sprinkler heads replaced or succe ssfully sample tested in last 10 years? Yes 16. Sprinkler coverage is acceptable? Yes 17. Proper number of spare sprinkler heads available with appropriate wrench Yes for each? 18. System left in, service? Yes 19. System gauges replaced or calibrated within the last 5 years? Yes 20. Sprinkler heads free of corrosion, paint, obstructions and/or physical Yes damage? 21. System drained and restored to normal operation? Yes 22. Was debris found in the Fire Department Connection (FDC)? Yes 23. Was the Fire Department Connection (FDC) back flushed in the last 5 Yes years? 24. Wa -signal r6ceived at the Central Station monitoring N/A Yes .Qmpany? 25. Was an internal pipe and valve inspection performed within the last 5 Yes years? Date Performed Sprinklers - Dry No 0 7 ON M-1 No 0 No C3 No No No C3 No 13 No No No No No No No No No No No No No No 21 Page 2 of 2 FIRE PREVENTION Serving Brier, EdNQhds �'.12425, Meridian Ave S INS PECTION REPORT SNOHOMISH CO. Mountlake Terraceand- FIR Ever'e'tt, XA 98208 0 EDMONDS OBRIER e Town of Woodway DISTR - T Phone (425) 551-1200 OWOODWAY 0 MOUNTLAKE TERRACE www.FireDistrictl.org Fax (425) 551-1272 0 UNINCORPORATED FREQUENCY STATION & SHIFT"' LOCATION: 40-1 Howell Way 365 17 6 I BUSINESS NAME: Edmonds Autobody PHONE: 4257717109 SCHEDULED DATE DUE 1' 09/01/12 MAILING 401 Howell Way LIFIR � 573 9152 ADDRESS: Edmonds 98020 BUSINESS OWNER: Taylor, Robert HOMEPHONE: 4257720357 PREFIRE EMERGENCY-1: Wilson Investments HOME PHONE: 4256721100 CURRENT KEY ACCESS-2: Taylor, Michelle HOMEPHONE: 4255081482 CITY YES NO BUSINESS LICENSE PERSON CONTACTED: INITIAL INSPECTION DATE NAME OF INSPECTOR: /S_ FIRE FE SYSTEMS: ANNUAL HAZARDS FOUND AND LOCATIONS COMMUNICATIONS 2 2 3 3 4 4 5 5 6 6 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION 2nd-. RE -INSPECTION FINAL RE I o EXTENSIO N -INSPECTION VIOLATIONS DATE DUE: DATE DUE: GRANTED TO: DATE DUE: CITED: PERSON PERSON PERSON CONTACTED: CONTACTED: CONTACTED: 1 INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: D TE: DATE: 3 VIOLATIONS VIOLATIONS PRE -CITATION CITATION ISSUED 1 15 1 5 LETTER SENT NUMBER: 4 CODE 5 DATE: SECTION: RETURN RECEIPT 3 7 3 7 RECEIVED 6 DISPOSITION: 7 .4 .8 4 18 DATE: LETTERNEEDED [] YES El NO LETTERNEEDED C] YES [I NO 8 FIRE DEPARTMENT COPY Serving Briet; Edmonds SNOHOMISH CO. "Ewa Mountlake Terraeeand IRE 941INW-poi4� '�'4io)IT the Town of Woodway STR' "I www.FireDistrictl.org LOCATION: 401 HowellWay BUSINESS NAME: Edmonds Autobody MAILING 401 Howell Way ADDRESS: Edmonds 13USINESS OWNER: Taylor, Robert EMERGENCY-1: Wilson Investments KEY ACCESS-2: Taylor, Michelle PERSON CONTACTED: NAME OF INSPECTOR: FIRE SYSTEMS: 12425 Meridian Ave S Everett, WA 98208 Phone (425) 551-1200 Fax (425) 551-1272 PHONE: 4257717109 98020 HOME PHONE: 4257720357 HOMEPHONE: 4256721100 HOME PHONE: 4255081482 FIRE PREVENTION INSPECTION REPORT 0 EDMONDS 0 BRIER E]WOODWAY [] MOUNTLAKE TERRACE El UNINCORPORATED FREQUENCY I STATION& SHIFF**' 365 17 A SCHEDULED DATE DUE 11' 09/01/11 UFIR � 573 9152 PREFIRE e'CURRENT CITY YES NO BU13INESS LICENSE Ej 0 INITIAL INSPECTION DATE W-p— 61— V_ FE/0 I It ANNUAL HAZARDS FOUND AND LOCATIONS COMMUNICATIONS 2 2 3 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: EXTENSION GRANTED TO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: DATE: 3 VIOLATIONS 1 5 VIOLATIONS 1 15 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 2 6 2 6 DATE: CODE SECTION: 5 3 7 3 7 RETURN RECEIPT RECEIVED 6 14 18 4 8 DISPOSITION: 7 LETTER NEEDED E] YES El No rLETTER NEEDED [] YES NO 8 FIRE DEPARTMENT COPY Pisw- N"iFa--rM PO Box 6683 Bellevue WA 98008 425-956-3434 Office LIC# BRIMSFS918KO 425-�956-3723 Fax Snohomish County Fire District #1 Confldence Test Report SPRINKLER - DRY SYSTEM Certification Given (One System per Report) YELLOW WHITE CONFIDENCE TEST 0 1 REPAIRS Occupancy Address: 401 Howell Way Occupancy Name: Edmonds Center Bldg Responsible Person First & Last Name: Wilson Investments Phone Number: 543-7441 Responsible Person Responsible Party Address, City, State, Zip: E—Mail Address Date of Inspection: 9/11/12 Inspection Annual Frequency/Type: Testers Name �Please Print): Gehlhausen SFD Certification Number: SCP — G04398 Central station monitoring? Yes C3 No 0 Monitoring Monitoring Required? Yes C3 No 0 Company Name: System Make: Grinnell System Model: E-2 System Size: 4 System Location: Back of Bldg Identification Number: 1 PROBILEms 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) SFD Certification Number: SCP - 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: Phone # Testing Agency: ,-Mailing Address: Building Representative (signature) bprinklers - Dry 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 Seattle Fire Department Fire Code for inspecting and testing requirements. 'General 1. Trip test conducted? Yes No 2. System tripped in 20 seconds. 3. Flow test conducted? Yes No 4. Static pressure: 112 psi Flow pressure: 100 psi 5. Number of Sprinkler Heads? 6. 2-inch drain? Other Yes No ..7. Flow switches, supervisory switches and alarm bells tested? N/A Yes No 8. Alarm bell operates? N/A Yes No 9. Air compressor refills system in 30 minutes or less? Yes No 10. Heat; actuation devices tested on pre -action and deluge N/A Yes No systems? :11. System inspected and lubricated? Yes No 12. Valves are sealed or supervised? Yes No 13. Signs are provided on valves? Yes No 14. Pumper connections and clapper valves unobstructed and turn freely? Yes No 15. Sprinkler heads replaced or successfully sample tested in last 10 years? Yes No 16. Sprinkler coverage is acceptable? Yes No ,117. Proper number of spare sprinkler heads available with appropriate wrench Yes No for each? System left in service? Yes No '19. System gauges replaced or calibrated within the last 5 years? Yes No Sprinkler heads free �of corrosion, paint, obstructions and/or physical Yes No damage? 21. System drained and restored to normal operation? Yes No 22. Was debris found in the Fire Department Connection (FDC)? Yes No 23. Was the Fire Department Connection (FDC) back flushed in the last 5 Yes No years? 24.. Was.a, signal received at the Central- Station monitoring N/A Yes No omp-E[nye ,25. Was an internal pipe and valve inspection performed within the last 5 Yes No years? Date Performed ,�Sprinklers - Dry Page 2 of 2 pir-a-- Has fk-- pu "dia"""da-l" PO Box 6683 Bellevue WA 98008 '425-956-3434 Office UC# BRIMSFS918KO 425-956-3723 Fax Snohomish County Fire District #1 Confidence Test Report 'SPRINKLER - WET SYSTEM Certification Given (One System per Report) 70 R,611DOM YELLOW C3 I WHITE CONFIDENCETEST REPAIRS Occupancy Address: 401 HowellWay Occupancy Name: Edmonds Center Bldg y Responsible Person First & Last Name: Wilson Investments Phone Number: 543-7441 Responsible Person Responsible Party Address, City, State, Zip: E—Mail Address t Date of Inspection: 9/11/12 Inspection Annual Frequency/Type: A 'I testers Name SFD Certification (Please Print): Tim Gehlhausen Number: SCP — G04398 Qe ntral station monitoring? Yes 0 No C3 Monitoring Monitoring Required? Yes C3 No 0 Company Name: Make. Grinnell System Model: A -S -.ystem stem Size: 8 System Location: Back side of Bldg Identification Number: PROBLEms FoUND: (if additional room is needed, please add a separate sheet) CORRECTIONS MADE: Date Corrected: Corrected By: (If6additional room is needed, please add a separate sheet) SFD Certification Number: SCP - 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: Phone# Testing Agency: Mailing Address: -.41 Building Representative (signature) �S'� knklers - 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 Seattle Fire Department Fire Code for inspecting and testing requirements. 3. Number of Sprinkler Heads: 4. 2-inch drain? Other Yes No 5. I Flow switches, supervisory switches and alarm bells tested? N/A Yes No 11 -T . ...... . . . Pressure regulating valves tested? N/A Yes No T Alarm bell operates? N/A Yes No System inspected and lubricated? Yes No Valves are sealed or supervised? Yes No 1-0. 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 No 13. Have the,zprinkler heads been �,replaced or -,successfully sample test in the Yes No . last,50,years,? : ...... .... ... ... .. ... .. . .... .. . .. . . . . . . ......... .... �-14. Proper number of spare sprinkler heads available with appropriate wrenches Yes No for each? System left in service? System gauges replaced or calibrated within the last 5 years? Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? 8. Was debris found in the Fire Department Connection (FDC)? 19. Was,the Fire, Department Connection (FDC) back flushed within the last 5 years? 20. Was an internal pipe and val ve inspectio n performed wi thi n th e I ast 5 y ea rs? Date Performed Yes No C3 Yes No C3 Yes 2 No 0 Yes No Yes No Yes [I No RI . ... .. . ....... . ... . ?,l. Wasa-sidn'al -received at the Central Station monitoring N/A LJ Yes 2 No C3 compan ? y ME isprinklers - wet Page 2 of 2 APPLICATION FOR PERMIT FOR MATERIALS OR PROCESSES January 3, 2012 Please verify and correct the following information: Name of Company (DBA): Edmonds Autobody Edmonds Location : 401 Howell Way In conformity with the terms of the International %.JI - application is - - Fire Code, Storage and- handling -of class- 1,11 -and III flammable hereby made to store, use and/or combustible liquids, repair garage, spray booth or maintain the following and welding operation. activity, storage or pro- cesses: c/o Details Unlimited Inc. Mailing Address: PFSE Everett, WA 982 EFD LIFIR #: (for office use) 57300009B152 Your Signature Your Name (print) Your Title Please make corrections, attach $40 payable to the City of Edmonds and mail to: Fire Marshal Department of Fire Prevention 121-5 th Avenue North Edmonds, WA 98020 FOR OFFICE USE ONLY Rec'd 5 1 Is—/12,- Check# `7 05_�_ PO Box 6683 Bellevue WA 98008 425-956-3434 Office LIC# BRIMSFS918KO Snohomish County Fire District #1 arapno Confidence Test Report 425-956-3723 Fax SPRINKLER -WET SYSTEM Certification Given (One System per Report) YELLOW WHITE _T CONFIDENCE TESTT-0 REPAIRS Occupancy Address: 401 HowellWay Occupancy Name: Edmonds Center Bldg Responsible Person First & Last Name: Wilson Investments Phone Number: 543-7441 Responsible Person Address, City, State, Zip: Responsible Party E—Mail Address Date of Inspection: 10/4/11 Inspection Annual Frequency/Type: Testers Name (Please Print): Tim Gehlhausen SFID Certification Number: SCP - G04398 Central station monitoring? Yes C3 No 0 Monitoring Monitoring Required? Yes 13 No El Company Name: System Make: Grinnell System Model: A System Size: 8 System Location: Back side of Bldg Identification Number: 1 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) SFD Certification Number: SCP - 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: Phone # Testing Agency: Mailing Address: 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 Seattle Fire Department Fire Code for inspecting and testing requirements. General 1. Flow test conducted? Yes No 2. Static pressure: 115p.s.i. Flow pressure: 98 p.s.i. 3. Number of Sprinkler Heads: 4. 2-inch drain? Other Yes No 5.- Flow switches, supervisory switches and alarm bells tested? N/A Yes No El 6. Pressure regulating valves tested? N/A Yes No 7. Alarm bell operates? N/A Yes No 8. System inspected and lubricated? Yes No 9. Valves are sealed or supervised? Yes No 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 No 13., Have the sprinkler heads been replaced or successfully sample test in the 'last Yes No 50 ye"a-irs? 14. Proper number of spare sprinkler heads available with appropriate wrenches Yes No for each? 15. System left in service? Yes No 16. System gauges replaced or calibrated within the last 5 years? Yes No 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical Yes No 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? 20. Was an internal pipe and valve inspection performed within the last 5 years? Yes No Date Performed 211. Was, a slignal received at the Central Station monitoring N/A Yes No company? Sprinklers - Wet Page 2 of 2 194r- 1%arimar"no "SW N43F40CM PO Box 6683 Bellevue WA 98008 425-956-3434 Office LIC# BRIMSFS918KO 425-956-3723 Fax Snohomish County Fire District #1 Confidence Test Report SPRINKLER -DRY SYSTEM F_ Certification Given (One System per Report) YELLOW WHITE R1 CONFIDENCE TEST I El � REPAIRS T old Occupancy Address: 401 Howell Way Occupancy Name: Edmonds Center Bldg Responsible Person First & Last Name: Wilson Investments Phone Number: 543-7441 Responsible Person Address, City, State, Zip: Responsible Party E-Mail Address Date of Inspection: 10/4/11 Inspection Annual Frequency/Type: Testers Name (Please Print): Gehlhausen SFD Certification Number: SCP - G04398 Central station monitoring? Yes 13 No 0 Monitoring Monitoring Required? Yes C3 No 0 Company Name: System Make: Grinnell System Model: E-2 System Size: 4 System Location: Back of Bldg Identification Number: 1 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) SFD Certification Number: SCP - 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: Phone # Testing Agency: Mailing Address: Building Representative (signature) Sprinklers - Dry 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 Seattle Fire Department Fire Code for inspecting and testing requirements. General 1. Trip test conducted? Yes No 2. System tripped in 22 seconds. 3. Flow test conducted? Yes No 4. Static pressure: 110 psi Flow pressure: 100 psi 5. Number of Sprinkler Heads? 6. 2-inch drain? Other Yes No 7. Flow switches, supervisory switches and alarm bells tested? N/A Yes No 8. Alarm bell operates? N/A Yes No 9. Air compressor refills system in 30 minutes or less? Yes No 10. Heat actuation devices tested on pre -action and deluge N/A Yes No systems? 11. System inspected and lubricated? Yes No 12. Valves are sealed or supervised? Yes No 13. Signs are provided on valves? Yes No 14. Pumper connections and clapper valves unobstructed and turn freely? Yes No 15. Sprinkler heads replaced or successfully sample tested in last 10 years? Yes No 16. Sprinkler coverage is acceptable? Yes -No 17. Proper number of spare sprinkler heads available with appropriate wrench Yes No for each? 18. System left in service? Yes No 19. System gauges replaced or calibrated within the last 5 years? Yes No 20. Sprinkler heads free of corrosion, paint, obstructions and/or physical Yes No damage? 21. System drained and restored to normal operation? Yes No 22. Was debris found in the Fire Department Connection (FDC)? Yes No 23. Was the Fire Department Connection (FDC) back flushed in the last 5 Yes No years? 24. Was a signal received at the Central Station monitoring N/A Yes No company? 25. Was an internal pipe and valve inspection performed within the last 5 Yes No years? Date Performed Sprinklers - Dry Page 2 of 2 APPLICATION FOR PERMIT FOR MATERIALS OR PROCESSES March 7, 2011 Please verify and correct the following information: Name of Company; DBA Edmonds Autobody Edmonds Location 401 Howell Way In conformity with the terms of Storage and handling of class 1,11 and III flammable and/or the International Fire Code, combustible liquids, repair garage, spray booth and welding application is hereby made to operation. store, use or maintain Ahe following activity, storage or processes: Mailing Address: tails U d Inc. 11� ! e "m >6 PI SE "A�pl verett WA A&502257161441 EFID LIFIR #: 57300009B152 (for office use) Your Signature P 11:1 0000, Your Name (print) Your Title Please make corrections, attach $40 payable to the City of Edmonds, and mail to: Fire Marshal Department of Fire Prevention 121-5 th Avenue North Edmonds, WA 98020 1 [-MAR 3 0 PAID EDMONDS FIRE DEPT. CITY OF EDMONDS DEPARTMENT OF FIRE PREVENTION PERMIT January 1, 2011 573-000-0913-1152 December 31, 2011 Date of Issue UFIR Number Date of Expiration I This PERMIT is issued to: I Edmonds Autobody I located at: 1401 Howell Way Edmonds, WA To engage in the business, occupation or process of: T And shall constitute permission to maintain, store, use or handle materials or to conduct process which produce conditions hazardous to life or property or to install equipment used in connection with such activities as follows: Storage and handling of class 1,11 and III flammable and/or combustible liquids, repair garage, spray booth and welding operation. I Allowed Occupant Load: I Pursuant to the provisions of the International Fire Code, any violation of the Code may be grounds for the revocation of this PERMIT. This permit does not take the place of any license required by law and is not transferable. Any change in the use or occupancy of premises shall require a new permit. This Permit Must Be Posted At All Times in The Premises Identified Above City of Edmonds Community Development Code 19.25.020 CITY OF EDMONDS 121 5� AVENUE N. - EDMONDS, WASHINGTON 98M - (425) 771-0215 FIRE DEPARTMENT LOCATION: 401 Howell Wy/5th Ave S BUSINESS NAME: Edmonds Business Center/Bldg. MAILING 403 Howell Way FIRE PREVENTION SAFETY SURVEY 401-550 PHONE: 4256721100 ADDRESS: Edmonds 98020 BUSINESS OWNER: Wilson Investments HOMEPHONE: 4256721100 EMERGENCY-1: Wilson, Bill HOME PHONE: 2065463773 KEY ACCESS-2: HOME PHONE: PERSON CONTACTED: NAME OF INSPECTOR: FIRE AS 10/0�!`D SYSTEMS: - .1 /0//o HAZARDS FOUND AND LOCATIONS / CON FREQUENCY STATION 11 SHIFT 365 17 D I SCHEDULED 0911011,10 DATE DUE 11 UFIR 1- 509 9152 INITIAL INSPFCTION b ANNUAL MUNICATIONS ENTER CODE ONLY ONCE 111 VIOLATION CODE 2 2 3 3 4 4 5 5 .6 6 7 /7 8 8 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: EXTENSION GRANTED TO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: 1 INSPECTOR, INSPECTOR, INSPECTOR- 2 DATE: DATE: DATE: 3 VIOLATIONS 5 VIOLATIONS 1- 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 6 2 6 DATE: CODE SECTION: 5 7 3 7 RETURN RECEIPT RECEIVED 6 7 4 18 4 8 1 DATE: DISPOSITION: 8 �, LETTER NEEDED E] YES NO LETTER NEEDED ] YES NO 1 FIRE DEPARTMENT COPY § § February 13, 2004 Fire Marshall Edmonds Fire Department 5 th A 1221 Avenue North Edmonds, WA 98020 Dear Mr. Westfall: D LECERfE 2004 FEB 1, 7 EDMONDS FIR'E DEPTI We have not yet received your form for renewal of Application for Permit for Materials or Processes. Our current Permit expired December 31', 2003. If you have any questions, please feel free to contact us. We thank you for your assistance in this matter and look forward to hearing from you soon. Sincerely, Cynthia Handley Customer Service Edmonds C6nt6r C4'at) ftell Way, Edffonds,-WA 98020 425.774.9292 Far 425.774.2050-�T.877.774.9292 CIVIC CENTER - EDMONDS, WA 98020 (206) 775-2525 FIRE DEPARTMENT CITY OF EDMONDS 89 0 9 C) August 13, 1991 Mr. Bill Wilson Wilson Investments 1110 North 175th, #220 Seattle, WA 98133 Dear Mr. Wilson, LARRY S. NAUGHTEN MAYOR The sprinkler system for your building at Howell Way in Edmonds has been extended to cover all areas which we required last December. We would like to thank you for your coopera- tion and for your concern with fire safety. If we can be of any assistance to you in fire or life safety in the future, please do not hesitate to call. TV: be Sincerely, I �� 1//�w Adwz"4L'I Tom VonSchuessler Senior Inspector 0 Incorporated August 11, 1890 e Sister Cities International — Hekinan, Japan ri Irk. WILSON INVESTMENTS 1110 NORTH 175th Suite 220 SEATTLE, WASHINGTON 98133 (206) 542-7441 January 29, 1991 Mr. Tan VonSchuessler, Senior Inspector c/o City of Edmonds Fire Dept. Edmonds, VM 98020 Re: Edmonds Center 5th and Howell, Edmonds, WA Dear Tan, Thank you for the opportunity to reinspect the building with you. Since our walk-through I have spoken with Stelte (403 Howell) and Turner (409 Howell) regarding the spray booth and installing addition- al sprinkler heads. Subsequently, Stelte advised me that he will be moving his business in March and will be taking the spray booth with him. Turner how hopes to move into Stelte's space. If it is okay with you, could we wait until these tenants move to conplete the installation of additional sprinkler heads? If not, please advise. Sincerely, Bill �Iilson Property Manager 13W/pf RECEIVED ..: �� u 1991 EIPMONDS FIRE DAM, RECEIVED 0 11991 SPAN11S F-IM M-M I 1b CITY OF EDMONDS CIVIC CENTER EDMONDS. WA 98020 (206) 775-2525 i, _ -4 2 FIRE DEPARTMENT "-e7v, 8 9 0 . 19 C) Mr. Bill Wilson �4 .2- -7+#) Wilson Investments 1110 North 175th, #220 Seattle, WA 98133 Dear Mr. Wilson, Sol December 10, 1990 LARRY S. NAUGHTEN MAYOR The National Fire Code states all sprinkler systems shall be maintained in an operative condition at all times and shall be replaced or repaired where defective. Sprinkler coverage., spacing and specification shall be maintained in accordance with nationally recognized standards at ail times. Sprinkler systems shall be extended, altered or augmented as necessary to maintain and continue protection whenever any building is altered remodeled or added to. The Grinnell Fire Protection Systems Company recently conducted an annual inspection of the sprinkler system which serves your building. The following items requite your immedi- ate attention to bring them into compliance: Stp M Company, Inc. - 463 Howell Way 0. Replace ceiling tile(s). ­­_50-2. Remove the duct hanging from the sprinkler pipe. v .);,3. Pro*ide sprinkler head coverage in the spray booth. Turner Exhibits - 409 Howell Way Provide two sprinkler heads to office area. Remove curtains and other items hanging from the sprinkler main and sprinkler pipes. Reposition the sprinkler head or duct which is blocking the sprinkler head. V­4 P o id sz*TMler coverage in paint and chemical closet, m A . --Replace mis. on ceiling tile. lean or replace painted sprinkler heads. Fam Grocer - 550-5th Avenue South Storage shall be no closer than 18" below sprin- kler heads. Provide additional sprinkler head protection tinder duct. work, upstairs near the women's bath- room. 0 Incorporated August 11, 1890 0 Wilson Investments December 10, 1990 Page 2 Fifth Avenue Cleaners - 540-5th Avenue South --- 1. Provide sprinkler coverage in bathroom. 2. Provide sprinkler coverage behind dry cleaning machine Please contact my office to present- a time schedule for the necessary repairs and alterations to your sprinkler system. Please feel free to contact me if I can provide any assis- tance in this matter. Sincerely, Tom VonSchuessler Senior Inspector TV:be I I INSPECTION REPORT No. ................................ CONFERRED WITH REPORT TO STREET CITY & STATE ATT. 1. REPORT OF INSPECTION ZIP INSPECTION CONTRACT NO. BUREAU FILE ................ NO. ................................ SET 1 OF 2 BUILDING OR LOCATION INSPECTED INSPECTOR GRINNELLOFFICE U'l-11=3 PHONE NO =.4--6(Z2 DATE 119 —.4.1 —!�a GENERAL A. (To be answered by the Owner or Owner's representative) a. Have there been any changes in the occupancy classification, machinery or operations since the last inspection? b. Have there been any changes or repairs to the fire protection systems since the last inspection? c. If a fire has occurred since the last inspection, have all damagea sprinkler system components been replaced? d. Has the piping in all dry systems been checked for proper pitch within the past five years? Date last checked (checking is recommended at'least every 5 years) e. Has the piping in all systems been checked for obstructive materials? Date last checked (checking is recommended at least every 5 years) I. Have all fire pumps been tested to their full capacity through the use of hose streams or flow meters within the past 12 months? g. Are gravity, surface or pressure tanks protected from freezing? h. Are any of the sprinklers 50 years old or older? (testing and/or replacement is recommended for such sprinklers) i. Are any extra high temperature solder sprinklers regularly exposed to termperatures near 300OF? B. (To be answered by the inspector) a. Have the sprinkler systems been extended to all visible areas of the building? b. Does there appear to be proper clearance between the top of all storage and the sprinkler deflector? c. Are the building areas protected by a wet system, heated, including its blind attics and perimeter areas, where accessible? d. Are all visible exterior openings protected against the entrance of cold air? 2. CONTROL VALVES a. Are all sprinkler system main control valves and all dther valves in the appropriate open or closed position? b. Are all control valves sealed or supervised in the open position? Ab!, <'j-;;Q�--n/0 Control Valves No. of Valves Type Easily Accessible Signs Valve Open Secured? (Sealed?) If yes, how? (Locked?) Yes I No (Supvd.?) Supervision Operational Yes No Yes No Yes No Yes No CITY CONNECTION TANK PUMP SECTIONAL SYSTEM A) A ALARM LINE 3. WATER SUPPUES Pressure Fire Pump & Tank /V,& a. Water supply source? Cityt�7p.4,-/, Gravity Tank '44= Pressure Fire Pump & City 44,4 Waterflow Test Results Made During This Inspection Pressure Fire Pump & Pond Test Pipe Located Size Test Pipe Static Pressure Before Flow Pressure Static Pressure After Test Pipe Location Size Test Pipe Static Pressure Before Flow Pressure Static Pressure After 4. TANKS, PUMPS, RRE DEPT. CONNECTIONS a. Do fire pumps, gravity, surface or pressure tanks appear to be in good external condition? b. Are gravity, surface and pressure tanks at the proper pressure and/or water levels? c. Are fire dept. connections in satisfactory condition, couplings free, caps or plugs in place and check valves tight? d. Are fire dept. connections visible and accessible? S. WET SYSTEMS a. No. of systems Make& Model -4: ,g2 g) b. Are cold weather valves in the appropriate open or dosed position? If closed, has piping been drained? c. Has the owner or owner's representative been advised that cold weather valves are not recommended by NFPA? d. Have all the antifreeze systems been tested? e. Date antifreeze systems were test f. The antifreeze tests indicate protection to: system 1 4- 5 temperature g. Did alarm valves, waterflow alarm indicators and retards test satisfactorily? G4550-1 INSURANCE BUREAU COPY No* $Not Applicable *Explain (No) Answers on Back of Steet 2 GMNELL ME PBM=ON REM COMPANX ING EXECUTIVE OFFICES 9 PROVIDENCE, R.I. INSPECTION CONTRACT NO. INSPECTION REPORT REPORT OF INSPECTION BUREAU FILE No. . ... .. NO. SET 2 OF 2 6. DRY SYSTEMS a. No. of systems Make & Model Date last trip tested 2/' b. is the air pressure and priming water levels normal? c. Did the air compressor operate satisfactorily? d. Were all low points drained during this inspection? e. Did all quick opening devices operate satisfactorily? f. Did all the dry valves operate satisfactorily during this inspection? g. Do dry valves appear to be protected from freezing? h. is the dry valve house heated? 7. SPECIAL SYSTEMS a. No. of systems Al Make & Model Type b. Were valves tested as required? c. Did all heat responsive systems operate satisfactorily? d. Did the supervisory features operate during testing? Heat Responsive Devices: Type Type of test Valve No. 1 ...... 2 ...... 3 ...... 4 ...... 5 ...... 6 ...... Valve No. 1 ...... 2 ...... 3 ...... 4 ...... 5 ...... 6 ...... Valve No. 1 ...... 2 ...... 3 ...... 4 ...... 5 ...... 6 ...... Valve No. 1 ...... 2 ...... 3 ...... 4 ...... 5 ...... 6 ....... Valve No. 1 ...... 2 3 ...... 4 ...... 5 ...... 6 ...... Valve No. 1 ...... 2 ...... 3 ...... 4 ...... 5 ...... 6 ...... Valve No. 1 ...... 2 ...... 3 ...... 4 ...... 5 ...... 6 ....... Valve No. 1 ...... 2 ...... 3 ...... 4 ...... 5 ...... 6 ...... Auxiliary equipment: No. Type Location Test results No* & ALARMS I N.A.t I No* Y�; a. Did the water motors and gong operate during testing? 7 b. Did the electric alarms operate during testing? --- c. Did the supervisory alarms operate during testing? 9. SPRINKLERS — PIPING a. Do sprinkle rs generally appear to be in good external condition? b. Do sprinklers generally appear to be free of corrosion, paint, or loading and visible obstructions? c. Are extra sprinklers available on the premises? d. Does the exterior condition of piping, drain valves, check valves, hangers, pressure gauges, open sprinklers and strainers appear to be satisfactory? e. Does the hand hose on the sprinkler system appear to be in satisfactory condition? 10. EXPLANATION OF "NO" ANSWERS (For Sections IB thru 9): 41 — / A 11. THE INSPECTOR SUGGESTS THE FOLLOWING NECESSARY IMPROVEMENTS. HOWEVER, THESE SUGGESTIONS ARE NOT THE RESULT Of AN ENGINEERING SURVEY: r; 7 12. ADJUSTMENTS OR CORRECTIONS MADE: 13. LIST CHANGES IN THE OCCUPANCY HAZARD OR FIRE PROTECTION EQUIPMENT, AS ADVISED BY THE OWNER IN SECTION 1A: 14. INSPECTION AND SUGGESTED IMPROVEMENTS WERE DISCUSSED W6H THE UNDERSIGNED OWNER OR OWNER'S REPRESENTAinki Signature of owner or owner's representative Date L DUPLICATE TO: STREET CITY & STATE ZIP ATT. tNot Applicable G4550 (Rev. 6/62) *Explain (No) Answers on Back of Sheet MURAMCE BUREAU CDPV 0. G4Z74RI FOR DRY PIPE VALVE TRIP TEST REPORT (&ANY GHMM FERE PRM=ON SYSTEMS COMP INSPECTION NO, STREET 4/0 t ffot!4�CITY STATE CONTRACT NO. DATE OF TRIP TEST INSPECTOR 942-' DAY WORK NO. NOTE: BEFORE ANY DRY PIPE VALVE IS TRIP TESTED. THE WATER SUPPLY LINE TO IT SHOULD BE THOROUGHLY FLUSHED. THE TWO INCH DRAIN BELOW THE VALVE SHOULD BE OPENED WIDE. AND WATER AT FULL PRESSURE SHOULD BE DISCHARGED LONG ENOUGH TO CLEAR THE PIPE OF ANY ACCUMULATION OF SCALE OR FOREIGN MATERIAL. IF THERE IS A HYDRANT ON THE SUPPLY LINE, THIS HYDRANT SHOULD BE FLUSHED BEFORE THE TWO INCH DRAIN IS OPENED. THE DRIP VALVE ON THE DRY PIPE VALVE SHOULDBE CHECKED BEFORE TRIPPING THE DRY POPE VALVE, TO SEE THAT IT IS IN OPERATING CONDITION. DRY PIPE VALVE$ SYSTEM NO. SYSTEM NO. SYSTEM NO. SYSTEM NO. VALVE SERIAL NUMBER 1-,-, , (,- 0 E MANUFACTURER (NAME) 6'rllwr VALVE MODEL VALVE SIZE 4- INCH INCH INCH INCH CONTROLLING SPRINKLERS I (LOCATION) (NUMBER) (APPROX) (APPROX) (APPROX) (APPROx) DATE LAST TRIP TESTEDT DATE LAST OPERATED? AIR L as LOS LOS LOS PRESSURE BEFORE TEST WATER LOS LOS L93 LOS SIZE AND LOCATION OF TEST VALVE WAS GATE VALVE BELOW DRY VALVE OPEN WIDE AT TEST? OF NOT. H W MANY TURNST .3 VALVE TRIPPED AT AIR PRESSURE LOS LOS LOS LOS WATER PRESSURE WL LOS LOS LOS LOS TIME I-, MIN /-3-SEC MIN SEC MIN SEC MIN SEC IF SYSTEM FLOODED, LIST TIME WATER REACHED TEST OPENING NA MIN SEC MIN SEC MIN SEC MIN SEC_ PERFORMANCE INTERIOR OF BODY VALVE CONDITION MOVING PARTS RUBBER FACING SEATS RESET? DID ALARMS OPERATE AT TRIP TESTI YC �7 ALL LOW POINT DRAINS BLOWN OUT? c__s- WATER CONTROL VALVE LEFT OPEN AND SEALED? ' 7/0 ALARM CONTROL VALVE LEFT OPEN AND SEALED? QUICK OPENING DEVICES SYSTEM NO. SYSTEM NO. SYSTEM NO. SYSTEM NO. DEVICE SERIAL NUMBER A) A MANUFACTURER (NAME) TYPE AND MODEL AIR PRESSURE IN UPPER CHAMBER LOS LOS LOS QUICK OPENING DEVICE TRIPPED AT SEC LOS SEC LOS SEC LOS SEC LOS PERFORMANCE QUICK OPENING DEVICE LEFT IN SERVICE AND CONTROL OPEN AND SEALED? LIST ANY UNSATISFACTORY CONDITIONS: REMARKS: C,- 41 4,7 INSURANCE BUREAU COPY 11 Grinneff FIRE PROTECTION SYSTEMS COMPANY 1106 54th Avenue East Tacoma, WA 98424-2733 Contractor's Lic. No. GRINNFP137LE 206-922-6644 Seattle Line 874-5011 Fax # 206-922-3118 Edmonds Fire Department 250 5th Avenue North Edmonds, WA 98020 Reference: Gentlemen: November 12, 1990 Family Grocer 401 Howell Way Edmonds, WA Enclosed please find copies of the Report of Inspection and the Dry Pipe Valve Trip Test Report for your records on the above referenced project. The following is an additional list of de- ficiencies found: 1) Replace all missing tile 2) Numerous heads too far from wall 3) Debris hanging-'fr*om pipe 4) Heads need to be added in olfice, spray booth, paint and chem- ical closet, bathroom, under stairs, under duct work upstairs near womans' restroom 5) Replace painted heads 6) Storage too high Thank you, GRINNELL FIRE.PROTECTION SYSTEMS COMPANY Santia R. La Service Manager SRL; kab Enclosures cc: Wilson Investments R EC E IV ED NOV 14 1990 .A �x . S I DEPT 3. DIVISION OF GRINNELL CORPORATION Awnco-ocu --hroads lvu&?Oezxa wl"s AMC -'4 _04lCe-- P7f