402 3RD AVE SFIRE PREVENTION
Serving Brier, P-aniona�, and
12425 Meridian Ave S
INSPECTION REPORT
SKOHONIISH Co.
T2 1"M Mowiflake Terrace
Everett, WA 98208
--GCMONDS
El BRIER
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
DISW—,.r
R
[ I UNINCORPORATED
J L U www.FireDistrict].org
Fax (425) 551-1272
.
FREQUENCY
STATION & SHIFT
LOCATION: 402 3 rd Avenue S 98020
Annual
17-D
BUSINESS NAME: Stella's Landing Bldg B
PHONE: 2062852205
SCHEDULED Apr 2017
DATE DUE �
MAILING
LIFIR � 427202
ADDRESS: 402 3rd Avenue S, Edmonds, WA 98020
BUSINESS OWNER: Mann, Lance
HOME PHONE:
�zAIO
L4�-, 511) Ve
EMERGENCY-1:Wold, Jim (A-307)
HOMEPHONE: 4255302700
CURRENT
KEY ACCESS-2:
HOME PHONE: 17
CITY IJYL(+ NO
BUSINESS
EMAIL:
LICENSE
PERSON CONTACTED:
7
INITIAL INSPECTION DATt
NAME OF INSPECTOR:,
FIRE SYSTEMS: AS 1/16 FA 1/16 FE 2/16 12:00:00-AM
H1AAA FIRE & SAFETY, INC
A' A a
30133RDAVENORTH
(WO) 223-3473 SEAME, INA 98109
INFOCAAAFIM.COM
EDMONDS
FIRE DEPARTMENT
"THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION"
FIRE ALARM SYSTEM
Status Given
(One System per Report)
RED—T-7
YELLOW
JXJ
I WHITE
Lj
CONFIDENCE TEST
IN
I REPAIRS
I
Lj
Sprinkler Monitoring Panel?E]
Occupancy Address: 402 3RD AVE S
Occupancy Name:' STELLAS LANDING
Responsible Person Lance Mann
First & Last Name:
Phone Number: (206) 268-3300
Responsible Person
Address, City, State, Zip:
Responsible Party lance@yateswood.com
E—Mail Address
Date of Inspection:
01/20/2016 09:00am PST
Inspection Annual
Frequency/Type: Quarterly
Testers Name Ricardo Mencias
(Please Print):
Nicet
Number: —
Identification
Number: 1
System Location Electrical Room
Central station monitoring? Yes El No [I
Monitoring
Monitoring Required? Yes El No [I
Company Name: Wash. Alarm
System Make: Silentknight
System Model: 5207
FIRE CODE VIOLATIONs FOUND: (If additional room is needed, please add a separate sheet)
#2 NAC Can not read EOL
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)
VA1111W.
Joppp-
Fire Alarm Systems
OrN
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 safetV sVstem. 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) 26.4 volts
4. Battery voltage (full load) 25.6 volts (signals operating)
5. Charge circuit voltage 27.2 volts
6. System operates properly on standby power?
7. All signals operate on AC power?
8. Number of initiating circuits 6
9. Number of signal circuits 2
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 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
DX
No
NoH
Yes
No
Yes
No
Yes
Yes
Yesnx
Yes
Yes
Yes
No
No
NoF1
No
No
No[:]
Yes
No
[:]
Yes
No[:]
N/A
Yes
No[-]
N/A Yeso
Yes
[-]
No
NoHx
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
41
41
N/A
Yes N
No El
25. Voice Speakers (Voice Clarity)
N/A
Yes[-]
No 1:1
26. Visual Alarm Devices
5
5
N/A [:1
Yeso
No E]
27. Smoke Detectors
2
2
N/A El
Yeso
No 1:1
28. Heat Detectors
19
19
N/A
Yes
No [--]
29. Duct Detectors
N/A
Yes
No El
30. Sprinkler Flow Switches
1
1
N/A
Yes
No [:]
31. Sprinkler Supervisory Switches
1
1
N/A
Yes
No El
32. Manual Pull Stations
9
9
N/A
Yes
No
33. Annunciator(s)
1
1
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
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 El
39. Phone lacks
N/A Yes No [-I
40. Call -in Signal
2
2
N/A [-I YesEl NOE]
Fire Alarm Systems Page 2 of 2
ill AAA FIRE & SAFETY, INC
a a a
30133RDAVENORTH
(800) M3473 SEAME, WA 98109
1NF0VL4AAFW.CQM
EDMONDS
FIRE DEPARTMENT
"THE NORTHWESTS MOST TRUSTED NAME IN FIRE PROTECTION"
SPRINKLER - WET SYSTEM
Status Given
(One System per Report)
RED
F]
I YELLOWFI
I WHITE
FX]
CONFIDENCETEST IN[ REPAIRS
Occupancy Address: 402 3RD AVE S
Occupancy Name:
STELLAS LANDING
Responsible Person Lance Mann
First & Last Name:
Phone Number:
(206) 268-3300
Responsible Person
Address, City, State, Zip:
Responsible Party
E—Mail Address
Date of Inspection: 01/20/2016 09:00arn PST
Inspection
Frequency/Type:
Annual
Quarterly 0
Testers Name Ricardo Mencias
(Please Print):
Nicet Certification
Number:
8021-0911 -E
Identification 1
Number:
System Location:
Garage
Central station monitoring? YesEl No D
Monitoring
Monitoring Required? Yes El No 13
Company Name:
Wash. Alarm
System Make: Silentknight
System Model:
5207
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: $.Maw
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: 125 p.s.i. Flow pressure: 115 P. S. i.
3.
Number of Sprinkler Heads: 112
4.
2-inch drain? Other Eg
Yes
El
No El
5.
Flow switches, supervisory switches and alarm bells tested? N/A El
Yes
0
NoEl
6.
Pressure regulating valves tested? N/A 0
Yes
[I
No El
7.
Alarm bell operates? N/A El
Yes
Z
No 1:1
8.
System inspected and lubricated?
Yes
FX]
No 0
9.
Valves are sealed or supervised?
Yes
N
No El
10.
Signs are provided on valves?
Yes
FRI
No
11.
Pumper connections and clapper valves unobstructed and turn freely?
Yes
nX
No El
12.
Sprinkler coverage is acceptable?
Yes
No
13.
Have the sprinkler heads been replaced or successfully sample test in the
Yes
n
No FXI
last 50 years? Date of last test:
14.
Proper number of spare sprinkler heads available with appropriate wrenches
Yes
N
No D
for each?
15.
System left in service?
Yes
59
No El
16.
System gauges replaced or calibrated within the last 5 years?
Yes
9
No El
Year changed: 2012
17.
Sprinkler heads free of corrosion, paint, obstructions and/or physical
Yes
0
NoEl
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 Yes El No 0
years? Date of last back flush NIA
20. Was an internal pipe and valve inspection performed within the last 5 years? Yes El No 0
Date Performed PVC
21. Is the hydraulic nameplate installed and visible on riser. Yes El No jD9
(Ref: NFPA 25 5.2.7)
22. Was a signal received at the Central Station monitoring N/A El Yes 0 No El
company?
Sprinklers - Wet Page 2 of 2
Serving Brier, Edmon ds, and
Terrace
www.FireDistrictl.org
LOCATION:
402 3 rd Avenue S 98020
BUSINESS NAME:
Stella's Landing Bldg B
MAILING
ADDRESS:
402 3rd Avenue S, Edmonds, WA 98020
12425 Meridian Ave S
Everett, WA W6'8
Phone (425) 551-1200
Fax (425) 551-1272 ,
PHONE: .2062852205
FIRE PREVENTION*
INSPECTION REPORT
0 EDMONDS
0 BRIER
El MOUNTLAKE TERRACE��;v'��%`
[I UNINCORPORATED�
FREQUENCY STATION & SHIFF"I
Ann ual 17-C
SCHEDULED
DATE.DUE 0Apr2016
LIFIR 11, 427202
BUSINESS OWNER: HOME PHONE:
Mann,Lance
Moto f -3d7 1-125- 5'10 ?-7
EMERGENCY-1: HOME PHONE: URREN
KEY ACCESS-2: Yates, Wood & Mcdonald" HOME PHONE: 425.6729068 ITY T YES NO
BUSINE
EMAIL: LIC S SS
EN E
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR: A
FIRESYSTEMS: AS1/16fAj/16FE2/15jFDLkBox
Q110 I f& 2�1((o I
egft�"tRM% ATIONS / COMMUNICATIONS
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1 st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION FINAL RE -INSPECTION VIOLATIONS
2ATE DUE:
DATE DUE:
GRANTEDTO: DATE DUE CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
N
O��ACTED:
INSPECTOR. OQVJLI� )VV.
INSPECTOR:
INSPECTOR: 2
RATE:..
E.
3
DATE:
VIOLATIONS
VIOLATIONS,,
---T
pRE.CITATION IIIIONISSUED--
5
1 f5
LETTER SENT NUMBER: 4
CODE
16
2 16
DATE: SECTION.__
RETURN RECEIPT
[7
3 7
RECEIVED 16
DISPOSITION: I
8
4 8
DAT 7
LETTER NEEDED YES NO
LETTER NEEDED 0 YES El No
8
oo
�'
�5'Meridian
FIRE PREVENTION
MISH-CO:- Serving Brier Edmonds, and'
2�_
1,24 Ave S,
INSPECTION REPORT
41
Mountlake Terrace
FIR
......
Everett, WA 98208
&YEDIVIONDS
ENRIER
ois
DISTRI I
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Phone (425) 551-1200
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
wwW.FireDistrictl.o�g
Fax (425) 55Y-1272
e FREQUENCY
STATION & SHIFT
LOCATION: 402 3 rd Avenue S 98020
Annual
17-B
BUSINESS NAME: Stella's Landing Bldg B
PHONE: 2062852205
SCHEDULEcApr 2015
DATE DUE
427202
MAILING
402 3rd Avenue S, Edmonds, WA 98020
LIFIR
ADDRESS:
BUSINESS OWNER: Mann,Lance
HOME PHONE:
'0
EMERGENCY-1- Yates, Wood & Mcdonald"
4256729068
HOME PHONE:
"CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
EMAIL:
LICENSE
PERSON CONTACTED: C pc-1:1 4 C
-1
INITIAL INSPECTION DATE
NAME OF INSPECTOB!�,, " ., , 0
L /I /j,-,
1/14(FAA/1-4 F
7- r15
HAZARDS FOUNDAND LOCATIONS / COMMUNICATIONS
(7N _/Z)
2
2
3
3
.4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VICLATION(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
VIO IONS
1 C 15
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
DATE:
CODE
SECTION:
5
13
7
RETURN RECEIPT
RECEIVED
6
4
8
4
_7
>8
DATE:
DISPOSITION:
7
11 LETTER NEEDED C] YES El NO
LETTER NEEDED E] YES El NO
8 x/
FIRE DEPARTMENT COPY
AAA Fire and Safety, Inc. FIRE DEPARTMENT
d —
3013 3' Ave. No. Confidence Testing
Seattle, WA. 98109
(800) .223-.3473 AUTOMATIC SPRINKLER SYSTEM
Address Ak, A\/�_q
Occupied As IA/b
Building Owner W r) &
Address 425 PONTIUS AVE N #203
Date of Inspection 02/09/2015 09:00am
City %A/A
Invoice #
Account#
Date
Zip Code- 98020
Phone No. __(206) 26.8-3300
City SEATTLE Zip Code 98109-5450
Type of Inspection Annual
Tester's Name Ricardo SFD Certification # _"nAr
DRY SYSTEM Location: MIA
1. Trip test conducted.
2. System tripped in seconds.
3. All flow switches, supervisory switches and alarm bells tested.
4. Alarrn bell operates.
5. -Flow test conducted.
Static pressure PSI.
Flow pressure PSI.
6. Two inch drain.
7. Air compressor refills system in thirty minutes or less.
8. System drained and restored to normal operation.
9. Heat actuation devices tested on Dre-action and deluRe systems.
WET SYSTEM Location: r-nrnnn
1. Flow test conducted.
Static pressure lon PSI.
Flow pressure 11 r, PSI.
2. Two inch drain.
V,me
3. Flow and supervisory switches and bells tested.
Vne
4. System inspected and lubricated.
GENERAL
I . Central station monitoring. Name # XA/mch
VC10
2. Sprinkler heads less than fifty years old.
VOL,
3. Pumper connections and clapper valves unobstructed.
Vno
4. Spare heads and wrench available.
VML-
5. System left in service.
-VeNo
6. Valves sealed and/or.supervised.
V,00
7. Gauges recalibrated or replaced (every five years).
V.ML-
8. Signs provided on valves.
VML-
9. Static water pressure 1,-)r) PSI.
PROBLEMS FOUND:
CORRECTIONS MADE:
Date corrected_ by
This is to certify that the sprinkler system has been properly tested and inspected for reliability to
cover the items listed in this re
Signature of Tester: 6 1 Date:
AAA Fire and Safety, Inc. FIRE DEPARTMENT Invoice
3013 3" Ave. No.
Seattle, WA. 98109 Confidence Testing Account# 262015
(800) .223-.3473 DatXe
AUTOMATIC SPRINKLER SYSTEM
Address 404 3RID AVE S City %A/A
Occupied As zf.ii e I anAinn
Building Owner W r) A - - Phone No. (206).?6E
Address 425 PONTIUS AVE N #203 city SEATTLE -
Date of Inspection 02/09/201509:OOaM Type of Inspection Ann
Tester's Name Ricardo SFD Certification #
DRY SYSTEM Location: W.
1. — Trip test conducted.
2. System tripped in seconds.
3. All flow switches, supervisory switches and alarm bel
4. Alarrn bell operates.
5. Flow test conducted.
• Static pressure PSI.
• Flow pressure PSI.
6. Two inch drain.
7. Air compressor refills system in thirty miin ics or less.
8. System drained and restored to normal o7ration.
9. Heat actuation devices tested on pre-aq�fon and deluge
WET SYSTEM
1. Flow test conducted.
• Static pressure
• Flow pressure
2. Two inch drain.
3. Flow and supervisory switi
4. Svstem inSDected and lubri
GENERAL
1. Central station moni
2. Sprinkler heads less
3. Pumper connectio
4. Spare heads and r(
5. System left in s i(
;atio ('-nrnrign
V,Me
7PSS1I
and bells tested. vno
o�ng. Name # %A/.,-h
-Aan fifty years old.
and clapper valves unobstructed.
.ich available.
6. Valves sealed nd/or supervised.
7. Gauges reca i rated or replaced (every five years).
8. Signs provi ed on valves.
r pressurl
9. S rpressure 1,)r, PSI.
CORR�CTIONS MADE:
Vne
vne
Vn,-
Vne
V'Me
Vine
V--
V,ML-
KOMI]
Zip Code 98109-5450
Dat corrected— by
IV,
'h* is to certify that the sprinkler system has been properly tested and inspected for reliability to
Yer the items listed injbis report.
Signature of Tester: (AXV��a e:
_4 3413WWVS NORtH,:_
i11�'1,;iAWtT.Lt:,;Vk* 98 log
284:- ft,l
�TIRE
284,-1769 FAX
'(206)
FM all AAA.FIRE.COM*
Ad8iess Va 2- 4 r-,/,#Ile
Oc6upied as: S
4d90,y1A elz FEkiDEPARTMEENT. INVOICE # )-Z-1 -5'0...
-Confidence Tesong Ac . couNT# 12-7Z9
FIRE A"AM. DATE
City: C'dt?UL91%4� /A4f Zip Code _&020
Building Owner: o. Ph. # 3 4;v
Address: City: Zip Code:
Date of Inspection: e of Inspection: Quarterly Igua
p _J? Acceptance Other
Tester's Name (PLEASE PR . R\M .7/ eekL -W-e j/t c �S SFD Certification#
— r '. - X4 o V__C'a
Control Panel Model #
No. of Initiating Circuits
No. of Signal Circuits
Battery Voltage 2L(o ( 3 Volts Charge Circuit Voltage 17. 2— volts
Battery Voltage Under Full Load 2- V Volts (signals operating)
1.
Trouble Signal With A/C Power Off
Yes
No —
N/A.
2.
System Operates Satisfactorily on Standby Power
Yes
No —
N/A.
3.
All auxiliary equipment operates: (elevators, fans, dampers)
-Yes
_��&o —
N/A.
4.
All Signals Operate On AC Power
Yes
No
5.
Have All Alarm Notification Appliances been checked for proper operation
Yes
No
6.
All Circuits Checked For Electrical Supervision
Yes _.N/A.
7.
Control panel checks made per manufacturer's instructions
Yes
No
NIA.
8.
Central station or remote connection
Yes
No
N/A.
Name of monitoring company k, 414r-94
9.
Key to panel available
Yes
No
N/A
TYPE OF EQUIPMENT
# OF UNITS TESTED
SAnSFACTORY
# OF UNITS IN BLDG
YES
NO
N/A,
BELLS, HORNS, CHIMES
VOICE ALARM SPEAKERS
VISUAL ALARM DEVICES
TROUBLE INDICATORS
z:
SUPER SWITCHES (AUTO SPR.)
SMOKE DETECTORS(S)
HEAT DETEC7rOR(S)
2,
MANUAL PULL STATIONS
VENTILATION CONTROLS OPERATE
CENTRAL STATION
ANNUNCIATORS
ELEVATOR CALL DOWN
FIRE DAMPER/SMOKE DAMPERS
PHONE JACKS
AUTO, DOOR UNLOCKS (FAIL'SAFE)
AUTO, DOOR RELEASE
I OTHERWI, kr 4_'/jU/ S
PROBLEMS FOUND: 1=3
,00==
CORRECTIONS MADE:
Date corrected
By
a z
TIIIS IS TO CERTIFY THAT TIJE FIRE ALARM SYSTEM HAS BEEN PROPERLY TESTED AND INSPECTED FOR RELIABILITY TO COVER
THE ITEMS LISTED IN T"PORT/-/
SIGNATURE OF TESTERP_
ELECTRICAL LICENSE# A4FA1C--7_4*'-XQ,�L1&
3013 3rd AVE NORTH
SEATTLE, WA 98109
(206) 284-1721
(800) 223-FIRE
(206) 284-1769 FAX
a "FE" w- * AAA.FIRE.COM
Address V();L- �V At,
Occupied as: --<
Building Owner: H. o, 4 Ph. # 70 � — 2— 6^ 9'--�30-0
FIRE DEPARTMENT INVOICE # 2�2-1 50
Confidence Testing ACCOUNT# 12- 7 J'f
AUTOMATIC SPRINK-LER SYSTEM DATE ///.4 Z/
City: eW1-)11tWCj-K LA4 Zip Code
Address: City:
Date of Inspection: to ' &OW — Type of Inspection: ( Ennuja�l
Tester's Name (PLEASE PRINT)
Zip Code:
Other
Iii CO—
SF9 Certification # CIF11
DRY SYSTEM
1.
con d d
Trip test (dry trip) conducted:
ucte
Yes
No
in
System tripped in seconds
2.
r
All flow switches supervisory switches & alarm bells tested
s su vis ry sl
I e p 0
Yes
No N/A
3.
_r es.
Alarm Bell oper es:
Yes
No N/A
4.
Flow tests condu ted:
re
Static Pressure psi
Yes
No
Flow pressure psi
2 inch drain?
Yes
No
5.
n
Systems inspect d and lubricated
Yes
No
6.
v
Air compressor r fills system in 30 minutes
Yes
No
7.
Systems drained and restores to normal operations
Yes
No
8.
Were the heat actuation devices tested on pre -action and deluge systems?
Yes
No N/A
WET SYSTEM
w-*No
1.
Flow test conducted:
Yes
Static Pressure 1.2— 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
N/A
4.
Systems inspected and lubricated:
Yes
No—
N/A
5.
Pressure regulating valves tested:
Yes
No
N/A
GENERAL
L'
Central Station Monitoring?
Yes
,�No
Name of Company- k, 4 Lt. rAL
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
Yes
�-' No
5.
Spare sprinkler heads are available
Yes
-- ff No
6.
Systems left in service
Yes
No
7.
Valves are sealed or supervised
Yes
8.
Signs are provided on valves
Yes
No
9.
City Static Water Pressure— 12-0 psi
PROBLEMS FOUND:
A.)" P VC- 0 -e,
mta; f.k
CORRECTIONS MADE:
Date corrected
By
THIS IS TO CERTIFY THAT THE SPRINKLER SYSTEM HAS BEEN PROPERLY TESTED AND INSPECTED FOR RELIABILITY TO COVER
THE ITEMS LISTED IN THIjSW
;V6RT:
SIGNATURE OF TESTER OFU�CICENSE#
Form #: 8304
LFire and Safety, In EDMONDS FIRE DEPARTMENT Invoice#12173 VQ
3013 Yd Ave. No. Confidence Tesfing Acd.#jQ2W 12,3
Seattle, WA. 98109 AUTOMATIC SPRWKLER SYSTEM - Date 1/11/2013
800.223.3473
Address 402 3rd AVE S City EDMONDS, WA Zip Code 98020
Occupied As STELLAS LANDING
Building Owner Same Phone No.206-268-3300
Address Same City Same Zip Code Same
Date of Inspection 1/11/2013 e Type of inspection ANNUAL
Tester's Name IL Mencias NICET Certification # 80211TO92711 / SFD CERT # M04506
DRY SYSTEM Location: N/A
test trip conducted. N/A
System tripped in 0 seconds.
All flow switches, supervisory switches and alarm bells tested. N/A
Alarm bell operates. N/A
Flow test conducted. N/A
Static pressure 0 psi.
Flow pressure 0 psi.
Two inch drain. N/A
Air compressor refills system in thirty minutes or less. N/A
System drained and restored to normal operation. N/A
9 Heat actuation devices tested on pre -action and deluge systems. N/A
WET SYSTEM Location: LIVING AREAS
Flow test conducted. YES
Static pressure 125 psi.
Flow pressure 115 psi.
Two inch drain. YES
Flow and supervisory switches and bells tested. YES REV;
System inspected and lubricated. YES
le.
GENERAL G c1carlif,�C*1t.
1. Central station monitoring. WASH. ALARM YES IT
Sprinkler heads less than fifty years old. YES
3. Pumper connections and clapper valves unobstructed. YES
Spare heads and wrench available. YES
System left in service. YES
Valves sealed and/or supervised. YES
Gauges recalibrated or replaced (every five years). YES
Signs provided on valves. YES
9. Static water pressure 125 psi
_LHydraulically designed system Placard on riser NO
11. PROBLEMS FOUND. NONE
CORRECTIONS MADE: NONE
Date corrected — By
This is to certify that the sprinkler system has been properly tested and inspected for reliability to cover the items
list on this test report
Signature of tester NICET License # 80211TO92711 SFD License #
M04506
AAA Fire and Safety, Inc. EDMONDS FIRE DEPARTMENT
3013 31d Ave. No. Confidence Testing
Seattle, WA. 98109 FIRE ALARM
800.223.3473
Address 402 3rd Ave S City Edmonds, Wa. Zip_28020
Occupied as SteHas Landing
Building Owner Same Phone # 206-268-3300
Address -Same City Same Zip Same
INVOICE # 12173
ACCOUNT#UW
DATE 1/11/2013
Date of Inspection 1/11/2013 Type of inspection ANNUAII, Tester's Name R. Mencias
Control Panel SILENTICNIGHT Model # -------------- SFD Certificate # M04506
No. of Initiating Circuits 6 No.of Signal Circuits 2
Battery Voltage 26.4 Battery Voltage Under Load 25.3 (signals operating) Charge Voltage 27.1
1 Trouble signal with A/C power off YES
2 System operates satisfactorily on standby power YES
3 auxiliary equipment operates (elevators, fans, dampers, etc.) YES
4 All signals operate on A/C power YES
5 All notification appliances checked for proper operation YES
6 All circuits checked for electrical supervision YES
7 Control panel checks per manufacturer's instructions YES
8 Central station or remote connection YES
9 Name of monitoring company WASH. ALARM
10 Key to panel available YES
TYPE
EQUIPMENT
# OF UNITS TESTED
SATISFACTORY
# OF TOTAL UNITS
Bells, Horns, Chimes
21
YES
21
Voice Alarm Speaker
0
0
Visual Alarm Devices
1
YES
1
Trouble Indicators
Panel
YES
Panel
Flow Switches
1
YES
1
Supervisory Switches
1
YES
Smoke Detectors
2
YES
2
Heat Detectors
12
YES
12
Manual Pull Stations
7
YES
7
Ventilation Control Ops.
0
0
Central Station
1
YES
1
Annunciators
1
YES
1
Elevator Call Down
1
YES
1
Fire and Smoke Damper
0
0
Phone Jacks
0
0
Door Unlocks (fail safe)
0
0
Door Release
0
0
Chemical Release
0
0
Other Duct Detectors
0
0
Problems found: None
Corrections Made: None
Date Corrected By.
TFUS IS TO CERTIFY THAT THE FIRE ALARM SYSTEM HAS BEEN PROPERLY TESTED AN
License MIENCIR*106LB
AAA Fire and Safety, In EDMONDS FIRE DEPARTNMNT Invoice#108174
3013 3rd Ave. No. Confidence Testing Acct#20000
Seattle, WA. 98109 AUTOMATIC SPRUOMER SYSTEM Date 1/13/2012
800.223.3473
Address 402 3rd AVE S City EDMONDS, WA Zip Code 98020
Occupied As STELLAS LANDING
Building Owner Same, Phone No. 206-268-3300
Address Same City Same , Zip Code Same
Date of Inspection 1/13/2011 Type Type of inspection ANNUAL
Tester's Name R. Mencias, NICET Certification # 80211TO92711 / SFD CERT # M04506
DRY SYSTEM Location: N/A
1. test trip conducted. N/A
2. System tripped in 0 seconds.
3. All flow switches, supervisory switches and alarm bells tested. N/A
4. Alarm bell operates. N/A
5. Flow test conducted. N/A
Static pressure 0 psi.
Flow pressure 0 psi.
6 Two inch drain. N/A
7 Air compressor refills system in thirty minutes or less. N/A
8 System drained and restored to normal operation. N/A
9 Heat actuation.devices tested on pre -action and deluge systems. N/A
WET SYSTEM Location: LIVING AREAS & EXISTWAYS
1. Flow test conducted.
YES
Static pressure 125 psi.
Flow pressure 115 psi.
2 Two inch drain.
YES
3- Flow and supervisory switches and bells tested.
YES
System inspected and lubricated.
YES
GENJERAL
1. Central station monitoring. WASH. ALARM
YES
2L Sprinkler heads less than fifty years old.
YES
ft
Corti
L Pumper connections and clapper valves unobstructed.
YES
4. Spare heads and wrench available.
YES
System left in service.
YES
In 0
6. Valves sealed and/or supervised.
YES
L>
7. Gauges recalibrated or replaced (every five years).
YES
8. Signs provided on valves.
YES
9. Static water pressure 125 psi
I.Q. Hydraulically designed system Placard on riser NO
11. PROBLEMS FOUND. NONE
CORRECTIONS MADE: NONE
Date corrected _ By
This is to certify that the sprinkler system has been properly tested and inspected
for reliability to cover the items
list on this test report
Signature of tester
NICET License # 802 1 IT09271 I SFD License
# M04506
AAA Fire and Safety, Inc.
3013 31d Ave. No.
Seattle, WA. 98109
800.223.3473
EDMONDS FIRE DEPARTMENT INVOICE # 108174
Confidence Testing ACCOUNT#20000
FIRF, AILARM DATE 1/13/2012
Address 402 3rd Ave S City Edmonds, Wa. Zip 98020
Occupied as SteHas Landing
Building Owner Same Phone # 206-268-3300
Address Same City Same Zip Same
Date of Inspection 1/13/2012 Type of inspection ANNUAIL Tester's Name R. Mencias
Control Panel SILENT1041GHT Model # SFD Certificate # M04506
No. of Initiating Circuits 6 N6.of Signal Circuits 2
Battery Voltage 25.8 Battery Voltage Under Load 25.3 (signals operating) Charge Voltage 26.7
1 Trouble signal with A/C power off YIES "
2 System operates satisfactorily on standby power YE ' S
3 All auxiliary equipment operates (elevators, fans, dampers, etc.) YES
4 All signals operate on A/C power YES
5 All notification appliances checked for proper operation YES
6 All circuits checked for electrical supervision YES
7 Control panel checks per manufacturer's instructions YES
8 Central station or remote connection YES
9 Name of monitoring company WASH. AILARM
10 Key to panel available YES
TYPE
EQUIPMENT
# OF UNITS TESTED
SATISFACTORY
# OF TOTAL UNITS
Bells, Horns, Chimes
21
YES
21
Voice Alarm Speaker
0
0
Visual Alarm Devices
1
YES
1
Trouble Indicators
Panel
YES
Panel
Flow Switches
1
YES
1
Supervisory Switches
1
YES
1
Smoke Detectors
2
YES
2
Heat Detectors
12
YES
12
Manual Pull Stations
7
YES
7
Ventilation Control Ops.
0
0
Central Station
1
YES
1
Annunciators
1
YES
1
Elevator Call Down
I
YES
1
Fire and Smoke Damper
0
0
Phone Jacks
0
0
Door Unlocks (fail safe)
0
0
Door Release
0
0
Chemical Release
0
0
Other Duct Detectors
0
0
Problems found: None
Corrections Made: None
Date Corrected By.
TI-HS IS TO CERTIFY THAT THE FIRE ALARM SYSTEM HAS BEEN PROPERLY TESTED AN
Electrical License MENCIR*106LB
AAA Fire and Safety, Inc. EDMONDS FIRE DEPARTMENT Invoice# 103204
3013 Yd Ave. No. Confidence Testing Account# 20000
Seattle, WA. 98109 AUTOMATIC SPRINKLER SYSTEM Date 12/20/2010
800.223.3473
Address 402 3 d . Ave S. City EDMONDS Zip Code 98020
Occupied As Stellas Landing
Building Owner Same / H.O.A. Phone No. 206-286-3300.
Address Same City _ Zip Code
Date of Inspection 12/20/2010 Type of Inspection Annual
Tester's Name Matt/Washburn SFD Certification # M04289/2103IT103009
DRY SYSTEM Location:
I . test trip conducted. ' N/A
2. System tripped in 0 seconds.
3. All flow switches, supervisory switches and alarm bells tested. N/A
4. Alarm bell operates.
N/A
5. Flow test conducted.
N/A
Static pressure 0 psi.
Flow pressure 0 psi.
6. Two inch drain.
N/A
7. Air compressor refills system in thirty minutes or less.
N/A
8. System drained and restored to normal operation.
N/A
9. Heat actuation devices tested on pre -action and deluge systems.
N/A
WET SYSTEM Location: Living Areas & Exitwgys
1. Flow test conducted.
YES
Static pressure psi.
Flow pressure - psi.
2. Two inch drain.
YES
3. Flow and supervisory switches and bells tested.
YES
4 . System inspected and lubricated.
YES
GENERAL
I . Central station monitoring. Name Wa.Alarm.
YES
2. Sprinkler heads less than fifty years old.
YES
3. Pumper connections and clapper valves unobstructed.
YES
4. Spare heads and wrench available.
YES
5. System left in service.
YES
6. Valves sealed and/or supervised.
YES
7. Gauges recalibrated or replaced (every five years).
NO
8. Signs provided on valves.
YES
9. Static water pressure /,R, � psi.
PROBLEMS FOUND: None.
CORRECTIONS MADE: None.
Date corrected By
R E�*Y
IEIoll
IWA Ll-wxol
This is to certify that the sprinkler system has been properly tested and inspected for reliability to cover
the items listed in this repo
Signature of tester SFD License
I
AAA Fire and Safety, Inc. EDMONDS FIRE DEPARTMENT Invoice# 103204
3013 3 d Ave. No. Confidence Testing Account# 20000
Seattle, WA. 98109 AUTOMATIC SPRINKLER SYSTEM Date 12/20/2010
800.223.3473
Address 404 3 d . Ave S. City EDMONDS Zip Code 98020
Occupied As Stellas Landing
Building Owner Same / H.O.A. Phone No. 206-286-3300.
Address Same City _ Zip Code
Date of Inspection 12/20/2010 Type of Inspection Annual
Tester's Name Matt/Washhurn SFD Certification # M04289/2103IT103009
DRY SYSTEM Location:
test trip conducted.
2. System tripped in 0 seconds.
3. All flow switches, supervisory switches and alarm bells tested.
4. Alarm bell operates.
5. Flow test conducted.
Static pressure 0 psi.
Flow pressure 0 psi.
6. Two inch drain.
7. Air compressor refills system in thirty minutes or less.
8. System drained and restored to normal operation.
9. Heat actuation devices tested on pre -action and deluge systems.
WET SYSTEM Location: Living Areas & ExitwUs
1. Flow test conducte
Static pressure /Z7 psi.
Flow pressure WIF psi.
2. Two inch drain.
3. Flow and supervisory switches and bells tested.
4. System inspected and lubricated.
GENERAL
I . Central station monitoring. Name Wa.Alarm .
2. Sprinkler heads less than fifty years old.
3. Pumper connections and clapper valves unobstructed.
4. Spare heads and wrench available.
5. System left in service.
6. Valves sealed and/or supervised.
7. Gauges recalibrated or replaced (every five years).
8. Signs provided on valves.
9. Static water pressure /A � psi.
PROBLEMS FOUND: None.
CORRECTIONS MADE: None.
Date corrected By
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
NO
YES
F , 0
9 pto-0 lbv
4 el-- I
5;;;0_0
This is to certify that the sprinkler system has been properly tested and inspected for reliability to cover
the items listed in this report.
Signature of tester__ z- SFD License #
� . . N
AAA Fire and Satiety Edmonds FIRE DEPARTMENT INVOICE# 103204
3013 P Ave. No. Confidence Testing ACCOUNT# 20000
Seattle, WA. 98109 FIRE ALARM DATE: 12-16-10
800.223.3473
Address: 402 3 rd. ave. s. . City: Edmonds Zip 98020
Occupied as: Stellas Landin
Building Owner: Phone # 206 -286-3300
Address Same City Same Zip Same
Date of Inspection: 12-16-10 Type of inspection Annual Tester's Name Matt/ ' Graue
Control Panel: silent knight Model # SFD Certificate # SCPM -04289/GraueLL964CK
No. of Initiating Circuits: addressable No. of Signal Circuits 4
Battery Voltage 7 Battery Voltage'Under Load (signals operating) Charge Voltage
1 . Trouble signal with A/C power off YES
2. System operates satisfactorily on standby power YES
3. All auxiliary equipment operates (elevators, fans, dampers, etc.) YES
4. All signals operate on A/C power YES
5. All notification appliances checked for proper operation YES
6. All circuits checked for electrical supervision YES
7. Control panel checks per manufacturer's instructions YES
8. Central station or remote connection YES
9. Name of monitoring company Washinaton Alann.
10. Key to panel available '
YES
TYPE
EQUIPMENT
# OF UNITS TESTED
SATISFACTORY
OF TOTAL UNITS
Bells, Horns, Chimes
27
YES
27
Voice Alarm Speaker
0
N/A
0
Visual Alarm Devices
Panel
YES
Panel
Trouble Indicators
Panel
YES
Panel
Flow Switches
I
YES
I
Supervisory Switches
1
YES
I
Smoke Detectors
2
YES
2
Heat Detectors
12
YES
12
Manual Pull Stations
8
YES
8
Ventilation Control Ops.
N/A
Central Station
1
YES
I
Annunciators
I
YES
I
Elevator Call Down
1
YES
I
-Fire and Smoke Damper
0
N/A
0
Phone Jacks
2
YES
2
Door Unlocks (fail safe)
0
N/A
0
Door Release
2
YES
2
Chemical Release
0
N/A
0
Water flow
I
YES
1
Problems found: None
Corrections Made: None
Date Corrected l3v
AAA Fire and Satlety
3013 P Ave. No.
Seattle, WA. 98109
800.223.3473
Edmonds FIRE DEPARTMENT
Confidence Testing
FIRE ALARM
INVOICE# 103204
ACCOUNT# 20000
DATE: 12-1.6-10
Address: 404 3 rd. ave. s. . City: Edmonds Zip 98020
Occupied as: Stellas Landin
Building Owner: Phone # 206 286-3300
Address Same City Same Zip Same
Date of Inspection: 12-16-10 Type of inspection Annual Tester's Name Matt/Graue
Control Panel: silent knight Model # SFD Certificate SCPM -04289/GraueLL964CK
No. of Initiating Circuits: addressable No. of Signal Circuits 4
4-1
Battery Voltage X4,i I Battery Voltage Under Load 201', 1Y (signals operatin-
g)
Charge Voltage Z-?
I . Trouble signal with A/C power off
YES
2. System operates satisfactorily on standby power
YES
3. All auxiliary equipment operates (elevators, fans, dampers, etc.)
YES
4. All signals operate on A/C power
YES
5. All notification appliances checked for proper operation
YES
6. All circuits checked for electrical supervision
YES
7. Control panel checks per manufacturer's instructions
YES
8. Central station or remote connection
YES
9. Name of monitoring company Washington Alarm.
10. Key to panel available
YES
TYPE
EQUIPMENT
# OF UNITS TESTED
SATISFACTORY
# OF TOTAL UNITS
Bells, Horns, Chimes
37
YES
37
Voice Alarm Speaker
0
N/A
0
Visual Alarm Devices
Panel
YES
Panel
Trouble Indicators
Panel
YES
Panel
Flow Switches
I
YES
I
Supervisory Switches
1
YES
1
Smoke Detectors
2
YES
2
Heat Detectors
14
YES
14
Manual Pull Stations
9
YES
9
Ventilation Control Ops.
N/A
Central Station
1
YES
I
Annunciators
1
YES
I
Elevator Call Down
1
YES
I
Fire and Smoke Damper
0
N/A
0
PhoneJacks
2
1 Flo
2
Door Unlocks (fail safe)
0
N/A
0
Door Release
2
YES
2
Chemical Release
0
N/A
0
Water flow
1
YES
I
Problems found: None
Corrections Made: None
Date Corrected
Electrical License M-04289
FIRE PREVENTION
If 11rV flF FOMICIRIDS SAFETY SURVEY
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIR DEPARTMENT
4S'
LOCATION: 402 3rd Avenue S
BUSINESS NAME: Stella's Landing Bldg 6 PHONE: 2062852205
MAILING POB #19320
ADDRESS: Seattle 98109
BUSINESS OWNER: Yates, Wood & Mcdonald" HOMEPHONE: 4256729068
EMERGENCY-1: Mann, Lance HOMEPHONE: 2062683317
KEY ACCESS-2: HOME PHONE:
01 FREQUENCY
STATION IL SHIFT'
17 A
I
SCHEDULED
DATE DUE 01 04/011110
UFIR o� 427
4152
ACTWE
e INITIAL INSPECTION DATE
PERSON CONTACTED: Nam- kJC4,1/
NAME OF INSPECTOR: S'� L, yL. d _W 9 0—
FIRE AS 11 /08 FA 11/08 FD LkI3x FE 1 10'7
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS WUN�ATIONS
T-11
F?
ENTER CODE ONLY ONCE 10
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
8
11st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE-INSPEC TION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED*
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE: -
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
7
RETURN RECEIPT
RECEIVED
6
7
4
18
4
8
DATE:
DISPOSITION:
8
� LETTER NEEDED [] YES NO
LETTER NEEDED 0 YES NO
FIRE DEPARTMENT COPY