The URL can be used to link to this page

547 DAYTON ST (2)0MISA Co. FIRE ST S-q7 OAVOIJ S-r Serving Briet: and 12425 Meridian Ave S Mountlake Terrace Everett, WA 98208 Phone (425) 551-1200 wwu�FireDistrictl. org Fax (425) 551-1272 LOCATION: 547 Dayton Street 98020 BUSINESS NAME: The Center PHONE: 4257715166 MAILING 547 Dayton Street, Edmonds, WA 98020 ADDRESS: BUSINESS OWNER: Jantz, Gregg/L HOME PHONE: FIRE PREVENTION INSPECTION REPORT -E<DMONDS 0 BRIER El MOUNTLAKE TERRACE [I UNINCORPORATED e- FREQUENCY I STATION 1, SHIFT--'s Annual 17-D SCHEDULEWay 2015 DATE DUE 509 UFIR 0 EME The Center HOME PHONE: 4257715166 RGENCY-1 rCURRENT KEY ACCESS-2: A351r4_ HOME PHONE: CITY YES NO BUSINESS EMAIL: LICENSE El PERSON CONTACTED: INITIAL INSPECTION DATE NAME OF INSPECTOR: _1> 0-70 -7b L(Y_ FIRL 'iY,'j I LIV16: AS 2/15 FA 1/14 FE12/13 FU LK BOX r &_1*11 III "':;11-h4p Fi� /j,4- HAZARDS FOUND AND LOCATIONS COMMUNICATIONS 1 1 2 2 3 3 4 4 5 5 6 6 7 7 1 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 co liance with the minimum standards adopted by the above jurisdictions. Any overlooked hazards or violations of the fire regulations does not imply approval of such co ions or violation. If you require additional information or to schedule a re -inspection for Edmonds or the Town of /oodway, call (425) 775-7720; for Mountlake Terrace or Brier, call (425) 754-0434. BUSINESS COPY S-q 7 L)AVTOAJ S-7- FIRE PREVENTION Serving Briei; Edinonds, and 12425 Meridian Ave S SNAID ��'CO. /( " INS PECTION REPORT I A4��' ' nilake Terrace Everett, WA 98208 FIRE --E:rEDMONDS 0 BRIER Phone (425) 551-1200 DIST;R Tp 0 MOUNTLAKE TERRACE 0 UNINCORPORATED � W"ww.FireDistrictl.org Fax (425) 551-1�72 547 Dayton -Street 98020 FREQUENCY I STATION& SHIFT Annual LOCATION: The Center 4257715166 BUSINESS NAME: PHONE: SCHEDULED May 2015 DATE DUE 509 MAILING 547 Dayton Street, Edmonds, WA 98020 LIFIR ADDRESS: Jantz, Gregg/L BUSINESS OWNER: HOME PHONE: The Center 4257715166 EMERGENCY-1: 77/-,5,'&G HOME PHONE: A) CURRENT YES NO KEY ACCESS-2: HOME PHONE: EMAIL: -c- (F CITY BUSINESS LICENSE PERSON CONTACTED: INITIAL INSPECTION DATE -7 AME OF INSPECTOR N -701 I> 0 D(2 7 RE SYSTEMS AS211517A 1114FE12713 t=KbOX FA HAZARDS FOUND AND,LOCATIONS COMMUNICATIONS 41 2 2 3 4 4 5, 5 6 6 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 D"S X 1st RE -INSPECTION 2nd RE -INSPECTION. FINAL RE -INSPECTION EXTENSION VIOLATIONS DATE DUE: DATE DUE: GRANTEDTO: DAT ED IUE:'. CITED: PERSON PERSON PERSON CONTACTED: CONTACTED: CONTACTED: INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: DATE: 3 VIOLATIONS VIOLATIONS PRE -CITATION CITATION ISSUED 1 5 1 5 LETTER SENT NUMBER: 4 CODE 5 2 6 2 6 DATE: SECTION RETURN RECEIPT 3 7 3 7 RECEIVED 6 DISPOSITION: 4 18 4 8 DATE: LETTER NE�15ED - E] YES El No LETTER NEEDED C] YES I—] NO 8 FIRE DEPARTMENT COPY Certification Given T:... RED YELLOW WHITE CONFIDENCE TEST REP�A§Rs FORE ALARM SYSTEMS (One Systorn per Repari) Occupancy Name: nw Comer 1br Coun-se Occupancy AddresS. 547 Dayton St. Edmonds Building Owner: Ibc Cento, for Comiscl inp -wid Ilea It PhonomUmbar: (425)771-5106 Owner Agent: pain Phone Number: _(425) 771 1-5 1 6f., Date of Inspection: 06/23/2 5 Rnspectiori Type: e/ Annual Quarterly Testers Name: _4eAj D1,4 SFO Certification Numbar: SCP-tsd�i Monitoring, ACT Phone M Account#: 81-1-117R.3 FACP Manufacturov'ifeal KnigbL Model #: 5208 Location: h-4 floor clevalor Vol Initiating Circuits, of Signal Circults: 4 Notes:_ ALARM SYSTEM FUNCTIONALITY YG5 No NIA All notification circulft operational? All circults chocked for electrical supervision? All auxiliary equipment operates (devators, fans, dampers)? Key to panel available? Operating inrtructlon& Et patU4? Trouble Indicatom function propeiiy? Test record postod at pa rid? Signals received at central station? Operator;�_ Problems Founj: . Corrections Made: Date Corrected* Corrected By: SFD Certification This certifies that this fire and life Sr&ety SySteM has Wen properly inspectad for reliability to cover tho Itoms listed In thl-m roportand vj:th So*40,o Pima 0,Ppar1MQr1t Moo L Code standafft, and'O PS- _,� OwneriManager for c 'r lye a, K-oon- ) Signature of Tester: Phoi Signature of eAffner,_ SYSTEM DEVICES MODEL P TOTAL TESTED SATISFACTORY? Yes MCI NIA HorniStrobes 19 Strobe Only 8 Worn Ort2y Spookor/Stroboss Speaker only SounderBase Bolls Manual PtAls Photo Smoke Detectors Ion Smoke Detectors 7 A I 4 Combination Smokc/Hcot 135' Rate pt Riza Heat 2000 Rate of Rise Heat 135* Fixed Tamp Heat 2001 Fixed Tomp Weat Duct Smoke Detectors Detector Remote Indicators. Rcmow Annunclatorn Elavator Recall Output Fan Presstirization Door HoRclors Door Unlock GurtainalRoll-down Doors Fire Fighter Phones Main FACP Trou bis with AC off? N40 Battery backup operational? No Battery voltage (no load) volts Battery voltage (fiA load) voks V,oltn Charge circuitvoltage [Battery Sizo 11 U& .Panel Type: Tgou ble, With AC car? YeG No Battory backup operationjil? Yes No Battary voltage (no Ioaci) volts Batte ry voltarje (fuil food) Chw9v circuit valtagu� volto �Baftsry S Panel Type: Trouble vvizh AC off? Yes No Battery backup operatiorial? Yes No Battery voltage (no food) volts Battery wobage (fuli load) vcAts Chargs circuit voltaqc voltv Battery Size PanelType: Trouble witli AG off? you No Battery backup operational? Yes No Battery voltage (no load) volts Battory vokago &10 load) volts Charge circuit vaitage valts Battery Siza Cdnfidenc.e Testing Company: 7 0.0 S=1 Fire Department Wolfe Fire Protection, Inc. 17321 Tye St. S.E., Ste. "B" - Monroe, WA 98272 Fax: 360.794.3080 0 Ph.: 360.794.8621 Confidence Test Report SPRINKLERS - WET Certification Given RED YELLOW WHITE (ONE SYSTEM PER REPORT) CONFIDENCE TEST: I LAI I REPAIRS:1 D Occuppncy`Address:_GQ Dalzi-oij St E_Jmoliijs OccupancyName: Build ingOwner: Phone Number: 7z �;16_z Re9ponsible Person: PCA M Phone Number: IG 7 71 r? ILI, BU'ilding Owner Address: S t/ 7 S�, r_dmoas L) Date -of Inspection: - 4� - i Inspection Frequency / Type: Annual Tester's Name (print): ASA�rv, k,,)(9 Certification Number: SCP- '?0qr2-0305 Central Station monitoring? Yes No Monitoring Co. Name: /19 -e, ri 4 -ew`_ Primary Component: System Make: System Model: ro System Location: Identification Number: ProblemsFound: (if additional room is required, please add a separate sheet.) Mori K Corrections Made: Date Corrected: Corrected by: (if additional room is required, please add a separate sheet.) 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 the Authority Having Jurisdiction's Fire Department Fire Code standards. All discrepancies are noted and have b en rep rte o the bu' i g Owner/Manager for corrective action. p Signature of Tester: . Phone #: 360.794.8621 Testing Agency: Wolfe Fire Protection, Inc. Mailing Address: 17321 Tye St. S E St "B" Monroe, WA 98272 Building Representative (signature): Sprinklers - WET Page: 1 of 2 The below items on the check list shall be inspected and tested. This list does notconstitute all of the required. inspecting_and testing of the Fire and Life Safety system. Refer to the Authority Having.Jurisdiction's Fire Department Fire Code for inspecting and testing requirements. .General- 'C!l - No: Cj'- 1, Flow Test conducted? ........................................................ ............. ................................................................... Yes 2. Staiiid�presisur'e: psi Flow Pressure: 70 psi To nu tal mber of sprinkier, heads on this -system? T� k '4- N o El Was 2" Main Drain checked? ....................................................................................... ! ................ Other [I Yes '5,'."FI_6w Switches, Supervisory Switches and Alarm Bells tested# ..................................... N/A E) Yesie( No C) 6. Pressure regulating valves tested? .............................................................................. N/A Yes 0 No El 7. Alarm Bell operate? ................................................................................... ................... N/A Ll Yes No C3 8..System inspected and lubricated ? ...................... ............................................................ Yes No C) �NoU,V.1jives�sealed or supervised? ............................................................................................................ Yes&) 10. Provided on all valves? ............................................................................................................. Yes& No C1 11. Pumper Connections and Clapper va Ives uno bst ru ct ed a nd turn fr eely ? ..... ................ Yesff No [I 12. Sprinkler coverage acceptable? , ................................... ........................................................... Yes JM -No (3 13-Have the sprinkler heads been replaced or successfully sample tested in the last 50 years? Yes Al, No Q 14-Aroper number spare sprinkler heads available with appropriate wrenchs for each? ............... Yes'&? No Ll 15. System left in service? ............................................................................................................. Yeso�' No Ll 16. System gauges been replaced or calibrated within the past 5 years? ............................. Ye No Q 17.-, Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? ..................... YesA N o C) 1.8.-Was, debris found in the, Fire Department Connection (FDC)? ................... ......................... . Yes EJ No 1.9�- Was the'Fire Department Connection (FDC) back flushed within the last 5 years? ....... ....... YesX N 0 Q 20. Was an internal pipe and valve inspection performed within the last 5 years? ................. Y e s.,Uf N o El Date Performed: 21. Was a signal received at the Central Station monitoring company? .................... NIA Q YesAf No Q Sprinklers * WET Page: 2 of 2 ai-n e -n' -c- , e- T* ... e- s t 'i" n, g— C* , o- m- p a' n, , y", Fire' Department Wolfe Fire Protection, Inc. 17321 Tye St. S.E., Ste. "B" - Monroe, WA 98272 Fax: 360.794.3080 Ph.: 360.794.8621 Confidence Test Report .SPRINKLERS DRY. Certification Give.n (ON.E SYSTEM PER REPORT) RED YELLOW WHIT CONFIDENCE TEST:'j 14 1 R E P A I R S: Occupancy Address: .51/7 Dc,,4an SE E-1makiJ5 OccupancyName: Ttie- 12/26-7-7 Building Owner: —�CA Phone Number: Responsible Person:- F)" 111) -fiolrd, Phone Number: W?G - 77 1 -5166- Building Owner Address: De�,, �Zlvd E-Amon J �s w`i Date o f Inspection: Inspection Frequency/ Type: Annual Tester's Name (print): L,146r) WOlk- Certification Number: SCP-q0t-1;-o3,o5-8�- Central Station monitoring? YesX No Monitoring Co. Name: Alci.cm nf,,4-el Primary Component:- System Make: .System Model: System Location: Identification Number: ProblemsFound: (if additional room is required, please add a separate sheet.) Corrections Made: D�te Corrected: Corrected by: (If additional room is required, please ad� a separate sheet.) 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''ahill is consistent with the Auphorlity Having Jurisdiction's Fire Departm.ent Fire Co*de standards. All discrepancies are.noteV and ha. e een " porfed,to the buildi-ng.Owner/Manager for corrective action. Signature of Tester: 4 Phone #: 360.794.8621 Testing Agency: �-Wolfe Fire Protect!", Inc. Mailing Address: 17321 Tye St. S E Ste "B" �- Monroe, WA 98272 Building Representative (signature):.. :11:�� Sprinklers - DRY Page: I of 2 The below items on the check list 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 A. Trip Test conducted? .................................. o._ ... . . .................................................................................................... Yes, No r 2. System tripped in 411- seconds. 3. Flow Test conducted? ...................................................................................................................................... YeS4 No 0 4. StaticPressur6: psi P low Pressure: psi 5. Total number of sprinkler heads on this system? 6. 2" Main Drain? . ................................................ ........... . ...................................................................... Other LI 'ie sW N o L:j 7. Flow Switches, Super�isory Switches and Alarm Bells tested? .......................................... N/A El YesA No Ll 8. Alarm Bell operates? ...................................... i ..................................................... I...* .......... N/A El Yesoff No 0 9. Air compress refill the system in 30 minutes or less? .............................................................................. Yesd No C3 Heat actuation devices, tested on the pre -action and deluge zystems? ............. N I Aa-'. -Y e s, Q, ''No E1--_ System inspected.and, lubricated,? ................................ .................................................... Ye:s,,h -No;Q, 12.,: V61*es�sealed or. supervised? .......................................................................................................... .... Yes,8' No 0-- 13.' Signs provided on all valves? ....................................................................................................... Yesa No'Lj 14. Pumper Connections and Clapper valves unobstructed and turn freely') .................. I ................................. Yes& No Ll 15. Sprinkler heads been.replaced or successfully sample tested in the last 10 years? ................................. . Yesid No Q rage ........... q_qyp_ _?ipqqpta le? ....... ..................... .... ......... Y -E es NoQ ��,111,fyoper number spare,sprinkler heads available- with appropriate wrenchs"for each? .... YesAT..No 0 18. System left,i*n sdirvide? ........... ...................................................................................... Y e s,�T No C) 19.. System gauges replaced or.calibrated within the last 5 years? ........................................................... Y e s.,_� No Ll 20.i"Sprinkler-heads free of corrosion, paint, obstructions and/or physical damage? ........................ YesA No 0 �,21.- System drained and-rdstored to normal -operation? ........................................ ...... .............. ........... Y e* s No (J 2 --Was;any debris.fou6d in the Fite Department Connection (FDC)?,.--. ........ ................... 21�1 ....... . Ye's El N 23.1 Was the Fire Department Connection (FDC) been' �baiA flushed in the last. 5 yearsl .................. YeSS No" LI 24. Was a signal received at the Central -Station monitoring company? ........................ N/A LI A Yes 'A No LJ & A 25. Was an internal pipe and valve inspection performed within the last 5 years? DatePerformed: Y e §j�� N o U Sprinklers * DRY Page: 2 of 2 SNO] Fl Serving Brier, Edmonds, and Mountlake Terrace DISTRICTwwwFireDistrial.orz LOCATION: I 547 Da�ton Street 98020 BUSINESS NAME: The Center MAILING ADDRESS: 547 Da�ton Street, Edmonds, WA 98020 BUSINESS OWNER: Jantz, Greng/L EMERGENCY-1: The Center KEY ACCESS-2: EMAIL: PERSON CONTACTED: qlor� NAME OF INSPECTOR: , �-o 04 AS-112/13FAIP14 F E 2i 1 3t F q)'L k B q.. '�; )'Ll 11 1 /11 vz / k-;' FIRE PREVENTION 12425 Meridian Ave S INSPECTIO14 REPORT 0 EDMONDS Everett, WA 98208 0 BRIER Phone (425) 551-1200 0 MOUNTLAKE TERRACE [I UNINCORPORATED Fax (425) 551-1272 PHONE: 4257715166 HOME PHONE: HOME PHONE: 4257715166 HOME PHONE: FREQUENCY I S TATION & SHIFT"' Ani 1 7-C SCHEDULED May "014 DATE DUE UFIR O'J:09 CURRENT CITY YES NO BUSINESS LICENSE INITIAL INSPECTION DATE '�- (-z- I HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS I 2 2 z 3 4 3 4 4 5 5 6 6 vi v 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1�1'RE-INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: EXTENSION GRANTEDTO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON i,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: 5 3 7 3 7 RETURN RECEIPT RECEIVED 6 ,4 18 4 18 DATE: DISPOSITION: 7 I LETTER NEEDED E] YES El NO LETTER NEEDED E] YES El NO 8 FIRE DEPARTMENT COPY gx& iz— 1-9073 340'A-,1. VV. �-IbU E. Ly1mfVaadWA52036 U (42.N)771-11LG Fo.,-�433)771-4423 Occupancy Name: W. Iding owner: Owner Agent: Date of Inspection: Testers Name: Manitoring: ACT Certification Given RED YELL 3141 WHITE CON FIDEN CE TEST REPAIRS FIRE ALARM SYSTEMS (One Sy5tean per Report) C-;uE,r for Couns;;dkaOccupancy Address: 547 Dayll3r) St. Edmarids Ceiaer f%w Comstfina ai-id Health -1 Phonellumber (4253)7"t-5166 Phone Number: (4 25) '77 1 - 6 6 () 1 .124!2014 Inspection Type: / Annual Quartedy Ken W, y SF 10 Certification N umben phone#: 190U- 752 2490 FACP Manufacture.— Shent Ki4ur Mode5:9: 3249 # of Initiating Circuits: 1 4 of Signa: CjrcujjG: 4 Account #: V-9'�83 Location. H ates - ALARM SYSTEM FUNCTIONALITY AU notification circuits operationar Ali circuits clier-ked for electrical supervision7 All auxiliarV equipment operates (elevators, fans, dampers)? Keyto panel available? oporating instructions at pand7 Trouble indicators function properly? Tost record potstod at pana17 Signals raceived at central station? Operator ProblemG Pound: A-20AX,- Corrections Made: Date Corrected: Corrected By:— (SF0 Caraffigantion .0, Thii3 caniflea that this fire and life saft-ty 5yQtem haz becan pr(upedy inzpeded for rePliab5hty to cover the items 1i gted in this report and iz- conzistent with Seatde Fire Depanment Fire Code atandards, and that discrepandes are noted and have been repotted to the building Owner/Manager for cooTecdye actlo*e�� Signature of Tester: Sipa-ture of Dw--Her, Phone*: 2D "., -� ( , o 7, SYSTEM DEACES MODEL4 TOTAL TESTED SA'"IS—EN TORY? y0s, iia KIIA HorniStrobas 18 v,"- j strobo0n;y 8 Horn Only Speaker on�y Soundur Manual "ha Photo Smokp. 0,6idurz ;;i1zh1 Knighl NIS-7A bjH Smoke Det-detLw& CoMbIhatioh 135' Rate of Rise Heat 200" Rato of Rise Hoat 135' Fixet] Temp Heat 20(r Fixed Temp Hoat Duct Smoke Detectors Deluctor Rern(mi Indicators Remote Annunciators Elf,vator Racaffl Output 71.3V injUhint; rin ARM Fan Prossurization L/ Door Holders L/ Door Uhlock CLraains1RoII=duwti Dears rivp Fightcr Phmos Main FACP PanelType: Trouble with AC off? No Battery backup operationaI7 6�0 NO Battery voltage fno load) d" volts Battery voltage tYug load) ),31='JVojts Chavp circuit vc:tage 'ivolts sattovy Giza -7 p Panc]Tvpe: Trouble with AC off? Yas Na Battery backup operationni? Yes No Battery vokage (no Luad) volts Battery voltage (full load) volts Charge circuit vokaga, volts Battery Size Troublo with A C off? Yes No Battery backup operational? Yes No Battary vo5tage (no Ecad) voItG Battary voltage �ufl load) volts Charge circuit voltage volts Battery Si2a Panel Tvve: Troubla with AC off? Yes No Battery backup operatianal? Yes KF-a aartery voDjtage f no Eaad) Battery vo:tage (full Ooad) volts volts Chavge circuit vokage vouts Battery Size Confidence Testing Company': Fire Department 'A ,A'DV_,4JVCED '%,FiRE PgoTEcTm, iNc. P.O. Box 1543 - Woodinville, WA 98072 Ph.: 425.483.5657 Confidence Test Report Confidence Testing: 206.793.0936 PRINKLERS - WET Certification Given RED YELLOW WHITE (NOTE: ONE SYSTEM PER REPORT) _F_ CONFIDENCE TEST: R E P A I R S Occupancy Address: Occupancy Name: Building'Owner: Ph6he Number: Responsible Person: Phone Number: Building Owner Address: . Date of Inspection: inspection Frequency/ Type: .�AR_ual_ Tester's Name (print): Certification Number: SCP--S Central Station monitoring? Yes_-Q�-�N`o_a Monitoring Co. Name: Primary Component: System Make: System Model: System Location: Identification Number: ProblemsFound: (if additional room is required, please add a separate sheet.) Corrections Made: Date Corrected: Corrected by: (If additional room is required, please add a separate sheet.) 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 the Authority Having Jurisdiction's Fire Department Fire Code standaris-. All discrepancies are notedjh0have been rep Vr o/��t,e, to th building Owner/Manager for co rrl"'qve action. Signature of Tester: d I Phone #: 425.483.5657 Testing Agency: 1(dvanced Fire Protection, Inc. MailingAddress: -P-.0'. B'oj.(.1543 -Woodinville, WA 98072 Building Rep re se n tative (signature): Sprinklers -, WET Page: 1 of 2 j olkbw items on the check -list shall be inspected and tested. This list does not constitute all of -the required l�_ ___ - inspeati d testing -of the Fire and Life Safety system. Referto the Authority Having-4urisdiction's _�jing an Fire Department Fire Code for inspecting and testing requirements. General 1. Flow Test conducted? .......... Yes4� No Ej .............. I ................................................ I .......................................................... 2. Static Pressu�e:. 2 -;",f ... '101 psi,��-��FI&�Pe.essure��-l-L—�I psi 3,77,otal,_number of sprinkler heads on this, system? 4. Was 2" Maiii, Drain cheqked7 ...... �t.; ....... .......... OthbIr.C) , I-lYbi ....... ........ No C3 5. -FloW,SwltchesV,Sup9rvlsory Switches and Alarm Be'lls tested? .................... ................ NJA D Yes,.Q—1 No El 6. Pressure regulatirfb,val, ................................................... -'D No D ,.e s 7. Alarm Bell operate? ................... * ............................................................. _X A Yes D J .',N 8. System inspected and I'dbricated"? ............................................................................................ Yes-2—No. D 9. V,alv,es�sO-aled�,�or-�"per.vised? ........................................ ............................... ..................................... Xesoi� C3, �No' 10. Provided on all valves? .............................................................................................................. Y e s-G�_. N o LI 11. Pumper Connections and Clapper -valves unobstructed an d turn freely ? .......... ......... Yeq�QNo C) 12.,Sprinkler coverage acceptable? ........... I ................................................................................... YeA:Q_.,No D 11 Have the sprinkler heads been replaced or successfully, sample tested in the last 50 years? Yes-QNo D Al 14.'Pr8p,er nimb'er spare sprinkler head 3,,-,vai lable with, appropriate wr"enc�'s for e.'ac'h? ................ . Y e N & 15. System left in service? ......... w .................................................................................................. Yes� No D been C 16,.,,Sys 0 jem gauges replaced or calibrated within the past 5 years? .......... .. Yes-E]-- No D 171prinkler heads free of corrosion, paint, obstructions and/or physical damage? ..................... Yes,,Lj No L) 18. Was debris found in the Fire Department Connection (FDC)? ................................................ Yes L) No-.63- 19. Was the Fire De,partmerit--,Connection,(FDCII back flushed within the last 5 years? es C3 No Cl 20. Was an internal- pipe and valve inspection performed within the last 5 years? ................. Yes-9__No C1 Date Pifformed: 21. Was a signal received at-thle Central Station monitoring company? .................... N/A (3 Yes=g-"*' No Cl Sprinklers - WET Page: 2 of 2 Confidence Testing Company: <" �-DVANCED P.O. Box 1543 - Woodinville, WA 98072 P -425.483.5657 h.: Seattle Fire. Department Confidence Test Report 206.386.1448 Confidence Testing Officer 206.615.1068 (fax) .206.233.7219Red Tag Hotline SPRINK LERS,.7,DRY Certification Given RED __rYELL0W WIHIITE� 9— (ONE SYSTEM. PE0REPORT) CONFIDENCE TEST: REPAIR'& Occupancy Address:. Occupancy, Name: Building Owner: Phone Number: Resporlsible, Person ;a!!6L4_ Pho Wumber: 77 S/ Buildingdw'ne�r Address: Date of Inspection:- Inspection Frequency Type: - Tester's Name (print): 11214;&C�� 45e?�140tl'_S_FD Certification Number SCP-1s: Central Station rn�nito�ing? Yes U'Nd El Monitoring Co.. Name: &AIW1,11112 Primary Component'. m.Make: Syste System Model: ,System- Location: Identificatim.Number: ProblemsFound: (if additional room is required, please add a separate sheet.) �w A, 77 - 77 Corrections Made- Date Corrected: Corrected' by: (if additional room is required, please add a separate sheet.) SFD Certification Number: SCP- This certifies thati this Fire and Life Safety system has been properly inspected for reliability to cover thel—tems listed in this report d istent with the Seattle Fire Department Fire Code standards, and all discrepancies �vlher/Manager_ are noted and have been -e to the bu' in � for corrective action. Signature of Tester: Phone #: 425.483.5657 Testing Agency: kdvanced Fire Protection, Inc. Mailing Address: P.O. Box 1543 - Woodinville, WA 98072 Building Representative (signature): i��j Sprinklers * DRY Page: 1 of 2 Th.q.,below items on the check list shall be inspected and tested. This list does not constitute'all of the re pired inspecting and testing of the Fire and Life Safety system. Refer to the Seattle Fire Department ....q Fire Code for inspecting and testing requirements. General 1. Trip.Test conducted? .......... I ...................................................... ......................................................................... Y e s 4E]1-7--�N o LI 2,.,- System tripped in seconds. 3. Flow Test conducted? .................... . ................... ... . ...................................................... ......................... Ye s--'[] No U 7" psi 4. static'"Pressure: psi Flow Pressure: 5. Total number of sprinkler heads on this system? 6. 2" Main Drain? ..................... I ............................................................................................................. Other E) Y e so@— N o 0 7. Flow Switches, SUpervisory.Switcfies-and Alarm Bells tested? .......................................... N/A Q Yeg�15* No El e 8. Alarm Belloperateis? .................. ........ ........... ............................................................. �N/A:U'Y s,,P- No Q 9. Air compress refill, -the system in'Id in-Inutes or less? ........................................ e s'U- N o U .................................... 10., Heat actuation"&ejvices tested on the prd .-'hction and deluge systems? ............ (N * /AoErYes 0 -No LI 11. System inspected and lubricated ? ...................................................................................... Y e SOS.: N o 0 12. Va,lves sealed or supervised? ............................................................................................................. Yes49--No E) 13. Signs provided on all valves? ......................................................................................................... Y e s.Q--N o C] 14. Pumper Connections and Clapper valves unobstructed and turn freely ? .................................................. Yes=U—No U 15. Spr - inkler heads been replaced or successfully sample tested in the last 10 years? ................................. Y e SC9,N o [I 16" Srrinkler, head coverage acceptable? .............. .................................................................. ... Yej _No,E) t �4_fv __J� 17. Propel r number spare sprinkler heads availabi I e with appropriate wrenchs for each? .................. Yes=@-mNo [I 18. S�te.m left in service? ............................................................................................................ Y els-El—N o 0 % System gauges replaced or calibrated within the last 5 years? ....................... .................. Y e s-=N o Ej ...... ....... ... 20. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? ........................ YescEll---No Ej 21. System drained and restored to normal operation? ................................................................... Yes.Q— No Ej 22. Was any debris found inIhe Fire Department Connection (FDC)? ............................................ Yes E) No 0- 23. Was the Fire Dekakhi�nt Conriectioionk(F been ackjIushed in the last 5 years.? ... Yes C] No D ............. 24. Was a signal received at the Central Station monitoring company? ........................ N/A El Yes M—No D 25. Was an internal pipe and valve inspe5�n performed within'the last 5 year s? Date Performed: C�9'011 C17 Y e s,.Q—'N o Q bprinKiers 9 uKy Page: 2 bf 2 Confidence Testing Company: A AN 0,�XKD�IVIA JC�ErDn-� FIRE PROTECTION, INC. — _l`<1 — P.O. Box 1543 - Woodinville, WA 98072 Ph.: 425.483.5657 &Faffthe Fire Department - Confidence Test Report 2-0_1�,306-4�44�8-eonfidenee=T-esting-Off4Ger. 206-_&�54-068-"a )- -2-06--2--33�-7-21-9R,e�d-T-ag-Hoffirre- SPRINKLERS - DRY Certification Given RED YELLOW WHITEA�]- (ONE SYSTEM PER REPORT) -CONFIDENCE TEST: .9--�R E P A I R S -F Occupancy Address: 11'��IV _27' Occupancy Name: -7?�12,� j, Building Owner: Phone Number: Respon - sible Person: Phone Number: -W,5- 77) Building Owner Address:_ Date of Inspection: Inspection Frequency/ Type: Unual Tester's Name (print): SFD Certification Number:. SCP-_5-Q..;?0_51F Central Station monitorin ? s No Monitoring Co. Name: (��-70- Primary, Component: System Make: System Model: ...Systern Location: /T 1511��p 5FOCI>7- Identification Number: Problems Found: if additional room is required, please add a separate sheet. Corrections Made: Date Corrected: Corrected by; (If additional room is required, 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 the Seattle Fire Department Fire Code standards, and -all-d-iscrepancies are noted and have been re rt id to the buildin , %finer/Manager for corrective action. Signature of Tester: Phone #: 425.483.5657 Testing Agency: Advanced Fire Protection, Inc. Mailing Address: P.O. Box 1543 - WoQdinville, WA 98072 Building Representative (signature): Sprinklers - DRY Page: 1 of 2 k J. The below items on the check list shall be'inspe'd6d 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 Rirb -Code for inspecting and testing requirements. General 1. Trip Test conducted? .......................................................................................................................................... Ye-s-U—No El 2. S ystem tripped in, seconds. 3. Flow Test conducted? ....................................................................................................................................... Y e s -EI'N-o LI 4. Static Pressure: psi Flow Pressure: 120 psi 5. Total ri�;f�bbvof sprinkler heads on this system? IFi- - 7 6. 2" Main Drain? ............ . ........................................................................... .......................... Other El 'N Yes-E5- No E) 7. Flow Switches, Supervis*CSWitch&-an'd4�AlarmwBelis tested? N/A /r No [I .......................................... 8. Alarm Bell operates? ............. ...................................................................................... —N/A El Yes No E 9. Air compress(r�ffll the-sy§,tem in 30'minutes or less? ................. ....................... . . ........ Ye's-��NoQ 10. Heat actuation tested on the pr6-a(ctI16d4n eiuge systems? ............... NIA -Ej"�Yes 0 No 0 11. System inspected and lubricated ? ............................ ......................................................... Yes--Ej- No El 12. Valves sealed or supervised? ............................................................ ...... ...... ..................... ...... Yea-U-No 0 13. Signs provided on all valves? ...................................................................................................... Yes-t3'No L] 14. Pumper Connections and Clapper valves unobstructed and turn freely ? ; .......................................... Yes-B—No (I ......... 15. Sprinkler heads been replaced or successfully sample tested Jn the last 10 years? ................................. Yes -El- No LI 16. Sprinkler ljead,cove rage. a cq, ........ .................. ........... qptable? . ........... Y e sCl� N o Q I 17. Proper number spare sprinkler heads available with appropriate wrenchs for each? .................. Y-e-s-Er-N o Ej 18. System left in service? .................................................................. ............................................ Yp::El--No [I 19. System gauges replaced or calibrated within the last 5 years? .......................... . ............ Ye.s-d No [I *2'0. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? ........................ Yes-U-No'Ej 21. System drained and restored to normal operation? .................................................................. Yesod—No E) 22. Was any del5ris fd"� in-the-Pir" �6,epartment Connection (FDC)? ............................................ Yes El No 23. Was the Fire Department Connection (FDC) been back flushed in the last 5 years.? ..... /4(4 - Yes [] No Ej 24. Was a signal received at the Central Station monitoring company? ........................ N/A L) Yes-Cj--No LI 25. Was an internal pipe and valve inspection_,P-IiyOMd,40thir�theFla�t 5)ye_a Date Performed: Yes4a' No 0 Sprinklers 9 DRY Page: 2 of 2 Confidence Testing Company: S-19-5 & Affir '(e F i r e . D Is p a r t m e n. t Confidence Test Report VA NCED 206-3�86.144TCoMM-e-ffc—e TMsIMTOfficer P.O. Box 1543 - Woodinville, WA 98072 -206�6175-tN" Ph.: 425.483.5657 2-G6�..72-T9RUd-TaTHUtlMw SPRINKLERS - WET Certification Given RED FYELLOW 'WHITE (ONE SYSTEM PER-0EPORT) CONFIDENCETEST: 1,a-1 REPAIRS - Occupancy Address: Occup��,qyName: Building.Owner: Ph6ne Number: Responsible, Person: Phone Number: Building Owner Address: Date of Inspection: Inspection Frequency Type: _6 �nl Tester's Name(print): —5,�IP-12'�SFD Certification Number: SCP---S'- CQ05�1 Central Station monitoring? Yes--Q—� No C3 Monitoring Co. Name: Primary Component: 4�Vl— 7Z System Make: System Model: System Location: Identification Number: Problems Fourll If additional room is required, please add a separate sheet. V Corrections Made Date Corrected: Corrected by: (if additional room is required, please add a separate sheet.) SFD Certification Number: SCPz_- -TVi s certifies that this.Fire and Life Safety system has been properly inspected for"r-61 lability to cover the items lisltedlri--this report and is consistent with the Seattle Fire'Department Fire Code standards, and all discrepancies are noted and have beep -Fe o ted to the buildipg ner/Manager 001V for corrective, action.- Signature of Tester: Phone #: 425.483.5657 Testing Agency: kdvanced Fire Protection, Inc. Mailing Address: P.O. Box 15 43 Woodinville, WA 98072 Building Representative(signature , 00, Sprinklers -, WET Page: 1 of 2 The below items on the check list shall be inspected and tested. This list does not constitute all of the i nspecting and testingof theFireand Life Safety system. Referto the Seattle Fire Department Fire Code for inspecting and testing requirements--__ General I. Flow, -Test -conducted? ..... �T: .................................................................................................................................... Y e s"�", No LI 2. Static Pressure: psi Flo . w Pro i "\ re: -' _77 psi 3. Totat number of s rinkler heads on this system? X;� -checked? 4. Was 2" Main Drain .................................................................................................. �7:---O th e r El 4Y e s U 1-14-o El ritcheO,.- 5. Flow Switches, Sup6rvisqrV iAd Alarm Bells tested? , V ..................................... N/A (j Yes-Ej- No 0 is, tested? .... ..................................................................... 6. Pressure regulating,V.alve N A..8�,>Y4tIQ No Ej 7. Alarm., -Bell, -operate? ........................................................................................................ N/A C) Yes -No El 7- 8. System inspecte�d!and lubricated. .............................................................. Yes--S No 0 f 7,1 iz V 9. Valves�sealed or supervised?.�.,...'...� ................. ?_ .................................................................... Yes*&- No El .10. F�rovided on all valves? ................................................................................ m ............................. Y e.s.El- N o El I I PumperConnections and Clapper valves unobstructed. and turn freely ? .............................................. . Yes-�_ No Ej, 12. Sprinkler coverage acceptable? ............................................................................................. Y e s-121- N o LJ 13'. Have"the sprinkler heads been replaced or successfully simple tested in the last 50 years? Yes -Or -No El 4- 14. Proper number spare sprinkler heads available with appropriate w-renchs for each? ............... Yes-5- No,E] 15. System left in service? ............................................................................................................ Y e s-tl- N o Q 16. System gauges been replaced or calibrated within the past 5 years ? ............... .............. Y e 9,CT- N o Q 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? ..................... Y e s-a- N o 0 18. Was debris found in -the Fire Department Connection (FDC)? ................................................ Yes L) No=5- 19. Was the Fire Departirp6rit Cpnnectio� (IFIDt)- back flushed within the last 5 years? Yes U No (3 20. Was an internal 'Me and valve inspection performed wit , hin the last 5 years? ................. Yes-U—No C1 Date Performed:' mpany? .................... N/A [I Yes b- No E) 21. Was a signal received at the��rvivtdo.� mez,�o, I lr�g L_', Sprinklers * WET Page: 2 of 2 FIRE PREVENTION Serving Briet; Edinonds- 12425 Meridian Ave S INSPECTION REPORT 00122z� SNOHOMISH CO. 0EDMONDS IRE, Mountlake Terraceand Everett, WA 98208 0 BRIER the Town of Woodway T Phone (425) 5514200 E]WOODWAY 0 MOUNTLAKE TERRACE R.1 www.FireDistrictl.org Fax (425) 551-1272 0 UNINCORPORATED 'IST FREQUENCY STATION & SHIF"� LOCATION: 547 Dayton Street 365 17 A I BUSINESS NAME: The Center PHONE: 4257715166 SCHEDULED DATE DUE � 05/01/12 MAILING PO Box 700 LIFIR � 509 5935203 ADDRESS: Edmonds 98020 BUSINESS OWNER: The Center HOME PHONE: 4257715166 ACTIVE EMERGENCY-1: Jantz, Gregg 2069476415 HOME PHONE: CURRENT KEY ACCESS-2: Jantz, lafon HOME PHONE: 2069.992417 CITY YES NO BUSINESS 1:1 El LICENSE PERSON CONTACTED: 'T) A INITIA INSPECTION DATE NAME OF INSPECTOR: A2 A4 Inp 11411 *A- -T'4-11 A lei // ?/) / I -FIRE A S 1 FA 3/11 FD Lki3x FE 1712/1 SYSTEMS: i _ Q_ ANNUAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 2 '?0 1 ii6j&j R�A P.-D 016A 10 Qef I Z V7 Q, ----6 2 6'�, 0 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: 1 INSPECTOR: &Jt/L 4- INSPECTOR: INSPECTOR: 2 DATE: ta DATE: DATE: 3 OLATIONS 1 5 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 O�� 2 6 2 6 DATE: CODE SECTION: 5 3 7 3 7 RETURN RECEIPT RECEIVED 6 14 18 4 18 DATE, DISPOSITION: 7 LETTER NEEDED E] YES [I NO LETTER NEiDED [] YES NO r 8 FIRE DEPARTMENT COPY 1w 19023 360'Ave W. &i& 13� Lywwd, WA 9W36 U.S-A- (42S) 771-11dd Fzt(42S) 771-422 =v , = Occupancy Name: Building Owner Owner Agent: Certification Given RED YELLOW I WHITE,,)�� CONFIDENCE TES1 FIRE ALARM SYSTEMS (One System per Report) REPAIRS Untor for coumulins Occupancy Address: 647 0syton St Edniands 77 - 1UcCw=fixC0=cM8&H=1d1 PhoneNumber. (42-5)771-5166 Anne Phone Number (425) 771-5166 Date of Inspection: OHM70 12 Inspection Type: �'- �"Wniu Quarterly Testers Name: JOW0160" SFD Certification Nlim�—: SCP-.(J -1979)� Monitoring: ACI Phone#: 1800-752-2490 Account #: 119-9785 FACP Manufacturer. 9i'=dKnish, Model #: 5209 Localjon: IstF loor Mwkiwd # of Initiating Circuits: I # of Signal Circuits: 4 Notes: ALARM SYSTEM FUNCTIONALITY Yea No NIA All notification circuits operational? All circuits chocked for electricalsupervislon? All auxiliary equipment operates (elevators, fans, dampers)? Key to panel avallabW Operating Instructions at panel? Trouble indicators function properly? Test record posted at panel? Sign&6 received at central station? Operator /X I I Problems Found: Corrected By: Corrections Made: Date C orrected: SFD Certificatlen #- This certifier, 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#: -Z(Z- Signature of Owner. Vj/ - b ISYSTEM DEVICES MODEL 0 TOTAL TESTED SATISFACTORY? Y". No N/A Horn!Strobea (I 7)Sygtan gunwr I (I)W/P IN strobe only 8 18 Y Ham Only Speaker/Strobe# Speaker only Sounder Bass Bons Manual Pull& Sil"r aighrM84A I Photo Smoke Detectors sx-pj)0�0'. 4 L( Ion Smoke Detectors Combination SmakeMeat 13r Rate of Rias Heat 20V Rate of Rise Heat 135.0. Fixed Temp Heat 20V Fixed Tamp Heat Duct Smoke Detectors X, Detector Remote Indicators Remote Annunciators EIevator.Reca Output oluv muchinu rm ARM 3 ?2 Fan Pressurization Door Holders Door Unlock CurtainslRalWown Doors Fire Fighter Phone& Main FACP Trouble with AC off? r-YeiisQ No Battery backup operational? No Battery voltage (no load) Volts Battery Voltage (full load) Vo its Charge circuit voltage %I, k volts as" size 1�w PanelTvpe: Trouble vvith AC off? Yea No Battery backup aiwational? Yes No Battery voltage (no load) volts Battery voltage (full load) volts Charge circuit Voltage valts; Battery Size PanelType: Trouble with AC off? Yes No Battery backup operational? Yes No Battery voltage (no load) -Vokg Battery Voltage (full load) Vohs ,Charge circuit voltage Volta Battey S126 PanelType: Trouble vvith AC off? Yes No Battety backup operational? Yes No Battery voltage (no load) volts BattWy VdtV* (fUlload) VCRs Charge circuit Voltage Vohs-' Baftwy Size FIRE PREVENTION Serving Brier, Ednionds 12425 Meridian Ave S INSPECTION REPORT SNOHOMISH CO. OEDMCINDS �";FIR Mountlake Terraceand Everett, WA 98208 0 BRIER E the Town of Woodwa-y Phone (425) 551-1200 0 WOODWAY 0 MOUNTLAKE TERRACE ST R., IT www.FireDi9trictl.--cfrg Fay (425) 551-1272 0 UNINCORPORATED FREQUE�CY STATION & SHIFT7*1 LOCATION: 54 7 365 - Dayton Street 1 17 D SCHEDULED BUSINESS NAME: The Center PHONE: 4257715166 DATE DUE ()5/0-1111 MAILING PO Box 700 FIR ' 509 593�5 203 ADDRESS: Edmonds 98020 IU BUSINESS OWNER: The Center HOME PHONE' 4257715166 ACTIVE EMERGENCY-1: Jantz, Gregg HOMEPHONE: 20694764 - 15 CURRENT YES NO KEY ACCESS-2: Jantz, Iafon HOME PHONE: 20699924.17 CITY BUSINESS LICENSE INITIAL INSPECTION DATE PERSON CONTACTED: A NAME OF INSPECTOR: _ �t7_ o FIRE AS 3111 FA 3/11 FD LkBx FEL/f -L SYSTEMS: ANNUAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 1 1 UL 01 2 2 3 3 4 4 5 5 6 6 7 7 61o'.pzzid- 1/7 Awj 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 x V CONTACTED: PERSON CONTACTED: PERSON CONTACTED: 1 INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: DATE: 3 LATIONS 1 5 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 2 6 2 6 DATE: CODE SECTION: 5 3 7 3 7 RETURN RECEIPT RECEIVED 6 4 8 4 18 DATE: DISPOSITION: 7 �LE7TT R �EED'�6" [] YES [I NO fLETTER NEEDED YES El NO 8 FIRE DEPARTMENT COPY Confidence Testing Company: D NCED .i V 4 FIRIE RPROITENCTI�ON�,INC. P.O. Box 1543 - Woodinville, WA 98072 Ph.: 425.483.5657 S-AffAl-e Fire Department Confidence Test Report 206.386.1448 Confidence Testing Officer 206.615.1068 (fax) 206.233.7219Red Tag Hotline SPRINKLERS - WET Certification Given RED YELLOW C1 WHITE —a — (ONE SYSTEM PER REPORT) CONFIDENCE TEST: R E P A I R S F [J 7 Occupancy Address: Occupancy Name: Building Owner: Phone Number: Responsible Person: YPhone Number: 22� - Building Owner Address: Pate of Inspection Inspection Frequency Type:'. Aojiva4— Tester's Name I (print): SFD Certification Number: SCP-_5,-0s?0_V Central Station monitoring? Yes-U— No Ll Monitoring Co. Name: Primary Component- ? /v ;;i�> System Make: System Model: H6,,"TT�AZ /C-' IIIAZtl;!!!� System Location: Identification Number: ProblernsFound: (if additional room is required, please add a separate sheet.) Corrections Made: Date Corrected: Corrected by: (If additional room is required, 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 the Seattle Fire Department Fire Code standards, and all discrepancies are noted and have been-r--,-pdrted to he uil n wner/Manager for corrective action. Signature of Tester i Phone #: 425.483.5657 Testing Agency: �dvanced Fire Protection, Inc. Mailing Address: P.O. Box 1543 -Woodinville, WA 98072 Building Re presentative (signature):, 1&=;1 Sprinklers * WET Page: 1 of 2 The below items on the check list shall be inspected.and tested. This. list does, not constitute all of the ��q,!�lred 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-Testconductedl ........................................................................................................................................ Y e� No E) 2. Static Pressure: psi Flow Pressure: psi 3. TotaUhumber of -sprinkler heads on this system? 4. Was 26'Maiii Drain"checked? . ...................................................................................................... 0 t h eir" (3 Y e s-@- No 0 5. Flow"qW" i , tches, Supervisory Switches and Alarm Bells tested? ..................................... N/A Ej Yes -a- No 0 6. Pressure regulating valves tested? .............................................................................. N /A -a- Yes (3 No 0 7. Alarrn',�Bell ....................................................................................................... N/A Yes-07 No 0 8. System inspected and lubricated ? .................................................................................. Y e s-d- N o 0 9. Valvels,,,"sealed or supervised? ............................................................................................ I ................. Yes-B- No Cl 10. Provided on all valves? ............................................................................................................. Y ers-t3- No Ll 11. Pumper,Connections and, Clapper valves unobstructed and turn freely ? .............................................. Y e sQ No 0 12. Sprinkler coverage acceptable? ............................................................................................. Yes-tj- No (3 13. HaV,64M sprtfikler heads been replaced or successfully sample tested in.the last 50 years? yel-0- No 0 14. Proper number spare sprinkler heads available with appropriate wrenchs for each? .............. Ye,!Er-El- No 0 15. System left in, service? ............................................................................................................. Yes-Ej- No 0 16. System gauges been replaced or calibrated within the past 5 years? .......... C�10169 ................ ................... Y es-U- N o El 17. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? ...................... Y e s--C3- N o El 18. Was debris found in the Fire Department Connection (FDC)? ................................................ Yes L) No-& A�.. 19. Was the Fire Department Connection (FDC) back flushed within the last 5 years? Ye& 0 No El 20. Was an internal pipe and valve inspection performed within the last 5 years? ................. Y e s-El-- No E) Date Performed: Ci�q/ 0 21. Was a signal received at the Central Si�tion; �rn`o*rfi 9''Firrg'06"olp,pany? .................... N/A Ej Y e 9-EF- No El Sprinklers * WET Page: 2 of 2 Confidence Testing Company: s6`4-7011-e- Fire Department A&kDVANCED P.O. Box 1543 - Woodinville, WA 98072 Ph.: 425.483.5657 Confidence Test'Report 206.386.1448 Confidence Testing Officer 206.615.1068 (fax) 206.233.7219Red Tag Hotline SPRINKLERS..- DRY, Certification Given RED 0 * FYELLOW, L) WHITE -D— (ONE SYSTEM PER REPORT) CONFIDENCE TEST: R E P A I R S: Occupancy Address: 2 72, \4 IV7-0-Al S 7- Occupancy.Name: Building Owner: Phone Number: Responsible Person: Phone' Number: Building Owner Address: Date of Inspection: Inspection Frequency Type: &Daua-L Tester's Name .(print): llxeo Y-,2�;> SFD Certification Number: SCP- Central Station monitoring? Ye.so, No D Monitoring Co. Name: 1441,0) Primary Oomponeft, 0/1 1--***Ry System Make:. System Model: Z2 ILE` Z System Location: Identification Number: Problems Found: (if add&nal room is required, please add a separate sheet) fell Corrections Made: Date Corrected: .Corrected by: (If addifional room is required, 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 the Seattle Fire Department Fire Code standards, and all discrepancies are noted and have bee orted to the ui wner/Manager for corrective action. Signature of Tester: Phone #: 425.483.5657 Testing Agency: Advanced Fire Protection, Inc. Mailing Address: P.O. Box 1543 - Woodinville, WA 98072 B u i Id in�'Re presentative (signature): Sprinklers e DRY i Page: 1 of 2 The below items on the check- list shall be inspected and tested. This list does not constitute all of the i�pqmjr4 inspecting and testing of the Fire and Life Safety-. system. Refer to the Seattle Fire -Department A--ffiret ode for inspecting and testing requirements"' General 1. Trip Test conducted? .......................................................................................................................................... Y e s-l!]--N o LJ 2. System Ir , 1 , pped in seconds. 3. Flow Test conducted? ..................................................................................................................................... Yesu- N5 a 2e�--Psi ;;(72 4. Static Pressure: Flow Pressure: Psi ---------- - - 5. Totakriumber of s rinkler on `6js' s,�.'Stern? 6. 2" Main Drain? ................................................................................................................................... Other El Yee-tj— No C) X- - - -7. Flow Switches, Supervisory Switches and Alarm Bells tested? .......................................... N/A Y e s-El— N o El 8. Alarm Bell operates? .......................................................................................................... N/A Cl Y e s, �N o D 9. Air compress refill.the system in 30,minutes or less? ............................................................................ Yes-5— No L) 1.0. Heat actuation devicesYtOgtedlon the�p�d-actio6�and deluge systems? ............ N I-A-tn-1 -Y-es, 0 No D 11. System inspected and lubricateA? .......................................................... ....................... Y 's. e 10—No (3 12. Yalves sealed or supervised? ............................................................................................................. Yes-2—No D 13. Signs provided on all val ves? ...................................................................................................... Yes--Ej--No Ej .14. Pumper Connections and Clapper valves unobstructed and turn freely ? .......................... Yes-t3— No D 15. Sprinkler heads been reolace.d dr-succ6isfully'sample tested in the last 10 years? ................................. Yes-tj—No D .16. Sprinkle6he�ad,,coverqge accd`�Jable? ... ......... �t( ....... i� ................ ! -�i .......... I--, ... Yes--Q— No D j., 17. Proper number spare. s'prIhklbe-he'*ads`av'ailable with appropriate wrenchs for each? .................. Y es--d--- N o C3 18. System left in service? ............................................................................................................... Yws� No C1 19. System gauges replaced or calibrated within the last 5 years? ........................... ............ ...... ....... ..... Yes-0— No (3 20.-Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? ........................ Yes-0- No D 21. System drained and restored to normal operation? .................................................................. Y es-lj,- N o 0 22. Was any debris found in the Fire Department Connection (FDC)? ............................................ Y e s (3 Nv-tj- 23. Was the Fire Department Connection (FDC) been back flushed in the last 5 years? ./M .... Yes D No 0 24. Was a signal received at the Central Station monitoring company? ........................ N / A Ej Y e sotr—N o L) 25. Was an internal pipe and valve ins 9- r pe�tion R�Io�rmed *.ifhin-ihe,lbstl�years? Date Performed: Y e s-t]—N o C3 Sprinklers - DRY Page: 2 of 2 ............. Certificatioh Giveh ............ ....... ....... ...... YELLOW WHITE RED CONFIDENCE TEST 19023 36, Ave W, Suita E, Lymmaud, W-k 98036 U.S.A. REPAIRS (47.S)771-1i66 Fax(42.S)77i-4422 FIRE ALARM SYSTEMS (One System per Report) Occupancy Name: Ct:nWr for Counsuling Occupancy Address: 547 Dayt-11 st. Edmands Building Owner. C=tcr for Cknu=liag & Hwith Phone Number: (425) 771-5166 Owner Agent: D-A-JAINa Afa6s��'f PhoneNumber: (425)771-5166 Date of Inspection: 05/26/2011 Inspection Type: V Annual Quarterly On MOYZ7hY7SFD Certification Number: SCP- Testers Name: ftu�� Monitoring: A c i Phone #:- 8 2 - 2 7 Account#: FACP Manufacturer: ltmi- goo4lViodel #: ',;-'L 0 8 Location: e>kec' ery # of Initiating Circuits: ( -j #of Signal Circuits: Notes: ALARM SYSTEM FUNCTIONAUTY yes No NIA All notification circuits operational? All circults checked for electricalsupervis !on? All auxiliary equipment operates (elevators, fans, dampers)? Key to panel AVAIIWO V7— Operating instructions at panel? Trouble indicators function properly? Test record posted at panel? Signals received at central station? Operator#-1-11 V Problems Found: Corrections Made: Date Corrected: Corrected By: SFD Certification M This certifies that this fire and life safety system has been properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code standards, and that discrepancies are noted and have been reported to the building Owner/Manager for corrective aratiog. Signature of Tester: Z)"'14 x4ltz— Phone #: �7 f - I ko G Signature of Owner: DorjlvcL-. ffla-kcsle--i ,,�jY§TEM DEVICES MODEL# TOTAL TESTED SATISFACTORY? Yes No N/A Ham/Strobes 54skm spmsar +!V + I Strobe Only Ham Only Speaker/Strobes Speaker only Sounder Base Belts Manual Pulls 4 x M3- -7 4 V/ Photo Smoke Detectors k — Pliz- 1-0 Ion Smoke Detectors Combination Smoke/Heat 135* Rate of Rise Heat 200' Rate of Rise Heat 7� 135' Fixed Tamp Heat 200' Fixed Tamp Heat Duct Smoke Detectors )C Detector Remote Indicators Remote Annunciators ;K Elevator Recall Output AAM x Fan Pressurization Door Holders )K Door Unlock x Curtains/Roll-down Doors I J- Fire Fighter Phones I —F Main FACP Trouble vAth AC off? No Battery backup operational? No Battery voltage (no load) volts Battery voltage (full load) j:E...V,0.voIt6 Charge circuit voltage Z-Z-LO- volts Battery size ]XV 74/1 PanelType: Trouble with AC off 7 Yes No Battery backup operational? Yes No Battery voltage (no load) volts Battery voltage (full load) volts Charge circuit voltage volts Battery Size PanelType: Trouble with AC off7 Yes No Battery backup operational? Yes No Battery voltage (no load) volts Battery voltage (full load) volts Charge circuit voltage volts Battery size PanalType: Trouble iWth AC off? Yes No Battery backup operational? Yes No Battery voltage (no lead) — volts Battery voltage (full load) -voks Charge circuit voltage volts Battery Size