55 PINE ST BLDG 87 7. -07 7-
RE PREVENTION
Serving Brier, Eanionas, and 12423 Meridian Ave S
INSPECTION REPORT
SN�HO'NI]Off Co.
Mozintlake Terrace Everett, WA 98208
FIRE
OEDMONDS
El BRIER
DISTRILUT
Phone (425) 551-1200
.
0 MOUNTLAKE TERRACE
[1 UNINCORPORATED
www.FireDistrictl- org
Fax(425)551 -1 272
FREQUENCY STATION & SHIFT_"�
LOCATION: 55 Pine Street 98020
Annual 17-C
Pt Edwards Condos Bldg 8
SCHEDULED Apr 2017
BUSINESS NAME:
PHONE:
DATE DUE
423
MAILING
LIFIR
ADDRESS: 55 Pine Street, Edmonds, WA 98020
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
HOME PHONE: 17
CURRENT YES NO
KEY ACCESS-2:
HOME PHONE:
CITY
BUSINESS F_� El
EMAIL:
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: F-6 F-0
FIRESYSTEMS: AS11/15FAjA4+5FE'11/1 12:00:OOAM
Date Last Serviced: - I[A
4 15 6
HAZARDS FOUND AND LOCATIONS /COMMUNICATIONS
.2
2
3
3
4
,4
5
5
�6
6
.01
.7
7
I AGREE TO 6ORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
7st RE -INSPECTION
2nd RE -INSPECTION
FINAL RE -INSPECTION
EXTENSION VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO.
DATE DUE:
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED.
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE*
DATE:
i DATE:
3
VIO LATION S
V1 OLATIONS
CITATION
PRE -CITATION
ISSUED
4
1 5
5
LETTER SENT NUMBER
CODE
5
2 6
2
DATE SECTION
RETURN RECEIPT
7
3 7
RECEIVED
X8
DISPOSITION.
4 8
4 8
DATE
LETTER NEEDED YES NO
LETTER NEEDED YES NO
�
co
Serving Brier, Edmonds, and
Mountlake Terrace
www.FireDistrict].org
LOCATION: a
.55 Pine Street 98020
BUSINESS NAME:
Pt.Edwards Condoq Bldg 8
MAILING
ADDRESS:
55 Pine Street, Edmonds, WA 98020
BUSINESS OWNER:
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE:
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
0 BRIER
[3 MOUNTLAKE TERRACE
0 UNINCORPORATED
EMERGENCY-1:
HOME PHONE: "CURRENT
KEY ACCESS.-2: HOME PHONE: CITY YES NO
EMAIL: BUSINESS El F-1
LICENSE
PERSON CONTACTED: (---fi C INITIAL INSPECTION DATE
NAME R:
- ��/ 7
EPTO C
FIRE PREVENTION
Serving Briei: Edinonds, and
EW5 Meridian Ave S
INSPECTION REPORT
FIEREMozintlake Terrace
Everett, WA 98208
0EDMONDS.
0 BRIER
STR1401T
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
[1 UNINCORPORATED
www.FireDistrictl.org
Fax (425) 551-1272
55 Pine Street 98020
FREQUENCY
Annual
STATION 1, SHIF
17-A
:,B LOCATION:
I
BUSINESS NAME: Pt Edwards Condos Bldg 8
PHONE:
SCHEDULEcApr 2015
DATE DUE
423
MAILING
c 55 Pine Street, Edmonds, WA 98020
UFIR 0
ADDRESS:
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
HOME PHONE:
"'CURRENT
KEY AC(jESS-2:
HOME PHONE:
CITY YES NO
EMAIL:
BUSINESS
LICENSE
IPERSON CONTACTED:
INITIAL INSPECTION DATE
/',MM��OF INSPECTOR:
.- I )a�-,dc
��
b I ItIVIb: A.c9_YfV1'i FA TrT/1.9 FF 1 n/1 '1zF;.R+k--Rny
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HAZARDS FOUND AND LOCATIONS /rOM N'18�TIONS
=U'
2
2
3
3
4
4
5
5
6
6
7
7
�,,�,,G!REE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st R&INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTEDTO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS"
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
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
.0
18
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED [-] YES NO
LETTER NEEDED C] YES [I NO
FIRE DEPARTMENT COPY
SNOHOMISH CO.
FIRE
DIST]
Serving Briei: Edmonds, and
Mountlake Terra.ce
I
. www.FireDistrictl.org
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
El BRIER
El MOUNTLAKE TERRACE
El UNINCORPORATED
FREQUENCY
STATION& SHIFT-'
LOCATION:
�
FitieSteet 28M
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1113
BUSINESS NAME:
PHONE:
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SCHEDULED
DATEDUE OApr2DI4
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ADDRESS:
55 R ro SL=4 b:dmarKJb,vVA OM20
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
HOME PHONE:
�'CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
1:1 1:1
EMAIL:
LICENSE
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR:
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
2 3
2
3
3
4 k,-t . _ccaz.
UJ et_e,
4
5
5
6
6
7
7
1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
lst RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE.
I
EXTENSION
GRANTEDTO-
FINAL RE -INSPECTION
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
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED [] YES N
-1 YES 0 N
rLETTER NEEDED F YES NO
8
FIRE DEPARTMENT COPY
---Ago 61__
1,
Sqrving Brier, Edmonds
FIRSNOHOMISH CO. '0*4 Mountlake Terraceand
W*)j the Town of Kboa'way
DISTRT www.FireDistrictl.org
LOCATION: 55 Pine St
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Far (425) 551-1272
BUSINESS NAME: 1-1 Ezuwarus conUOS D[Ug 0 PHONE:
MAILING
ADDRESS:
BUSINESS OWNER: HOME PHONE:
2063880180
�EMEPGENCY-1: Copeland Grp(Prop.fogr) HOME PHONE:
vt K , E 4CCESS-2: bc��, �ainr HOME PHONE: 20642,U433
PERSON CONTACTED: [/-I rL�.g'L�
NAME OF INSPECTOR:
FIRE AS 9/1 '11 FA 9/11 I'D Lkf3x'
SYSTEMS: 101t 2— toll-L OV--
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
0 BRIER
0 WOODWAY
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY I STATION & SHIF"�
365 17 C
SCHEDULED
DATE DUE 1' 94/0113
UFIR � 423 4152
\1 _1/
CURRENT
CITY YES NO
BUSINESS
LICENSE
FNITIAL INSPECTION DATE
FE 4af -4—
_L
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 NEkf 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:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
18
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED F] YES NO
LETTER NEEDED F] YES NO
1
8
FIRE DEPARTMENT COPY
(Y41
d
Serving Brier, Edmon 1241`5' Meridian Ave S
Mountlake Terraceand Everett, WA 98208
the Town of Woodway Phone (425) 5514200
I T www.FireDistrictl.org Fax (425) 551-1272
ATION: 55 Pine St
NAME: Pt Edwards Condos Bldg 8
All I1%Ir_1
BUSINESS OWNER:
EMERGENCY-1: Copeland Grp(Prop Mgr)
KEY ACCESS-2: +f*—&a96A9_UaiW_
10 t^j 1�\,c_\<'1>ej
nn.11qnnnAnn
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
0 BRIER
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FREQUENCY I
365
STATION& SHIFT')
17 B
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SCHEDULED 04/01/12
DATE DUE 1'
UFIR 1, 423
4152
HAZAF,IDS FOUND AND LOCATIONS COMMUNICATIONS
IN,
AS
G A
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
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
%
-DATE DUE.,
DATE DUE:
GRANTED TO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
C NTACTED:
CONTACTED:
1
2
INSPECTOR:
INSPECTOR:
INSPECTOR:
DATE:
DATE:
DATE:
3
VIOLATIONS
PRE -CITATION
CITATION ISSUED
1 f_�P��IONS
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
8
FLETTER
18
DATE:
7
LETTER NEEDED C] YES [I NO
NEEDED F] YES NO
8
FIRE DEPARTMENT COPY
Revised Date 6/16/09
SMITH FIRE SYSTEMS MANAGEMENT, LLC
DATE 9, 20
05MMUPItf AUTOMATIC SPRINKLER SYSTEM JOB # 4jyS
1106 54th Avenue East, Tacoma, WA 98424 PERFORMANCE EVALUATION
Phone: (253) 248-2000 Fax: (253) 248-2360
Site Name PT. EDWARDS CONDOMINIUMS- BUILDING 8
Address: 55 PINE STREET, EDMONDS, WA 98020
Contact Person -TOYAN COPELAND Telephone # (206) 388-0180
System # I Type WET Area Covered
System # 2 Type DRY Area Covered
System # Type Area Covered
System# Type Area Covered
System # Type Area Covered
Type of Occupancy (CIRCLE): Other:
Assembly Storage Industrial Offices Retail Apartments Condominiums Residential
A. OWNERS SECTION
1. Has there been any fire protection modifications since the last inspection?: Yes [-� No F Describe below:
2. Describe any fire(s) since last inspection: .
3. Date (appro)dmate if unknown) sprinkler system was installed: 2007
4. Name of installabon company: CUSTOM SPRINKLER
B. INSPECTOR'S SECTION (All responses reference current Inspection)
1 GENERAL YES NO NIA
a. Does the system have a hydraulic plaque? /Y
b. Are the risers labeled and what are the specifics?
Discharge density .15 Per 1950 Sq. Ft. residual pressure at riser 56 psi.
Gallons per minute
c. Is the building fully sprinklered?
Is the entire sprinkler system in service?
e. Record water pressure at riser:
PSI
2. CONTROL VALVES YES NO N/A
a. Are all sprinkler system control valves and all other valves in the appropriate
open or closed posifion? r
49—
b. All control valves operated through full range of motion and returned to normal position?
c. Are all control valves in the open position?
'Locked 1:1 Sealed Z1. Tampered
d. Are all control valves properly signed?
PT. EDWARDS CONDOMINIUMS—B.UILDING.8. Page 1 of. 4
Revised Date 6/16/09
3. FIRE DEPARTMENT CONNECTIONS
a. Are fire department connections in satisfactory condition (Unobstructed view,
couplings rotate freely, caps are in place)?
b. FDC backflushed in NEW 2007 . (Required every 5 Years)
4. WET SYSTEMS
a. Have anfifreeze system solutions been tested? Solution %
b. Were the antifreeze test results satisfactory? Specific Gravity Reading(s)
c. Does the building appear to be adequately heated at time of inspection?
e. Internal exam of piping conducted in CPVC (Required every 5 Years)
5. DRY SYSTEMS
a. Is the air pressure and priming water level in accordance with manufacturer's instructions?
b. Has the operation of the air or nitrogen supply been tested?
Is it in service?
c. Were the low points drained during this inspection? How Many? 11�7
d . Did quick -opening devices operate satisfactorily?
e. Did the heating equipment in the dry pipe valve room operate at the time of inspection?
f. Was the dry valve tripped during this inspectioO
Deg
X
4-C
-4-
N/
DRY PIPE
OPERATING
TEST
DRY VALVE
Q.O.D.
MAKE
—MODEL
SERIAL NO.
MAKE
MODEL
SERIAL NO.
TYCO
DPV-1
Q.O.D. TRIP
OK
TIME TO TRIP
THRU TEST PIPE
WATER
PRESSURE
INITIAL AIR
—PRESSURE
TRIP POINT
PRESSURE
TIME WATER REACHED
TEST OUTLET
ALARM
OPERATED
LOCAL
ALARM
OPERATED
REMOTE
MIN.
SEC.
PSI
PSI
PSI
MIN.
SEC.
SYS #2
q C
19
g. Date dry pipe valve trip tested (control valve fully open).
h. Internal exam of piping conducted in NEW 2007 (Required every 6 Years)
6. ALARMS
a. Did water motor gong test satisfactorifly?
b. Did electrical bell test satisfactorily?
c. Is the system supervised with alarm? Who? SFSM @A VANTGUARD— 89-6951
Operator #
d. Did alarm monitoring service test satisfactorily?
e. Waterflow alarm?
f. Valve tamper monitoring?
g. Hi/Lo Air Switch
2009
PT. EDWARDS CONDOMINIUM.S—PUILDING8.,
Page 2 of 4
Revised Date 6/16/09
7. SPRINKLERS, GAUGES & MIC TESTING
a. Are all sprinklers free from corrosion, foreign material, or paint?�
b. Are there any non -dry sprinkler heads manufactured prior to 1920?
c. Are all non -dry sprinkler heads less than 75 years old? Date of last sample testing:
d. Are all non -dry sprinkler heads less than 50 years old? Date of last sample testing:
e. Are all dry type sprinkler heads less than 10 years old? Date of last sample testing:
f. Are all FAST RESPONSE sprinkler heads less than 20 years old? Date of last sample testing:
g. Is there fluid in the glass bulbs?
h. Is a head wrench, stock of spare sprinklers and Teflon tape available?
1. Does the exterior condition of the sprinkler system appear to be satisfactory*7
j. Date of last MIC testing?
8. WATERFLOW TEST AT MAIN DRAIN MADE AT SPRINKLER RISERS
_4L
TEST PIPE
DATE
TEST PIPE
LOCATION
SIZE
TEST PIPE
STATIC
PRESSURE
RESIDUAL (FLOW)
PRESSURE
RISER
2"
00
2
RISER
log
3
4
5
9. Explain any "No" answers and comments:
PT. EDWARDS CONDOMINIUMS— BUILDING 8 Page 3 of 4
Revised Date 6/16/09
10. Adjustments or corrections made during this inspection:
11. Although these comments are not the result of any engineering review, the following desirable improvements are recommended:
System 1
5�
is operabonal
System 2
is operatonal
System 3
is operational
System 4
is operational
System 5
El
is operational
El
is operationalvAth defects
El
is operational with defects
El
is operational with defects
E]
is operational with defects
E]
is operational with defects
E]
is not operational
is not operational
is not operational
is not operational
is not operational
SMITH FIRE SYSTEMS MANAGEMENT, LLC
1106 54th Avenue East, Tacoma, WA 98424
Phone: (253)248-2000 Fax: (253)248-2360
ln4�
Name
WA SFMO ITT 0
PT. EDWARDS CONDOMINIUMS- BUILDING 8
Page 4 of 4
SMITH FIRE SYSTEMS MANAGEMENT, LLC
DATE C,
, Foww, CONFIDENCE TESTING FIRE ALARM JOB# INS- 20
1106 54th Avenue East, Tacoma, WA 98424
Phone: (253) 248-2000 Fax: (253) 248-2360
SITE NAME _PT. EDWARDS CONDOMINIUMS— BUILDING 8
ADDRESS 55 PINE STREET, EDMONDS, WA 98020
CONTACT TOYAN COPELAND PHONE (206) 388-0180
or -
NAME OF TESTER 3 CERTIFICATION NO. 'AA0 -7
DATE OF INSPECTION (� -7"0 - VI TYPE OF INSPECTION AtA^111-,'k
CONTROL PANEL MANUFACTURER SILENT KNIGHT MODEL NO. 5820XL
NUMBER OF INITIATING CIRCUITS ADDRESSABLE NO. OF SIGNAL CIRCUITS ADDRESSABLE
BATTERY VOLTAGE 7'(0. *�)o VOLTS CHARGE CIRCUIT VOLTAGE .1 -->, _L
BATTERY VOLTAGE UNDER FULL LOAD &,S-. 0 VOLTS (SIGNALS OPERATING)
1. Trouble signal with AC power off
2. System operates satisfactory on standby power
3. All signals operate on AC power .
4. Have all alarm notification appliances been checked for proper operation?
5. AJI circuits checked for electrical supervision
6. Control panel checks made per manufacturers instructions
7. All auxiliary equipment operates (Elevators, fans, dampers)
8. Central station or remote connection
Name of Monitoring Company
9. Key to panel available
10. Operating instructions at panel?
11. Service Label or Tag (SFC Appendix 111-13)
12. Did you sign off Item 8 on the Elevator Log
VOLTS
YES
�2
NO
Ej
N/A
[I
YES
JR
NO
El
N/A
[I
YES
[9
NO
[j
N/A
E]
YES
[_1
NO
CR)
N/A
El
YES
ER
NO
[_1
NIA
E:1
YES
NO
N/A
[_1
YES
NO
NIA
[:1
YES
NO
N/A
[-I
SFSM 0 AVANTGUARD- 89-6951
YES
�i
NO
0
N/A
E3
YES
&
NO
El
N/A
El
YES
[9
NO
El
N/A
El
YES
R
NO
El
N/A
El
PT. EDWARDS CONDOMINIUMS— BUILDING 8 1 of 2
a
EQUIPMENT TESTED
TYPE OF EQUIPMENT
NUMBERS OF
UNITS TESTED
SATISFACTORY
NO. OF UNITS
IN BUILDING
YES
NO
N/A
Bells, Homs, Chimes
Voice Alarm Speakers
84
Visual Alarm Device
oZ3
23
Trouble Indicators
"17
2
,Super. Switch (Auto. Spr.)
3
3
Auto Spr. Flow Switches
2-
2
Smoke Detectoqs)
28
Heat Detector(s)
I
Manual Pull Stations
9
Ventilation Controls Operate
Central Station
I
Annunciators
1
Elevator Call Down
SO
1
Fire Damper/Smoke Dampers
Phone Jacks
Auto. Door UnloGks - (Failsafe)
Auto. Door Release
Pther
PRO LEMS FOUND: 0-rt4-% CJLM CA.&c- r reQ 4 Y Q V -7 3-jA19
Za acx---gs 4a. 3
0a ot 20� r 7-06
CORRECTIONS MADE:
DATE CORRECTED BY
THIS IS TO CERTIFY THAT THE FIRE ALARM SYSTEM HAS BEEN PROPERLY TESTED AND INSPECTED FOR
RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT.
SMITH FIRE SYSTEMS MANAGEMENT, ILLC
...... 456� 1106 54th Avenue East, Tacoma, WA 98424
Phone: (253) 248-2000 Fax: (253) 248-2360
'(�rTXM W% boo-'
Signature Ins r Print Name Date
tive Date
PT. EDWARDS CONDOMINIUMS— BUILDING 8 2 of 2
47 11
Revised Date 6/16/09
SMITH FIRE SYSTEMS MANAGEMENT, LLC
DATE
AUTOMATIC SPRINKLER SYSTEM
JOB #
1106 54th Avenue East, Tacoma, WA 98424 PERFORMANCE EVALUATION
Phone: (253) 248-2000 Fax: (253) 248-2360
Site Name PT. EDWARDS CONDOMINIUMS— BUILDING 8
Address: 55 PINE STREET, EDMONDS, WA 98020
Contact Person TOYAN COPELAND Telephone # (206) 388-0180
System # I Type KET Area Covered
System # 2 Type DRY Area Covered
System # Type Area Covered
System # Type Area Covered
System # Type Area Covered
Type of Occupancy (CIRCLE): Other:
Assembly Storage Industrial Offices Retail Apartments Condominiums Residential
A. OWNERS SECTION
1. Has there been any fire protection modifications since the last inspection?: Yes El No F1 Describe below:
2. Describe any fire(s) since last inspection:
3. Date (approximate if unknown) sprinkler system was installed: am Z0011
4. Name of installation company: -CUSTOM SPRINKLER
B. INSPECTOR'S SECTION (All responses reference current Inspection)
1. GENERAL
a. Does the system have a hydraulic plaque?
b. Are the risers labeled and what are the specifics?
Discharge density .15 — Per 1950 Sq. Ft. residual pressure at riser
Gallons per minute I(). M -
c. Is the building fully sprinklered?
d. Is the entire sprinkler system in service?
e. Record water pressure at riser
2. CONTROL VALVES
a. Are all sprinkler system control valves and all other valves in the appropriate
open or closed position?
b. AJI control valves operated through full range of motion and returned to normal position?
c. Are all control valves in the open position?
Locked �_.�pjaed Tampered
d. Are all control valves propedy.signed?
56 psi.
YES NO N/A
Psi
YES NO N/A
Revised Date 6/16/09
3. FIRE DEPARTMENT CONNECTIONS
a. Are fire department connections in satisfactory condition (Unobstructed view,
couplings rotate freely, caps are in place)?
b. FDC backfiushed in IBM . (Required every 5 Years) Njt%.,j 7,W-7
4. WET SYSTEMS
a. Have antifreeze system solutions been tested? Solution %
b. Were the antifreeze test results satisfactory? Specific Gravity Reading(s) Deg
c. Does the building appear to be adequately heated at time of inspection?
e. Internal exam of piping conducted in 4NOWl' PVC (Required every 5 Years)
5. DRY SYSTEMS
a. Is the air pressure and priming water level in accordance with manufacturer's instructions?
b. Has the operation of the air or nitrogen supply been tested?
Is it in service?
c. Were the low points drained during this inspection? How Many? 5
d. Did quick -opening devices operate satisfactorily?
e. Did the heating equipment in the dry pipe valve room operate at the time of inspection?
f. Was the dry valve tripped during this inspection?
DRY PIPE
OPERATING
TEST
DRY VALVE
Q.O.D.
MAKE
MODEL
SERIAL NO.
MAKE
MODEL
SERIAL NO.
TYCO
DPV-1
O.O.D. TRIP
OK
TIME TO TRIP
THRU TEST PIPE
WATER
PRESSURE
INITIAL AIR
PRESSURE
TRIP POINT
PRESSURE
TIME WATER REACHED
TEST OUTLET
ALARM
OPERATED
LOCAL
ALARM
OPERATED
REMOTE
MIN.
SEC.
PSI
PSI
PSI
MIN.
SEC.
SYS #2
00- to
g. Date dry pipe valve trip t�sted (control valve fully open).
h. Internal exam of piping conducted in A* (Required every 5 Years) 700-1
6. ALARMS
a. Did water motor gong test satisfactorily?
b. Did electrical bell test satisfactorily?
c. Is the system supervised with alarm?
Operator #
d. Did alarm monitoring service test satisfactorily?
e. Waterflow alarm?
f. Valve. tamper monitoring?
g. Hi/Lo Air Switch
M-r r77ff',%A1A Mr%e% ~%&IM�KAIL111 IAA^
Who? SFSM @A VANTGUARD— 89-6951
Z
0101
Revised Date 6/16109
7. SPRINKLERS, GAUGES & MIC TESTING
a. Are all sprinklers free from corrosion, foreign material, or paint?
b. Are there any non -dry sprinkler heads manufactured prior to 1920?
c. Are all non -dry sprinkler heads less than 75 years old? Date of last sample testing:
d. Are all non -dry sprinkler heads less than 50 years old? Date of last sample testing:
e. Are all dry type sprinkler heads less than 10 years old? Date of last sample testing: MIN
f. Are all FAST RESPONSE sprinkler heads less than 20 years old? Date of last sample testing: IMM
g. Is there fluid in the glass bulbs?
h. Is a head wrench, stock of spare sprinklers and Teflon tape available?
1. Does the exterior condition of the sprinkler system appear to be satisfactory?
j. Date of last MIC testing?
8. WATERFLOW TEST AT MAIN DRAIN MADE AT SPRINKLER RISERS
.400,
T
TEST PIPE
DATE
TEST PIPE
LOCATION
SIZE
TEST PIPE
STATIC
PRESSURE
RESIDUAL (FLOW)
PRESSURE
RISER
2-1
2
t7
RISER
11.
3
4
5
9. Explain any "No" answers and comments:
PVCICZ:7�- -to Some uOms. -M A"wEn b-F
M 21""EMPA-02 11MV RM
KG WE 01�0
Revised Date 6/16/09
10. Adjustments or corrections made during this inspection:
Although these comments are not the result of any engineering review, the following desirable improvements are recommended:
System I
F]
is operafional
System 2
is operational
System 3
is operational
System 4
F]
is operafional
System 5
[]
is operational
JZ
is operational with defects
El
is operational with defects
El
is operational with defects
El
is operational with defects
El
is operational vAth defects
El
is not operational
F1
is not operational
El
is not operabonal
El
is not operational
1:1
is not operationai
SMITH FIRE SYSTEMS MANAGEMENT, LLC
1106 54th Avenue East, Tacoma, WA 98424
Phone. (253) 248-2000 Fax: (253) 248-2360
it-n"Tname. WA SFMO 1Tr #
"U.
SMITH FIRE SYSTEMS MANAGEMENT, LLC:
H DATE
.�rl,.— CONFIDENCE TESTING FIRE ALARM JOB #
1106 54th Avenue East, Tacoma, WA 98424
Phone: (253) 248-2000 Fax: (253) 248-2360
SITE NAME PT. EDWARDS CONDOMINIUMS- BUILDING 8
ADDRESS 55 PINE STREET, EDMONDS, WA 98020
CONTACT TOYAN COPELAND PHONE (20 ) 388-0180
NAME OF TESTER &111 C CERTIFICATION NO.
nr.4-E
DATE OF INSPECTION S-CN- 10 TYPE OF INSPECTION AT) n LVA
CONTROL PANEL MANUFACTURER SILENT KNIGHT MODEL NO. 5820XL
NUMBER OF INITIATING CIRCUITS ADDRESSABLE NO. OF SIGNAL CIRCUITS ADDRESSABLE
BATTERY VOLTAGE VOLTS CHARGE CIRCUIT VOLTAGE Ira
BATTERY VOLTAGE UNDER FULL LOAD C� VOLTS (SIGNALS OPERATING)
1. Trouble signal with AC power off
2. System operates satisfactory on standby power
3. All signals operate on AC power
4. Have all alarm notification appliances been checked for proper operation?
5. All circuits checked for electrical supervision
6. Control panel checks made per manufacturer's instructions
7. AJI auxiliary equipment operates (Elevators, fans, dampers)
8. Central station or remote connection
Name of Monitoring Company
9. Key to panel available
10. Operating instructions at panel?
11. Service Label or Tag (SFC Appendix 1.11-13)
Did you sign off Item 8 on the Elevator Log
VOLTS
YES
Cg
NO
F1
N/A
Ej
YES
NO
El
N/A
Ej
YES
NO
[j
N/A
El
YES
NO
El
N/A
E]
YES
NO
N/A
E]
YES
NO
N/A
YES
2q
NO
El
N/A
YES
09
NO
El
N/A
SFSM 0 AVANTGUARD- 89-6951
YES
[X
No
El
N/A
El
YES
NO
El
N/A
0
YES
No
El
N/A
El
YES
. NO
WA
EQUIPMENT TESTED
TYPE OF EQUIPMENT
NUMBERS OF
UNITS TESTED
SATISFACTORY
NO. 0 UNITS
IN BUILDING
YES
NO
N/A
Bells, Horns, Chimes
Voice Alarm Speakers
84
84
Visual Alarm Device
23
23
Trouble Indicators
2
2
Super. Switch (Auto. Spr.)
3
3
Auto Spr. Flow Switches
2
X
2
Smoke Detector(s)
28
x
28
Heat Detector(s)
I
X
I
Manual Pull Stations
9
9
Ventilation Controls Operate
Central Station
Annunciators
Elevator Call Down
Fire Damper/Smoke Dampers
Phone Jacks
Auto. Door Unlocks - (Failsafe)
Auto. Door Release
Other
PROBLEMS
CORRECTIONS MADE:
DATE CORRECTED BY
\ % - v r 1 1( 11 - - - - - A ,
THIS IS TO CERTIFY THAT THE FIRE ALARM SYSTEM HAS BEEN PROPERLY TESTED AND INSPECTED FOR
RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT.
-4— . -
CITY OF EDMONDS
121 5� AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
LOCATION: 55 Pine St
BUSINESS NAME: Pt Edwards Condos Bldg 8 PHONE:
MAILING
ADDRESS:
BUSINESS OWNER: HOME PHONE:
FIRE PREVENTION
SAFETY'gURVEY
EMERGENCY-1: Copeland Grp(Prop Mgr) HOME PHONE: 2063880180.
KEY ACCESS-2: Copeland, Toyan HOME PHONE:
FREQUENCY
STATION 1, SHIFT"
-17 D
�
SCHEDULED
DATE DUE 1� 04/01/10
LIFIR 1� 423
4152
e- INITIAL INSPECTION DATE
PERSON CONTACTED: -'s I
NAME OF INSPECTOR: e"' 06 0
FIRE XS 9/IJ1 t-A V/U1 I-L) LKbX Z� 1p,
j
9YSTEMS: 81V, 1 0 �. 912,(olo ANNUAL
HAZARDS FOUND AND LOCATIONS
0 2_
/ COMMUNICATIONS
ENTER CODE ONLY ONCE 1�
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
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
7
4
18
4
8
DATE-
DISPOSITION:
1 8
LETTER NEEDED [] YES NO
LETTER NEEDED [] YES 0 NO
—
fft
FIRE DEPARTMENT COPY
-A
Point Edwards Building Five-55 Pine St.
r- irc; E- vuruation plan-ParkijaS
N / Meeting Place
Exit II/S B/S B/S Ills
Fxit
NO.
II/S
ril d
0
441
4- 45 a 44 no
41 Q
% I
%
Stairs #2
0 Smoke Detector B/S- Bell/Strobe FIRE EMFRGENCY GUIDE
Every alarm must be treated as a fire emergency. If you hear the fire, alarin take these steps to ensure a safe evacuation of the
Fire Extinguisher Annunciator building.
MN I - Leave your area as quickly as possible, closing the doors as you go.
Fire Alarm Pull 2. Use the stairs, not the elevator, to evacuate the building.
FACP- Control Panel 3. If you are unable to exit using the stairs, stay in your area.
4. Once outside, move away from the building to the designated meeting place.
5 : Do not go back into the building for any reason until the Fire Department has
given permission to reenter.
N /
Meeting Place 17,
4 (Anit 101
(Anit 102
N
. I ILI'
VI
Stairs ft2
0 Smoke Detector B/S- Bcll/Strobe
Fire Extinguisher NN Annunciator
Fire Alarm Pull FACP- Control Panel
Point Edwards Building Eight-55 Pine St.
Fire Evacuation plan -First Floor
(Jnit io6
(].,it 101 (Anit 105
Cr IF �__
0 0 0 Ur,it 107
L2 j
Elc. Mccl L
0 Ivs
COUNT
0 1
113 6-
ur,it 105
Stairs 9 1 1 FACP
FIRE EMERGENCY GUIDE
Every alarra must be treated as afire emergency. If you hear the fire alarm take these steps to ensure a safe evacuation of the building.
1. Leave your area as quickly as possible, closing the doors as you go.
2. Use the stairs, not the elevator, to evacuate the building.
3. If you are unable to exit using the stairs, stay in your area.
4. Once outside, move away from the building to the designated meeting place.
5. Do not go back into the building for any reason until the Fire Department has
given permission to reenter.
Point Edwards Building Five-55 Pine St.
I-, ire F-vnexintion plan-Reconcl Vlnor
Meeting Place
IL —1 i— —J5
Unit 206 Unit 207 i Unit 2.08 Unit 709
Unit 205
Cc VIM
V11-1 -cr
_j I— �--
+-0 "s 4— 0 0 -+13 0 -4 o'
Unit. Z04 ------- Unit Z 10
Un
-Vo
(_Init 202 nit 20 1 (_Init 2 12
X 0
(_Init Z I I
Stairs #2
nit Z05
LM - PAM 'Wr:
Stairs #1
%'e
r
Smoke Detector BIS- Bell/Strobe FIRE EMERGENCY GUIDE
Every alarm must be treated as a fire emcrgcncy. If you hear the fire alarm take thcsc steps to ensure a safe evacuation ofthe
Fire Extinguisher A Annunciator building.
nN ' - Leave your area as quickly as possible, closing the doors as you go.
Fire Alarm Pull 2 Use the stairs, not the elevator, to evacuate the building.
FACP- Control Panel 3* Ifyou are unable to exit using the stairs, stay in your area.
4. Once outside, move away from the building to the designated meeting place.
5. Do not go back into the building for any reason until the Fire Department has
given permission to reenter.
0 Smoke Detector B/S- Bell/Strobe
Point Edwarcls DiAilcling R;Sht-SS P;ne St. n Fire Extinguisher NN Annunciator
Fire Evacuation plan -Third Floor 0 Fire Alarm Pull FACP- Control Panel
Meeting
Place
N /
FIRE EMERGENCY GUIDE
Every alarm must be treated as a fire emergency. Ifyou hear the fire alarm take these steps to ensure a safe
evacuation oftlic building.
I . Leave your arca as quickly as possible, closing the doors as you go.
2. Use the stairs, not the elevator, to evacuate the building.
3. Ifyou are unable to exit using the stairs, stay in your area.
4. Once outside, move away from the building to the designated meeting place.
5. Do not go back into the building for any reason until the Fire Department has
given permission to reenter.
LEVEL L3
N