550 DAYTON ST (2)y
57 FIRE,PREVENTION
S�rving Brier, E monus, uhd 12425 Meridian Ave S INSPECTION REPORT
SNOHO NprEbmONDS
Mountlake Terrace Everett, WA 98208
/11 BRIER
FIR 0 MOUNTLAKE TERRACE
Phot7e (425) 551-1200
_Dl_ Twww.Fi�eDi�trictl. org . Fax (425) 551-1272 0 UNINCORPORATED
XnEQUE
LOCATION: 550 Dayton Street 98020 nua)ICY Slyf �& SHIFT
BUSINESS NAME: 550 Dayton Condos PHONE: SCHEDULED May 2017
MAILING 550 Dayton Street, Edmonds, WA 98020
ADDRESS:
BUSINESS OWNER:
EMERGENCY-1: AAj.f%j ll�.k9
KEY ACCESS-2:
EMAIL: A
PERSON CONTACTED:
NAME OF INSPECTOR:
Date Last Serviced: A5 li 111 4,11-4 r(— 4 1 -+
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
Mo
2__
3
4
5
6
7
422
LIFIR 0
HOME PHONE:
-5,
HOME PHONE: CURRENT
HOME PHONE: 17 CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
2
3
4
5
6
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X ('
1 st RE -INSPECTION
2nd RE -INSPECTION
FINAL RE-iNSPECTION
EXTENSION VIOLATIONS
DATE DUE,
DATE DUE
GRANTEDTO CITED:
DATE DUE.
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED
CONTACTED.
INSPECTOR,
INSPECTOR*
2
INSPECTOR:
DATE;
DATE-
DATE. 3
VIOLATIONS
VIOLATIONS
CITAT IONISSUED
PRE -CITATION
1 5
1 5
LETTER SENT NUMBER.
CODE 5
2 6
2
DATE: SECTION.
RETURN RECEIPT
6
7
3 7
RECEIVED
DISPOSITION:
7
8
4 8
DATE -
LETTER NEEDED YES NO
LETTER NEEDED [j"YES NO
8
I � 4
SNOHOMISH CO.
---FIRE
Serving Brier, Edmonds, and
Mountlake Terrace
www.FireDistrictl.org
LOCATION:
550 Dayton Street 98020
BUSINESS NAME:
550 Dayton Condos
MAILING
ADDRESS:
550 Dayton 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
0 EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
FREQUENCY I STATION & SH1F`*1
Annual W-A
SCHEDULED
DATE DUE �
PASY 20166
UFIR �
422
.EMERGENCY-1: HOME PHONE: CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
EMAIL: BUSINESS
LICENSE
INITIAL INSPECTION 9ATE
PERSON CONTACTED: 511'
NAME OF INSPECTOR: Re- o �13� 0. jCIr 77-
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
In our continuing effort to promote fire safety and prevention within the community, your fire department conducts
regularly scheduled "Fire Safety Survey Inspections" of all.businesses and multi -family occupancies in th Cities
"""es
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 u
w I ill find the item(s) that were noted during. our inspection which require attention to bring them into compXIiad
w ith the minimum standards adopted by the above jurisdictions.
Any overlooked hazards or violations. of the fire regulations does not imply approval of such conditions or violation.
If you require additional information or to schedule a re -inspection for Edmonds, call (425) 775-7720; for
Mountlake Terrace or Brier, call (425) 744-6231.
SNOM42k*C.'O.
FIRE
0 T'
Serving Brier, Edmohids, and 2425 M&idian Ave S
Mountlake Terrace Everett, WA 98208
Phone (425) 551-1200
XNA00 A JMJL%j JL www.FireDistrictl.org Fax (425) 551-1272
FIRE PREVENTION
IN�PECTION REPORT
4ffEDMONDS
El BRIER
[I MOUNTLAKE TERRACE
El UNINCORPORATED
LOCATION: 550 Dayton Street 98020
r FREQUENCY
Annual
I STATION 11 SHIF'*11
17-D
550 Dayton Condos
BUSINESS NAME:
PHONE:
SCHEDULED May 2015
DATE DUE
MAILING
550 Dayton Street, Edmonds, WA 98020
422
UFIR
ADDRESS:
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1: T2VA&Z )4QWAa0
HOME PHONE: 41�_ (A 7
�63 CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY
BUSINESS
YES NO
El 1:1
EMAIL:
LICENSE
i
PERSON CONTACTED: j0VJy1Lz L\.L)A"rz_1f)
NAME OF INSPECTOR: ks
INITIAL INSPECTION DATE
7/ 7
01 (0 0 ?
STEVIS�� 4/14 FA 4/14 FE 4/14
FD Lk Box
HAZARDS FOUND AND LOCATIONS COMMUNIEATIONS
2
2
3
3
4
4
5
5
6
6
7
7
r
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
GRANTEDTO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1 y
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
4
18
4
18
DATE:
DISPOSITION: V
LETTER NEEDED [-] YES NO
LETTER NEEDED [] YES El NO
8
FIRE DEPARTMENT COPY $
N
jrr,
FIRE PREVENTION
Serving Briet: Edmonds, and
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
FIRE
Mountlake Terraee
WA 98208
OEDMONDS
0 BRIER
DISTR' TwwwFireDistrict].
Phone (425) 551-1200
[1 MOUNTLAKE TERRACE
0 UNINCORPORATED
org
Fax (425) 551-1272
"-FREQUENCY STATION & SHIF"I
LOCATION: 550 Dayton Street 98020
Annual 17-C
I
BUSINESS NAME: 550 DaAon
Condos
PHONE:
SCHEDULED Mav 2014
11,
Li r_ Li U r_
1 422
MAILING LIFIR
550 Dayton Sireet, Edmonds, WA 98020
ADDRESS:
BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: HOME PHONE: "'CURRENT
CITY --- 'YES NO
KEY ACVSS-2: HOME PHONE: BUSINESS [j
EMAIL: LICENSE
N INITIAL INSPECTION,DATE
PERSON CONTACTED:
xj)
NAME OF INSPECTOR: —.0
j
AS 4/1.f- .11 2 FE Fq<�. BoV
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
/2
1z
3
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS% X
I st RE -INSPECTION
2nd RE -INSPECTION
FINAL RE -INSPECTION
EXTENSION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED.
CONTACTED:
1
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
I
7
3
7
RECEIVED
6:
DISPOSITION:
4
18
4
18
DATE:
LETTER NEEDED [-] YES NO
LETTER NEEDED [] YES NO
8
FIRE DEPARTMENT COPY
21104/2014 15:38
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Page 316
Ff vula Alaf m Sy5tem, Ix.
861 Indus&y Dr.
Tukwlla, WA 98188
206-575-.19V office
FRO&AWWAV fsa4jW
RY SPRINKLER SYSTE
Occupancy Naum 550 Dajdon PI Con&s
Occupancy Ad dress: 550 Dayton St
Building owner 550 DMon Can& Ann
Person ResponsibLe Bonnie
SeatUe Fire Department
Confi&nm Tea Repmt
2D&3Wl4Q CorMence Testing 0111mr
206-615-1068 (fox)
206-233-7219 Red Tag Hoftw
C=fification Give'n
RED = IYEUOW = j WHM gi
—CONFIDENCE TEST;;�f REPAIRS
Edmonds
Customer Phone
Email:
(425)697-5637
Owner Address 550 Dayton SL, #201 c/o Bonnie EWmonds WA
Date of Inspection: q Ac q Inspection Frequencyrl'ype
Testers Name: SFP Certification #: SCP-
Identifmr.
Central Station Monitoring: Wj yes n NO System Location:
Monitoring Required? Fe yes n No Monitoring Company-
98020
Ann Quararly f--j
Parking Garage
Froula Almm Systems
System Make Vkftuuc System Model S1756
P00MM
Lef = T" , =— I Mr-.,,-fqW4
Mfs caffm that this fheand lik safily systannhn bmn pupe4y inspeamf forrdJobft to coverthe itars fimd in
this repmt end is oomiaot vjffi Dqxffbrnt Cbftstarxbuds6andthatcfisomparKimarenoWdm-Abmc
bomrqxxWtotbebui&gOmwd.hnogwfcr%RM — Wactiam
ff"nom dTeaw. Fbme# 205-sr-C,
TestbgAywc3r FkcL&A6mnSw*m&FW
1bsftAddmss W lg!*M Qrr- IiAam� WA 98M
RWMP9PWMtatiM (Sigr�)
21104/2014 15:38 Page 4/6
[Tbe iterns on the cbeck&ts below shall be inspected and tested. M list does nDt constute all ofthe
r oquked ius� and tesfing of the fire and bt safety systems. Refer to the Seattle Fke DeparMznt Fre
Code fDr itispectim ind testing Tequin=nts-
General
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
Trip test conducted?
System tripped irk 1 C2 - seconds
Main drain and Inspectues Drain fbw ted condticted?
Stafic Pressure: leg --psi
Number of Sprinkler beads? +-100
2- inch drain? Odler E)
FbDw switches, supervisory switches and alarm bels tesW? E3
Akirm. bell operates? 0
Air compressor reek system in 30 mhtes or less?
Heat actuation devices tested on pre-actim aW dehW systems?
System iizpected and libicated?
Valves are sealed or supervised?
Sips are provided on valves?
Pumper comectpris and cbpper valves UnDbstruded and turn fiW
Sprada heads replaced or successfi* sample tesW in last 10 years?
Date of be tesr 2004
Sprinkler coverage is acceptable?
Proper number of sp= sprinkler heads avaiIable with appropriate
wrench ofcach?
System left in service?
System gauges replaced or caffirated wdJm last be yew?
2011
Year cWnged?
Spridkier beads fhee ofoorrosioni put obstrucWns and/or pkysical damage9
System dramed and restored 10-mrina] operalm?
Was debris fbund in the Re Dqmrtinant ConnectiDn MX)?
Was tbe FDC backfiusbed in the last five years?
Date of last teW 2011
Was a sigiW received at the Central Station mDnkoring compmp.
Is ft hydraulic nameplate instalIed and vimbk on riser� ifNO then YeIbw Tag
Was an internal pipe and valve inspectiDn perfDrined willin the lad five years?
Date Perfbnned? Unknow n
Test Results A
N/A7 Yes
V"I
A
P.
No
13
I
2110412014 15:38
Page 5/6
Awla Abf m Systww, Lw--
861 lndbty Dr.
TLIkWIa WA 98188
206-575-IM Mr"
FRaL459OWD, Fsa43M
SeaWe Fim Department
Coffida" Tag Mpod
Bfv-3WI448 Cufulaxe TeOV Offl=
2D&415-1068 (fax)
20&233-7219 RW Tag Hafte
Of
SPRINKLER SYSTEM�.- CeTfification Given
RED i --i ::7j iT]E)Z—
CONFIDENCE TEST c
REPAIRS
occupamyNamc 550 Dayton P1 Condos
Occup&M Address: 550 Dayton St
Busiding ownw. 550 Da0on Condo Assn
Person Revonsibie Bonnie
Owner Address 550 ftlon St, #201 c/o Bonnie
Date of Inspection:
Testa$ Name:
System ID #:
Central Station Monitorinip. W1 Yes 0 NO
Monitoring Required? 6a yes El No
System Make
PAID"am IbLmd
NIA
M D -F:Zl f
FAlmonds
CAntad Number: 425-697-5637
Fanxift.
Ednionds WA 98020
Inspeebon Frequeneyfrype Annul fe Quarterly E]
SIFT Certification #: SCP- —
System Location: Pw*hig Gwve
Monitoring Company: Froula Alam S)ntaw
System Model Shotgun
Vis catifies that dis fiecand I& saW systenihas bempmpedy impected fixnfidnifty toomwthe it= b3ted in
tizis report and is r 7 wis' - v,&h Dqxah=1 Cbcbstandw&,, andthat dsampencks am mted and bave
bemrqxNtedtothebu&ftOmxdN4smVxfwcomecti%eadmm
Fhcne# 206-575-195Z
TastkVAgmy- Fzc;A&Afiqr
i9ogennL
TwtigAftcss 82 kkkistry D2w— 1—biwift WA 9111
Bj&ftR*W9eMtHtiVe (Sig�)
Page
11w ftm on ft dwkbsts below shall be inspected and teste& Ibis list does not consMde all of1he
requRvd insp=* and testing offt fim mid a sakty system Refer to the Seattle Fire Departzned Fire
Code br inspectirg and testing reqiinnants.
General
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
Test Results Acceptable
N/ATYes I No
Main Dram and hWector's Dram fk)w test condueted?
Stadcpressure-./L-26 p.s.i FiDw pressure: 90 p-s-i
Number ofSprHckr Heads: + - 100
2-inch drain? Odw Ll
Ll
FiDW SWtChDS, supervisory switches and alarm bells tested? 0
ja
U
Pressure Tepiatiag valm tested? g
L3
Ll
Alum bell operates? 13
El
System inspected and lubricated?
U
Valm are scaled or supervised?
13
Signs arc provided on valves?
L)
Pumper connectiow and clapper valves umbstructed and mm fiwbO 0
A
Ll
Sprinlder coverage is acceptable?
Haw the spn*ler heads been replaced or sw=sd* sarnple tested m
L)
dwIM50yrsp DateoflastteW 2004
Proper number of spare sprinkler heads available with appmphate
VMMCbeS fDr each?
13
System H in service?
Ll
System puges replaced or caMnzted within the lag fiw years?
year Changed? 2011
Spridder heads free of corrosion, paint, obstruictiDw and/or physical.
damage?
A
U
Was debris fowd in the Fire Department ComectiDin (FDQ?
Old
13
Was the FDC back &shed with tbe-last five years?
Date PeriDnind? 2011
�y
LN
Was an iriternal pipe and valve inspectwn perfi)rmed with the last five
years? Date Performed? NIA
L3
L3
Is the hydraulic nameplate insWW and visible on riser, ifNo, then Yelow Tag
U
Was a signal received at the Cemal Sta&n ronnitoring con4wW L)
L3
[a Alarm Systems, Inc.
Frou
Seattle Fire Department
861 Industry Dr.
Tukwila, WA 98188 El"161111
206-575-1962 office WIW'111.�%��'
206-575-8168. fax SINCE 1072
Confidence Test Report
206-386-1448 Confidence Testing Officer
206-615-1068 (fax)
206-233-7219 Red Tag Hotline
FIRE ALARM SYSTEM
Certification1piven
RED
YELLOW C3
I WHITE
(One System per Report)
CONFIDENCE TEST Ca I - REPAIRq 1 0
A _
1-t
5i Name: COL�
Occupancy Address: 125= Occupancy
Building Owner: EL (cm i) c 5 Phone Number:
Responsible Person: go'n—n—e-V !A.20 1 PhoneNumber:
Building Owner
Address:
Inspection Annual
.1 'D - ate of Inspection: I/ Frequency/Type: Quarterly[3 (Kigh Rise Only)
Testers Name SFD Certification
(Please Print):,. Number: SCP- V'-
-Central Station Monitoring
Yes No C3
Monitoring? Company Name:
stem Type: Fire Alarm System Make:
Zystern Model: 5700
Identification
'System Location: *2riw4f 12��j Number:
PROBLEms FoUND: (Nadditional';�om is nec6, please add a separate sheet)
-CORRECTIONS MADE: Date Corrected: Corrected By:
�(Jf additional room Is needed, please add a separate sheet) SFD Certification Number: SCP -
This certifies that this fire and life safety system has been properly inspected for reliability to cover the
Items listed in this report and is consistent with Seattle Fire Department Fire Code standards, and that
discrepancies are noted and have been reported to the building owner/manager for corrective action.
Signature of Tester: Phone#
Testing Agency:
Address:
�.IMailing
_Buildinq Representative (signature)
J6
"TF- 01
Page I of 2
The items on the checklists below shall be inspected and tested. This list do es 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.
Alarm System Functionality
1.
Trouble signal with AC power off7
Yes
No 0
2:
Sy§tem� operates property on, battery backup?
0
3.
Vol'
Battery voltage (no load) ts
4-
Batte load) Volts.($i nals dDeratin 9
aryvoltagp (full 29t
5.
Charge circuit voltage 22, 3 volts
S*
ystem operates property on standby power?
YesZ.
No 0
7.
All signals operate on AC power?
Yesg
No 0
.8.
P u rriber of In Itlating circ u Its
%
1 9.
'humber of signal circuit's 2�_
.10.
Does alarm system meet audibility. standards as accepted?
Yes 0
No El
11.
At . I . circui . ts ch . ecked I for e . lectrical supervisi on?
Yes,9
No 0
12.
Allawkiliary equipment operates (Elevators farts, dam pers .
Yesl.e.,.
No 0
13.
Ventilation controls operate?
N/A 0
Yes 11
No 0
14.
Key'to, panel. available?,
Yes, Iff
,No 0,
15.
Operating instructions at panel?
YesZ
No 0
16.
Trouble Indicators function properly?
Yes Ef
NoQ
17.
Remote Annunciator Panels function properly?
N/A
Yes 0
No El
18.
Elevator Call Down functions Oroperty?
e$.
Y"
-No 0
19.
Test record posted at panel?
Yes -ET
No 0
1
20.
General alarm automatic time delay (minutes)
N/A A.?f
21.
Was a signal received at the Central Station monitoring company?
N/A 0
Yes;Z
No El
22.
Other Devices (Specify)
-N io
System
Devices
Total Number of
Units in Building
Total Number Units
Tested
Test Results Acceptable
24. Bells, Horns, Chimes
N/A
0:
Yes 0
No 0
26. Voice Speakers (Voice Clarity)
N/A
0
Yes 0
No El
28. Smoke Detectors
N/A
0
YeS,9
NOTI
30. Heat Detectors
N/A
El
Yes 0
No 0
32. Duct Detectors
N/A
b
Yes 11
No 1:1
34' Sprinkler Flow Switches
2-
2-
N/A
El
YeSz
No 0
36. Sprinkler Supervisory Switches
N/A
0
Yes Z
No 0
38. Visual Alarm Devices
40. Manual Pull Stations
N/A
N/A
0
El
Yes Z,
Yes/Ef
No 0
No 0
z
42. Annunciator(s)
N/A
11
Yes El
No 0
d
44. Beam Detectors
N/A
C1
Yes 0
No 171
d
46. Automatic Door Unlocks
N/A
1:1
Yes El
No 0
le
48. Automatic Door Release
N/A
0
Yes EJ
No 0
z
50. Fire Dampers, every 4 yrs.
N/A
11
Yes 0
No 0
Communication Equipment
Total Number of
Units In Building
Total Number Units
Tested
Test Results Acceptable
52. Phone Sets
N/A
El
Yes El
No El
54. Phone Jacks
N/A
0
Yes 0
No 0
56. Call -in Signal
N/A
0
Yes 0
No, 11
Froula Alarm Systems, Inc.
861 Industry Dr. TukvAla, WA 98188
206-575-1962 office
CIT 206-575-8168 fax
-01
Page 2 of 2
..'Froula Alarm Systems, Inc.
.18.61 Industry Dr. V7
.T.ukwila, WA 98,188
;k%-575-11962 office
'�06-575-8168 fax
Seattle Fire Department
Confidence Test Report
206-386-1448 Confidence Testing Officer
206-615-1068 (fax)
206-233-7219 Red Tag Hotline
SPRINKLER - WET SYSTEM
Certification Given
(One System per Report)
RED 0
1 YELLOW
WHITE
-CONFIDENCE TEST Lo I ,REpAIRS, 1-1 -1
,Occupancy Address:
Occupancy Name:
flesponsible Person
First & Last Name: '9104 0 e,/
Phone Number: Ll 2,5
Person
Responsible Party
,,,Responsible
ddress, City, State, Zip:
E-Mail Address
V_Qate of Inspection: /-n' h-z--
Inspection Annual
Frequencyrrype:
�Tbsters Name
SFD Certification
12-256
'�(Please Print):
Number SCp_
Identification
Number:
System Location: 10*3 CAPR9
Central station monitoring? Yes'a No 0
Monitoring
Monitoring Required? YesX No 0
Company Name:
System Model: &U1
System Make: - IVA-
'�SEATTLE 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) SFD Certification Number: SCP -
This certifies that this fire and life safety system has been properly inspected for reliability to cover the
Items listed in this report and is consistent with Seattle Fire Department Fire Code standards, and that
discrepancies are noted and have been reported to the building Owner/Manager for corrective action.
-�,$ignature of Tester: _/Qo/
Phone #
J.
Building Representative (signature)
Sprinklers - Wet
Page 1 of 2
7-
itute all of the required
The items on the checkJists below shall be inspected and tested. This list does not consti
system, Refer to the Seattle Fire Department Fire Code for inspecting
inspecting and testing of the fire and life safety
and testing requirements.
"Peneral
M, Drain and IhSO&W-S Drain flow test,conducted?
ain
Yes
N
2.
Static pressure: 100 p.s.i. Flow pressure: Oc 9 P.s...1i...,
3.,
Number of Sprinkler Heads:
4.
2-inch drain? Other
Yes
No
5. .
FloW sWitches,:supery i sory switches and ala rm,be.1 is tested7, N/A
No
Pressure regulating valves tested? N/A
Yes
No
:'6.
1.
Alarrh� bell o'perates?: .,N/A
'Yes
No,C3
,.,18.
System inspected and lubricated?
Yes
No C3
44
Valves are sealed or supervised?
Yes
No
10.
Signs are provided on valves?
YesO
No C3
11.
Pumper connections and clapper valves unobstructed and turn freely?
Ye..
;:N
12.
Sprinkler coverage is acceptable?
Yes
No
::11
Have the sprinkler heads been replaced or successfully sampl6 test'in the'...
-Yes
'C3
last 50 years? Date of last tes t-.,,: cot
'No
'14.
Proper number of spare sprinkler heads available with appropriate w renches
Yes
No
A
for each?
left in service?
15. System
16. System gauges replaced or calibrated within the last 5 years?
Yearchanged:
obstructions and/or physical
7. Sprinkler heads free of corrosion, paint,
damage?
1�� 18. Was debris found in the Fire Department Connection (FDC)?
19. Was the Fire. Department Connection TDC) back flij ' shedvithi'll the last.5,
years? Date. of last back flush,
20. Was an internal pipe and valve inspectio performed within the last 5 years?
Date Performed
21. Is the hydraulic nameplate installed and visible on riser, if, No. then Yell I ow ag.
(Reft NFPA 25 5.2.7)
r't` 22. Was a signal received at the Central Station monitoring N/A
company?
Froula Alarm Systems, Inc.
861 Industry Dr. Tukwila, WA 98188
206-575-1962 office
Sprinklers - Wet
RIAR fAy
Yes ;r
''NoO
Yes
No
Yes
No:
Yes
NoO
Yes.
No
Yes
No
Yes
No
C3 Yeso No 0
Page 2 of 2
Frdula Alarm Systems, Inc.
861 Industry Dr.
Tukwila, WA 98188 1J.,1611
266-575-1962 offioe
206-575-8168 fax
Seattle Fire Department
Confidence Test Report
206-386-1448 Confidence Testing Officer
206-615-1068 (fax)
206-233-7219 Red Tag Hotline
SPRINKLER — DRY SYSTEM
Certification Given
(One System per Report)
RED C3
YELU
WHITE
CONFIDENCE TEST REPAIRS
_I,ffl _A-
5':5-0 X <;.t PL
Occupancy Address: C--), .4 Occupancy Name: colltdo
Responsible Person
First & Last Name:� 8-0 k7 Y% +-4 Phone Number: YZ5- 69'� --5632
Responsible Person Responsible Party
Address, city, State, Zip: E-Mail Address
Inspection Annual
Date of Inspection: 123 Frequencyrrype:
Testers Name SFD Certification f2 -25 0
(Please Print): Number SCP-
Identification Number System Location:
'(Required):
> -e-3, go -
central station monitoring? Yesp" No 0 Monitoring
monitoring Required? YeSX No 0 Company Name:
VfC+T-Vb-C— System Model: S7�7 5-,c
System Make:
SEATTLE FIRE CODE VIOLATIONs FOUND: (if additional room is needed, please add a separate sheet)
CORRECTIONS MADE: Date Corrected: Corrected By:
(if addhional room is needed, please add a separate sheet) SFD Certification Number: SCP -
This certifies that this fire and life safety system has been properly inspected for reliability to cover the
Items listed in this report and is consistent with Seattle Fire Department Fire Code standards, and that
discrepancies are noted and have been reported to the building Owner/Manager for corrective action.
Or
Phone # 7
Signature of Tester:
Building Representative (signature)
Page 1 of 2
I The items on the checklists below shall be inspected and tested. This list does not constitute all of the required
inspecting and testing of the fire and life safety system. Refer to the Seattle Fire Department Fire Code for inspecting
and testing requirements.
General
1. Trip test conducted? Ye4 NO
System.trIpp6d in ..seconds,.
3. Main Drain and Inspector's Drain flow test conducted? YesJ3 No
Static re.' A20---Psi
pressu
5.
Number of Sprinkler Head
6
2 inch-drainZ
Qthe'r: 'E'
e
Yes'M
N ac.3
7.
Flow switches, supervisory switches and alarm bells tested?
N/A C3
Yes
-.No
8.
Alarm, bell operates?
'N/A
Yes
No"O
9.
Air compressor refills system in 30 minutes or less?
Yes.,O
No
10
Hint I a ctuation devicesteste I d,on pre-actii . on and deluge systems?,
N/A , -g:,:Yes
0
No�o
'11.
System inspected and lubricated?
Yes
No
12.,
Valves are sealed or supervised?
YeseEl
No
i
13.
Signs are provided on valves?
Yes 0
No
14.
Pumper connections and clapper valves unobstructed and'turn freely?
Yes 0
No [1
15.
Sprinkler heads replaced or successfully sample tested in last 10 years?
Date of last test:
Yes
No
16.
Sprinkler coverage Is acceptable7
Yes,9
NO C3
17.
Proper number of spare sprinkler heads available with appropriate wrench for
Yes.;3
No
each?
System left,in service?
Yeso
No
19.
System gauges replaced or calib te d within the last 5 years?
Yes C3
No C3
Year changed:
20.
Sprinkler heads free of corrosion, paint, obstructions and/or physical dama e?
9
Yes,0
No C3
1�
21.
System drained and restored to normal operation?
Yes 0
No 13
22
Was debris found in the Fire Department Connection (FDC)?
Yes 13.
NoM
23.
Was the Fire Department Connection ( D back flushed in the last 5 years?
�D
YeF,,M
No 13
Date of last back flush
24.
Was a signal 'received. at the Central Station monitoring company? N/�A 0
Yeso
No
25. is the hydraulic nameplate Installed and visible on riser, if No then Yellow Tag. Yq.�V No 0
(Ref: NFPA 25 5.2.7)
26. Was an internal pipe and valve inspection performed within the last 5 years? Date Yesjol, No 0
Performed
ystems, Inc.
Froula Alarm S
861 Industry Dr. Tukwila, WA 98188
Sprinklers - Dry 206-575-1962 office Page 2 of 2
206_571,�8168 fax
RIANCE
FIRE PROTECTION
5 YEAR
Fire Sprinkler
CONFIDENCE TEST 1 �3'1 REPAIRS I C3
8168 304"' Ave SE. PO Box 428
Preston, WA 98050-0428
Phone: (206) 682-6636 Fax: (206) 682-6744
WA Contractors License: RELIAFP102L I
www. reliancefire. com
Certification Given
YELLOW 0 1 WHITE
.5 1� 0 1 A I
Occupancy Address: - - fl- Occupancy Name: o
LA" M qtow
Responsible Person
First & Last Name:
Responsible Person
Address, City, State, Zip:
Date of Inspection:
Testers Name
(Please Print):
System Make
System Size:
OEM" �'.
Phone Number:
Responsible Party
E—Mail Address
Inspection
Frequency/Type:
-A 0 0
5 - Year
�(Pqq IT-05-2'(glo
1%814C 'F�wc Alew",
clasit im 8awk6;
Identification Number:
PROBLEms FoUND:
V ()I^t:y
CORRECTIONS MADE: Date Corrected: Corrected By:
Signature of Tester: Phone # (206) 682-6636
resting Agency: Reliance Fire Proterfion, Inc.
Vlailing Address: PO BOX 428, Preston WA 98050-0428
3uilding Representative (signature)
WA State IT #
Ei'm 1.,wk Vr�v 141w
V
,,::� rf System Location:
;�j7
General
pip6..in§pection 'at- riser and cross m.ain'done?
Yes
-No C3
I-.,.',z..,l9tern.al
2. All check valves inspected? N/A C3
Yes O��
No C3
Fire De t.:Con6L-ction: bakkflush d?,:�
partmen e
Yes C3
No 0
4. FDC.visually inspected?
'Yeso__�'
No C3
g balibrat id -
e —or, rep aci V
,
6. Any corrosion found?
Yes 0
NoCK'
mmehd -Yes')O
NO'
SNO
,T
D
Serving Brier, Edmonds
Mountlake Terrace, and
the Town of Woodway..
www.FireDistrict1.6`rg_'
LOCATION: 550 Dayton St
BUSINESS NAME: 550 Dayton Condos
MAILING 550 Dayton St
ADDRESS: Edmonds
BUSINESS OWNER: �
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE:
98020
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
0 EDMONDS
[3 BRIER
OWOODWAY
[I MOUNTLAKE TERRACE
0 UNINCORPORATED
FREQUENCY STATION & SHIFT)
366 17 D
SCHEDULED
DATE DUE � (115/01/11
UFIR � 422 5203
EMERGENCY-1: Howard, Bonnie #201 HOME PHONE: 4256975637
KEY ACCESS-2: HOME PHONE:
e CURRENT
CITY YES NO.
BUSINESS
LICENSE 1:1 1:1
PERSON CONTACTED:
NAME OF INSPECTOR:
INITIAL' INSPECTION DATE
FIRE FA 4/10 S 40 0
SYSTEMS: %V1-'\ �Lkl"
IFD Lk x FE41n
6V-- ANNUAL
HAZARDS FOUPD AND LOCATIO14S / COMMUI 11CATIONS
yJe, F�WJJD
2
2
3
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
DATE DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
INSPECTOR:
-INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECE0T
RECEIVEd'
6
4
13
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED E] YES El NO
LETTER NEEDED F] YES NO
8
FIRE DEPARTMENT COPY