641 BELL ST (2)SNOHOMISH CO.
FIRE
DIST]
ST&e
Serving Bri er, Edmonds, and 12425 Meridian Ave S
Mountl4ke Terrace Everett, WA 98208
Phone (425)* 551-1200
T www.FireDistrictl.org Fax (425) 551-1272
LOCATION:
.641 Bell Street 98020
BUSINESS NAME:
Bell North Condos
MAILING
ADDRESS:
641 Bell Street, Edmonds, WA 98020
BUSINESS OWNER:
McMann, Pat
EMERGENCY-1:
A_Uet4k 101
KEY ACCESS-2:
EMAIL:
CONTACTED: fs r
'NAME OF INSPECTOR:
PHONE:
4257732787
FIREPREVENTION
INSPECTION REPORT
)6 EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[I UNINCORPORATED
0' FREQUENCY STATION & SHIF_*�
AI mitial I — - - —
I I _Lj
SCHEDULED
DATE DUE 0
UFIR 0
� 422
HOME PHONE:
HOME PHONE: CURRENT
HOME PHONE: CITY YES NO
BUSINESS
LICENSE 1:1 M
INITIAL INSPECTION DATE
L105 %0(6 n1lb
FIRE SYSTEMS: AS 6/15 FA 10/15 FE�-V
Pt twu Qd %V -I/
DataftcastoDwAsadocAriONS COMMUNICATIONS
COL Q
A
2
2
3
3
4
5
5
-6
6
7
__7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1 st RE -INSPECTION
2nd RE -INSPECTION
/EXT/ENSION
FINAL RE-INSPECT0'r4
VIOLATIONS
DATE DUE:
DATE DUE:
�,GhANTEDTO-
DATE UE:
CITED:
PERSON
CONTACTED: 'Zftey
PERSON
CONTACTED: &20A)c
PERSON
CONTACTED:
I
INSPECTOR: I-) 1h)MA)
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:.
DATE:
3
VIO IONS;, y,
PRE -CITATION
4
CITATION ISSUED
J9
LETTER SENT
NUMBER:
6
2
6
DATE:
CODE
SECTION:
5
RETURN RECEIPT
6
3
3
7
R CEIVER
7
DISPOSITION:
8
4
8
DATE:
\,LETTER NE EDED [] YES NO
LETTER NEEDED F] YES 0 NO
8
FIRE PREVENTION
Serving Brier, Edmonds, and
12425 Meridian Ave S
INSPECTION REPORT
�NOT�02IEn�130.
OEDMONDS
FIRE
Mountlake Terrace
Everett, WA 98208
0 BRIER
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
DISTRT
www.FireDistrictl.org
Fax (425) 551-1272
[1 UNINCORPORATED
r- FREQUENCY
STATION 1, SHIFF`*1
LOCATION:
641 Bell Street 98020
Annual
17-A
I
BUSINESS NAME:
Bell North Condos
PHONE: 4257732787
sCHEDULEDJUl 2015
DATE DUE
422
MAILING
641 Bell Street, Edmonds, WA 98020
FIR
[U
ADDRESS:
Pat K11 A oil)
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
1:1
1:1
EMAIL:
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
11�
30 —A;'
NAME OF INSPECTOR:
FIRE SYSTEMS-
A-q r,11A PA 1n11A Pr= rvii I- k
r%�R.CATIONS / COMMUNICATIONS
A�a I �.Y_�/' L.,e -,4,1
2
-A
2
3
-4e
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
In our continuing effort to promote fire safety and prevention within the community, your fire department conducts
regularly scheduled "Fire Safety Survey Inspections" of all businesses and multi -family occupancies in the Cities
covered by Snohomish County Fire District 1.
You are to be congratulated on the relative,good condition of your occupancy in regards to fire safety. Above you
will find the item(s) that were noted during our inspection which require attention to bring them into compliance
with the minimum standards adopted by the above jurisdictions.
Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions or violation.
If you require additional information or to schedule a re -inspection for Edmonds or the Town of Woodway, call (425)
775-7720; for Mountlake Terrace or Brier, call (425) 754-0434.
BUSINESS COPY
Serving Briei; Edmonds, and
_SNOH,9MISH CD...
FIRE Molintlake Terrace
DISTRINIT www.FireDistricti.org
LOCATION: .641 Bell Street 98020
BUSINESS NAME: Bell North Condos
MAILING
ADDRESS: 641 Bell Stree,t,-Edmonds, WA 98020
BUSINESS OWNER: Pat vi, 0,
FIRE PREVENTION
I 2425'Ve"i�-idii3aflive S f 7' INSPECTION REPORT
0 EDMONDS
Everett, WA 98208 0 BRIER
Phone (425) 551-1200 0 MOUNTLAKE TERRACE
0 UNINCORPORATED
Fax (425) 551-1272 ; I
PHONE: 4257732787
HOME PHONE:
" FREQUENCY I STATION & SHIF'**�
Annual 17-A
SCHEDULEDJUI 2015
DATE DUE
422
LIFIR 0
EMERGENCY-1: HOME PHONE: "'CURRENT
KEY ACCESS-2;,' HOME PHONE: CITY YES NO
BUSINESS
EMAIL: LICENSE 1:1 1:1
INITIAL INSPECTION DATE
PERSON CONTACTED:
NAME OF INSPECTOR: —P J(J
FIRF ';Y.I;TFM.O,- A(Z R11A IYAl'51A r:l= R/11 I
tjfpjSd=qL�8,V8�8FATIONS COMMUNICATIONS
2
f
2
3
3
4
4
5
5
6
6
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
11st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
I
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
01,
3
DATE:
DATE:
DATE:
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:
7
4
.8
4
18
DATE:
LETTER NEEDED [] YES El NO
LETTERNEEDED [] YES El NO
.10
FIRE DEPARTMENT COPY
Con
,,fidence Testing Company:
Wolfe Fire
Protection, Inc.
17321 Tye St. S.E., Ste. "B" - Monroe, WA 98272
Fax: 360.794.3080 19 Ph.: 360.794.8621
Fire Department
Confidence Test Report
SPRINKLERS - WET
Certification Given
RED
YELLOW
WHITE
(ONE SYSTEM PER REPORT)
CONFIDENCETEST: j=-C9 I REPAIRS:T 0
J, ,
Occupancy Address: 61q I 13t-Rsi— D-Morld<
Occupancy Name: Re 1) A10(+ � (CVIAO�
BuildingOwner: Pell-Mr)(ik ASL
Responsible Person:
Phone Number:
Phone Number:
Building Owner
Address: Z11! Rell S4, -Lo'l-c ;'()? EdwotiAs, wa 90?,0
Date of Inspection: 6- Z3- ,5
Inspection Frequency / Type: Annual
Tester's Name (print):
Certification Number: SCP- 90'/G -0'-�06 E6-
Central Station monitoring? Yes No C1
Primary Component: Fe_f,�-u'
Monitoring Co. Name: CVVAIP.-',t� �6rt,(f, +V
System Make:
System Model:
System Location: "tj Z-,2L2_1L_Zf
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 Auth�pity Having Jurisdiction's Fire Department Fire Code standards.
All discrepancies are noted and have geen rep rteqyto-the building Owner/Manager for corrective action.
Signature of Tester:
Testing Agency: Wolfe Fire Protectiod, Inc.
Phone #: 360.794.8621
Mailing Address: 17321 Tye St. S.E., Ste. "B" Monroe, WA 98272
Building Representative (signature):
Sprinklers - WET
Page: 1 of 2
Tke�o 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 Authority Having Jurisdiction's
Fi.re Department Fire Code for inspecting and testing requirements.
General
1. Flow Test conducted? ............................................................................................................ Yes No El
2. Static Pressure: psi Flow Pressure: psi
3. Total number of sprinkler heads on this system?
4..Was 2" Main Drain.checke,d? .... ............................. i ........................................ Other
Yes Q
5. Flow Switches, Supervisory Switches and Alarm Bells testedl ......................... N/A D
Yesff
No 0
6. Pressure regulating valves tested? .............................................................................. N/A
Yes Lj
No 0
7.Alarm Bell operates? ............................................................................................. N/A 0
Yes,.,M-
No Q
8. System inspected and lubricated ? ..................................................................................
Yes
No 0
9. Valves sealed or supervised? ...............................................................................
Yes
No 0
10. Signs provided on all valves? ................................................................................................... Yes 91 No Ej
11. Pumper Connections and Clapper valves unobstructed and turn freely ? ................ Yes I�f No LI
12. Spr,4ikler head coverage acceptable? .......................................................... Yes No El
13. Have the sprinkler heads been replaced or successfully sample tested in the last 50 years? Yes6 No C3
14. Proper number spare sprinkler heads available with appropriate wrenches for each? ...... Yes �i:> N o 0
A
15.-System left in service? ............................................................................................................ Yes P� No [I
16. System gauges been replaced or calibrated within the last 5 years? .... ........ Yes No L)
17. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? .... Yes No LI
18. Was any debris found in the Fire Department Connection (FDC)? ........................ Yes El NoZ
19. Was the Fire Department Connection (FDC) been back flushed in the last 5 years? ... Yes 0) No Ej
20. Was an internal pipe and valve inspection performed within the last 5 years? .................. Y e sb7 N o LI
- I '�O/ �-
Date Pe rmed:
21. Was a.s,ignal received at the Central Station monitoring company? .................... N/A El
Yes No 0
Sprinklers - WET Page: 2 of 2
FIRE ALARM
CONFIDENCE TEST
(one system per report)
Olympic Security & Communications Systems
PO Box 3559 Arlington, WA 98223
360-652-1088 800-540-7233
RED 1:1 1 YELLOw El I WH
pancyAddress:6-Y/ 11"t :57 t-1DAdAQL95 Occupancy Name: - 173& 41- "o I" -"
ing Owner: eq ui N reiz -,-> A ts - Responsible Person -N 4- MC-ItAkIIIIJ
e Number: JQ Phone Number: ('10 T)l 7 %2 -2 67
ing Owner Address: s4fo E Alternate Phone # All
A
of Inspection: 1-7 ( (C-1 Inspection Type: Annuax, Quarterly 11 Acceptance 0
Name (Please Print)
Certification
Trouble signal with AC power ott?
Tca LF
Imu �
System operates properly ba tte backup?
load) vo---
Battery I Its Battery Voltage (full loa
charge volt Re c;27
N&O
voltage (no
System operates prope!`Won standby power?
Y
No El
All signals- operate on AC'p'ower-?
Yes
No 0
Number of initiating circuits: Number of signal circuits:_
Does system meet audibility standards?
Yes
No 0
circuits checked for electrical supervision?
'y6s
No 0
41 a-ux-illi -a —ry -e-q- u-ip m- en t-op e-ra"t-e-s-('elevators-, fa-ns-,d-a-m p-ers)-?
N/A 0
Yesq
No 0
�e-nt-ila--tio—n-c-ont-ro-isop-e-r-at-e?
Yes
No 0
Ke - y to panel availa - bl - e? .--
Yes
-Yes
No 0
bp-e--ra-t-i-ng—in-s-tr-u-ct-i-ons—at panel?--
No El
Pull - stati - on restore tools at mai . n pa I nel (ro ds, . key I s, etc.) 7
N/A [Fl
Yes 0
NoO
Troubi(e indhc-ators'function properly? Af-
N/A 0
Y, e
No 0
Remote Annunciator Panels function properly? ---Z/ 7
N/A A
Yes 0
NoO
neva-tor C-allbow n fun cti oris pro-perly?-
Y�`sN?
-No 0
Test record posted at panel?
Yes
NOD
�eneril af�r`m automatic time delay:
--N/Al)
Central station monitoring company received signals?
Yes
No 0
--'Y"e-s---'
-No El
System' left"in se - rvice?
Ye s
No 0
�nf6-rm-e-dow-ner-ofinspe-ct-io--n&--te--s-ti-n--g--re-s-ul-t-s--a-nd—a-ll-s-y-st-e--m-de-f-i-c-ie—nc-ie-s?----
y6s
-NO 0
Number of stories:
Yes 0
No 0
boall�locking -devices release upon activation of the fire alarm system?
N/,A III
-Yes E3
El
Do all locking devices release upon power failure?
N/A
Y 0
No 0
b-,�esi-he-d6-or-to-roofunlo-ck?-----------'
W/A
_Y!S _0
es
No 0
Do doors unlock but not unlatch?
N/A
Yes 0
Noo
nanel�for�doors-�thatif.ail.;toLunlo-c-k�?,-,&-,�.d.,:-.�.-;.-
j��4 'A
-y'
-'eS
No- El
Ace Speakers (voice clarity)
Heat Detectors
Duct Detectors
Sprinkler Flow Switches
Sprinkler Supervisory Switches
Visual Alarm Devices
ManuaFPull Stations
Automatic Door Unlocks
Automatic Door Release
.,-- 1-1
- -* 77 -
_i:_1
NIA,4?9
Yes 0
No-b--
-�TA-ff
Yes
--No Ej-
N/A
Yes El
No 0
N/A..0
Yes 0
No 0
N/A E3
1�s
No 0
kjAb
-Yes-
N -0 Ej
N/A 0
Yes
146 El
-N-/-,A---El-
-Ye—sjo
'No Ej
N/Ao�
Yes 1:1
No El
N/A 0
Yes 0
Central Station Monitoring? Yesio No 0 Monitoring Company Name: Ock"apte SU'C41L4
Control Panel Man - ufacturer:-.S) Model Number:
Problems Found:
,
V4 t 111— r— 1
ClIese-V J'e-)e-
r-]
T
Corrections Made: Date Corrected: Corrected By:
Signature of Tester:
Customer
Date: i ot-fllev —
Date: I ly 2 Ll"Z
FIRE PREVENTION
'SNOHOMISH
'Serving Briei: Edmonds, and
12425 Meridian Ave S
INSPECTION REPORT
CO.
)gtDMONDS
FIRE
Mountlake Terrace
Everett, WA 98208
0 BRIER
ST R
TV'-
Phone (425) 551-1200
Fax 551-1272
0 MQUNTLAKE TERRACE
O;PNINCORPORATED
wwFireDistrict]. org
(425)
FREQUENCY
STATION 1, SHIFT
LOCATION:
641 Bell Street 980,20
Annual
17-D
I
BUSINESS NAME:
Bcll NorLh Candm-
PHONE: 4207,732787
SCHEDULED
DATE DUE I` Jul 20114
MAILING
UFIR I, 4a'
ADDRESS:
B41 licil Slrccl, F_dman&,vVA 08020
_ol
BUSINESS OWNER:
Pat
HOME PHONE:
&E.
"CURRENT
RGENCY-1:
HOME PHONE:
KEY AbCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
EMAIL:
LICENSE
,
PERSON GO ., NTACTED:
INI IAL INSPECTION DATE
NAME OF INSPECTOR.
17 F/ -/X
I -IRE SYS I EMS:
AS 51,14 FA 1 (V.ff FE'97,1,3
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
4149 V
2
2
3
3
4
4
5
5
6
6
7
7
I AGREEITO 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:
I
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
E:
DATE:
3
- VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
�2
6
2
6
DATE:
CODE
SECTION:
5
IPT
4
18
4
18
DATE:
DISPOSITION:
7
LETTER NEEDED F] YES NO
LETTER NEEDED [] YES NO
8
FIRE DEPARTMENT COPY
Confidence Testing Company:
,A'DVANCED
P.O. Box 1543 - Woodinville, WA 98072
Ph.: 425.483.5657
Fire Department
Confidence Test Report
Confidence Testing: 206.793.0936
SPRINKLERS - WET
Certification Given
RED C1
YELLOW CI-FWHITE
n—
(NOTE. ONE SYSTEM PER REPORT)
CONFIDENCETEST: ��j REPAIRS:1 Fj
Occupancy Address: 6, -5// _7
Occupancy Na me: A�IL /1,/ Cr� L�0 -.">
Building Owner:
Responsible Person: 7—
Building Owner
..Address:
Date of Inspection: fZ
Phone Number:
Phone Number:
Inspection Frequency Type: Annual
Tester's Name (print):
Certification Number: SCP7
Central Station monitoring? Yest9- No C3
Monitoring Co. Name: eaj._�, 01- V-111i �?/C_
Primary Component: bV,-E-- 7- )P/
System Make:_ L
System, Model:
System Location: epe_5-�A,-1 r- nz
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.)
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 a' re noted-- d have been reported to the building Owner/Manager for corre ctiVe action.
Signature of Tester
Phone 425.483.5657
Testing Agency: dvanced Fire Protection, Inc.
Mailing Address: P.O. Box 1543 - Woodinville, WA 98072
Building Representative (signature):
Sprinklers WET Page: 1 of 2
41
18
The el ems on the check list shall be inspected and tested. This list does not constitute all of the required
insp- ing arid- testing of the Fire and Life Safety system. Refer to the Autho.rity Having Jurisdiction's
Fire" Department Fire Code for inspecting and testing requirements.
General
1. FlOw.16stIcOndUcted? ........................................................................................................................................
Y e s.,2_
N o El
2. Static Pressure: psi Flow Pressure: psi
-------- ---
3. Tota-I numberlof sprinkler heads on this system?
J
z
4. Was 2" Main Drain.checked? ... ............ ............................................................................
Yes 4EI-
No C)
5. Flow Switches, S'upervisqr-y Switches and Alarm Bells tested? .....................................
NIA Q
Yes-Q-
No E)
6. Pressure regulatingwalyes tested? t � ...... ; ........................................................
Yes El
No 0
7. Alarm Bell operate? .......................... "*.v .................................................................. .
No El
8. System inspected'. and lu6ric'. ated -7'
....... ............................................................
Y e s.:f=)-
N o [I
9. Valves sealed or supervised? ............................................. . . .. ......... . ......... .................... ............ Y e s-t�F No 0
10. Provided on all valves? ............................................................................... !..,: ............................ Yes4n, No C1
11. Plumper Connections and Clapper valves unobstructed and turn freely ? .................... Y e S-Ea- No 0
12. Sprinkler coverage acceptable? ............................................................................................. Yes.Q_ No El
13. Have the sprinkler heads been r epi aced or successfully sampi e tested in t he last 50 years ? Ye s-63— No (j
14. Proper number spare sprinkler head3 nvailable with appropriate wrenchs for each? .............. Yes -El- No 0
15. System left in service? ............................................................................................................ Y e s,,Q-- No (j
16. System gauges been replaced or calibrated within the past 5 years? ............................. Y e sa- N o LI
17. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? ..................... Y e soEl N o 0
18. Was debris found in the Fire Department Connection (FDC)? ................................................ Yes [I No.9
19. Was the Fire Department Connection (FDC) back flushed within the last 5 years? ..A,14 ... Yes 0 No El
20. Was an internal pipe and valve inspection performed within the last 5 years? ................. Y e s_Q_-N o 0
Date Performed:
21. Was a signal received at the Central Station monitoring company? .................... N/A E) Yes 9— No 0
Sprinklers 9 WET Page: 2 of 2
4.
FIRE ALARM
CONFIDENCE TEST
(one system per report)
Olympic Security & Communications Systems
PO Box 3559 Arlington, WA 98223
360-652-1088 800-540-7233
RED 1:1 1 YELLOW 1:1 1 WHITE
Occupancy Address: (P" I Occupancy Name: Z)Ci I 1YQf11-%
Building Owner: OwNAr-s 4s-%oC-. Responsible Person,: e- n/I 2? rd
Phone Number:(Lyas) -rg-saJ6 Phone Number: OZ.
Building Owner Address:.-,S4-kaC- AlternatePhone# N18
Date of Inspection: L-g Inspection Type: Annual §4 Quarterly El Acceptance 13
4 ITester's Name (Please Print): cStf%X0 PIAIWVA!9�- - Certification
Trouble signal with AC power off?
��7st —em -&p —er. a Ce s--prio-p ei-ri y--o'n- b- -atte rY b a- c-k- u- p ?
Battery voltage (no load) �,olts Battery Voltage 11 loa,di�
charge voltage
S
� iNd
- P,
ystem operates properly on stin � power.
All signals operate on AC power?
Yi(isj
—14-0-d
Number of initiating circuits: ISP, of iii-n-al cir-c-u-it-s-:-_::z
--
Does system meet audibility standards?
Yes q�P
No 0
-d fc�r e�l-ectirica-f
cirauits�`checke superviso
Y---;g--
e s
-N 0- -0-
All auxilliary equipment operates (elevators, fans, dampers)?
N/A 0
YesVoil
No 0
,V �ntilation controls operate?
___Yes 11
N -o E-1-
Key to panel available?
Yes 10
No 0
�ratinCmstructions.at panel?
Rp
Pull station restore tools at main panel (rods, keys, etc.)
N/A
Yes 0
No 0
Trouble indii—ato-rs f-`unctio-n prop`er-l`y?-'
Remote Annunciator Panels function properly?
N/A)3
Yes 0
No 0
ti-��a-to-r-C-a-I-I-D-o-wn-fun,c-tio-nsp-ro-p-e-rl-y-?-
0
Test record posted at panel?
Yes
No .0
�e —ne r -a I -a- �a r m 'a u t om -a t i c t i m e d- e- -1 a'y':
N/A
Central-sta--tio-n -mo-n-i-t-o-ri-ng-c-o,-m-p-,an-y -r`e`c`ei`ved -sig-nals?--
Yes 12
No 0
W�`s.afu--1-N;a I kth rough done? 7
System left in service?
Yes
No 0
informed owner of inspection & testing results and all system deficiencies?
---No
-
El
Number of storieS7
Yes 0
No 0
6�ai[!Ji Vini 4-ev�s relea-se-upon activation of the fire alarm system?
oc g
__��A 1A
e o
---Nan
Do all locking devices release upon power failure?
N/A
Yes 11
No 0
56—es,t6ie-do—orto -roofu`nFock-?-----------
N/A -
Do doors unl�c but not unl
N/
Yes 0
No 0
6i,hee,ejan,a.C�essjke.y,at lip
-,thjeLcq[jtrp_ _4p.eL1jforAAQqrs;;t
�
, 71�11i-m6-
re I �n��
N/A P. .11t:.) LLJ L�-j
Voice Speakers (voice clarity)
N/AR) Yes 0 No El
,Detectors
Heat Detectors
N/A 0 Yes 0- No.0
N/A Yes 0 No 0
Dbc Oetectors
N
Sprinkler Flow Switches
N/A 0 Yes 0 No 0
�p�rinkler Supervisory Switches
N/A 0 Yes El No 0
Visual Alarm Devices
-7
N/A 0 Yes 0 No 11
Manual,Pull Stations
N/A Yes 0 No, 0
Automatic Door Unlocks
N/At Yes 1:1 NoO
(0
Automatic Door Release
N/A Yes
Central Station Monitoring? Yes No F-1 Monitoring Company Name:
Control Panel Manufacturer:1Tj*1,0,j- Model Number: Sc�)OTI
Problems Found: Q�0&c
Corrections Made: Date Corrected:
Corrected By:
Signature of Tester:
Customer Signaturel:iat-N�-
Date:
Date: IaIW
Of
FIRE ALARM Olympic Security & Communications Systems
CONFIDENCE TEST PO Box 3559 Arlington, WA 98223
(one system per report) 360-652-1088 800-540-7233
Iding Owner: r'-z'_,'LE.
me Number: � OL co
[ding Owner Address: 64vic—
e of Inspection: I es fa!�-' I (
Name (Please
RED E] I YELLOW 1:1 1 WHITE K
Occupancy Name:
Responsible Person: M
Phone Number: _TA/yLcF'
Alternate Phone # Nhu
inspection Type: Annual Quarterly El Acceptance El
Certification
Trouble signal with AC power off?
Yes pi
NO U
�Y�st-ern-o��rrates properly - on b , a . t . tery .- ba , ckup?
_NO.0
c
Battery voltage (no load) 41���fts Battery Voltage (full load) harge voltage
,y eWoi-perik es properly on stanclb)�power?
N_O_0_'
�raie on AC power?
_Um� -W.;�be-r o-f -signal
Yes
NOD
er,of initiating circuits: circuits:
Does system meet audibili y sta ar�s
Yes -6'
Nf6 b
All'circuits checked for electrical supervision?
All auxilliary equipment operates (elevators, fans, dampers)?
N/A El
Yes-0
No 0
entilation.controls operate?
N/A
0
K , ey to panel available?
Yes 0
No El
9,p��ati(ng� instructions at panel?
Pull station restore tools at main panel (rods, keys, etc.)
N/A Pa
Yes 0
No 0
Troulle,indicators function properly?
N/A 0
Yes -A
_N6
Remote Annunciator Panels function properly?
N/A 0
YesA
N6ff
ti-�-vat—or--C-all-Do-w-nfu-n-ctio-n-s-p,ro-per-l-y?
Test record posted at panel?
Yes p
No 0
��l alarm.automatic time delay:
Central station monitoring company received signals?
Yes 14
No 0
-7-
a-si-Pull walkthrough done?
Ye-s- %_____Wir--
System left in service?
Yes J@
No 0
Rnfo-rini-ci 'ection & testing results and all system deficiencies?
ownerof insp-
_No_E_1_
Number tories--
Yes 0
No 0
]ockingdevices releas---
do=all e upon activation of the fire alarm system?
N/A
Do all locking devices release upon power failure?
6o—es,the clo6�_to ro-of u n_1_ock?___
Ye%;
'Y6
Do doors unlock but not unlatch?
N/A 50
Yes El
No 0
essikev-.-a-tith—ea�--on—tr,o-I.-Da-ne-li-fo-r4,-d-o-o-
0
Voice Speakers (voice clarity) NlArg Yes 0 No 0
iLrr'n 6o kke., D et,!c to rs N/A 1:1 Yes. V
Heat Detectors 0 N/AV Yes 0 No 0
pu�t,Detectors N/A i4� Yes � F No., 0,
—We 7so' No 0
Sprinkler Flow Switches N/A 0
��Ier'Supervisory Switches N/A El Yes No 0'
Visual Alarm Devices N/A ED Yes IF NOO
N/A 0 Yes ---No 0,
�a �uarPull Stations
Automatic Door Unlocks N/A)U Yes 0 No 0
7 -Ves-ia, No 0
,Automatic Door Release
Central Station Monitoring? Yes �b No Monitoring Company Name: &S-C )ZAL
Control Panel Manufacturer:, Model Number: ST;L09
Problems Found:
Corrections Made: Date Corrected: Corrected By:
Signature of Tester:
Customer
I U, 111� W Ma
_T_
Confidence Testing Company:
D VA NCED
I RE PROTECTION, INC.
P.O. Box 1543 - Woodinville, WA 98072
Ph.: 425.483.5657
Fire Department
Confidence Test Report
Confidence Testing: 206.793.0936
SPRINKLERS - WET
Certification Given
RED
YELLOW 0—f
WHITE 4a—
(NOTE: ONE SYSTEM PER REPORT)
CONFIDENCETEST: j4j�4-11EPAIRS:j j
Occupancy Address: 66c6pancy Name: 'V
Building Owner: Phone Number:
Responsible Person: Phone Number:
Building Owner
Address:
Date of Inspection:—,/ 6 —//c/ Inspection Frequency Type: A nn u a I
Tester's Name (print): 'OVW062�) Certification Number: SCP'_�7 —/We:2 �1_r
Central Station monitoring? Yes42F-- No L) Monitoring Co. Name: 0*4 Y1,2 ZC
Primary Componentc;�, System,Make:
System Model:
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.) Numb6jr: SCP-
—Certification
This certifies that this Fire and Life Safety system has been properly inspected for reliability to cover the items
listed in this report and I s consistent with the Authority Having Jurisdiction's Fire- Department Fire Code standardsv-
All discrepancies are no ave emen-re r1ed to the building Owner/Manager for correc�ive action.
Signature of Test Phone #: 425.483.5657
Testing Agency:-' Advanced Fire Protection, Inc.
Mailing Address: P.O. Box 1543 - Woodinville, WA 98072
Building Rep res e ntative (signature):
Sprinklers * WET
Page: 1 of 2
Th,�Jbelow items on the -check list shall be inspected and- tested. This list does not constitute all of the required
, V.
ids-k- 4t in `Ih4iesting of the Fire and Life Safety system. Refer to the Authority Having Jurisdiction's
Fire Deogrrtment Fire Code for inspecting and testing requirements.
General
1� 30- Ydst-cori&cted? ............................................................. I .............................................. I ................................
Y e,&:JD_ No C3.
2. Static Pressure: --psi. Flow Pressure-; psi.
Tnumber-of sprinkler heads on this-syst
3. Total. em?
-4. Was 2" Main Drain checked? . .................................................................................................. 01-h-er 0-- ---Ye,`s,..O_ —No C1
5. lFlow Switches, Supervisory Switches and Alarm Bells tested? ..................................... N/A Cj_
Y e i.,Q— N o 0
6. Pressure regulating� Nes,test!p#? w. ......................................... ........... N IA.,�Y--_Q No C3
7�
7.-Alarm'Bell operate? ........................ �' _r� ............................................................................ f
N iF
?
8. System inspected andIubricated . . ................................................................................... �e' j�� No C3
9. V�Ives, -sealed or supervised? ................... .......................................................... ............. ..........
Ye N o C3
10. Provided on all valves? ........................................................................................ ; ....................
. Y e SoEff N o 0
_Aow
11. Pumper Connections and Clapper valves unobstructed and turn freely 1 ....................
Yejj:4_ No E)
12. Sprinkler coverage acceptable? .............................................................................................
Yeq.Q� No Cl
13. Have the sprinkler heads been replaced or successfully sampld'4=ein the last 50 yearO
Yesoa— No C3
14. Proper number spare sprinkler heads available with app ropriate wrenchs foreach? ..............
Yes=9—No C1
15. System left in service? ............................................................................................................
Ye%.U�_No Q
16. System gauges been replaced or calibrated within the past 5 years? ............................. Y e s--g— N o [I
.*- —4-
17. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? ..................... Y ks-9— No C1
18. Was debris found in the Fire Department Connection (FDC)? ................................................ Yes Ej No-8
Yes 0 No Q
19. Was the Fire Departme.nf,donnection (FDC,),�back flushed within the last 5 years? .. . ....
�f6 , _4within the last 5 years? ................. Yes
20. Was an internal -pipe and valve inspection pe rme o
Date Performed:
21. Was a signal received at the Central Station monitoring company? .................... N/A LI Yes
,,Gr' N o 0
Sprinklers WET Page: 2 of 2
FIRE PREVENTION
Serving Brier Edmonds
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
FIRE Mountlake Terraceand
Everett, WA 98208
EDMONDS
BRIER
e Town of Woodway
DISTR T
Phone (425) 551-1200
0 WOODWAY
[I MOUNTLAKE TERRACE
wthww.FireDistrictLorg
Fax (425) 551-1272
0 UNINCORPORATED
FREQUENCY
STATION & SHIFT")
LOCATION: 641 Bell St
365
17 D_
BUSINESS NAME:
Bell North Condos
PHONE:
SCHEDULED
DATE DUE 0 07/01/13
MAILING 64113ell St
UFIR 0 422 7203
ADDRESS:
Edmonds
98020
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
HOME PHONE:
CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
1:1
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE FA 6/11 AS 6/12 FD IkBx
FE L / r5
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
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 compliance
with the minimum standards adopted by the above jurisdictions.
Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions or violation.
If you require additional information or to schedule a re -inspection for Edmonds or the Town of Woodway, call (425)
775-7720; for Mountlake Terrace or Brier, call (425) 754-0434.
BUSINESS COPY
Confidence Testing Company:
IDVAHCEID
P.O. Box 1543 - VVoodinvifle, WA 98072
Ph.: 425.483�5657
Confidence Test Report
206.386.1448 Confidence Testing Officer
206.615.1068 (fax)
206.233.7219Red Tag Hotline
SpmNKLERS - WET
CertfflcaUon G�ven
RED
YELLOW
WHITE
(ONE SYSTEM PER REPORT)
CONFIDENCE TEST: R E P A I R S
Occupancy Address: sT —,Occupancy Name:
Building Owner: Phone Number:
Responsible Person- Phone Number:
Building Owner
Address:
Date of Inspection: /v�l Inspection Frequency Type: Annual
Tester's Name (print): hWr"Z.4> SFD Certification Number: SCP-,
Central Statio n monitoring? Yes-Ej' No D Monitoring Co. Name:
Primary Component: IZZE 7— RZS3&�- System Make:
System Model:.
System Location: Identification Number:_
ProblemsFound: (1fadditional 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 discrepandi-6's
are noted and have been repo I r/Manager for corrective action.
-,,#d'to the building - wne
Signature of Tester: Phone #: 42 5.483.5657
Testing Agency: Advanced Fire Protection, Inc.
Mailing Address: P.O. Box 1543 -Woodinville, WA 98072
Building Rep rese nta ti ve (signature):
Sprinklers - WET Page: 1 of 2
W4ow items on the check list shall be inspected and tested. This list does not constitute all of the required
ing and testing of the Fire and Life Safety system. Refer to the Authority. Having Jurisdiction's
Fird Department Fire Code for inspecting and testing requirements.
General
tconducted? ...... -x ......................................................................................................... ................... Y e SJ� q. C3
2. Static Pressure: psK-�-' ,Flow--'Pre679Ufe-: psi
3. Tdtal'number-of sprinkler heads on this system?
- ----------
-00z; .0 h e r4a-
4. Was 2" Main Drain che6ked? 2� ........... :�. I%z / ................. .......... .......... 0 /t No 0
5. Flo" Switches, Supervisor
w y. Switches and Alarm Bells tested? ..................................... N/A (3 YeswO— No Ej
6. Pressure regulatinr' N
tested? .......... -Y, e s E I No 0
7. Alarm Bell operate? ...................... ........................ ......................... .................
N/A'El NV,Ej
' j 41
8. System -inspected-�'ri'd-lubricat6d"?-��..� ...... M ................................. ....... *.- Y e s-8-- No LI
9. Valves sealed or supervised? ................. Yes.Q- No C1
10. Provided on all valves? ............................................................................................................. Ye6,a No El
I.I.-Rupper Connections and Clapper valves unobstructed and turn freely I ......... . ......... Yes43- No 0
12. Sprinkler coverage acceptable? ............................................................................................. Y e §,Ej- N o (3
13. Have the sprinkler heads been replaced or successfully sample tested in the last 50 years? Yee-t2- No E)
14 per numbers a
.Pro p re sprinkleir head3 nvailable with appFopriate wrenchs for eac-0 ... ..'....".-. Ye�� No* L),
15. System left in service? ............................................................................................................ YesaEl-- No LI
I - - I
16. Syptem gauges been replaced or calibrated within the past 5 years? ............................. Yes-63— No 0
17. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? ..................... Y eA,@- N o Q
18. Was debris found in the Fire Department Connection (FDC)? ................................................ Yes (3 NPQ
19. Was the Fire Department Corin ection (FD�)�ba� ? No 0
flushed within th e last 5 years Y e s 0
e
20. Was an internal pipe and valve inspection performed wft�in the last 5 years? ................. YesEj--No L)
Date Performed:
21. Was a signal received at the Central Station monitoring company? .................... N/A El Yes-8—No El
.- Sprinklers -, WET Page: 2 of 2
Confidence Testing Company:
__.AA'DV_,4NCED
_V__- FIRE PROTECTION, INC.
P.O. Box 1543 - Woodinville, WA 98072
Ph.: 425.483.5657
,ft-4-10 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
YELLPW
WH)TE
(ONE SYSTEM PER REPORT)
CONFIDENCE TEST: R E P A I R S F
-Occupancy Address:4 �// &EZ S 7—
Occupancy Name: 414 A/ /SM/220 S
Building,Qwner: Z�24
Responsible Person: 7q7A
Phone Number:
Phone Number: 223
Building Owner
Address:
Date of Inspection: r17
Tester's Name (print): '11,45er'll
Inspection Frequency Type: Annual
- OC,
SFD Certification Number: SCP-S ,?0 57F
Central Station monitoring? Yes -El' No El
Monitoring Co. Name: //A/)p//,,, Ll
Primary Component:
System Make: r F1111—RA r-
System Model:
System Location: )Ms�o
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.)
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 cons . tent with the Seattle Fire Department Fire Code standards, and all discrepancies
are noted and have b ted to e bui4ding'Pw.`6her/Manager for corrective. action.
Signature of Tester: &&�?-42'
— Phone #: 425.483.5657
Testing Agency: Advanced Fire Protection, Inc.
Mailing Address: P.O. Box 1543 -Woodinville, WA98072
Building Re prese n tati ve (signature):
Sprinklers e 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
jecpired inspecting and testing of the Fire and Life Safety system. Refer to the Seattle Fire Department
�0? rrreobbode for inspecting and testing requirements. . -
General
1. Flow Ust-conducted? ...............................................................................
......................................................... Yes-9—.No 0
2. Static Pressure: psi Flow Pressure: �;?!E�psi
3. Total number of sprinkler heads on this system?
4. Was 2" Main Drain checked? ................................................................................. —�Yes,9- No 0
0 t,h e4r-B
5. Flow Switches, Supervis itches and Alarm Bells tested? ..................................... N/A L) Yes.0 No 0
- __ W-?W - - __ - __ - - - --- ____ - - __ ____
6. Pressure regulating valves tested? ...... ......................................................................... N/A-Ej— Yes 0 No LI
7. Alarm Bell operate? .......................................................................................................... N/A El Yz,-,-& No 0
8. System inspected and lubricated ? .................................................................................. Y e s-d- N o LI
9. Valves seiled or'supervised? . ........................................
.................. .................................................... Yee=@-, No 0
10. Provided on all valves? ............................................................................................................. Y e s-@- N o E)
11- Pumper Connections and Clapper valves unobstructed and turn freely ? ............................................... Yez-@- No Q
12. Sprinkler coverage acceptable? .............................................................................................. Y e s-El- N o LI
13. Have the sprinkler heads been replaced or successfully sample tested in the last 50 years? Yes-5- No (3
14 . Proper number spare sprinkler heads available with appropriate wrenchs for each? .............. Yes-U—No El
15. System left in service? ................................. ........................................................................ Yes--U--No C)
16. Sys
wq%gauges been replaced or calibrated within the past 5 years? ............................................ Yes No
17. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? ..................... Ye_s-2--- No E)
18. Was debris found in the Fire Department Connection (FDC)? ................................................ Y es -ID' No 0
19. Wa's the Fire Department Connection (FDC) back flushed within the last 5 years? ... Y e �s No L)
20. Was.an internal pipe and valve inspection performed within the last 5 years? ................. Y e)Atj7 No L)
Date Performed:
21. Was a signal received at the Central Station monitoring company? .................... N/A 0 Yes -Er No El
Sprinklers o WET Page: 2 of 2
FIRE PREVENTION
Set-ving Bi-iei; Ednibnds
12425 Met-idian Ave S
INSPECTION REPORT
SNOHOMISH CO.
mo zintlake,.,Terrace, and
TIRE
Everett, WA 98208
0 EDMONDS
0 BRIER
�_,6
DISTR(�fl the Town of ffibodway
I T
Phone (425) 551-1200
0 WOODWAY
0 MOUNTLAKE TERRACE
www.FireDistrictl.org
Fax (425) 551-1272
0 UNINCORPORATED
FREQUENCY
STATION & SHIF"�
LOCATION: 641 Bell St
365
17 5
BUSINESS NAME:
.1 Bell North Condos
PHONE:
SCHEDULED
DATE DUE 11' 07/01/11
MAILING 641 Bell St
UFIR � 422 7203
ADDRESS:. Edmonds 98020
BUSINES§
,AOWNER:
HOME PHONE:
'CURRENT
EMERGENCY-1:
HOME PHONE:
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
BUSINESS
LICENSE
PE SON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR: c -15M 1 71)�
FIRE FA�qA 1, AS 6/1 1,FD LkBx
FES.("
SYSTEMS: 1,1010
AN�YAL
I ')
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
No ffA 2f Fa (JAJ I
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:
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
18
4 18
DATE:
DISPOSITION:
7
LET-rER NEEDED C] YES [I NO
LETTER NEEDED [] YES NO
8
FIRE DEPARTMENT COPY
FIRE ALARM SYSTEMS
(One System Per Report)
Olympic Security & Communications Systems
P.O. Box 3559
Arlington, WA 98223
800-540-SAFE
360-652-1088
CONFIDENCE TEST
REPAIRS
CERTIFICATION GIVIEN7RED
0
YELLOW
0
WHITE
Occupancy Address: 6 q I �&
s) -1 Occupancy Name: Be I I wodi,
Building Owner: 'Ge ( \ t4 . C ,,-j ? t A C( t Responsible Person: Al _5A.iiit
Phone Number: fta-L S) -7 115 -
5- 10 Phone Number:
0
Building Owner Address: 5AQ\ P'
Date of Inspection a#66
Inspection Type: Annualv Quart rly 0 Acceptance
D
Testers Name (Please Print):S"t� a'A
r4A\M Certification Number:ffi'qAV-y-."+ q]
Z ,is
Alarm System Functionality
Trouble signal with AC power off?
YetV
No 0
System operates. properly on-baftery b ck
-d-LO
Yed'f
No 0
Battery voltage (no load)
volts Battery Voltage (full load) charge voltage
System.operat6s properly, on standby power?-
�es'�+
No El
All signals operate on AC power?
Yes
No El
No. of initiating circuits
no. of signal circuits
Does alarm system meet audibility standards?
Yes-P
No El
All circuits chocked for -electrical s�upervWon?
YeqS
No 0
All auxiliary equipment operates (Elevators, fans, dampers)?
N/A-V
Yes 0
No El
Ventilation controls operate?
N/A 0
Ye"
No 0
Key to panel available?
Yes
No El
Operating instructions at panel?
Yes
No 0
Trouble indicators function properly?
Yes'@
No 11
Remote Annunciator Panels functionproperly?
N/A 97
Yes 0
No 11
Elevator Call Down functions properly?
N/A 0
YeM
No 0
Test reyord posted 11 at. panel?
Yes'�p
No Ej
General alarm automatic time dealy
(minutes)
N/A DC
Other Devices Specify)
#A
Yes 0
No 0
Other Devices (Specify)
P)/19
Yes 0
No 0
Communication Equipment
Total Number of Units in Building
Total Number Units Tested
Test Results Acceptable
Phone Sets
__4
N/A 0
YesS9
No 0
Phone Jacks
N/A�
Yes El
No El
Call -in Signal
N/A 0
Yes �0
No 0
System Devices
Total Number of Units in Building
Total Number Units Tested
Test Results Acceptable
Bells, Horns, Chimes
C-0
N/A El
YeglpE
No 0
Voice Speakers (Voice Clarify)
C
NIA&
Yes C1
No 0
Smoke Detectors
N/A 0
Yes [So
No 0
Heat,Detectors
N/AV
Yes 0
No 0
Duct Detectors
N/A Yes El
No El
Sprinkler Flow Switches
N/A
YesA
No 0
Sprinkler Supervisory Switches
N/A El
Yes'Q
No 0
Visual Alarm Devices
N/A 0
Yeslii�
No 0
Manual Pull Stations
N/A 0
Yes 50
No 0
Door Unlocks
N/A,93 Yes El
No El
Automatic Door Release
N/A El
Yes 9
No 0
Central station monitoring? Yes No El
Monitoring company name: C)1_#9Wr-
Control panel manufacturer:
G)is
Model Number: 17S j
Problems Found: A) rfts-0
Corrections Made: Date Corrected: Corrected By:
Signature of Tester: Date:
Customer Signature: Date: kag=M 171 alai I U
Confidence Testing Company:
D VA NCED
P.O. Box 1543 - Woodinville, WA 98072
Ph.: 425.483.5657
Svrafft,e, Fire Department
Confidence Test Report-
206.386.1448 Confidence Testing Officer
206.615.1068 (fax)
206.233.7219Red Tag Hotline
SPRINKLERS - WET
Ceftification Given
RED 0
FYELLOW D
WHITE—El—
(ONE SYSTEM PER REPORT)
CONFI . DENCETEST: I—a-1 REPAIRS-FLI
Occupancy Address: e� e711 =�az, 4&1g�Egccupancy Name: /V
Building Owner: 117104, Phone Number:
Responsible Person: Phone Number:
Building Owner
Address: /7k
Date of Inspection: 1, Inspection Frequency Type: _4awLa
Tester's Name (print): �_SFD Certification Number: SCP 1_5
Central Station monitoring? Ye% No El Monitoring Co. Name:
Primary Component: // =2 System Make:
System Model:
System Location: 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 discrepancies
are noted and have bV, ted t; �t Zb' oin ner/Manager for corrective action.
een rep
Signature of Testei Phone #: 425.483.5657
Testing Agency: Xdvanced Fire Protection, Inc.
Mailing Address: P.O. Box 1543 -Woodinville, WA 98072
Building Representative(signature):
Sprinklers 9 WET Page: 1 of 2
-constitute all of the
,he below items on the check list shall be inspected and tested. This list does'not
'(dq'uired inspecting and testing of the Fire and. Life Safety system. Refer to the Seattle Fire Department
Fire Code for inspecting and testing requirements.
General
1. Flow Test conducted? ......................................................................................................................................... Yesifl— No D
2. Static Pressure: psi Flow Pressure: psi
I Total number of sprinkler heads on this system?
4. Was 2" Main Drain checked? ............................ I .......................................................................... OtherEl Yes-0— No El
5. Flow Switches, Supervisory Switches and Alarm Bells tested? ..................................... N/A F-i Y e s-E3- N o Ej
6. Pressure regulating valves tested? ..............................................................................
N/A-5-
Yes U
No C3
7. Alarm Bell operate? .......................................................................................................
.... ......
N/A El
Yes-,�J`
No C)
8. System inspected and lubricated ? .................................................................................. Yes-t3— No C]
9. Valves sealed,-br supervised? ............................................................................................................ Yes-f-1- No Q
10. Provided on all valves? ............................................................................................................. Yes-5' No Cj'
11. Pumper Connections and Clapper valves unobstructed and turn freely ? ...................
................. Yes-0- No Q
12. Sprinkler coverage acceptable? ............................................................................................... Y e V[T- N o Ej
13. ll ave the,sprinkler,heads,been replaced, -or successfully- sample tested in the'last 50 --rd' N o C3
years?, Yes
14.. Proper number spare sprinkler heads available with appropriate .wrenchs for each? .............. Y e s-cl— N o El
15. System left in service? ............................................................................................................. Yes'U- No (3
16. System gauges been replaced or calibrated within the past 5 years? ............................................. Yes [I No-n-
17. Sprinkler heads free of corrosion, paint, obstructions and/or physical damage? ..................... Y e s-CT— No Q
� 18. Was debris found in the Fire Department Connection (FDC)? ................................................ Yes El N
19. Was the Fire Department Connection (FDC ) back flushed within the last 5 years? ................. Yes [I
20. Was an internal pipe and valve inspection performed within the last 5 years? ................. Yes El No-O
Date Performed:
21. Was a signal received at the Central Station monitoring company? .................... N/A (3 Yeg-O' No Q
Sprinklers - WET Page: 2 of 2
— — — — — — — — — — — —
CITY OF EDMONDS
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 - (425) 771-0215
FIRE DEPARTMENT
t
LOCATION:
641 Bell St
BUSINESS NAME:
Bell North Condos
MAILIN'G
641 Bell St
ADDRESS:
Edmonds
BUSINESS OWNER:
EMERGENCY-1:
KEY ACCESS-2:
PHONE:
93020
HOME PHONE:
HOME PHONE:
HOME PHONE:
FIRE PREVENTION
SAFETY SURVEY
FR�QUENCY
STATION& SHIFT'
365
17 A_
SCHEDULED
DATE DUE 01
07/01/10
LIFIR 11- 422
7203
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR: 5-/1 0 all _4z 'RIO -.;. 1:90 /0
FIRP FA n/i In AR SMIR Fn I kRit FE- k 110,
SYSTEMS:
ANNUAL
HAZARDS FOUND AND LOCATION� / COMMUNICATIONS
ENTER CODE ONLY ONCE 11�
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
8
11st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE,
DATE DUE-
PERSON
GRANTED TO:
DATE DLIE*
PERSON
CITED:
PERSON
CONTACTED:
CONTACTED:
INSPECTOR
CONTACTED:
INSPECTOR
INSPECTOR
3
DATE.
DATE.
PRE -CITATION
DATE.
CITATION ISSUED
VIOLATIONS
VIOLATIONS
5
1 5
LETTER SENT
NUMBER:
4
CODE
5
2
6
2
6
1 DATE:
RETURN RECEIPT
SECTION:
3
7
13
7
RECEIVED
DISPOSITION:
7
4
18
k4 8
LETTER NEEDED E] YES NO
DATE:
1
8
LETTER NEEDED [] YES NO
TIRE -DEPARTMENT COPY
i��VANCED City of:41 "Silre Fire Department
N=Lp���, CONFIDENCE TEST REPORT
A A A ^ ^^^ ^ A � A � ^ ^
beaxiie r1re wepartmetit uii11UV11%;t2 I V�11,1111119 WillilitV1. &VW--J0V- I-4A-ALVW.V 11U. IVU40
WET - AUTOMATIC SPRINKLERS Certification Given
(NOTE: ONE SYSTEM PER REPORT) I RED Q I YELLOW El I W H I T E—,g
Date of Inspection: CONFIDENCE TEST. Annua4Q—Quarterly 0 Acceptance El REPAIRS: C]
7Tester'sName (print): SFDCortirication Number.
Occupancy Name: -,--7-e- *S
Occupancy Address: 1,�'1711 -L-77
Respqqsible Person:
Phone Number:
Building Owner's Name:
Building Owner's Address:
Contact Person:
"P ne Number:
Central Station monitoring?
Yes -El- No 0
Control Panel Manufacturer:
/1/-,#
Monitoring Co. Name: OU,
C
Model Number:
/V -4
ProblemsFound: (if additional room is required, please add a separate slieet.)
CorrectionsMade: (if addifional room is required, please add a separate shest.) DateCorrected: Corrected by:
The below items on the check list shall be inspected and tested. This list does not constitute all the required inspecfing'ai�d'testing
of the Fire and Life Safety system. Please refer to the Seattle Fire Department Fire Code , for inspecting and testing requirements.
80. Was a Flow Test conducted?
81. Static Pessure: psi Flow Pessure: ;? -5 psi
82. Wasr Main Drain checked? 4,
83. Were all Flow Switches, Supervisory Switches and Alarm Bells tested?
84. Does the Alarm Bell operate ?
85. Were all valves inspected and lubricated ?
86. Were Pressure Regulating valves tested?
87. Were all valves "sealed" or supervised?
88. Are signs provided on all,veilves?
89. Are the Pumper Connections and Clapper valves unobstructed ?
90. Are the sprinkler heads less than 50 years old?
91. Is the sprinkler head coverage acceptable'?
92.-Aff�oatd sprinkler heads'availa ble?
93. Was the system left in service?-
Yes-B—
No C)
Yes--E3-
No C]
Other Q Y e s-B-
No E]
,N/A El Yes-&.
No [I
N/A Q Y e s-@-
No C)
Y e s-@-
No Q
Yes Lj
No -@-
Yes-@-
No L]
Yes-E�-
N o (j
Yes--B-
No E]
Y e s-E3-
No Q
Y e s-9-�
Yes-EI-
No 0
Yes-E�-
No Q
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 discrepancies are noted and have been
reported to the building Owner/Manager for corrective action.
Signature of Tests
Testing Agency: Advanced Fire Protection, Inc. Phone: .14,25.483.5657
Mailing Address: P.O. Box 1543 , Woodinville, WA 98072
Wesffall, John
From: Smith, Mike
Sent: Thursday, July 07, 2005 7:03 AM
To: Fire Dept Group
Subject: New Stuff
The follow are new fire prevention features for 2 buildings in town:
1) Band of America 306 Main St has a new Manual Fire Alarm. The system consists only of manual pull stations and horn
strobes throughout. The system is not monitored. The only way the alarm is activated is by pulling a pull station or the
activation of the only smoke which protects the panel located in the basement electrical room. There is no Lock Box.
The system was added as the b.4nk will be leasing out office space in the basement.
2) Bell North Condos 6-411 Bell St. This is a new 4 plex with the following: fully sprinklered, automatic fire alarm, wall
mounted single snout FDC-, no exterior PIV, a non stretcher size elevator Oust for you, Marc) and a lock box located to the
right of the front door.
Any questions give me a call.