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Fire Alarm Document
I I SIEMENS �agenui{y-fore fe SYSTEM RECORD OF INSPECTION AND TESTING NFPA 72 REPORT Inspectionrrest Start Daterrime: 10 Mar 2020 0700 Inspection Test Completion Date/Time: 20 Mar 2020 1500 Contract Number: 440P-277976 Notification Number:_ Supplemental Form(s) Attached: Yes 1. PROPERTY INFORMATION Name of property: Sunrise Of Edmonds Address: 1 Description of property: Name of property representative: JOHNSON CONTROLS FIRE PROTECTION LP (30226971). Address: 6600 Congress Ave, Boca Raton, FL, 33487-1213 Phone: Fax: E-mail: 2. TESTING AND MONITORING INFORMATION Testing organization: SIEMENS Address:_ Phone: Fax: E-mail: Monitoring organization: JCI Address: Tacoma, WA Phone: Fax: E-mail: Account number: Phone line 1: Phone line 2: Means of transmission: Digital Entity to which alarms are retransmitted:_ Phone: 3. DOCUMENTATION On -site location of the required record documents and site -specific software. 4. DESCRIPTION OF SYSTEM OR SERVICE 4.1 Control Unit System Name: SUNRISE OF EDMONDS FACP Panel Name: Basement Panel Location and Address: Basement, , Edmonds, WA Manufacturer: Siemens Model number: Desigo Modular 4.2 Software and Firmware Firmware revision number: 14.02.0025 4.3 System Power 4.3.1 Primary (Main) Power Nominal voltage: 120 Amps: 15 Location: Basement Overcurrent protection type: Circuit Breaker Amps: 20 Disconnecting means location: Basement Electrical Rm 4.3.2 Secondary Power Type: Storage Battery Location: Basement Battery type (if applicable): Sealed Lead Acid Calculated capacity of batteries to drive the system: In standby mode (hours): 4 In alarm mode (minutes): 15 © Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+TM, a service of Siemens Industry, Inc. Page 1 of 4 I SIEMENS 1"e -'"icy-fore fe. 4.4 Nottificatio//n Appliance Power Extender Panels 4.4.1 Primary Power ID Location Input Panel Over- Over - Volts Amps current current Type Amps 4.4.2 Secondary Power ID Location 5. NOTIFICATIONS MADE PRIOR TO TESTING Monitoring organization Contact: JCI Building management Contact: All Building occupants Contact: All Authority having jurisdiction (AHJ) Contact: Other, if required Contact: 6. TESTING RESULTS 6.1 Control Unit and Related Eouinment NFPA 72 REPORT Primary Supply Location Disconnect Location Battery Voltage Amp Standby Alarm Type Rating Rating Hours Minutes Time: 0700 Time: 0700 Time: 0700 Time: Time: Description Visual Inspection or Functional Test Comments Control unit Functional Disconnect switches Functional Fuses Functional Ground -fault monitoring Functional Interface Equipment Functional Lam s/LEDs/LCDs Functional Local annunciator Functional Primary Power Functional Remote annunciators Functional Remote power panels Functional Supervision Functional Trouble signals Functional 6.2 Secnndary Power Description Visual Inspection or Functional Test Comments Battery condition Functional Charger test Functional Discharge test Functional Load voltage Functional Remote panel batteries 6.3 Notification Appliance Power Extender Panels Secondary Power ID Location 6.4 Alarm and Supervisory Alarm Initiating Device Attach supplementary device test sheets for all initiating devices. 6.5 Notification Appliances Attach supplementary appliance test sheets for all notification appliances. Test Battery Battery Pass/ Method Voltage Amps Fail © Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+TM', a service of Siemens Industry, Inc. Page 2 of 4 SIEMENS /t�$ernHifr-(orG fe.. 6.6 Interface Equipment Attach supplementary interface component test sheets for all interface components. NFPA 72 REPORT b.r otTervismg station Description monaonn Received Comments Time / Elapsed Time Pass/Fail Alarm signal Yes 0730 / Pass Alarm restoration Yes 1100 / Pass Trouble signal Yes 0700 / Pass Trouble restoration Yes 1500 / Pass Supervisory signal Yes 0735 / Pass Supervisory restoration Yes 1105 / Pass 6.8 Public Emeraencv Alarm Renortina Svstem Description Yes No Time Comments Alarm signal ❑ 0 NA NA Alarm restoration ❑ 0 NA NA Trouble signal ❑ 0 NA NA Trouble restoration ❑ 0 NA NA Supervisory signal ❑ 0 NA NA Supervisory restoration ❑ 0 NA NA 7. NOTIFICATIONS THAT TESTING IS COMPLETE Monitoring organization Contact: JCI Building management Contact: All Building occupants Authority having jurisdiction (AHJ) Other, if required Contact: All Contact: Contact: 8. SYSTEM RESTORED TO NORMAL OPERATION Date: 20 Mar 2020 Time: 1500 9. CERTIFICATION This Testing Was Performed in Accordance with Applicable NFPA Standards. Signed: Date: Printed name: David Steele Title: Technician License No.: S-07829 Organization: SIEMENS Phone: Qualifications (refer to NFPA 72, Section 10.5.3): Inspection, Testing, Service, Programming Time: 1500 Time: 1500 Time: 1500 Time: Time: 10. DEFECTS OR MALFUNCTIONS NOT CORRECTED AT CONCLUSION OF SYSTEM INSPECTION, TESTING, OR MAINTENANCE 11. ACCEPTANCE BY OWNER OR OWNER'S REPRESENTATIVE The undersigned accepted the test report for the system as specified herein: Signed: Printed name: Date: Organization: JOHNSON CONTROLS FIRE PROTECTION LP (30226971) Phone: Pursuant to applicable codes and standards, the owner or designated representative is responsible for proper maintenance and care of the system(s) identified in this report. During the site inspection, if Siemens has identified code deficiencies or impairments, Siemens will recommend certain corrective actions contained in this report. In the event the owner fails to correct such deficiencies or impairments within the required time period per the code, Siemens may be required to report such deficiencies or impairments to the Local AHJ or Fire Marshall per regulatory requirements. Customer shall hold Siemens harmless and releases Siemens of any and all liability due to Customer's failure to correct such deficiencies or impairments. ©Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+TM, a service of Siemens Industry, Inc. Page 3 of 4 SIEMENS 1tn4e ,mid , -fa r-Uo- 12. OTHER 12.1 Special Procedures 12.2 Comments NFPA 72 REPORT © Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+Tm, a service of Siemens Industry, Inc. Page 4 of 4 SIEMENS �t�9.e�nui>{y-fore fe SYSTEM RECORD OF COMPLETION Date of Acceptance:_ Supplemental Pages Attached: Yes Contract Number: 440P-277976 1. PROPERTY INFORMATION Name of property: Sunrise Of Edmonds Address: 1 Description of property: Name of property representative: JOHNSON CONTROLS FIRE PROTECTION LP (30226971). Address:_ 6600 Congress Ave, Boca Raton, FL, 33487-1213 Phone: Fax: E-mail: 2. INSTALLATION, SERVICE, TESTING, AND MONITORING INFORMATION Installation contractor: Siemens Industry Inc Address: Phone: Fax: E-mail: Service organization: Address:_ Phone: Fax: E-mail: Testing organization: SIEMENS Address:_ Phone: Fax: E-mail: Effective date for test and inspection contract: Monitoring organization: JCI Address: Tacoma, WA Phone: Fax: E-mail: Account number: Phone line 1: Phone line 2: Means of transmission: Digital Entity to which alarms are retransmitted:_ Phone: 3. DOCUMENTATION On -site location of the required record documents and site -specific software: 4. DESCRIPTION OF SYSTEM OR SERVICE This is a: Modification Permit number: NFPA 72 edition: 4.1 Control Unit Manufacturer: Siemens Model number: Desigo Modular PANEL LOCATION: Basement 4.2 Software and Firmware Firmware revision number: 4.3 Alarm Verification Z This system does not incorporate alarm verification. Number of devices subject to alarm verification: NA _ Alarm verification set for NA seconds NFPA 72 REPORT © Siemens Industry, Inc , Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+TM', a service of Siemens Industry, Inc. Page 1 of 3 r, SIEMENS �k$.ehuifr-fore fe 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: 120 Control panel amps: 15 Overcurrent protection: Type: Circuit Breaker Amps: 20 Branch circuit disconnecting means location: Basement Electrical Rm Number: NFPA 72 REPORT 5.1.2 Secondary Power Type of secondary power: Storage Battery Location, if remote from the plant: Basement Calculated capacity of secondary power to drive the system: In standby mode (hours): 4 In alarm mode (minutes): 15 5.2 Control Unit Power extender panels are listed on the supplementary form Notification Appliance Power Panel Supplementary Record Of Completion. 6_ CIRCUITS AND PATHWAYS Pathway Type Dual Media Pathway Separate Pathway Class Survivability Level Signaling Line Level 1 Style 4 Class B Level 1 Device Power Initiating Device Level N/A Level Notification Appliance Level 1 Class B Level 1 7. REMOTE ANNUNCIATORS Address Type Location 01:013 Remote Annunciator LOBBY PANEL 01:014 Remote Annunciator FL2 NURSE STATION ANUUNCIATOR 01:253 Annunciator (MKB/PMI) PMI-D (a-,) address 253 8. INITIATING DEVICES Type Quantity Addressable or Conventional Alarm or Supervisory Sensing Technology Heat Detector 4 Addressable Alarm Manual Pull Station 11 Addressable Alarm Special Hazard System 1 Addressable Alarm System Smoke Detector (P) 119 Addressable Alarm Waterflow Device 2 Addressable Alarm Control Valve Switch 8 Addressable Supervisory High- or Low -Pressure Switch I Addressable Supervisory System Smoke Detector (P) (Supv) 107 Addressable Supervisory 9. NOTIFICATION APPLIANCES Type Quantity 10. SYSTEM CONTROL FUNCTIONS Type Quantity Relay 4 Remote Relay 18 ©Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+Tm a service of Siemens Industry, Inc. Page 2 of 3 SIEMENS <1N4.CtnNi{y -for (� fC. 11. INTERCONNECTED SYSTEMS This system has Interconnected systems: 12. CERTIFICATION AND APPROVALS 12.1 System Installation Contractor This Testing Was Performed in Accordance with Applicable NFPA Standards. Signed: Date: Printed name: David Steele Organization: Siemens Industry Inc Title:. Site Installation Technician Phone: 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed: Date: Printed name: David Steele Organization: Siemens Industry Inc. Title: Site Installation Technician Phone: 12.3 Acceptance Test Date and time of acceptance test: Installing contractor representative: David Steele Testing contractor representative: David Steele Property representative:_ AHJ representative: Edmonds Fire, NFPA 72 REPORT © Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+TM', a service of Siemens Industry, Inc. Page 3 of 3 NFPA 72 REPORT SIEMENS �t.ge�.ui{y -for G fe. INITIATING DEVICE SUPPLEMENTARY RECORD OF INSPECTION AND TESTING Inspection/Test Start Date/Time: 10 Mar 2020 0700 Inspection/Test Completion Date/Time: 20 Mar 2020 1500 Contract Number: 440P-277976 Notification Number: 1. PROPERTY INFORMATION Name of property: Sunrise Of Edmonds Address: 1 2. INITIATING DEVICE TEST RESULTS 2.1 Initiating Devices Equipment Summary Total Qty Functionally Functionally Visually Visually Failed Qty Failed % Tested Qty Tested % Tested Tested % 253 70 27 7% 0 0% 0 0% 2.2 Initiating Devices Equipment Summary by Type Total Qty Functionally Functionally Visually Visually Failed Qty Failed % Device or System Type Tested Qty Tested % Tested Tested % Qty 8 5 62.5% 0 0% 0 0% Control Valve Switches 4 0 0% 0 0% 0 0% Heat Detectors 1 1 100% 0 0% 0 0% High- or Low -Pressure Switches 11 11 100% 0 0% 0 0% Manual Pull Stations 1 0 0% 0 0% 0 0% Special Hazard Systems 119 46 38.7% 0 0% 0 0% System Smoke Detectors (P) 107 5 4.7% 0 0% 0 0% System Smoke Detectors (P) (Supv) 2 2 100% 0 0% 0 0% Waterflow Devices 2.3 Initiating Devices Testing Results by Type Control Valve Switches Row Date Dev.# Location Visual/ Pass/ Functional Fail 1 03/13/20 01:001-014 WET SYSTEM TAMPER Functional Pass 2 03/13/20 01:001-016 DRY SYSTEM TAMPER Functional Pass 3 03/13/20 01:001-024 OSYTAMPER Functional Pass 4 03/13/20 01:001-025 OSY TAMPER Functional Pass 5 03/13/20 01:001-029 GARAGE ELEV.A PIT TAMPER Functional Pass 6 01:001-030 GARAGE ELEV.B PIT TAMPER 7 8 01:001-032 GARAGE ELEV.MECH RM.TAMPER 01:001-037 OUTSIDE P.I.V. TAMPER Heat Detectors Row Date Dev.# Location Visual/ Pass/ Functional Fail 1 01:001-011 GARAGE LEV.GENERATOR WHEAT _3 4 01:003-053 FLA KITCHEN HEAT 01:003-054 FLA KITCHEN HEAT 01:003-055 FLA KITCHEN JANITOR CLOSET -HEAT High- or Low -Pressure Switches © Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+Tm a service of Siemens Industry, Inc Page 1 of 7 SIEMENS �ti�.ecui{r -For G fe. Row Date Dev.# Location NFPA 72 REPORT Visual/ Pass/ Functional Fail 3/20 01:001-038 DRY SYSTEM HI-LO-AIR Functional Pass Manual Pull Stations Row Date Dev.# Location Visual/ Pass/ _ Functional Fail 1 03/13/20 01:003-039 FL.1 STAIR A MANUAL PULL Functional Pass 2 03/13/20 01:003-042 FL.1 EXIT PASSAGEWAY MAN.PULL _ Functional Pass 3 03/13/20 01:003-045 FL.1 DINING SE.EXIT MAN -PULL _ _ _ Functional Pass 4 03/13/20 01:003-051 FL.1 MAIN ENTRY EXIT MAN -PULL Functional Pass 5 03/13/20 01:004-009 FL.1 STAIR D EXIT-MAN.PULL Functional Pass 6 03/13/20 01:004-013 FL.1 CORR.124 NORTH EXIT-MAN.PUL Functional Pass 7 03/13/20 01:004-043 FL.1 STAIR B EXIT-MAN.PULL Functional Pass 8 03/13/20 01:005-020 FL.2 STAIR A EXIT -MANUAL PULL Functional Pass 9 03/13/20 01:006-039 FL.2 STAIR B EXIT -MANUAL PULL Functional Pass 10 03/13/20 01:007-016 FL.3 STAIR A EXIT -MANUAL PULL Functional Pass 11 03/13/20 01:008-045 FL-3 STAIR B EXIT -MANUAL PULL Functional Pass Special Hazard Systems Row Date Dev.# Location 01:003-057 FL.1 KITCHEN HOOD ALARM Visual/ Pass/ Functional Fail System Smoke Detectors (P) Row Date Dev.# Location Visual/ Pass/ Functional Fail 1 03/13/20 01:001-001 GARAGE LEV. ELECT. RM.SMK Functional Pass 2 01:001-002 GARAGE LEV.CORR.AT ELEC.RM.SMK 3 03/13/20 01:001-003 GARAGE LEV.ELEV.A LOBBY SMK Functional Pass 4 03/13/20 01:001-004 GARAGE LEV.ELEV.B LOBBY SMK_ Functional Pass 5 01:001-005 GARAGE LEV.CORR.AT HSKPG.SMK 6 01:001-006 GARAGE LEV.HOUSEKEEPING SMK 7 01:001-007 GARAGE LEV.CLEAN UTILITY RM.SMK 8 01:001-008 GARAGE LEV.STORAGE SMK 9 03/13/20 01:001-009 GARAGE LEV.SPRINKLER RM.SMK. Functional Pass 10 03/13/20 01:001-010 GARAGE LEV.CORR.STAIR SMK Functional Pass 11 01:001-012 GARAGE LEV.STAIR A STORAGE SMK 12 03/17/20 01:001-017 ELEVATOR MECH.RM.SMK 13 01:001-020 GARAGE LEV.STAFF LAUNDRY RM.SMK 14 01:001-021 GARAGE LEV.SOILED UTILITY RM.SMK Functional 15 03/13/20 01:001-026 BASEMENT CORRIDOR BY LAUNDRY RM. Functional Pass 16 01:003-023 FL.1 3 SEASONS PORCH -SMOKE 17 01:003-027 FL.1 MAINT.OFFICE 134 SMK 18 01:003-029 FL.1 WORK ROOM 1113 SMK 19 01:003-030 20 03/17/20 01:003-031 21 01:003-032 FL.1 CORR.AT WORKRM.113 SMK FL.1 ELEV.B LOBBY SMK Functional Pass FL.1 CORR.AT ELEV.B LOBBY SMK 22 03/13/20 01:003-033 FLA SERVERY 147 SMK Functional Pass 23 01:003-034 FL.1 DINING SW. SMK 24 01:003-035 FL.1 ACCESS CORR.141 SMK 25 01:003-036 FL.1 EXIT PASSAGEWAY W.SMK 26 01:003-040 FL.1 EXIT PASSAGEWAY CENTER SMK 27 01:003-041 FL.1 EXIT PASSAGEWAY S.SMK © Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+T^+ a service of Siemens Industry, Inc. Page 2 of 7 SIEMENS �ti9.ecnuil'y -for G fe.. Row Date Dev.# Location 28 03/13/20 29 03/13/20 30 31 32 01:003-043 FLA DINING -CENTER SMK 01:003-044 FLA DINING-S.SMK 01:003-046 FLA DINING -SE. SMK 01:003-047 FLA PRIVATE DINING SMK 01:003-048 FL.1 TRASH/RECYCLE RM. SMK NFPA 72 REPORT Visual/ Functional Functional Functional Pass/ Fail Pass o.... 33 01:003-049 FLA DINING-N.SMK 34 01:003-050 FLA BISTRO SMK 35 01:003-056 FLA KITCHEN OFFICE SMK 36 01:004-002 FLA CORR.AT MARKETING-SMK 37 01:004-003 _ FLA EXEC.DIRECTOR RM-SMK 38 01:004-004 FLA HAIR SALON 125-SMK _ 39 01:004-005 FLA MARKETING 128-SMK _ 40 01:004-006 FLA STAFF LOUNGE-SMK 41 01:004-007 FL 1 STAFF LOUNG TOILET-SMK 42 01:004-008 FL.1 HOUSEKEEPING 150-SMK 43 03/13/20 01:004-010 FLA CORR.B NW-SMK Functional Pass 44 03/13/20 01:004-011 FLA CORR.B CENTER W-SMK Functional Pass 45 03/13/20 01:004-012 FLA CORR.AT RES. 112-SMK Functional Pass 46 01:004-017 FLA CORR.B CENTER EAST-SMK 47 01:004-018 FL.1 ELEVATOR A LOBBY_ -SMK 48 03/13/20 01:004-023 FL.1 CORR.B EAST-SMK Functional Pass 49 01:004-025 FL.1 TELEPHONE BOOTH-SMK 50 01:004-026 FLA ELECT.RMA 18-SMK _ 51 01:004-027 FL.1 PARLOR 117-SMK 52 03/13/20 01:004-035 FL1 CORR.A WEST-SMK Functional Pass 53 03/13/20 01:004-039 FL CORR.AAT STAIR B-SMK Functional Pass 54 01:004-047 FL.1 CONFERENCE RM.129-SMOKE 55 01:005-003 FL.2 HOUSKEEPING RM.238-SMOKE 56 01:005-004 FL.2 RESIDENT LAUNDRY RM. SMOKE 57 03/13/20 01:005-007 FL.2 CORR.AT RESIDENT 214-SMOKE Functional Pass 58 01:005-008 FL.2 ELEV.B LOBBY -SMOKE 59 01:005-015 FL.2 CORR. AT RES.216-SMOKE 60 03/13/20 01:005-025 FL.2 CORR.AT STAIR A -SMOKE Functional Pass 61 03/13/20 01:005-033 FL.2 CORR. AT HSKPG.RM.238-SMOKE Functional Pass 62 01:005-041 FL.2 STORAGE RM.235 SMK 63 03/13/20 01:006-003 FL.2 CORR.B AT TELEPHONE BOOTH Functional Pass 64 01:006-004 FL.2 SPA 243-SMOKE 65 03/13/20 01:006-005 FL.2 CORR.B AT ACTIVITY RM-SMOKE Functional Pass 66 01:006-006 FL.2 ACTIVITY RM.DRS-SMOKE 67 01:006-007 FL.2 ACTIVITY RM-SMOKE _ 68 01:006-008 FL.2 ARTS AND CRAFTS -SMOKE 69 03/13/20 01:006-009 FL.2 CORR.@A.L.000RD.RM.280-SMK Functional Pass 70 01:006-010 FL.2 A.L.000RD.RM.280-SMOKE 71 03/13/20 01:006-012 FL.2 CORR. AT RES.213-SMOKE Functional Pass 72 01:006-016 FL.2 WELLNESS RM.231-SMOKE 73 01:006-017 FL.2 NURSE RM.232-SMOKE 74 03/13/20 01:006-018 FL.2 CORR AT RES.21 1 -SMOKE Functional Pass 75 03/13/20 01:006-019 FL.2 ELEV.A LOBBY -SMOKE Functional Pass 76 03/13/20 01:006-023 FL.2 CORR. AT RES.209-SMOKE Functional Pass 77 01:006-024 FL.2 ELECT.RM.225-SMOKE 78 01:006-025 FL.2 GRAND FOYER 224-SMOKE _ © Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved This report was created by TechAdvance+TPA, a service of Siemens Industry, Inc. Page 3 of 7 SIEMENS �ti9.e�ui{y for G fe NFPA 72 REPORT Row Date Dev.# Location Visual/ Pass/ Functional Fail 79 03/13/20 01.006-030 FL.2 CORR. AT_RES.208-SMOKE Functional Pass 80 01:006-034 FL.2 CORR. AT RES.203-SMOKE 81 82 83 01:006-038 01:006-047 01:006-049 FL.2 CORR.AT STAIR B-SMOKE FL.2 TELEPHONE BOOTH SMOKE FL.2 TOP OF STAIR D-SMOKE 84 01:007-002 FL.3 HOUSKEEPING RM.337-SMOKE 85 03/13/20 01:007-005 FL.3 CORR.0 AT RES.314-SMOKE Functional Pass 86 03/17/20 01:007-009_ FL.3 ELEV.B LOBBY -SMOKE Functional Pass 87 03/13/20 01:007-012 FL.3 CORR.0 AT _STAIR A -SMOKE Functional Pass 88 03/13/20 01:007-021 FL.3 CORR.0 AT RES.318-SMOKE Functional Pass 89 01:007-028 FL.3 TOP OF STAIR A -SMOKE 90 03/17/20 01:007-029 FL.3 TOP OF ELEV.B SHAFT -SMOKE Functional Pass 91 03/13/20 01:007-030 FL.3 CORRIDOR C @ HOUSE KEEPING Functional Pass_ _ 92 01:008-003 FL.3 PUBLIC TOILET AT SPA -SMOKE 93 03/13/20 01:008-004 FL.3 CORR.B AT RES.312-SMOKE_ _ Functional Pass 94 01:008-005 FL.3 SPA -SMOKE _ 95 03/17/20 01:008-006 FL.3 ELEV.A LOBBY -SMOKE Functional Pass 96 01:008-007 FL.3 LIVING RM.NORTH DET-SMOKE 97 98 01:008-008 01:008-009 FL.3 LIVING RM.SOUTH DET-SMOKE FL.3 CORR.B AT QUIET RM-SMOKE 99 01:008-010 FL.3 QUIET RM-SMOKE 100 03/13/20 01:008-014 FL.3 CORR. AT STAFF RM.331-SMOKE Functional Pass 101 01:008-016 FL.3 RESIDENT LAUNDRY RM-SMOKE 102 01:008-017 FL.3 STAFF RM.331-SMOKE 103 03/13/20 01:008-018 FL.3 CORR.D AT TERRACE -SMOKE _ _ Functional Pass 104 01:008-019 FL.3 ACTIVITY RM.333-SMOKE 105 01:008-020 FL.3 WEST DINING 329A-SMOKE 106 01:008-021_ FL.3 WEST DINING SHUTTER -SMOKE 107 03/13/20 01:008-022 FL.3 SERVING 330 SHUTTER -SMOKE _ _ _ Functional Pass 108 03/13/20 01:008-023 FL.3 CORR. AT EAST DINING -SMOKE Functional Pass 109 03/13/20 01:008-024 FL.3 EAST DINING EXIT -SMOKE Functional Pass 110 03/13/20 01:008-025 FL.3 EAST DINING -SMOKE Functional Pass 111 03/13/20 01:008-027 FL.3 NW. DINING -SMOKE _ Functional Pass 112 01:008-028 FL.3 ELECT.RM.325-SMOKE 113 01:008-029 FL.3 STORAGE RM.346-SMOKE 114 03/13/20 01:008-030 FL.3 CORR. AT RES.309-SMOKE _ Functional Pass 115 01:008-035 FL.3 CORR. AT RES.302-SMOKE 116 01:008-039 FL.3 CORR. ATRES.304-SMOKE 117 03/13/20 01:008-044 FL.3 CORR. AT STAIR B-SMOKE Functional Pass 118 01:008-051 FL.3 TOP OF STAIR B-SMOKE 119 03/17/20 01:008-052 _ FL.3 TOP OF ELEV.A SHAFT -SMOKE Functional Pass System Smoke Detectors (P) (Sup )_ _ Row Date Dev.# Location Visual/ Pass/ 01:004-014 01:004-015 Functional Fail FLA RESIDENT 112 ENTRY-SMK FLA RESIDENT 112 BEDRM-SMK 3 01:004-016 FL.1 RESIDENT 112 BEDRM-SMK 4 03/13/20 01:004-019 FL.1 RESIDENT 110 ENTRY-SMK Functional Pass 5 01:004-020 FL.1 RESIDENT 110 BEDRM-SMK 01:004-021 FL.1 RESIDENT 111 ENTRY-SMK © Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+TPA, a service of Siemens Industry, Inc. Page 4 of 7 SIEMENS f*tnge�ai{y for(.r fe. Row Date / Dev.# Location 7 01:004-022 FL.1 RESIDENT 111 BEDRM-SMK 8 01:004-028 FLA RESIDENT 101 BEDRM-SMK 9 01:004-029 FLA RESIDENT 102 BEDRM-SMK 10 01:004-030 FLA RESIDENT 103-SMK 11 01:004-031 FLA RESIDENT 103 BEDRM-SMK 12 01:004-032 FLA RESIDENT 108 ENTRY-SMK 13 01:004-033 FL.1 RESIDENT 108 BEDRM-SMK 14 01:004-034 FLA RESIDENT 109 BEDRM-SMK 15 01:004-036 FLA RESIDENT 107 ENTRY-SMK 16 01:004-037 FLA RESIDENT 107 BEDRM-SMK 17 01:004-038 FL.1 RESIDENT 106 BEDRM-SMK 18 01:004-040 19 01:004-044 20 21 22 23 24 25 26 27 28 29 01:004-045 01:004-048 01:004-049 01:005-006 01:005-009 01:005-010 01:005-011 01:005-012 01:005-013 01:005-014 FLA RESIDENT 104-SMK FLA RESIDENT 105 BEDRM-SMK FLA RESIDENT 105 BEDRM-SMK _ FL.1 RESIDENT 103 COMMON -SMOKE FL.1 RESIDENT 105 COMMON -SMOKE FL.2 RESIDENT 223 ENTRY -SMOKE FL.2 RESIDENT 214 ENTRY -SMOKE FL.2 RESIDENT 214 BEDRM.-SMOKE FL.2 RESIDENT 215 BEDRM.-SMOKE FL.2 RESIDENT 223 BEDRM.-SMOKE FL.2 RESIDENT 222 BEDRM.-SMOKE FL.2 RESIDENT 222 ENTRY -SMOKE 30 01:005-016 FL.2 RESIDENT 221 ENTRY -SMOKE 31 01:005-017 FL.2 RESIDENT 221 BEDRM.-SMOKE 32 01:005-018 FL.2 RESIDENT 216 ENTRY -SMOKE 33 01:005-019 FL.2 RESIDENT 216 BEDRM.-SMOKE 34 01:005-023 FL.2 RESIDENT 220 ENTRY -SMOKE 35 01:005-024 FL.2 RESIDENT 220 BEDRM.-SMOKE 36 03/13/20 01:005-026 FL.2 RESIDENT 218-SMOKE 37 01:005-027 FL.2 RESIDENT 217 BEDRM.-SMOKE 38 01:005-028 FL.2 RESIDENT 217 ENTRY -SMOKE 39 40 41 42 43 44 45 47 48 01:005-029 01:005-030 01:005-031 01:005-032 01:005-034 01:006-011 01:006-013 01:006-014 01:006-015 01:006-020 49 01:006-021 50 01:006-022 51 01:006-026 52 01:006-027 FL.2 RESIDENT 217 BEDRM.-SMOKE FL.2 RESIDENT 219 BEDRM.-SMOKE FL.2 RESIDENT 219 ENTRY -SMOKE FL.2 RESIDENT 219 BEDRM.-SMOKE FL.2 RESIDENT 223-SMOKE FL.2 RESIDENT 212-SMOKE FL.2 RESIDENT 213 BEDRM-SMOKE FL.2 RESIDENT 213 BEDRM-SMOKE FL.2 RESIDENT 213 ENTRY -SMOKE FL.2 RESIDENT 211 ENTRY -SMOKE FL.2 RESIDENT 211 BEDRM-SMOKE FL.2 RESIDENT 210-SMOKE FL.2 RESIDENT 201-SMOKE FL.2 RESIDENT 202-SMOKE 53 01:006-028 FL.2 RESIDENT 209 ENTRY -SMOKE 54 01:006-029 FL.2 RESIDENT 209 BEDRM-SMOKE 55 01:006-031 FL.2 RESIDENT 208 ENTRY -SMOKE NFPA 72 REPORT Visual/ Pass/ Functional Fall Functional Pass © Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+TM', a service of Siemens Industry, Inc. Page 5 of 7 NFPA 72 REPORT SIEMENS �hgetiui�y�orG fe.. Row Date Dev.# Location 56 01:006-032 FL.2 RESIDENT 208 BEDRM-SMOKE Visual/ Pass/ Functional Fail 57 01:006-033 FL.2 RESIDENT 207-SMOKE 58 03/13/20 01:006-035 FL.2 RESIDENT 203-SMOKE Functional Pass 59 01:006-036 FL.2 RESIDENT 204-SMOKE 60 01:006-037 FL.2 RESIDENT 204 BEDRM-SMOKE 61 01:006-042 FL.2 RESIDENT 206 ENTRY -SMOKE 62 01:006-043 FL.2 RESIDENT 206 BEDRM-SMOKE 63 01:006-044 FL.2 RESIDENT 206 BEDRM-SMOKE _ 64 01:006-045 FL.2 RESIDENT 205-SMOKE 65 01:006-048 _FL.2 RESIDENT 204-SMOKE _ 66 01:007-003 FL.3 RESIDENT 313 ENTRY -SMOKE _ 67 01:007-004 FL.3 RESIDENT 313 BEDRM-SMOKE 68 01:007-006 FL.3 RESIDENT 322 ENTRY -SMOKE 69 01:007-007 FL.3 RESIDENT 322 BEDRM-SMOKE 70 01:007-008 FL.3 RESIDENT 323 BEDRM-SMOKE 71 01:007-010 FL.3 RESIDENT 321 ENTRY -SMOKE 72 01:007-011 FL.3 RESIDENT 321 BEDRM-SMOKE 73 01:007-013 FL.3 RESIDENT 316 ENTRY -SMOKE 74 01:007-014 FL.3 RESIDENT 316 BEDRM-SMOKE 75 01:007-015 FL.3 RESIDENT 316 BEDRM-SMOKE 76 01:007-019 FL.3 RESIDENT 320 ENTRY -SMOKE 77 01:007-020 FL.3 RESIDENT 320 BEDRM-SMOKE 78 01:007-022 FL.3 RESIDENT 319-SMOKE 79 03/13/20 01:007-023 FL.3 RESIDENT 318-SMOKE Functional Pass 80 01:007-024 FL.3 RESIDENT 317-SMOKE 81 01:007-025 FL.3 RESIDENT 315 ENTRY -SMOKE 82 01:007-026 FL.3 RESIDENT 315 BEDRM-SMOKE 83 01:007-027 FL.3 RESIDENT 314-SMOKE 84 01:007-031 FL.3 RESIDENT 311 85 01:007-032 FL.3 RESIDENT 312 86 01:007-033 FL.3 RESIDENT 310 87 01:008-002 FL.3 RESIDENT 323 ENTRY -SMOKE 88 01:008-012 FL.3 RESIDENT 323 BED ROOM 89 01:008-015 FL.3 RESIDENT 304-SMOKE 90 01:008-031 FL.3 RESIDENT 301-SMOKE 91 01:008-032 FL.3 RESIDENT 302-SMOKE 92 01:008-033 FL.3 RESIDENT 309 ENTRY -SMOKE 93 01:008-034 FL.3 RESIDENT 309 BDRM-SMOKE 94 01:008-036 FL.3 RESIDENT 308 ENTRY -SMOKE 95 01:008-037 FL.3 RESIDENT 308 BDRM-SMOKE _ 96 01:008-038 FL.3 RESIDENT 307-SMOKE 97 03/13/20 01:008-040 FL3 RESIDENT 303-SMOKE Functional Pass 98 01:008-041 FL.3 RESIDENT 304 ENTRY -SMOKE 99 01:008-042 FL.3 RESIDENT 304 BDRM-SMOKE 100 01:008-043 FL.3 RESIDENT 305-SMOKE 101 01:008-048 FL.3 RESIDENT 306 ENTRY -SMOKE 102 01:008-049 FL.3 RESIDENT 306 BDRM-SMOKE 103 01:008-050 FL.3 RESIDENT 306 BDRM-SMOKE 104 01:008-055 ROOF DUCT-DET.RTU-1 ©Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+Tm a service of Siemens Industry, Inc. Page 6 of 7 0 SIEMENS 1"gtAnui{y -For G fe Row Date / Dev.# 105 01:008-056 106 01:008-057 107 01:008-058 Location ROOF DUCT-DET.RTU-6 ROOF DUCT-DET.RTU-7 ROOF DUCT-DET.RTU-11 NFPA 72 REPORT Visual/ Pass/ Functional Fail Waterflow Devices Row Date Dev.# Location Visual/ Pass/ Functional Fail 1 03/13/20 01:001-013 WET SYSTEM WATERFLOW Functional Pass 2 03/13/20 01:001-015 DRY SYSTEM WATERFLOW Functional Pass See main System Record of Inspection and Testing for additional information, certifications, and approvals. © Siemens Industry, Inc., Smart Infrastructure Division, 2009-2020. All rights reserved. This report was created by TechAdvance+TM', a service of Siemens Industry, Inc. Page 7 of 7