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FIRE PREVENTION
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Serving Brier, Edmonds, ana
Hr 96H IZSH CO.
12425 Meridian Ave S
INSPECTION REPORT
FIREs Mountlake Terrace
Everett, WA 98208
❑ BRIER NDS
, _
Phone (425) 551-1200
❑ MOUNTLAKE TERRACE
❑UNINCORPORATED
DISTRT www.FireDistrictl.org
Fax (425) 551-1272
31 Pine Street 98020
FREQUENCY STA ION 8 SHIFT
Annual �7-C
LOCATION:
Pt Edwards Condos Bldg. 7
SCHEDULED Apr 2017
BUSINESS NAME:
PHONE:
DATE DUE ►
MAILING 31 Pine Street, Edmonds, WA 98020
424
UFIR ►
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HOME PHONE:
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INITIAL INSPECTION DATE
NAME OF INSPECTOR:i, .�'r,
:
FIRE PREVENTION
' .Serving Brier, Edmonds, and
12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO.
FIRE Mountlake Terrace
Everett, WA 08208
❑ EDMBONDS
RIER s
❑RIER
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Phone (425) 551-1200
❑ MOUNTLAKE TERRACE, ;. .
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17-Bu
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DATE DUE ► A r 2016
MAILING
FR424
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BUSINESS OWNER:
HOME PHONE:
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HOME PHONE:
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DATE DUE:
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SNOHOMISH CO.
FIRE
DIST:
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.Serving Brier, Edmonds, and
Mountlake Terrace
www.FireDistrictl.org
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
`LOCATION:
45 Pine Street 98020
BUSINESS NAME: PHONE:
Pt Edwards Condos Bldg 9
MAILING
ADDRESS:
45 Pine Street, Edmonds, WA 98020
BUSINESS OWNER: HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ MOUNTLAKE TERRACE ,
[]UNINCORPORATED
FREQUENCY STATION & SHIFT
17-B
SCHEDULED
DATE DUE ► A r 2016
E4F24
EMERGENCY 1: HOME PHONE: CURRENT
KEY ACCESS-2: HOME PHONE: CITY .YES NO
EMAIL: BUSINESS
LICENSE
PERSON CONTACTED:
_' I INITIAL INSPECTION DATE
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NAME OF INSPECTOR: M 1 / I1167
FIRE SYSTEMS: AS 10/14 FA 10/14 FE 1/15 FD Lk Box/
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DATE DUE: T
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_
8
John J. Dowling
From: kathy [kathym@pointedwardshoa.com]
Sent: Thursday, August 18, 2016 10:21 AM
To: John J. Dowling
Cc: Deb Carter; ericm@pointedwardshoa.com
Subject: Point Edwards Fire Safety Issues
Hi Marshal Dowling,
I wanted to let you know that the lock has been repaired for Building 31 riser room and I have a key for the Building 45
riser room for you also.
Our on -site office is located at 93 Pine Street and we are open 8:OOam-4:30pm Monday — Friday.
If you need anything else please feel free to contact me at 425-673-0616.
Kathy Marsh
Point Edwards HOA
93 Pine Street
Edmonds, WA 98020
425-673-0616 Office
425-673-0629 Fax
kathym@pointedwardshoa.com
I am using the Free version of SPAMfighter.
SPAMfighter has removed 17437 of my spam emails to date.
Do you have a slow PC? Try a free scan!
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1
CITY OF EDMONDS
BUSINESS LICENSE APPLICATION -- COMMERCIAL
FEE: $125.00
CITY CLERK'S OFFICE, BUSINESS LICENSE DIVISION
121 5111 AVENUE NORTH, EDMONDS, WA 98020 PHONE 425.775.2525
n
Building
❑
Engineering
O
Fire
❑
Planning
❑
Police
OFFICE USE ONLY
BL#
Customer #
SIC
I Year
Class
Sector
1167-1
Date Paid
TR#
op4Z3
Fee
Mailed
Deleted
INSTRUCTIONS: Please complete the application in full and attach the required floor plan. Middle Initial or name required of all parties concerned. If no
middle name, please indicate by writing NMN. Sign and return application with fee. Please advise of any change In status. New license required if
business changes location or ownership. Notification to City of Edmonds required if business closes. License expires December 31" each year. Renewal
must be submitted prior to/January 31" to avoid hate fees. f
BUSINESS NAME
BUSINESS ADDRESS ' 119, _H6iL%r.4'.
Street Suite # City, State, Zip Code
MAILING
or PO Box # / Suite #
BUSINESS PHONE( 'q97 11 h
j��,!" ! `604 ]q � WA STATE TAX ID # (UBI) � 3 ,6
C/rL BUSINESS E-MAIL Fr C_ Ur cto ti a, /GO OlUSINESS WEBSITE a� Z/170_.�C=J�G1 r1',15 0 70
BUSINESS OWNER / MAIN CONTACT
EMERGENCY NOTIFICATION (For Premise Access in Emergency):
Last
Last Name
PREVIOUS BUSINESS AT THIS
NUMBER OF EMPLOYEES_ SQUARE FOOTAGE OF BU/E
'SINESS SPACE —IL
TYPE OF BUSINESS - PLEASE CHECK APPROPRIATE CATEGORY: ' PROPOSED OPENING
ri CONSTRUCTION
u FINANCE, INSURANCE, REAL ESTATE
❑ LANDSCAPE, HORTICULTURAL
❑ MANUFACTURING
❑ NON-PROFIT
❑ RETAIL
❑ SECONDHAND DEALER
r7 SERVICES
,i— WHOLESALE
❑ OTHER
Phone Number
BUSINESS HOURS: (O wit fo lo%J✓YIQ
DAYS OPEN:
❑ SUNDAY A WEDNESDAY
;4 MONDAY ATHURSDAY
9d TUESDAY XXTRIDAY
❑ SATURDAY
1 I
AMUSEMENT DEVICES ON PREMISES? YES NO A IF YES, TOTAL NUMBER LIQUOR SOLD ON PREMISES? YES NO_)L_
r
/GAMBLING? YES_ NO_2�_ CIGARETTES SOLD ON PREMISES? YES NO—%—
FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED? YES NO IF YES, PLEASE PROVIDE A LIST OF MATERIALS AND QUANTITIES:
P.A`KING SPACES ON SITE: TOTAL SPACES �-3 ACCESSIBLE SPACES FOR HANDICAP `PARRKING
DOES THE Rt1SINESS CONTAIN AN FNTRANCF ACCFRRIRI F Tn PFRSnNR WITH nIRARII ITIPS? VFS J, Nn1
APPLICANT
NAME C9
Printed Name Ign
TITLE g)),f4a4 DATE
Applications may be mailed in with a check, brought in person, faxed to 425-771-0266 or emailed to business.license@edmondswa.aov
with a valid phone number. We will call you for a Visa or MasterCard payment.
!1
NAME SOLE PROPRIETORSHIP
LAST FIRST MIDDLE INITIAL
ADDRESS
STREET SUITE/APT/UNIT# CITY/STATE/ZIP CODE
HOME PHONE( ) DRIVERS LICENSE OR ID # & STATE
DATE OF BIRTH CITY/STATE OF BIRTH COUNTRY OF BIRTH
PARTNERSHIP - PARTNER 1
NAME
LAST FIRST MIDDLE INITIAL
ADDRESS
STREET SUITE/APT/UNIT # CITY/STATE/ZIP CODE
HOME PHONE( I DRIVERS LICENSE OR ID # &
DATE OF BIRTH CITY/STATE OF BIRTH COUNTRY OF BIRTH
PARTNERSHIP - PARTNER 2
NAME
LAST FIRST MIDDLE INITIAL
ADDRESS
STREET SUITE/APT/UNIT # CITY/STATE/ZIP CODE
HOME PHONE( 1 DRIVER'S LICENSE OR ID # & STATE
-�- CORPORATION/ LLC or PLLC �1 ��/
NAME OFCORPORATION D/i.1/7 S �� (L(rj `5 FEDERAL TAX ID# °X.61 ' 10 j 9
CORP.ADDRESS WI±L
Street Suite, Apt. Unit# City, Sta a and Zip Cade Phone Number
CORPORATE OFFICERS:
Last Name First Name MI Title 1 L DateofBirth Driver's License or Other ID# /State
.11
. .
( A
LOCAL CONTACT '
Lest Name First Name MI Title DateofBirth
L
Driver's License or Other ID# /State Phone Number
CITY USE ONLY:
BUILDING DEPT.
APPROVE
DISAPPROVE DATE
SIGNATURE
OCCUPANT LOAD
BUILDING PERMIT
OCCUPANCY GROUP
COMMENTS
ENGINEERING
[] APPROVE
0 DISAPPROVE DATE
SIGNATURE
FIRE DEPT.
APPROVE
DISAPPROVE DATE
SIGNATURE
U.F.I.R.
COMMENTS
PLANNING DEPT,
0 APPROVE
Q DISAPPROVE DATE
SIGNATURE
ZONING CODE
CONDITIONAL USE PERMIT
COMMENTS
POLICE DEPT. APPROVE 0 DISAPPROVE DATE SIGNATURE
COMMENTS
Freezers
Fryer and ho=od
Food machineSinks
Food mixer
Bathrooms:]
FOffice
Door Main door
IN
sNoo>u co. Serving Brier; Edmonds, and
i
FIDEMountlake Terrace
DISTRIUT, www www.FireDistrictl.org
31 Pine Street 98020
LOCATION:
BUSINESS NAME: Pt Edwards Condos Bldg. 7
MAILING
ADDRESS:
31 Pine Street, Edmonds, WA 98020
9` BUSINESS OWNER:
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 5514272
PHONE:
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
FREQUENCY I STATION & SHIFT
Annual 17-A
SCHEDULED4pr2015
DATE DUE
uFIR 424
EMERGENCY-1: HOME PHONE:
CURRENT
KEY ACCESS-2: HOME PHONE:
CITY YES NO
BUSINESS ❑
EMAIL:
LICENSE
PERSON CONTACTED:
INITIAL INSPECTIONPATE
NAME OF INSPECTOR: ' n
101 1 Ll", 1/15—
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1 ,
1
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2
3
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4
4
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6
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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:
I
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
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1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE "�.
SECTION:
-,5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
B
FIRE DEPARTMENT COPY
SNOHOMISH CC
FIRE
DIST
Sef=ving Brier; Edmonds, and
Mountlake Terrace
www FireDistrictl. org
FIRE PREVENTION
12425 Meridian Ave S INSPECTION REPORT
Everett, WA 98208 ❑ ElBBEDMORIERRIER S
Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE
Fax (425) 551-12 %2 [I UNINCORPORATED a
,I LOCATION:
BUSINESS NAME: PHONE:
PLEdvardSCmdus BWb. 7
MAILING
ADDRESS: 31 Pir cSLrccl Eddrnormt, WVA OW20
FREQUENCY STATION & SHIFT
Ant RI 17-n
SCHEDULED
DATE DUE ► r 2014
UFIR t g
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BUSINESS OWNER: HOME PHONE:
EMERGENCY-1: HOME PHONE: CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
EMAIL: BUSINESS ❑ ❑
LICENSE
PERSON CONTACTED: INITIAL INSPECTION DATE
S. I
NAME OF INSPECTOR:
t-�SY5�1115: AS VIM FA &VIZ FE 1 =2 FDLk Box 938108
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I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
III 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:
a
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
0
�.
. Serving Brier, Edmonds
SNOHOMISH CO.
FIREMountlake
Terrace,and
��
D IS,R T
the Town of Woodway
FireDistrictl.
www org
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LOCATION: 31
Pine St
BUSINESS NAME: Pt Edwards Condos 6Idg. 7
MAILING
ADDRESS:
BUSINESS OWNER:
EMERGENCY-1: Property Manager
KEY ACCESS-2:
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE:
HOME PHONE:
HOMEPHONE: 2063880180
HOMEPHONE: 2064234433
"PERSON CONTACTED:�--
NAME OF INSPECTOR:
FIRE AS 9/11 FA 9/11. SP 2/08 FD LkBx
SYSTEMS: /0I% hV,
FIRE PREVENTION
INSPECTION REPORT
❑ EDMONDS
❑ BRIER
❑ WOODWAY
❑ MOUNTLAKE TERRACE
❑ UNINCORPORATED
UENCY
i5
I STATION & SHIFT
17 C
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JE ° 04/01/13
424
4 152
CURRENT
CITY YES NO
BUSINESS
LICENSE
INITIAL INSPECTION DATE
FE ►491J-2
ANNUAL
HAZARDS FOUND AND LOCATIONS / COAMUNICATIONS
..1 rA1
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 XY
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
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INSPECTOR:
INSPECTOR:
i
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
`
7
RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
e
FIRE DEPARTMENT COPY
`'
FIRE PREVENTION
Serving Brier; Edmonds
='12425 Meridian Ave S
INSPECTION REPORT
SNOHOMISH CO
FIREMountlake
Terrace,and
Everett, WA 98208
❑ EDMONDS
El BRIER
STI*aeo*T
the Town of Woodway
www FireDistrictl. org
Phone (425) 551-1200
Fax 425 551-1272
( )
❑ WOODWAY
AKE TERRACE
❑ UNINCOMOUNTRPORATED
❑UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATION:
31 Pine St
365
17 B
I
BUSINESS NAME:
Pt Edwards Condos Bldg. 7
PHONE:
DATE DUE SCHEDULED►
04/01/12
MAILING
UFIR ► 424
4 152
ADDRESS:
BUSINESS OWNER:
HOME PHONE:
EMERGENCY-1:
,�`
ProP ffrl Manager
HOME PHONE: 2063380180
CURRENT
KEY ACCESS-2:
tifil, JwsarzYMaint
HOME PHONE: - 21164234433
CITY
YES NO
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BUSINESS
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LICENSE
PERSON CONTACTED: INITIAL INSPECTION DATE
NAME OF INSPECTOR: l 12, 1 Z
FIRE AS 9111 FA 9/11 FD LkBx
SYSTEMS: oq k k ` / I .�. ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
1 41
1 Z<I
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
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
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INSPECTOR: //
INSPECTOR:
INSPECTOR:
2
DATE:/v
DATE:
DATE:
3
VI CATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
4
8
4
8
DATE:
DISPOSITION:
7
LETTER NEEDED ❑ YES ❑ NO
LETTER NEEDED ❑ YES ❑ NO
8
FIRE DEPARTMENT COPY
Revised Date 6/16/09
SMITH FIRE SYSTEMS MANAGEMENT, LLC
DATE I-Z(-.,
AUTOMATIC SPRINKLER SYSTEM JOB # #qy Q;f
1106 54th Avenue East, Tacoma, WA 98424 PERFORMANCE EVALUATION
Phone: (253) 248-2000 Fax: (253) 248-2360
Site Name PT. EDWARDS CONDOMINIUMS— BUILDING 7
Address: 31 PINE STREET, EDMONDS, WA 98020
Contact Person TOYAN COPELAND Telephone # (206) 388-0180
System # 1 Type WET Area Covered
System # 2 Type DRY Area Covered
System # Type Area Covered
System # Type Area Covered
System # Type Area Covered
Type of Occupancy (CIRCLE): Other.
Assembly Storage Industrial Offices Retail Apartments Condominiums Residential
A. OWNER'S SECTION
1. Has there been any fin; protection modifications since the last inspection?: Yes ❑ No ❑ Describe below:
2. Describe any fire(s) since last inspection:
3. Date (approximate if unknown) sprinkler system was installed: 2008
4. Name of installation company: CUSTOM SPRINKLER
B. INSPECTOR'S SECTION (All responses reference current Inspection)
1. GENERAL YES NO N/A
a. Does the system have a hydraulic plaque? h
b. Are the risers labeled and what are the specifics?
Discharge density .15 Per 1950 Sq. Ft. residual pressure at riser 79 psi.
Gallons per minute 341
c. Is the building fully sprinklered? b
d. Is the entire sprinkler system in service? W
e. Record water pressure at riser: ,tcb PSI
2. CONTROL VALVES YES NO N/A
a. Are all sprinkler system control valves and all other valves in the appropriate
open or closed position? k
b. All control valves operated through full range of motion and returned to normal position?
c. Are all control valves in the open position?
Locked ❑ Sealed a Tampered (�
d.. Are all control valves properly signed?
PT. EDWARDS CONDOMINIUMS— BUILDING 7 Page 1 of 4
Revised Date 6/16/09
3. FIRE DEPARTMENT CONNECTIONS
a. Are fire department connections in satisfactory condition (Unobstructed view,
couplings rotate freely, caps are in place)?
b. FDC backflushed in NEW 2008 . (Required every 5 Years)
4. WET SYSTEMS
a. Have antifreeze system solutions been tested? Solution %
b. Were the antifreeze test results satisfactory? Specific Gravity Reading(s)
c. Does the building appear to be adequately heated at time of inspection?
e. Internal exam of piping conducted in CPVC (Required every 5 Years)
5. DRY SYSTEMS
a. Is the air pressure and priming water level in accordance with manufacturer's instructions?
b. Has the operation of the air or nitrogen supply been tested?
Is it in service?
c. Were the low points drained during this inspection? How Many?_��
d. Did quick -opening devices operate satisfactorily?
e. Did the heating equipment in the dry pipe valve room operate at the time of inspection?
f. Was the dry valve tripped during this inspection?
—1Q—
x
Deg
ttkCC
DRY PIPE
OPERATING
TEST
DRY VALVE
Q.O.D.
MAKE
MODEL
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MODEL
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OK
TIME TO TRIP
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INITIAL AIR
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TRIP POINT
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TIME WATER REACHED
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PSI
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q-21_LI
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g. Date dry pipe valve trip tested (control valve fully open).
h. Internal exam of piping conducted in NEW 2008 (Required every 5 Years)
6. ALARMS
a. Did water motor gong test satisfactorily?
b. Did electrical bell test satisfactorily?
c. Is the system supervised with alarm?
Operator #
d. Did alarm monitoring service test satisfactorily?
e. Waterflow alarm?
f. Valve tamper monitoring?
g. HVLo Air Switch
Who? SFSM @ AVANTGUARD— 89-6947
PT. EDWARDS CONDOMINIUMS-- BUILDING 7 Page 2 of 4
Revised Date 6/16/09
7. SPRINKLERS. GAUGES & MIC TESTING
a. Are all sprinklers free from corrosion, foreign material, or paint?
b. Are there any non -dry sprinkler heads manufactured prior to 1920?
c. Are all non -dry sprinkler heads less than 75 years old? Date of last sample testing:
d. Are all non -dry sprinkler heads less than 50 years old? Date of last sample testing:
e. Are all dry type sprinkler heads less than 10 years old? Date of last sample testing:
f. Are all FAST RESPONSE sprinkler heads less than 20 years old? Date of last sample testing:
g. Is there fluid in the glass bulbs?
h. Is a head wrench, stock of spare sprinklers and Teflon tape available?
I. Does the exterior condition of the sprinkler system appear to be satisfactory?
j. Date of last MIC testing?
8. WATERFLOW TEST AT MAIN DRAIN MADE AT SPRINKLER RISERS
UNKNOWN
TEST PIPE
DATE
TEST PIPE
LOCATION
SIZE '
TEST PIPE
STATIC
PRESSURE
RESIDUAL (FLOW)
PRESSURE
1
RISER
2"
/00
1215-
2
RISER
2"
00
-7r
3
4
5
9. ,,Explain any "No" answers and comments:
• A)y Q�"'da Try oc..i"�1 i9g
- TC&'L'A4) ka-gd' .� U.w.r-FS aoL av2i; ao7 aoi
` QGO/NMt.r�7[ ��`� JGovr�/J/AFL s� "'Q—J b 'I- .114C CC-r0t0f C .r-
��✓i ��!/� ISM %�g^Vf ..S/OL' LG
PT. EDWARDS CONDOMINIUMS— BUILDING 7 Page 3 of 4
Revised Date 6/16/09
10. Adjustments or corrections made during this inspection:
11. Although these comments are not the result of any engineering review, the following desirable improvements are recommended:
System 1
System 2
System 3
System 4
System 5
❑
[�D
❑
❑
❑
is operational
is operational
is operational
is operational
is operational
[OO",
❑
❑
❑
❑
is operational with defects
is operational with defects
is operational with defects
is operational with defects
is operational with defects
❑
❑
❑
❑
❑
is not operational
is not operational
is not operational
is not operational
is not operational
SMITH FIRE SYSTEMS MANAGEMENT, LLC
1106 54th Avenue East Tacoma WA 98424
�* Phone: (253) 248-2000 Fax: (253) 248-2360
or
7-Z1-
Date
PT. EDWARDS CONDOMINIUMS— BUILDING 7 Page 4 of 4
SMITH FIRE SYSTEMS MANAGEMENT, LLC
DATE
' CONFIDENCE TESTING FIRE ALARM JOB # S (� 2
1106 54th Avenue East, Tacoma, WA 98424
Phone: (253) 248-2000 Fax: (253) 248-2360
SITE NAME PT. EDWARDS CONDOMINIUMS- BUILDING 7
ADDRESS 31 PINE STREET, EDMONDS, WA 98020
CONTACT TOYAN COPELAND PHONE (206) 338-0180
NAME OF TESTER _ J �ot��v _ CERTIFICATION NO. / S D 7
DATE OF INSPECTION J -(:,2t> — j I TYPE OF INSPECTION
CONTROL PANEL MANUFACTURER SILENT KNIGHT MODEL NO. 5820XL
NUMBER OF INITIATING CIRCUITS ADDRESS NO. OF SIGNAL CIRCUITS ADDRESS
BATTERY VOLTAGE VOLTS CHARGE CIRCUIT VOLTAGE % oZ VOLTS
BATTERY VOLTAGE UNDER FULL LOAD oZS • 0 - VOLTS (SIGNALS OPERATING)
1. Trouble signal with AC power off
2. System operates satisfactory on standby power
3. All signals operate on AC power
4. Have all alarm notification appliances been checked for proper operation?
..,5. All circuits checked for electrical supervision
6. Control panel checks made per manufacturer's instructions
7. All auxiliary equipment operates (Elevators, fans, dampers)
8. Central station or remote connection
Name of Monitoring Company
9. Key to panel available
10. Operating instructions at panel?
11. Service Label or Tag (SFC Appendix III-B)
12. Did you sign off Item 8 on the Elevator Log
YES
R
NO
❑
N/A
❑
YES
E;
NO
❑
N/A
❑
YES
NO
❑
N/A
❑
YES
❑
NO
D9)
N/A
❑
YES
®
NO
❑
WA
❑
YES
®
NO
❑
WA
❑
YES
CR
NO
❑
N/A
❑
YES
V
NO
❑
WA
❑
SFSM 0 AVANTGUARD-• 89-6947
YES
R
NO
❑
N/A
❑
YES
5?
NO
❑
N/A
❑
YES
�R
NO
❑
N/A
❑
YES
�§
NO
❑
N/A
❑
PT. EDWARDS CONDOMINIUMS— BUILDING 7 1 of 2
EQUIPMENT TESTED
TYPE OF EQUIPMENT
NUMBERS OF
UNITS TESTED
SATISFACTORY
NO. OF UNITS
IN BUILDING
YES
NO
N/A
Bells, Horns, Chimes
Voice Alarm Speakers
sv
78
Visual Alarm Device
25
Trouble Indicators
2
Super. Switch Auto. S r.
cp
4
Auto S r. Flow Switches
g
2
Smoke Detecto s
2k
4C5
28
Heat Detector(s)
%
1
Manual Pull Stations
/3
x
13
Ventilation Controls Operate
4dEk
Central Station
/
)0
1
Annunciators
Z
2
Elevator Call Down
1
k
1
Fire Damper/Smoke Dampers
Phone Jacks
Auto. Door Unlocks - Failsafe
Auto. Door Release
1
Other
PROBLEMSFOUND: ND 64"--r /w _;->C*
CORRECTIONS MADE:
DATE CORRECTED
BY
THIS IS TO CERTIFY THAT THE FIRE ALARM SYSTEM HAS BEEN PROPERLY TESTED AND INSPECTED FOR
RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT.
J SMITH FIRE SYSTEMS MANAGEMENT, LLC
1106 54th Avenue East, Tacoma, WA 98424
Phone: (253) 248-2000 Fax: (253) 248-2360
T-PdfC, Oawem ti'
Name Date
PT. EDWARDS CONDOMINIUMS— BUILDING 7 2 of 2