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HomeMy WebLinkAboutFire Alarm System Report - FIR Inspections - 8/12/2004 - -- -- - - . . I -, MVJ,t-ca abU 4Z7 7756 P. 01 MASON COUNTY FIRE MARSHAL 410 WEST BUSINESS PARK ROAD 33a •40 to 0wo SHELTON, WA 98584 360/427-7535 �c FAX 360/427-7756 CODE ENFOACEMENT FIRE INSPECTIONS FIRE INVESTIGATION PUBLIC EDUCgTION I FIRE ALARM SYSTEM REPORT OF INSPECTION Date: F - --C) Name of Facility: Occupied As:_ Scl,cc/ Address: A eS . 2Z 5 o o Hjw 3 City: WA: County: �4so�J Zip: �85 z 8 Telephone: 3� z —Zro Building Destination (if more than one building); Inspection By: ZJAge r7`Fr44,,J Title; Date of In pection: �- Iz-off Type of Test: Monthly ( 'I Quarterly ( j Semi-Annual ( } nnual (� Z. Type of System: Noncoded �4 Common coded ( } Selective coded ( ( Dual coded (as pertaining to Chapter 212-14 WAC) 3. Local Fire D©partment: 4. Fire Department Official Contacted; 5. Test Received at Fire Depert►„em+7: ves r nio 6. Master Box Reset A.M. 7, Comments, explanation of results, action taken, etc. A,�a f rb A-u&i4 a 'I r MCFMO 03-5/93 i EQUIPMENT TESTED NUMBER OF SATISFACTORY CHECK UNITS TEST TYPE AND TYPE OF EQUIPMENT TESTED DATE YES NO N/A MANUFACTURER Control Panel Manual Station 0, Heat Detectors ZO t, Smoke Detectors 13 13Rk -lkbO1-0'j i r 2, Audible Alarm Dev ces / 3. Visual Alarm Devices - it. Code Transmitters 5. Automatic Ooor Releases Z- S. Trouble Indicators / ��A.IE 7, Master Alarm Box 3. Batteries 2— 3, Charier E14 r Generator 1 . ventilation Control —�— — 2. Fire Department ✓ --- Interconnection 3. Central Station / Interconnection / 4. Exterior Sprinkler Electric —�- Alarm Ball — 5. Sprinkler Water Flow Switch j. Sprinkler Gate wive Supervision Switch 7. Annunciators Automatic Time Delay of General Alarm Minutes. None Installed (X) No ( J Test of alarm system emergency power, satisfactory? Yes ( Thls is to certify that this fire alarm system has been properly inspected for 'eliability covering the items listed In this report and is consistent with NFPA Fire Alarm Mainte ance Standards. A, Signature of Owner or Representative � E B. Signature of Fire Alarm Firm Representati.� C, Name o` Firm S4��c� .��C(�o� ►cS l f Phone C. vlailing Address i JAN-29-02 12 :59 PM DEPT. EMERGENCY SERVICES 360 427 7756 P. 01 MASON COUNTY FIRE MARSHAL ` �0loco 410 WEST BUSINESS PARK ROAD SHELTON, WA 98584 360/427-7535 FAX 360/427-7756 CODE ENFORCEMENT FIRE INSPECTIONS FIRE INVESTIGATION PUBLIC EDUCATION FIRE ALARM SYSTEM REPORT OF INSPECTION Date: Q� Name of Facility: Occupied As:- Address: AID, ZZ�pp 4—v J —city: W County: 94fOl-k Zip: 2M Telephone: 072 Z/O Building Destination (if more than one building): Inspection By: ���J L 11a:;k Title: Date of Inspection: . 'Type of Test: Monthly [ l arterly [ } Semi-Annual ( } Annual (� 2. Type of System: Noncoded ) Common coded [ } Selective coded ( J Dual coded (as pertaining to Chapter 212-14 WAC 3. Local Fire D©partment: r' 4. Fire Department Official Contacted: 5. Test Received at Fire Department?: Yes [ } No [ I N 14 rcy4,,v, / �1'et, 6. Master Sox Reset A.M. P.M. / I of results action taken U -SdY1oke- MCFMO7. Comments, explanation: , e c. e- s 03-5/93 JAN-29-02 12 :59 PM DEPT. EMERGENCY SERVICES 360 427 7756 P. 02 EQUIPMENT TESTED f NUMBER OF SATISFACTORY CHECK UNITS TEST TYPE AND TYPE OF EQUIPMENT TESTED DATE YES NO NIA MANUFACTURER Control Panel 03 Manual Station ✓ e 0. Heat Detectors Zen) ✓ ., �� p� I, Smoke Detectors 13 /Z , -( 2. Audible Alarm Devices 3. Visual Alarm Devices 4. Code Transmitters 5. Automatic Door Releases :c S. Trouble Indicators 7. Master Alarm Box ✓ �---� 9. Batteries 3. Charger le/ J. Generator 1. Ventilation Control ✓ �-- 2. Fire Department f Interconnection 3. Central Station / ✓ / Interconnection 4. Exterior Sprinkler Electric ; Alarm Bell S. Sprinkler Water Flow Switch r--� 3. Sprinkler Gate Valve Supervision Switch 7. Annunciators Automatic Time Delay of General Alarm Minutes. None Installed Test y emergency of alarms stem emer enc power, satisfactory? Yes [v� No [ l s This is to certify that this fire alarm system has been properly inspected for -eliability covering the items listed in this report and is consistent with NFPA Fire Alarm Mainte lance Standards. A. Signature of Owner or Representative S. Signature of Fire Alarm Firm Representative C. Name of Firmt D. Mailing Address-7'�69 372� Phone Ni Z5 -zFS JAN-29-02 12 :59 PM DEPT. EMERGENCY SERVICES 360 427 7756 P. 01 1 a.33 b (o�ooc7- MASON COUNTY FIRE MARSHAL 410 WEST BUSINESS PARK ROAD F ,1 L E SHELTON, WA 98584 COPY 1 s_ o 360/427-7535 FAX 360/427-7756 CODE ENFORCEMENT FIRE INSPECTIONS FIRE INVESTIGATION PUBLIC EDUCATION FIRE ALARM SYSTEM REPORT OF INSPECTION Date: Name of Facility; Occupied As: Address: -City: ii WA: County: MIISOi i Zip: Telephone: 277- ;?-1 Building Destination (if more than one building): Inspection Ins B G /� fi p y: � �i�� Title: Date of In pection: dZ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Type of Test: Monthly j I Quarterly ( j Semi-Annual Annual Z. Type of System: Noncoded (11--c-,ommon coded ( j Selective coded ( ) Dual coded (as pertaining to Chapter 212-14 WAC) 3. Local Fire Department: 4. Fire Department Official Contacted: 5. Test Received at Fire epartment?: Yes [ I No ( I A/;4 o- 6. Master Box Reset �� A.M.&/ P.M. l 7. Comments, explanation of results, action taken, etc. /(nit S 6- �✓� G�t r G r t vc�!(( ✓ v` f MCFMO 03-5/93 i JAN-29-02 12 :59 PM DEPT. EMERGENCY SERVICES 360 427 7756 P. 02 EQUIPMENT TESTED NUMBER OF SATISFACTORY CHECK UNITS TEST TYPE AND TYPE OF EQUIPMENT TESTED DATE YES NO N/A MANUFACTURER Control Panel &114.-ems Manual Station `s 0. Heat Detectors Z� L l3J ��Qcr2 1. Smoke Detectors Z 1 _ /�ez -dN' 2. Audible Alarm Devices l7i/ 3. Visual Alarm Devices 4. Code Transmitters 5. Automatic Door Releases S. Trouble Indicators 7. Master Alarm Box 9. Batteries 3, Charger �. Generator 1. Ventilation Control 2. Fire Department Interconnection 3, Central Station Interconnection 4. Exterior Sprinkler Electric Alarm Bell 5. Sprinkler Water Flow Switch 5. Sprinkler Gate Valve Supervision Switch 7, Annunciators �U Automatic Time Delay of General Alarm Minutes. None Installed (� enc ower, satisfactory? Yes (�No [ Test of alarm system emergency p Y This is to certify that this fire alarm system has been properly inspected for reliability covering the items listed In this report and is consistent with �A Fire Ma interiance Standards. A. Signature of Owner or Representative i B. Signature of Fire Alarm Firm Representative G, Name of Firm � vwz'Cf D. Mailing Address z Phone N�(z, Inspection Contract No.__ File No. FIREL 15RC=TION SERVICES DIVISION 9th & Columbia Bldg. GH-5I, Olympia, WA 98504-4151 ' FIR£ ALARM SYSTEM REPORT OF INSPECTION Date L,7 Name of Facility: Occupied as: Address: County:- Zip G Sal=Telephone�3��/ o75 -25l" 3 Building Designation (if more than one building) Inspection by: Title Date of inspection: ---------------------------- I. Type of Test: Monthly ❑ Quarterly ❑ Semi-Annual ❑ Annual ' 2. Type of system: Noncoded 0 Common coded ❑ Selective coded ❑ Dual coded ❑ (as pertaining to chapter 212-1 ) 3. Local Fire Department: 4. Fire Department Official Contacted: A� 5. Test Received at Fire Department: Yes ❑ No ❑ 401 6. Master Box Resat & A.M. P.M. 7. Commnts, explanation of unsatisfactory results, action taken, etc. S_FM 222, Rev. 5/78 ORIGINAL FORM TO BE RETURNEti TO STATE FIRE OARSHAL. EQUIPMENT TESTED UM —SATISFACTORY N TYPE OF EQUIPMENT UNITS TESTED DATE . CHECK MANUFACTURER Yes No N/A 8. Control Panel 9. Manual Station 10. Heat Detectors Z� 13 1 ✓ IPAl 11. Smoke Detectors -Audible arm l ff y� 12. Devices °�" visual Alarm l/y 01-1 13. Devices 14. Code Transmitters ✓ Automatic Door Jcfo n�,[iC 15. Releases 1E . Trouble Indicators 0 � 17 . Master Alarm Box -P-4, ui( GEC+/ 17- Batteries Z ✓ (2 19. Charver / -te 20. Generator I j2: Ventilation Control Fire Department I 22 . Interconnections entraStation / ✓ �I l o 23. Interconnection Exterior Sprinkler 24 . Electric Alarm Bell )01 Sprinkler water 25. Flow Switch Sprinkler Gate Valve 2E. Supervision Switch 127. Annunciators ' 2E. Automatic Time Delay of General Alarm Minutes. None rNo lied 29. Test of alarm system on emergency power, satisfactory? Yes ❑ 30. This is to certify that this fire alarm system has been properly inspected for reliability covering the items listed in this report and is consistent with NFFA Fire Alarm Maintenance Standards. A. Signature of Owner or Representative --5 S. Signature of Fire Alarm Firm Representative C. Name of Firm Sound Electronics -D. Mailing Address 1929 Tacom ve S Tacoma. -WA Phone No1472-2955 E. Electrical Contractors License SOUNDE-414OR3 F. Specialty Electricians License Inspection Contract No. File No. • FIRz PROTECTION SERv= DMSFON 9th & Columbia Bldg. &H-51, Olympia. WA 98504--4151 FIRE ALARM SYSTEM REPORT OF IIYSAECTIOl1 Date �, �? h I Name of Faci 11 ty: Occupied as: Address: city �,�L�/�12 D Aj Zip �8.��z ' TeIephon'(36 0> a2?S- County:_ /�/ - Building Designation (if more than one building) Inspection by: Title �C Date of inspection: I. Type of Test: Monthly ❑ Quarterly ❑ Semi-annual ❑ Annual ,�l 2. Type of system: Noncoded ❑ Common called ❑ Selective coded ❑ Dual coded ❑ (as pertaining to chapter 212-14 WAC) 3. Local Fire Department: A ��/�e_ 4. Fire Department Official Contacted: 5. Test Received at Fire Department: Yes ❑ No Q 6. Master Box Reset A.M. p•'M• 7. Caa*nents, explanation of unsatisfactory results, action taken, etc. ►of 40 - Lo0000 r .) i.j,; PERMIT A�����ANG OUR SFM 222, Rev. 5/78 ORIuIkAL FORli TO BE RETURNED TO STATE FIRE riAtRShAL• EQUIPMENT TESTED SATISFACTORYNUMBER OF TEST. PE AND TYPE OF EQUIPMENT UNITS TESTED DATE . CHECK MANUFACTURER Yesl No N/A S. Control Panel ✓ y _ are r 9. Manual Station v NO IVori EIS 10. Heat Detectors D l D 11. Smoke Detectors Audio le Alarm �� d� 12. Devices / r ° Visual Alarm 13. Devices MORVA � I14. Code Transmitters Automatic Door 2 ,/ I5. Releases lb. Trouble Indicators 17. Master Alarm Box 2 fba�E,eSa � C.. i 18. Batteries 19. Charcer ! >/ A) 2C. Generator � I � 121. Ventilation Control Fire Department 22. Interconnection � Central tation / � I /) 0 � 7P 2 .. Interconnection Exterior SprinKlerl ( �- 24. Electric Alarm Bell 1� Sprinkler Water 25. Flow Switch Sprinkler Gate Valve I 26. Supervision Switch 27. Annunciators 28. Automatic Time Delay of General Alarm Minutes. None Installed ❑ 29. Test of alarm system on emergency power, satisfactory? Yes ❑ No ❑ 30. This is to certify that this fire alarm system has been properly inspected for reliability covering the items listed in this report and is consistent with NFPA Fire Alarm Maintenance Standards. A. Signature of Owner or Representative S. Signature of Fire Alarm Firm Representative C. Name of Firm Sound Electronics 0. Mailing Address 4621 Pacific Ave . Tacoma , Wa . 98408 Phone No.472-2955 E. Electrical Contractors License # SO NDE*14OR3 F. Specialty Electricians License C2•¢%�'r���s - Inspection Contract No. File No. FIRZ TROT'..CTICN SEVZCES DIVISION 9th & Columbia Bldg. Cii-51, Olympia, WA 98504-4151 FIRE ALARM SYSTEM REPORT OF IMPECTION Date -7— Name of Facility: gEz' F"q-zlc - Occupied as: 5 Address: /E- 2 /G� `fir,✓ C i tic County: .A4A:75 Zip el� s2� Telephoni-74 ) .27S "288-- Building Designation (if more than one building) Inspection by: C� �E !-OK1 Title r Date of inspection: S 1. Type of Test: Monthly ❑ Quarterly ❑ Semi-Annual ❑ Annual 2. Type of systems: Noncoded;a Cocamon coded ❑ Selective coded ❑ Oual coded ❑ (as pertaining to chapter 212-14 WAC) 3. Local Fire Department: 4. Fire Department Official Contacted: if? 5. Test Received at Fire Oepartment: Yes ❑ No ❑ � 6. Master Box Reset A.M. P.,M. 7. Comments, explanation of unsatisfactory results, action taken, etc. SFM 222, Rev. 5/78 ORIGINAL F0PV TO BE RETLRNEil TO STATE FIRE i•tARShAL. 1 - Y EQUIPMENT TESTED - NUMBER Of TEST. TYPE AND TYPE OF EQUIPMENT UNITS TESTED DATE CHECK MANUFACTURER Yes I No N/A E. Control Panel t —7 9. Manual Station A " COb: ,- 10. Neat Detectors O b O 11. Smoke Detectors s Z Afio�/ 12 . Devices r Visual Alarm � � Al ejAlt" 13. Devices 14. Code Transmitters Automatic Door 15 . Releases 1E. Trouble Indicators 17. Master Alarm Box v OMZC 18. Batteries �' I/ Sr (�/ LaAp 19. Ch arcer 20. Generator i 21. Ventilation Control Fire Department I 22. Interconnection Central Station T_ /4��c= co G7� I 23. Interconnection Exterior prin er ( I I 24. Electric Alarm Bell prinkler Water ( i 2S. Flow Switch Sprinkler Gate Valve 25. Supervision Switch 27. Annunciators 28. Automatic Time Delay of General Alarm Minutes. None Installed 29. Test of alarm system on emergency power, satisfactory? Yes ❑ No ❑ I 30. This is to certify that this fire alarm system has been properly inspected for reliability covering the items listed in this report and is consistent with NFPA Fire Alarm Maintenance Standards. A. Signature of 0tiwner or Representative B. Signature of Fire Alarm Firm Representative C. Name of Firm Sound Electronics D. Mailing Address 4621 Paci f i r- Ave . Tacoma , G1a . 98408 Phone No.472-295 5 E. Electrical �zntractors License I SOUNDE*140R3 F. Specialty Electricians License Inspection Contract No. File No. F= swzccgs Divrsa aRT 9th & Caiumbia Bldg. GH-5I, Olympia. WA 98504-41SI FIRE X" SYSTEM REPORT OF INSPECTION Datez Z-a-5 Name of Facility'. A'-X'� -Occupied as: Address: 2 O Cit' County: /27 Zip 8 Telephone. o? Building Designation (if mart than one building) Title Inspection by- 8� ��v Date of inspection:---- -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 1. Type of Test: Monthly Q Quarterly Q Semi-Armval Q Annual 2. Type of system: Noncoded Z tommon•coded Q Selective: coded Q Dual coded Q (as pertaining to chapter 2I2-14 wAC) 3. Local Fire De.parta�ent: 4. Fire Department Official Contacted: S. Test Received at Fin Department: Yes No 6. Master Box Reset t/E/ A.M. P.•M. 1. Comments, ex 1 ana /U 0t i an of unsatisfactory results, action taken, etc. S SFM 222. Rev. 5/78 ORIGIOL FORM TO BE RMRNEJ TO STATE FIRE AARSHAL. EQUIPMENT TESTED SATISFACTORYNUMBER OF TEST. TYPE TYPE OF EQUIPMENT UIN ITS TESTED DATE' CHECX MIAXUFACTURER Yes No N/A B. Cantrvl Panel 9. Manual Station 10. Heat Detectors 11. Smoke Detectors / 3 a 1 o e arm v. 12. Devices / Visual Alarm 12. Devices �� �/ LI 5jl�e4t9�-- 14. Code Transmitters Automatic Door ,/%,���.� �Orc,S 15 . Releases " �� lfi. Trouble Indicators 17. Master Alarm Box 19. Batteries <-- -Z 19. Charter 1 20. Generator 121. Ventilation Control Fire Department 22. Interconnection Central Station / , 23. Interconnection Exterior prink erg I r� 24. Electric Alarm Bell prinkler Water 25. Flow Switch prinx er Gate are 25. Suoervision Switch 27. Annunciators _ ��,� t-; 7 2E. Automatic Time Delay of General Alarm Minutes. None Installed 29. Test of alarm system on emergency power, satisfactory? Yes Q No Q 30. This is to certify that this fire alarm system has been properly inspected for reliability covering the item listed in this report and is consistent with NFPA Fire Alarm Maintenance Standards. A. Signature of Owner or Representative B. Signature of Fire Alarm Firm Representativ '/j C. Ham of Firm Sound Electronics 0. Mailing Address4621 Pacific Ave . Tacoma , Wa . 98408 Phone Nob72-2955 E. Electrical Contractors License # 140R3 F. Specialty Electricians License # Inspection Contract No. File No. FIRM 7RQTE 01i SERVICES DMSFON 9th & Columbia Bldg. CI!-5I, Olympia. WA 98504-4151 FIRE ALARM SYSTEM REPORT OF INSPECTION Date Name of Facility: Occupied as• �� I Address•. z J bCa c.J -� _City County: {�i��—S OJ Zip S Telephone Building Designation (if more than one building) Inspection by• ` 6-11WS L'i OW'476-L Ti tle � K1 �rin / Oate of inspection: I. Type of Test: Monthly Q Quarterly ❑ Semi-Annual Q Annual Q 2. Type of system: Noncoded ❑ Common coded ❑ Selective coded ❑ OuaI coded ❑ (as pertaining to chapter212-114 WAC) 3. Local Fire Oepartment:T 4. Fire Department Official Contacted:=,I�4- 5. Test Received at Fire Oepartment: Yes ❑ No Q 6. Master Box Reset A.M. 2.1m. 7. Cca*oents, explanation of unsatisfactory results, action taken, etc. SFtM 222. Rev. 5/78 ORIGINAL FORH M BE RETLRNEJ TO STATE FIR£ MAShAL. I EQUIPMENT TESTED -NUA10 OF TEST. SATISFACTORY TYPE N TYPE OF EQUIPMENT UNITS TESTED DATE . CHECK MANUFACTURER Yes No N/A B. Control Panel �r 9 - 9. Manual Station 10. Heat Detectors O Lam. S G" 11. Smoke Detectors Audible arm IZ. Devices 17 Visual Alarm ,Qaf��`�Io� 13. Devices 14. Code Transmitters (" ~ Automatic Door IS . Releases 16. Trouble Indicators Q 17. Master Alarm Box 18. Batteries I L � 19. Ch araer k) 20. Generator (� i21. Ventilation Control d Fire partm`nt 22. Interconnection Central Station 23. Interconnection le. �7� Exterior Sprinklerl � 24. Electric Alarm Bell a ? prinkler Water Z5. Flow Switch prink I er ate a ve 26. Suoervision Switch 27. Annunciators ' 28. Automatic Time Delay of General Alarm Minutes. None Installed 29. Test of alarm system on emergency power, satisfactory? Yes z No Q 30. This is to certify that this fire alarm system has been properly inspected for reliability covering the items listed in this report and is consistent with NFPA Fire Alarm Maintenance Standards. A. Signature of Owner or Representative i B. Signature of Fire Alarm Finn l Representative-..- C. Name of Finn Sound Electronics 0. Mailing Address 4621 Pacific Ave . Tacoma Wa . 98408 Phone No1+72-2955 E. Electrical Contractors License # DE*140R3 F. Specialty Electricians License # kFZ-77 k ' ,,c_ I __ Inspection Contract No. File No. FIRZ 15ROTECTION SERVICES DIVISION 9th & Columbia Bldg. GH-51, Olympia, WA 98504-4151 FIRE ALARM SYSTEM REPORT OF INSPECTION Date Name of Facility: L Occupied as- Ste— -o Address: /U & -2 9C10 County: Jkll)_ Zip 9 ��� � Telephone Building Designation (if more than one building) Inspection by: Title Date of inspection: /° 1. Type of Test: Monthly ❑ Quarterly ❑ Semi-Annual ❑ Annual 0 2. Type of system: Noncoded [D Common coded ❑ Selective coded ❑ Curl coded ❑ (as pertaining to chapter '212-/14W�C) 3. Local Fire Department: Xj e /&' -- 4. Fire Department Official Contacted: AJ� 5. Test Received at Fire Department: Yes P No ❑ %/ �� � 6. Master Box Reset A)IX A.M. P.M. 7. Comments, explanation of unsatisfactory results, action taken, etc. i SFM 222, Rev. 5/78 ORIGINAL FORM TO BE RETURNED TO STATE FIRE OARSHAL. EQUIPMENT TESTED UM Y N TYPE OF EQUIPMENT UNITS TESTED DATE . CHECK MANUFACTURER Yes No N/A 8. Control Panel 9. Manual Station 10. Heat Detectors ✓ T Ace— 'eke 11. Smoke Detectors / 3 �' u b e arm W 12. Devices Visual Alarm / ci S6W1j—C 13. Devices 7 14. Code Transmitters Automatic Door `,,� y,� � � f 15. Releases 16. Trouble Indicatorsl P 17. Master Alarm Box 18. Batteries 19. Charaer 20. Generator 21. Ventilation Control Fire Department 22. Interconnection Central Station v' 23. Interconnection L'f/ Exterior Sprinkler ! 24. Electric Alarm Bell Sprinkler Water v 25. Flow Switch prink er ate Valve 26. Suoervision Switch 27. Annunciators •- 28. Automatic Time Delay of General Alarm Minutes. None Installed 29. Test of alarm system on emergency power, satisfactory? Yes ❑ No 30. This is to certify that this fire alarm system has been properly inspected for reliability covering the items listed in this report and is consi ent with NFPA Fire Alarm Maintenance Standards. A. Signature of Owner or Representative B. Signature of Fire Alarm Firm Representative C� C. Name of Firm Sound Electronics D. Mailing Address 4621 Pacific Ave Tacoma , Wa . 98408 Phone No1+72-2955 E. Electrical Contractors License # SOUNDE*140R3 F. Specialty Electricians License # ( ���+�'�� �`� C- Inspection Contract No. File No. FT_RY. 15RG=TION SzRVICzS DIVISION 9th & Columbia Bldg. C�ii-51, Olympia. WA 98504-4151 FIRE ALARM SYSTEM REPORT OF INSPECTION Date s Namp of Facili ty:�A f Occupied as• • City ,"ddre5 S' �i County: 56 Zip Telephone �I Building Designation (if more than one building) / Title �1 Inspection by: Oate of inspection: - - - - - - - - - - - - - - - - - 1. Type of Test: Monthly ❑ Quarterly ❑ Semi-Annual ❑ Annual L�4 2. Type of systev: Noncoded '� n coded ❑ Selective called ❑ Oual coded Q (as pertaining to C1apt--r 212-14 WAC) 3. Local Fire Department: r 4. Fire Qepart-ment Official Contacted: Received at Fire Department: Yes No ❑ 5. Test Rec- 6. Master Sox Reset A.,'M. - P.M. 7. Coatoents, explanation Uf unsatisfactory results, action taken, etc. o ` SF#M 222, Rev. 5/78 ORIGINAL FORM TO BE RETURNEil TO STATE FIRE 0ARSHAL. EQUIPMENT TESTED UM Y TYPE ES N TYPE OF EQUIPMENT UNITS TESTED DATE . CHECK MANUFACTURER Yes No N/A /^o n 6 8. Control Panel 9. Manual Station 10. Heat Detectors 11. Smoke Detectors ucio ie Alarm 12. Devices visual A1arm 13. Devices 14. Code Transmitters I �t Automatic Door 15 . Releases 16 . Trouble Indicators I I " 17 . Master Alarm Box I ( I I �18. Batteries Sa ` 19. Chaser - A�__L I 20. Generator �21. ventilation Control r ire par'.ment ., - I I 22. Interconnection ( 1� Central Station 2�. Tnterconnection exterior ScrinKierl 24 . Elec_ric Alarm Bell Sprinkler Water 25. Flow Switch I Qri nK ler Gate d Ye I I 126. Suoervi s i on Switch I 127. Annunciators - I 2S. Automatic Time Delay of General Alarm Minutes. None Insto ed 29. Test of alarm system on emergency power, satisfactory? Yes 0" No ❑ 30. This is to certify that this fire alarm system has been properly inspected for reliability covering the items listed in this report and is consistent with NFPA Fire Alarm Maintenance Standards. ' A_ Signature of Owner or Representative B. Signature of Fire Alarm Firm Representative C. Name of Firm Sound Electronics D. Mailing Address 4621 Paci Eic Ave . Tacoma , Wa . 98408 Phone No1►72-2955 E. Electrical Contractors License I SOUNDE';140R3 F. Specialty Electricians License Inspection Contract No. File No. FIB 15RIIT-=0N SERVICES D=SI0N 9th & Columbia Bldg. Gii-51, Olympia, WA 98504-4151 FIRE ALARM SYSTEM REPORT OF INSPECTION Date A 1,57 Nacre of Facility: Occupied as• S Address. ^,� 22 100 f7` Ci tBC [}i= ��/ Ile- County: • ►J Z i p Sl.:z cc'� Telephone -2 7 a�3 Building Designation (if more than one building) Inspection by: /f�ow►� S � Q /F� Title /ec G�,�,�,✓}u/ Oate of inspection: 3�� /Sy 1. Type of Test: Monthly ❑ Quarterly ❑ Semi-Annual ❑ Annual ❑ 2. Type of system: Noncoded ❑ Colmn coded ❑ Selective coded ❑.,1 Oual coded ❑ (as pertaining to cttap"r 212-14 WAC) 3. Local Fire Dep ar rit• 2 .Z 4. Fire Oepartment Official Contacted: /i o ' ar*,.men t. ❑ 5. Tess Received at Fire Dep Q' lyo-,,,•��,,,� r 5. Master Box Reset! ?— A.M. P.M. l 7. Czmmnts, explanation of unsatisfactory results, action taken, etc. �X G {o` ,�je C_ 4 -cam e, V' S / • SF M 222, Rev. 5/78 ORIGINAL FORK TO BE RETLRNEJ TO STATE FIRE MARSHAL. EQUIPMENT TESTED UM Y TYPE AND MANUFACTURER TYPE OF EQUIPMENT UNITS TESTED DATE YeSCMEC N/A --7377 8. Control Panel v -comae 9. Manual Station A)."i 10. Heat Detectors 11. Smoke Detectors 43 u i b a Vim 12. Devices Vi sua i AIaY-m 13. Devices- 14. Code Transmitters I �/ Automatic Door IS. Releases z--4 7.5 16. Trouble Indicators 117. Master Alarm Box 18. Batteries Q J�w 19. Charger 20. generator i21.. Ventilation Control Fire Department I �- [Z2. Interconnection Central Station v� 23. Interconnection Exterior SprinKler 24. Electric Alarm Bell orinkler Water 25. Flow Switch I prinx er Gate Valve 126. Supervision Switch 127. Annunciators 28. Automatic Time Delay of General Alarm Minutes. None Installed ®� 29. Test of alarm system on emergency parer, satisfactory? Yes No ❑ 30. This is to certify that this fire alarm system has been properly inspected for reliability covering the items listed in this report and is consistent with NFPA Fire Alarm Maintenance Standards. A. Signature of Owner or Representative B. Signature of Fire Alarm Firm Representativ C. Name of Firm Sound Electconics D. Mailing Address 4621 Pacific Ave Tacoma . Wa . 98408 Phone No./472-2955 E. Electrical Contractors License # DE*140R3 F. Specialty Electricians License # -/Zr- 'C - �' �' .ice• �%;. �V r i CA VA 5 d�7/� t IWO a,s 5 N