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Equipment Tested
Mason County Fire Marshal Inspection Contract No.
Mason County Bldg. III File No.
426 W. Cedar
P.O. Box 186
Shelton, WA 98584
FIRE ALARM SYSTEM
REPORT OF INSPECTION
�c�1�-
Name of Facility: Belfair Motel (PF725) Date: I2-I�/
Occupied as: Motel
Address: 23322 NE Highway 3
County: Mason Zip: 98584 Telephone:
Building Designation (if more than one building)
Inspection By: �^ l , ttL Title: Technician
Date of Inspection: __) L- 11 -o r y
1. Type of Test: Monthly ( Quarterly ( Semi-Annual ( ) Annual (X)
2. Type of System: Noncoded ( ) Common Coded ( ) Selective Coded ( ) Dual Coded ( )
(As pertaining to Chapter 212-14 WAC)
3. Local Fire Department: Belfair— Mason Co Fire Dist 2
4. Fire Department Official Contacted: N/A
5. Test Received At Alarm Center: ( ) Yes ( ) No
6. Master Box Reset )D , AM PM
NN
7. All Test Satisfactory y� Yes ( ) No
8. Comments explanation of uns tisfactory results cti n taken etc.
Equipment Tested
SATISFACTORY
TYPE OF EQUIPMENT #OF TEST YES NO N/A TYPE&MANAFACTURER
UNITS DATE
9. CONTROL PANEL 1 '2_I q_I� Silent Knight 5700
10.MANUAL STATION 3 `Z Silent Knight SD505-PS
11.HEAT DETECTORS X
12.SMOKE DETECTORS 1 , l� Silent Knight SD505-AHS
13.AUDIBLE DEVICES 37 `2_Iq Gentex GEC24-WR
14.VISUAL DEVICES 32 �2. +� Gentex GEC24-WR
15.CODE TRANSMITTERS X
16.AUTOMATIC DOOR RELEASES X
17.TROUBLE INDICATORS - I'� x Panel
18.MASTER ALARM BOX X
19.BATTERIES 2 ». I Werker 12V 7.5AH
20.CHARGER - 1�,I� Panel
21.GENERATOR X
22.VENTILATION CONTROL X
23.FIRE DEPT INTERCONNECTION - lg X
24.CENTRAL STATION INTERCONNECTION - Panel
25.EXT.SPRINKLER ELEC ALARM BELL X
26.SPRINKLER WATER FLOW SWITCH X
27.SPRINKLER GATE VALVE SUPER SWITCH X
28.ANNUNCIATORS X
29. Automatic time of General Alarm Minutes. None Installed ( ).
30. Test of alarm system on emergency power, satisfactory? ( Yes ( ) No
31. This is to certify that this fire alarm system has bee 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: PIONEER FIRE & SECURITY, INC.
D. Mailing Address: P O Box 597, E. Olympia, WA 98540-0597 Phone No. 360-491-8141
E. Electrical Contractors License#: PIONEFS963LC
12- -332--so - C-00
I
Equipment Tested
Mason County Fire Marshal Inspection Contract No.
Mason County Bldg. III File No.
426 W. Cedar
P.O. Box 186
Shelton, WA 98584
FIRE ALARM SYSTEM
REPORT OF INSPECTION
Date: 1-2•19 • ao 13
Name of Facility: Belfair Motel
Occupied as: Motel
Address: 23322 NE Highway 3
County: Mason Zip: 98584 Telephone:
Building Designation (if more than one building)
Inspection By: C?afQ jdfil A,5 Title: Technician
Date of Inspection: 1-2. 15 - 13
1. Type of Test: Monthly ( Quarterly ( Semi-Annual ( ) Annual (X)
2. Type of System: Noncoded( ) Common Coded ( ) Selective Coded( ) Dual Coded ( )
(As pertaining to Chapter 212-14 WAC)
3. Local Fire Department: Belfair— Mason Co Fire Dist 2
4. Fire Department Official Contacted: N/A
5. Test Received At Alarm Center: ( Yes ( ) No
6. Master Box Reset AM PM
7. All Test Satisfactory Yes ( ) No
8. Comments, explanation of unsatisfactory results, action taken, etc.
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it
Equipment Tested
SATISFACTORY
TYPE OF EQUIPMENT #OF TEST YES
1 a ,1 NO N/A TYPE&MANAFACTURER
UNITS DATE
9. CONTROL PANEL 1 I a I l�j Silent Knight 5700
10.MANUAL STATION 3 (2.1 Silent Knight SD505-PS
11.HEAT DETECTORS X
12.SMOKE DETECTORS 1 Silent Knight SD505-AHS
13.AUDIBLE DEVICES 37 12 1 Gentex GEC24-WR
14.VISUAL DEVICES 32 U -19
Gentex GEC24-WR
15.CODE TRANSMITTERS X
16.AUTOMATIC DOOR RELEASES X
17.TROUBLE INDICATORS - I2 tq Panel
18.MASTER ALARM BOX X
19.BATTERIES 2 ��.�Cl k Werker 12V 7.5AH
20.CHARGER - 2,(� Panel
21.GENERATOR X
22.VENTILATION CONTROL X
23.FIRE DEPT INTERCONNECTION - X
24.CENTRAL STATION INTERCONNECTION - I c) ,� Panel
25.EXT.SPRINKLER ELEC ALARM BELL X
26.SPRINKLER WATER FLOW SWITCH X
27.SPRINKLER GATE VALVE SUPER SWITCH X
28.ANNUNCIATORS X
29. Automatic time of General Alarm Nam— Minutes. None Installed ( ).
30. Test of alarm system on emergency power, satisfactory? (� Yes ( ) No
31. This is to certify that this fire alarm system has bee 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; "
� 9 //
B. Signature of Fire Alarm Firm Representative: vl�lil'LS
C. Name of Firm: PIONEER FIRE & SECURITY INC.
D. Mailing Address: P O Box 597 E. Olympia, WA 98540-0597 Phone No. 360-491-8141
E. Electrical Contractors License#: PIONEFS963LC
50 OC611
Equipment Tested
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Mason County Fire Marshal Inspection Contract No.
Mason County Bldg. III File No.
426 W. Cedar
P.O. Box 186
Shelton, WA 98584
FIRE ALARM SYSTEM
REPORT OF INSPECTION
Name of Facility: Belfair Motel Date: 7.31, Z.OfZ
Occupied as: Motel
Address: 23322 NE Highway 3
County: Mason Zip: 98584 Telephone:
Building Designation (if more than one building)
Inspection By: QSka- Title: Technician
Date of Inspection: 7 31. i-
1. Type of Test: Monthly ( Quarterly ( Semi-Annual ( ) Annual (X)
2. Type of System: Noncoded( ) Common Coded ( ) Selective Coded( ) Dual Coded ( )
(As pertaining to Chapter 212-14 WAC)
3. Local Fire Department: Belfair— Mason Co Fire Dist 2
4. Fire Department Official Contacted: N/A
5. Test Received At Alarm Center: % Yes ( ) No
6. Master Box Reset AM PM
7. All Test Satisfactory Yes ( ) No
8. Comments, explanation of unsatisfactory results, action taken, etc.
1
Equipment Tested
SATISFACTORY
TYPE OF EQUIPMENT #OF TEST YES NO N/A TYPE&MANAFACTURER
UNITS DATE
9. CONTROL PANEL 1 1 ? ✓i" Silent Knight 5700
10.MANUAL STATION 3 73j Silent Knight SD505-PS
11.HEAT DETECTORS X
12.SMOKE DETECTORS 1 j 31 Silent Knight SD505-AHS
13.AUDIBLE DEVICES 37 731 Gentex GEC24-WR
✓
14.VISUAL DEVICES 32 .7 3 / Gentex GEC24-WR
15.CODE TRANSMITTERS X
16.AUTOMATIC DOOR RELEASES X
17.TROUBLE INDICATORS - Panel
13
18.MASTER ALARM BOX X
19.BATTERIES 2 Werker 12V 7.5AH
�31 '
20.CHARGER - 731 / Panel
21.GENERATOR ✓ X
22.VENTILATION CONTROL X
23.FIRE DEPT INTERCONNECTION - X
24.CENTRAL STATION INTERCONNECTION - 3`.+� Panel
25.EXT.SPRINKLER ELEC ALARM BELL X
26.SPRINKLER WATER FLOW SWITCH X
27.SPRINKLER GATE VALVE SUPER SWITCH X
28.ANNUNCIATORS X
29. Automatic time of General Alarm Minutes. None Installed fv�'
30. Test of alarm system on emergency power, satisfactory? ( ) Yes ( ) No
31. This is to certify that this fire alarm system has bee 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; yy ff /
B. Signature of Fire Alarm Firm Represent at' e /I411 i,
C. Name of Firm: PIONEER FIRE & SECURITY, INC.
D. Mailing Address: P 0 Box 597, E. Olympia, WA 98540-0597 Phone No. 360-491-8141
E. Electrical Contractors License#: PIONEFS963LC
I
Equipment Tested
Mason County Fire Marshal Inspection Contract No.
Mason County Bldg. III File No.
426 W. Cedar
P.O. Box 186
Shelton, WA 98584 --�a- 5a - 0601
REPORT OF.INSPECTION
Date:
Name of Facility: Belfair Motel
Occupied as: Motel
Address: 23322 NE Highway 3
County: Mason Zip: 98584 Telephone:
Building Designation (if more than one building) '
Inspection By: 14SL r Title: Technician
Date of Inspection: 3-1q://
1. Type of Test: Monthly ( Quarterly ( ) Semi-Annual ( ) Annual (X)
2. Type of System: Noncoded( ) Common Coded ( ) Selective Coded( ) Dual Coded ( )
(As pertaining to Chapter 212-14 WAC)
3. Local Fire Department: Belfair-'Mason Co Fire Dist 2
4. Fire Department Official Contacted: N/A
5. Test Received At Alarm Center: (�j Yes ( ) No
6. Master Box Reset AM PM
7. All Test Satisfactory (Q,) Yes ( ) No
8. Comments, explanation of unsatisfactory results, action taken, etc.
Equipment Tested
SATISFACTORY
TYPE OF EQUIPMENT #OF TEST YES NO N/A TYPE&MANAFACTURER
UNITS DATE
9. CONTROL PANEL 1 I Ig-11 Silent Knight 5700
10.MANUAL STATION 3 Silent Knight
11.HEAT DETECTORS ,J
12.SMOKE DETECTORS 1 -7 / Silent Knight� �_
13.AUDIBLE DEVICES 37 7 1H v Gentex.
G�24-w K
14.VISUAL DEVICES 32 Gentex
7•w &6c,2y w�
15.CODE TRANSMITTERS X
16.AUTOMATIC DOOR RELEASES
17.TROUBLE INDICATORS - I J Panel
18.MASTER ALARM BOX x
19.BATTERIES 2 IN
Werker �Zd 7570L
20.CHARGER - , ly Panel
21.GENERATOR
22.VENTILATION CONTROL
23.FIRE DEPT INTERCONNECTION
24.CENTRAL STATION INTERCONNECTION i -� l4 Panel
25.EXT.SPRINKLER ELEC ALARM BELL X
26.SPRINKLER WATER FLOW SWITCH X
27.SPRINKLER GATE VALVE SUPER SWITCH X
28.ANNUNCIATORS X•
29. Automatic time of General Alarm Minutes. None Installed
30. Test of alarm system on emergency power, satisfactory? %` Yes ( ) No
31. This is to certify that this fire alarm system has bee 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 Representat' e:
C. Name of Firm: PIONEER FIRE & S CURITY, INC.
D. Mailing Address: P O Box 597, E. Olympia, WA 98540-0597 Phone No. 360-491-8141
E. Electrical Contractors License#: PIONEFS963LC
Equipment Tested
Mason County Fire rs I Inspection Contract No.
Mason County Bldg. III File No.
C
426 W. Cedar
P.O. Box 186 RECEIVEDShelton, WA 98584 R
FIRE ALARM SYSTEM JUN Z 9 2010
REPORT OF INSPECTION
426 W. CEDAR ST.
Date:
Name of Facility: Belfair Motel
Occupied as: Motel
Address: 23322 NE Highway 3
County: Mason Zip: 98584_Telephone:
Building Designation (if more than one building)
Inspection By: /4�14 e,.,- Title: Technician
Date of Inspection: &'dill- Z010
1. Type of Test: Monthly ( Quarterly ( Semi-Annual ( ) Annual (X)
2. Type of System: Noncoded( ) Common Coded ( ) Selective Coded( ) Dual Coded ( )
(As pertaining to Chapter 212-14 WAC)
3. Local Fire Department: Belfair— Mason Co Fire Dist 2
4. Fire Department Official Contacted: N/A
5. Test Received At Alarm Center: M Yes ( ) No
6. Master Box Reset C9n AM PM
7. All Test Satisfactory ( ) Yes ( ) No
8. Comments, explanation of unsatisfactory results, action taken, etc.
Al! 4 sL i4swej
r
Equipment Tested
SATISFACTORY
TYPE OF EQUIPMENT #OF TEST YES NO N/A TYPE,1-, MANAFACTURER
UNITS DATE
9. CONTROL PANEL 1 ! Silent Knight 5700
10.MANUAL STATION 3 �P/_ 1� Silent Knight
11.HEAT DETECTORS �P
12.SMOKE DETECTORS 1 _j Silent Knight
Y
13.AUDIBLE DEVICES 37 f Gentex
14.VISUAL DEVICES 32 Gentex
15.CODE TRANSMITTERS
16.AUTOMATIC DOOR RELEASES
17.TROUBLE INDICATORS - / , Panel
18.MASTER ALARM BOX lD
19.BATTERIES 2 /,/ Werker
20.CHARGER - Panel
21.GENERATOR
22.VENTILATION CONTROL
23.FIRE DEPT INTERCONNECTION - -1 Panel
24.CENTRAL STATION INTERCONNECTION - }` Panel
25.EXT.SPRINKLER ELEC ALARM BELL X
26.SPRINKLER WATER FLOW SWITCH X
27.SPRINKLER GATE VALVE SUPER SWITCH X
28.ANNUNCIATORS
29. Automatic time of General Alarm Minutes. None Installed .
30. Test of alarm system on emergency power, satisfGcto;? �pu,6 Yes ( ) No
31. This is to certify that this fire alarm system has bee 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; G
B. Signature of Fire Alarm Firm Representative: �un
C. Name of Firm: PIONEER FIRE & SECURITY. INC.
D. Mailing Address: P O Box 597 E. Olympia, WA 98540-0597 Phone No. 360-491-8141
E. Electrical Contractors License #: PIONEFS963LC