Loading...
HomeMy WebLinkAboutPP - 2600 SOUTHCENTER MALL - UNKNOWN - PERMITS AND PLANS2600 SOUTHCENTER MALL ASSOCIATED PERMITS 17-F-083 D16-0335 17-5-077 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit DIG- ca3 -F-oY3 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 206-575-4407 Project: Project:, Tat` Type of Inspection: ��� 1 Fes- All., J Address: a6v0 SL ,q j l Suite #: FC - /,r Contact Person. Special Instructions: Phone No.: ?proved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: I1' ,AI' Pfre_ 4461. iha,i --tic-30t.3 Fire Alarm: L( Sy f k,,170-1- — Ok ,powi.14 1-yp- 4 LiA 44 Monitor: 0 Pre -Fire: p1..._ . - ok Occupancy Type: A --)- P.77 fl Needs Shift Inspection: `f Sprinklers: I1' Date: Fire Alarm: L( Hood & Duct: `r Monitor: 6.4,4,..trti L, Pre -Fire: Permits: Occupancy Type: A --)- Inspector: J-1 ( Date: -.1 --) Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 3/14/14 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit 2th PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 206-575-4407 Project: Cu Thifr Sprinklers: k-ir Type Inds rrk`67R-- Address:V Al ! / L /G 1"? Conta"ctTP n: Suite # : Special Instructions: ` Monitor: C� "11 Phone No.: ,Approved per applicable codes. Corrections required prior to approval. COMMENTS: coveNa— Apetzov Needs Shift Inspection: Date: 574g/ Sprinklers: k-ir Fire Alarm f C�l Hood & Duct: YE' ` Monitor: C� "11 Pre -Fire: Permits: Occupancy Type: 4- 2 ' • i Inspector: 6, c4- Date: 574g/ Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 3/14/14 T.F.D. Form F.P. 113 TUKWILA FIRE MARSHAL'S OFFICE Phone: 206-575-4407 • Fax: 206-575-4439 • Email: FireMarshal@tukwilawa.gov OttiL.444 CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will be assessed. Contractor is responsible for supplying manpower for Final Acceptance Test with two-way communications. Date 5 4 /%0/ 7 / Permit # Property Address 2,00 ,SOACP�Yb ft'/4!iL Suite # City TUKWILA /� / Zip Code Name of Facility /C✓a y -7 j e(k4 z' Occupied as .5/ ', of Owner or Representative �d4of Phone # Installing Company Installing Contractor's Address /91.3/ sC A-I/E • S,rS- City 11yPhone # ogeed -g - 58'32 Installer's Name (PRINT) License and/or Certificate ,f1-/ 771'IOZ/ H7 General Contractor /Oft/ S i.✓ pr! Electrical Contractor FACP Equipment Manufacturer _ _____.e_f s Model # XLS This system has been in�st lied, pre -tested and o erates in accordance with the standards listed below and was inspected by �/ !t• �� On (date) 59/20/ 7 and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter 1L 7and/or IFC SEC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions Manufacturer's Instructions Other (specify) Tukwila City Ordinance Numbers 2050, 2051 UL Central Station Monitor 75770 1/0 System is monitored by ArldeitAl S SIGNED — l Date .s/8/2/i 7 System Firmware: Installed version ,:a Checksum Date Initial program Installation Date Revisions and Reasons Programmed by EQUIPMENT INSTALLED AND TESTED: Control Panel _ of _ Make/Model Manual Station of Make/Model Smoke. Detectors of Make/Model Heat Detectors _ of _ Make/Model Duct Detectors _ of _ Make/Model A/V Devices of Make/Model Audio Devices _ of _ Make/Model Visual Devices T of 11 Make/Model fie- z u1 " Auto Door Release _ of _ Make/Model Trouble Indictors of Make/Model Batteries Readings Battery Full Load Charge Generator _ of _ Make/Model HVAC Controls _ of _ Make/Model Fire Alarm Dialer of Make/Model Monitored by Annunciator of Make/Model Sprinkler System. (Fire Alarm connections only) Water Flow Sw. _ of _ Make/Model Valve Tamper Sw. _ of _ Make/Model PIV _ of Make/Model Elec. Alarm Bell _ of _ Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audi visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes _0,,L•1•002_ � .wr' -T,� est-oi;,i System on emergency power, satisfactory? Yes _ No _ Wrest Witnessed by Title Date Comments: Fire Alarm Certificate.doc Revised: 6/17/14 TFD FP Form #110 2600 SOUTHCENTER MALL ASSOCIATED PERMITS 04-F-173 07-S-231 14-F-089 04-F-074 07-S-015 14-F-035 14-S-080 04-S-120 13-F-170 14-S-037 04-S-036 13-F-008 13-S-172 01-S-116 12-F-168 12-S-260 01-S-097 12-F-213 12-S-209 00-S-314 11-F-244 12-S-118 00-S-298 10-F-243 11-S-235 99-S-272 09-F-194 10-S-223 98-S-254 09-F-102 09-S-164 95-S-037 09-F-021 08-S-540 08-H-242 08-F-320 08-S-399 D13-0384 08-F-298 08-S-301 D13-0379 08-F-250 08-S-288 D13-308 08-F-239 08-S-239 D13-190 08-F-231 08-S-228 D12-330 08-F-214 08-S-165 D12-251 08-F-202 08-S-163 D12-121 08-F-181 08-S-161 D11-306 08-F-175 08-S-134 D10-254 08-F-169 08-S-133 D10-245 08-F-167 08-S-098 D10-223 08-F-104 08-S-096 D09-211 07-F-032 08-S-066 D08-499 D08-247 D04-007 M07-292 D08-155 D02-006 M07-271 D08-153 D01-186 M07-225 D08-100 D00-241 M07-211 D08-046 D99-0445 M07-204 D08-016 D99-0306 M07-187 D07-478 D99-0201 M06-248 D07-484 B93-0439 M04-112 D07-454 M20-225 M04-104 D07-396 M14-0089 M01-160 D07-381 M13-098 M00-159 D07-375 M12-193 M99-0119 D07-353 M10-133 M93-0184 D07-326 M09-004 888189 D06-420 M08-130 6343 D04-206 M08-090 6078 D04-013 M08-053 5390 D04-012 M08-027 2858 D04-010 M08-015 0459-M City of Tukwila APR 1 5 2 Steven M. Mullet, Mayor Fire Department Thomas P. Keefe, Fire Chief TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Project Name f I' ► dc) Address -7 Z CT Som j-4 G e ler MO/ !/ D0y_ a rz Permit No . WY"' /-' OR 3 r) 4/ —A-- . 7 7% -ova Retain current inspection schedule (/ Needs shift inspection Suite # V Approved without correction notice Approved with correction notice issued Sprinklers: tri"5 Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: Authorized Signature FINALAPP.FRM c/o Date Y Rev. 2/19/98 T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206-575-4404 • Fax: 206-575-4439 i INSPECTION RECORD Retain a copy with permit p INSPECTION NUMBER PERMIT PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT /a- s- ao� 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: A-€ rosoles Type of Inspection: sP c6o-e--- Address: 67b Suite #: s.c. mkt c Contact Person: Special Instructions: Permits: Phone No.: Approved per applicable codes. riCorrections required prior to approval. COMMENTS: `Ta Coyer Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: A Inspector: j s ---d--- Date: (Mil Z__ Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 444 Andover Park East, Tukwila; .WA 98.188 - Phone 20x-575-4407= Fax 206-=575-4439 E-mail: tukfdpry@ei.tukwila.iwa,us CONTRACTORS MATERIAL AND TEST CERTIFICATE Fla ALARM AND. FIRE DETECTION: swop S Fire alarm System is ready for Fire Department acceptance testing. Failure: oftesf.will result in termination of the testing and additional fees .will beassessed. Contractor is responsible for supplying manpower for Final Acceptance Test with two-way enhith n cations. Date /0/9// Z 070 Perin it # .12 -f -o213 Property Address .10_ 0 • Ala!' fy-k.L va N Suite # 22 j City _TUKWILA Zip Code Name of Facility SO ut f kCe r ,r" /GHQ it Occupied as Ave fl 5d! ? Owner or Representative - Phone # Installing Company &Cie nAZA < o. Installing Contractor' Address City S eal- 4 Phone # 8—(ire;-- Installer's Name (PRINT) R f L — ,Q License and/or Certificate `©u,t'_ General Contractor Electrical Contractor 5 c �Gl C FACP Equipment Manufacturer . Model # XL 10 This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by R , c AC. O wQ. On (date) /WS /r7 and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter 12 4 5 6 7 and/or IFC SEC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions Manufacturer's Instructions Other (specify) 7( Tukwila City Ordinance Numbers 2050, 2051 , f UL Central Station Monitor 1' System is monitored by !J ] A _5 SIGNED 11-- 1c Date /t5/9/ Z.. System Firmware: Installed version Checksum Date Initial program Installation A _ Date Revisions and Reasons AL, Programmed by \' EQUIPMENT INSTALLED AND TESTED: Control Panel _ of . Make/MOM • „ Manual Station of Make/Model Smoke Detectors of .__ Make/Medal _ Heat Detectors of _ Make/Model _ Duct Detectors 4 oft_ Make/Model ;kieln,r 4(15. A n -`31' . A/V Devices 11 of 4-1 Make/Mbdel 'G/►2etr s HC- .C1,0 Audio Devices of Make/Model . . Visual Devices 2–of .2- Make/Model 51 Cr"€ -w 5 4 - Auto Door Release — of — Make/Model Trouble Indictors — of _ Make/Model Batteries Readings Battery Full Load Generator of Make/Model HVAC Controls _ of _ Make/Model Fire Alarm Dialer of Make/Model Monitored by • Charge Annunciator of Make/Model 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. _ of _ Make/Model Valve Tamper Sw. _ of Make/Model PIV _ of _ Make/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do yo meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes No Test of alarm System on emergency power, satisfactory? Yes _ No _ Test Witnessed by Title Date Comments: eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form ill 10 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: et(SOJAS Type of Inspection: S �r so✓��-- `Pc /--e_ �( KJvt Address: ` c� (I S. C Suite #: l Contact Person: Pre -Fire: Special Instructions: Phone No.: EA0.kpproved per applicable codes. Corrections required prior to approval. COMMENTS: cituAt-- ok Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ) �w__ s-.=)___ Date: /0//o/% Z firs.: 1 $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 a INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit ©a fr'a- ate) PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: A -Cr o Col -e.5 Type of In pection: SP / ,F -i4 Address: 6? 0 ( _ Suite #: Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: / . A b) I p4- pipatN s ,',J ,a-i/vC_ e a.. i41,00 -e, 1,1 L {-(;ki44-47 rv-4 w. s r J.s y lg"e--1. '5P ei-c:A6" C() ro 5k,c ( /—S(Ace6e5 A & N plc -e.._ . (DI SO Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: G'^ VitiA,S- Date: lc,/t/,2- Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 I INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit /)- 5- X03 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 62 t� 2� R Type of Inspection: 3 e co Li .i -- Address: 6 go S L-- Address: Suite #: 44-L t-- Contact Person: `S„q,- Special Instructions: Occupancy Type: Phone No.: Approved per applicable codes. XCorrections required prior to approval. COMMENTS: I,. Ah S -A-,s lecsts ;Ai -C,-, „i (- �* r,2,4/2_ b, IQ cok-- Co v - j A -2-e v- c -Cal. C Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: _ Occupancy Type: (.c - i r ;,<J sr c J-4 d7 0 1.... iv Co ti itr o +I -t! y4,Le.ik--S Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: _ Occupancy Type: Inspector: /f .- ,�_,,,1 Sa- Date: / o/2 Z / / c Hrs.: 1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 9 -- INSPECTION NUMBER INSPECTION RECORD Retain a copy with pe 10 -S -aa -3 pia - PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project:Type dei Sprinklers: Fire Alarm: of Inspection: �P cam Address: 6.00 Suite #: ' _c__, t -L— Contact Person: a Special Instructions: Phone No.: (>4pproved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 6 ,s--� Date: /v/asl76) Hrs.: I 0./(li. $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION BUREAU • I 444 Andover Park East, Tukwila, WA 98188 - Phone206-5154407 - Fax 206-5754439 E-mail: tukfdprv@a ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will be assessed. Contractor is responsible for supplying man ower for Final Acceptance Test with two-way communications. Date 1/ 7(1 /O Permit # /i) -11 X(3 Property Address Suite # (0 0'_. City� TUKWILA 4-7-7ii, ip Code Name of Facility S ' U � ��e/t / 7 Occupied as 17 Owner or Representative �s / r d.>>� / Phone # Installing Company (it)Gh^I • e.0 (l Lr -J14 Installing .Contract r s' Address /76% � / 51Lk S , City SoAL/ a Phone# ,Z6- l�� - a S`' Installer's Name (PRINT), \ ��rt-t S l -Pr License and/or Certificate Wirt -S9 i Q F Swiii General Contractor earhtr gtake Electrical Contractor FACP Equipment Manufacturer_ S en teitS Model # k/Z. This system has been installed, pre-teste/nd operates in accordance with the standards listed below and' Q - was inspected by C cams' On (date) //7( and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter 12 4 5 6 7 and/or IFCSEC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions \( 'Manufacturer's Instructions • Other (specify) Tukwila City Ordinance Num ars 2050, 2051 UL Central S : 'on onitor / • tCs System is monitored by SIGNED J. Date // System Fi ware: Installed version Initial program Installation Revisions and Reasons Checksum Date ///f( 6 Date Programmed by EQUIPMENT INSTALLED AND TESTED: Control Panel (• of Manual Station of Smoke Detectors of Heat Detectors of Duct Detectors A/V Devices of_61 Audio Devices of Visual Devices / of Auto Door Release of Trouble Indictors of Batteries Readings Battery 9,-1, Ci Make/Model .Screw e/l. Make/Model Make/Model .Make/Model Make/Model F Make/Model 5tfn S' Mdke/Model Make/Model dtvt-t eAS Make/Model - Make/Model Full Load a (0,-3 Charge a7, 7 Generator _ of _ Make/Model HVAC Controls _ of_ Make/Model Fire Alarm Dialer _ of_ Make/Model Monitored by Annunciator of Make/Model • 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. _ of Valve Tamper Sw. _ of PIV _ of Elec. Alarm Bell of Make/Model Make/Model Malce/Model Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes No Test of alarm System on emergency power, satisfactory? Yes No Test Witnessed by Title Date . Comments: eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #110 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: w y 8 Type of Inspection: --,-0„4-L /c14/54. Address:v ��v Suite #: _C, l4LL_ Contact Person: Special Instructions: Pre -Fire: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: y Sprinklers: i r> — 0 J( Hood & Duct: pJ Monitor: G gr,,rd, „Alj Pre -Fire: fAiL ---- G Occupancy Type: -/L — bg-_ --'‘ r -e_ ci d-, (AL " OK Needs Shift Inspection: y Sprinklers: i //// 2 //o Fire Alarm: yes Hood & Duct: pJ Monitor: G gr,,rd, „Alj Pre -Fire: Permits: pJ ,t) -e„ Occupancy Type: /v\ Inspector: k S-,)____ Date: //// 2 //o Firs.: r 7 r $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.E.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Akof) ti.,) g Type of Inspection: 41:1thyl-c. Address: ` go Suite #: �o s.c.... mod -t— Contact Person: Special Instructions: Permits: Phone No.: Approved per applicable codes. corrections required prior to approval. COMMENTS: s- I Cla sct-e s woo kms-- SQJAL Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: G r)".y..V. Ta- Date: /tie/ lc Hrs.: ( $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F..D. Form F.P. 113 2 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit D I 0 -- 2'IS— PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: A ads h p Type of Inspection: �: F /`G , .zii, 1 Address: 6gc s,c, 414 LL Suite #: Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: (S)na 5s 4 ! s4r)01 Fitz-- ,e4f - --t 1' - /Cie Cweiny/e".a( Needs Shift Inspection: Sprinklers:/ 15 , Fire Alarm: Hood & Duct: / Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: / 15 , Date: > J/G f ii Hrs.: / X$80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from he City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 CROWN_FIRE-PROTECT ION 425 481 8695 • FAX TRANSMITTAL CROWN FIRE PROTECTION INC. Ent Compan MEE 6.7.04 Fire Prevention Bureau Tukwila Fire Department Demo Permit Number of Pages (Inc 0 Urgent tiding Cover RI For Review 1 Fax No. ij ff P. 01 206.575.4439 Vc'k S \C) YYNck1) ❑ Plea;.! Comment 0 Please Reply From Jessica Robinson Comments PH:425.481.7669 FX:425.48 J .8695 We need a demo permit to remove 8 sprinki,..r drops for the new walls at the Ann Taylor Loft project at the Southcenter Mall. The building permit dumber is D04-010. The mall does not know what the address for this project is going to be at this tin le, IUKWILA FIRE DEPARIivwt141 Please call: 575-4407 and give this job 140. O and exact address for shut. down or restoration approval. 0/V /7 P.O. SOX 12113 MILL CREEK, WA 98082 PI: 425.481.7669 FX:425. 481.8695 Ciz of Tukwila LE AUG 1 3 2004 Steven M. Mullet, Mayor Fire Department Thomas P. Keefe, Fire Chief TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Project Name / ivw /4.71,p/2 LF - Address 7/ 9 .5A /114 1/ Permit No.,'o— O Y v kn6)7" /Cj Retain current inspection schedule KNeeds shift inspection Suite # VApproved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: f Halon: Monitor: Pre -Fire: Permits: A/ 6-77--- Authorize8-Signat re Date FINALAPP.FRM Rev. 2/19/98 T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206-575-4404 • Fax: 206-575-4439 /2_ INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit MAY 1 2 2008 DO -- 3? -s X8`5' (39 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: tv\t — ,O VA -44- Type of Inspection: it1,14,14.L..0-A---- Address: (SSI 5 . C. M Suite #: Contact Person: i -0 Special Instructions: Phone No.: Approved per applicable codes. COMMENTS: Corrections required prior to approval. 0 I& - 'TU CA) v9 iikvtoi2,0 — 0 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 4.(Ajoil,„,, %5 ►Z Date: 5, 7 , n$ Hrs.: Z $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION BUREAU . 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E mail: tukfdpr'•v@ci.tukwila_wa.us CONTRACTORS MATERIAL A.ND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarzl System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testin and additional fees will'b.e assessed. Contractor is responsible°for • supplying manpower for Final Acceptance Test with two-way communications. Date =7P -VQ • Pa t# e9J - Property Address . l SOo T H e.E rE Ie M Atm Suite # • CityTukwila °�"Code I�S l g Name of Facility ( e ST 1 EE CD Occupied ashe...4-1-2s Owner or Representative Phone # j Installing Company GURezD t fa � S' ec � cL.t -"4' S'ys s Installing Contractor's Address I -7 4 3 1 'YT AU E. S. City �JeA'Cr L Phone # 2 O 6- fE, Z Z. - (fl S 4-5 Installer's Name (PRINT) ( t- p C t ,'V '(Z Pt TL- I r License and/or Certificate -R. PP3Og ,hl j -i General Contractor _ �6Ci . Electrical Contractor \ \NA`fe FACP Equipment Manufacturer S." -,'e dvt e_ tJ S Model # jC LS This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by __LH ik-t-L 1 (= r . On (date) .and includes the devices listed on back. Circle all that apply: X • NEPA. 72, Chapter 5 Q0)and/or IFC SEC 907 . NFPA 70, National Electrical Code, Article 760 Manufacturer' sInstructions X Manufacturer's Instructions . Other (specify) _ Tukwila City Ordinance Numbers 2050, 2051. UL Central Station Monitor • System is monitored. by SIGNED Date System Fitinware: Installed version . Checksum D ate EQUIPMENT INSTALLED AND TESTED: Control Panel Manual Station Smoke Detectors Heat Detectors Duct Detectors. A/V Devices Audio Devices Visual Devices Auto Door Release Trouble Indictors Batteries • Readings Battery of I• of of _ of of ofb of `Z of Z of of Make/Model 5.1 e rvt e (n S Make/Model. Generator of HVAC Controls 4 of 1_ Fire Alarm Dialer of . L S Make/Model S (e vie a s (-WP-- 1 Make/Model Make/Model S i e (vt, e, as AD2-f Make/Model S I Men Make/Model (....et al. WALL 7ET--MC-C).3 oe lv Make/Model 5 ( e yvt Make/Model Make/Model Pull Load . 2 R- •M C-cu3etd. Make/Model Make/Model Make/Model Charge Sl. e..Mex\ 5 TR ti - R Monitored by _k>JEST E EL D (jC- Pt1 L PA t3 E Annunciator of Make/Model D Sprinkler System. (Fire Alarm connections only) Water Flow Sw, Valve Tamper Sw. PP/ Elec. Alarm_ Bell of of of of Make/Model Make/Model. Make/Model Make/Model Automatic time Delay of Water Plow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? . Yes X No Test of alarm System on emergency power, satisfactory? Yes No Test Witnessed by Title Comments: Date 2 otawCwA INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit POSTE- - S- /3q PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: � w MAto ` " ' P Sprinklers: Fire Alarm: Type atcre--S5 of Inspection: / 14.1. 1 [' /14.% (1) Address: 65-7 Suite #: S c. L Contact Person: Special Instructions: Phone No.: [LApproved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: d� 5-7(/ Date: 71/b/6.5 Hrs.: / $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit p:7- 37 O - — goa. iktoi - V PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: pi 6472,0 ` � Fire Alarm: Hood & Duct: Type of Inspkctiho: $: ,c Address: f:,,—) Suite #: s.,c . ri -� Contact Person: Special Instructions: Phone No.: proved per applicable codes. Corrections required prior to approval. COMMENTS: CA — OK ix( e Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ( 5"1 Date: -7/ gy(oi Hrs.: 1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION RECORD Retain a copy with permit � a INSPECTION NUMBER � `'�; CITY OF TUKWILA FIRE DEPARTMENT b0-7 _ 3 >5. -- PERMIT NUMBERS 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: PM Y Fire Alarm: Y Type of Inspection: . `\re_ -c-, 04 L kJ Monitor:' ikr) Address: 65 s . L , Suite #: "I+ L, Contact Person: 1h c ('l 5,541 Special Instructions: Aiol0e_ Ph n ?o-2, - (q (1- ? 3 Approved per applicable codes. Corrections required prior to approval. COMMENTS: fe_sS 1,''q k( - k V -e C -L Needs Shift Inspection: j-' Sprinklers: Y Fire Alarm: Y Hood & Duct: kJ Monitor:' ikr) Pre -Fire: (U) Permits: /tJ Occupancy Type: ('l Inspector: �i y Date: %�/Kp6 Hrs.: I 4`n the City of Tukwila Finance Department.. Call to schedule a reinspection. $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with -permit 0(\) b3 - )oo -461- PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Oh, -1-42, r}o' €. Sprinklers: Fire Alarm: Type of Inspection: "` ,, " . i Pre -Fire: Address: 'S-6 Suite #: 5". (. � 61-(___ Con C_ tact P'rson; , ., i> /,%1,/o Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: i/612 /1-nr k cm) r4L "ht`` e p 1 i- citiJ e-- /14- 42& *C) ecreG)5 PA41% Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: �,1,-1,3—/$7 Date: G/a-- va g Hrs.: ( $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit FoS1r� 6-5- IL( Vv - /00 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project:Type ` e Fire Alarm: of Inspection: Monitor: Pre -Fire: Address: 6 5.c . r4 aLe___ Contact Person: Suite #: MAP -6# ii.) Special Instructions: Phone No.: goJ - s70 .� 4 6 �7 gl,Approved per applicable codes. Corrections required prior to approval. COMMENTS: 5r .fluP(i__ Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 4 - Date:G,7 /G, Hrs.: i$80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from e the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER. INSPECTION RECORD Retain a copy with permit MAY 2 p 2008 .>b' - loo Os -S — /to/ PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Wyfity x /boc, nose,„,--- Type of Inspection: .e llf-iivFlL'L Address: b�G, a , e, im Suite #: ConXct Person: I, (%y7;-/9 , 14 srfi.7 r3 Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: S7 -'r ' 21$ @, 140 I i'- Z IS (•' %�� /syil�Lo d/L/-IV Go✓kri Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: L j,/c . Date: 5M4g Hrs.: z a $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 1 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit MAY 16 2008 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Li h,1--61-1.0x5.4)"a: 1'v\mie Type of Inspe ion: Address: t,5-(0, S- C . rz\okl 1i Suite #: ContactPerwn: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: 04pcii Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 5---1 y Date: Of 2, wg Hrs.: 1-1($80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit (OE) PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: ar4_42_ flDtz.e_ 61A-cx ,i ke,t' Type of Inspection: 4(-) /14 Jtrj Address: 1,4414_,L Pre -Fire: Contact Person: /1/l , % ��� Suite #: Special Instructions: Phone No.: $'15I - x"70- % proved per applicable codes. Corrections required prior to approval. COMMENTS: ec-55 'qk I;(v) Ott Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 457 V Date: 7/ c y/r% Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit / j /ci r 1 g -loo PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Pro]'ect: 1A)10 -g, t /+7au3- rs I,t k 4-1414- Type of Inspection: Hood & Duct: C. C, Suite #: ` Contact Person: w1A42-0I rt.) Occupancy Type: Special Instructions: Phone No.: 'ts 1- Y70- 1.16 -7 proved per applicable codes. Corrections required prior to approval. COMMENTS: /Tv ore_ d Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: » S' I y Date: -7/ / , kg Hrs.: 1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T. F.ID. Form F.P. 113 TUKWILA F ?REV -WI -ION BA J 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alauu System is ready for Fire Department acceptance testing. Failure of test will result in teuuination of the testing and additional fees will be assessed. Contractor is resp onsi l:e'for supplying manpower for Final Acceptance Test with two-way communications. • Date • %/ Property Address. City Tukwila Name of Facility Occupied. as Permit# a29 -r- 239 - SOUTH •. M ACL Suite # Zip Code 9,15 i z g � ; F 1 E. C -D . Mi A t_L Owner or Representative r v Phone # 'r-46 ( d 7 o Installing Company r;uAtzD i A Sec �Y3 4-e wt S Installing Contractor's Address 1'7 4 3 1 A . 5; City c5eATT't:E Installer's Name (PRINT) License and/or Certificate General Contracto Electrical Contractor Phone # Z U 6- -Cc, 2 Z. - (o S +'5. - Kot+ -i s 1 ftTC FACP Equipment Manufacturer 5 e S Model # 'jC L S This system has been installed, pre -tested and operates in'accordance with the standards listed below and was inspected by I HOit4 S t -t-L �_ On (date) and includes the devices listed on back. Circle all that apply: NEPA 72, Chapter g)5 and/or I C SEC 907 • NFPA 70, National Electrical Code, Article 760 Manufacturer's.Instructions X Manufacturer's Instructions Other (specify) _ Tukwila City Ordinance Numbers 2050, 2051. UL Central Station Monitor System is monitored by SIGNED Date System Firmware: Installed version _. -� Checksum Date EQUIPMENT INSTALLED AND TESTED: Control Panel of 1 Manual Station of Smoke Detectors of Heat Detectors of Duct Detectors. j of 1 AN Devices a of a Audio Devices of Visual Devices 2 of 2 - Auto Auto Door Release of Trouble Indictors • of Batteries • Readings B attery Make/Model i t? rvi e tr1 S Make/Model L S Make/Model Si € 04e n s N V P-- 1 1 • Make/Model Make/Model Si ervterns A D2 - P Make/Model 5 t e. i e n S 5 Cr- MC. - e W Make/Model Make/Model j 1 E wI �t1 i 2 tZ - • M G - C. uJCet i 1 `r j) Ota Make/Model Make/Model Full Load Charge Generator of Make/Model HVAC Controls j of 4_ Make/Mo.del eiMell s 1-''R 1 - Fire Alarm Dialer _ of — . Make/Model Monitored by 1€S -T Ft ELD (NLS. PAL)E L Annunciator of Make/Model ❑ Sprinkler System. (Fire Alai in connections only) Water Flow Sw. Valve Tamper Sw. PIV Elec. Alauui Bell of of of of Make/Model Make/Model Make/Model Make/Model. Automatic time Delay of Water Plow Alatizr seconds. None installed Do you meet audible/visible requirements of WAC 51-20, IFC -SEC 907., and/or NFPA 72 Chapter 6? . Yes X No Test of alarm System on emergency power, satisfactory? Yes _ No Test Witnessed by Title Comments: Date S INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit bog- too PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: IA vrE SVU, NkA4-iLer- Type of Inspection: Address: GS6 Sc_ viAtiew Suite #: Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: R -AL O (C_— Needs Shift Inspection: `/ Hrs.: j Sprinklers: '1 Fire Alarm: y Hood & Duct: (4 Monitor: N,w, ht, otic Pre -Fire: 14�� Permits: Occupancy Type: vvv kkispector: etAjAii /512 Date: /10- f p4 Hrs.: j ti $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from th City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit C9 a n y wog-Joo PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila. Wa. 98188 206-575-4407 Project: L:It-e. i -f. c.,}e, 91tostc_(c Type of Inspection: Fire Alarm: Address: Myt2fyeAvv., L Suite #: 65-0 s.c. 141/1-1,4.--�1 Con ct Person: fl/rt Special Instructions: Phone No.: proved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: Sty Date: -7/5/05 H rs.: ok-F7 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER Yr INSPECTION RECORD Retain a copy with/permit 9 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: /Muit,/v Type of Inspection: .5),2# nIlL1.L"7Z.-- Address: tpgb 5 Suite #: friA,W Contact Per on: -i-- '( Phone No.: tali, Special Instructions: pproved per applicable codes. Corrections required prior to approval. COMMENTS: - 4 -- Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 4tAja its- i z Date: g-/ i&fos Hrs.: / $84:00 REINSPECTION FEE REQUIRED. You will receive an invoice from e City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 City of Tukwila Fire Department APR 2 6 2000 John W. Rants, Mayor F E TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Project Name cY)0As \\-\LL. rAo.c\C Address 115 L (y.\ Retain current inspection schedule Thomas P. Keefe, Fire Chief Permit No. Needs shift inspection Suite # Approved without correction notice ),‹ Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: iN\IN7;:la Authorized Signature FINALAPP.FRM Date T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: (206) 575-4404 • Faz (206) 575-4439 ABEL FIRE PROTECTION FAX TRANSMITTAL 20E- 481FItE CROWN FIRE PROTECTION, INC. Compan 5ubiec 5.15.01 Fire Prevention Bureau fukwita Fire Department Shut Down Number Number of Pages (Including Cover) ❑ Urgent M For Review rin Jessica Robinson P.01 Fax No. 206.575.4439 0 Please Comment 0 Please Reply PH:425.481.7669 FX:42.5.481.8695 we need a shutdown number to change out five painted sprinkler heads in the Hallmark space located at 715 Southcenter Mall. If you have any questions or need any additional information, pease do not hesitate to call. TUKWILA FIRE DEPARTMENT Please call: 575-4407 and give this job No. 0/-4' //( and _xact address for shut, down or restoration approval. e`1A71(ye casT f/s1,4 hens 5/77/0/ P.O. ROX 12113 MILL CREEK, WA 98082 PH: 425.481.7669 FX:425. 48 1.8695 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit o9-5 - L34=, po`7- 3; PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: r ,ge o -e. Sprinklers: Fire Alarm: Type of Inspection .10 fv r),v E '-,--55 ! 4 I ism Address: ,3 7 Suite #: S .c. ,t 1 k L L Contact Person: / Special Instructions: Phone No.: a4:,a-`IN-8712, proved per applicable codes. Corrections required prior to approval. COMMENTS: gess l } �t.F, e'_4"7 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: n Inspector: /../\ 3-/V Date: Vilog Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit Q'~ s-0 3�•b PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: g\o-e... Sprinklers: Te of Inspection: Hood & Duct: Address: ,3-7 5 Suite #: .4 , r/Li -L Lr. Contact Person: Occupancy Type: Special Instructions: Phone No.: ga - /4-/-, X712 A -Approved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: / 5'J (/ Date: '2 l V o S Hrs.: 1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER • INSPECTION RECORD Retain a copy with -7s�sOd TJUN 6 2008 oF- S- P31 PO -7 - PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: /50, ;,e._ Sprinklers: Type of Inspecction: /-1'`9 D -o l C ov e Address: (37 S - c_ Suite #: ►.-% "4-- L-- Contact Person: c. k or) Special Instructions: Occupancy Type: Phone No.: Approved per applicable codes. nCorrections required prior to approval. COMMENTS: p1 O oka-1 � 1 o Psi" 13 6Z. 1{ s 9-(O PS r / S-oo N2. -S Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 5-'y Date, 6/Z10 8 Hrs.: L- ' v 1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit -, _a 00- 35-3 /"'la ? - / 27 2'0'2_ 3.4-6 b PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: e,c).E._ Sprinklers: Type of I spection• kket8 Iv I e a \ ct \ec -c6U4i-L- Address: . '7 Suite #: S,L . itvW, L Contact P rson: Special Instructions: Monitor: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: i' Sprinklers: Y Fire Alarm: Y Hood & Duct: rt/ Monitor: (j KPr t.) Pre -Fire: 1•1 Permits: N Occupancy Type: (✓"- Inspector: iy�j j(� Date: 7/4/09$ Hrs.: Vik/$80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 L__ TUKWILA FIRE P'RE TTQN BUREAU. 444 Andover Park East, -Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MYIA:TERIAL AND TEST -CERTIFICATE • FIRE ALARM AND FIRE DETECTION SYSTEMS • Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will b.e assessed. Contractor is responsible°for • supplying manpower for Final Acceptance Test with two-way communications. • • • '74/7/ Date • Permit # -74-- 2.50 Property Address. 637 SOOT- C.P:131-EZ M RLL. Suite # City Tukwila Zip Code cVZ1 $ Name of Facility (I es—r— 11 E. L.D . M A Li - Occupied as . I36.8E Owner or Representative Phone # Installing Company C.;vAiZD A 1,.\ Sec ) cz. j rLe Sys A-ew S . Installing Contractor's Address I-7 4 3 1 gT AVE - s; CitySeA-tz'c:E •• Phon.e# Zvi- G2z - (0 5 4 -s - Installer's Name (PRINT) ( HoM fL5 'R.Pc Tt... I C License and/or Certificate t . P.T 1. I `Tem arn 4`t H • General Contractor 44ti /e1 �'�J5 j . Electrical Contractor FACP Equipment Manufacturer • ' M e ii Model # . LS This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by -1—HOm its P rL ! F On (date) and includes the devices listed on back. Circle all that apply: X NFPA. 72, Chapter 507 and/or IFC SEC 907 • NFPA 70, National Electrical Code, Article 760 Manufactirer's.Instructions X Manufacturer's Instructions Other (specify) K Tukwila City Ordinance Numbers 2050, 2051. - UL Central Station Monitor System is monitored by SIGNED Date System Firmware: Installed version . Checksum Date EQUIPMENT INSTALLED AND TESTED: Control Panel 1 of Manual Station of Smoke Detectors 5 of Heat Detectors of Duct Detectors- _(_ of J AN Devices Z of 2 Audio Devices of Visual Devices 2 of Z Auto Door Release of Trouble Indictors . of Batteries Readings Battery Make/Model . J i e e S . X L S Make/Model Make/Model Make/Model Make/Model i e v( e. ns A 1)2 - P siemens kVP- Make/Model S PM fl 5 Make/Model Make/Model Si e Make/Model Make/Model C;t'Ce4r)'n-t SET"- M C- CW oe W 2R-•MG-CLI3 1,,j) cite_ Full Load . Charge Generator of Make/Model HVAC Controls j_ of 1 Make/Mo.del 'j i cm e,6 S -TR 1 - Fire Alarm Dialer of . . Make/Model Monitored by l S -f F t D Pd_L_ pAk E +L Annunciator of Make/Model 0 Sprinkler System. (Fire Alaini connections only) Water Flow Sw. Valve Tamper Sw. PIV Elec. Alainu Bell of of of of Make/Model Make/Model Make/Model Make/Model Automatic time Delay of Water Flow Alaiun seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? . YesX No Test of alarm System on emergency power, satisfactory? Yes _ No Test Witnessed by Title Comments: D ate F" I City of Tukwila ie"--„e„� Fire Department Project Name (,. Address TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM AUG 112 + Steven M. Mullet, Mayor Thomas P. Keefe, Fire Chief Permit No. V/ )--r; // Retain current inspection schedule Needs shift inspection Suite # Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: /-fVA-C. Hood & Duct: P-" Halon: A/ Monitor: Pre -Fire: A/ Permits: ,21,04 Authorized Signature Fate FINALAPP.FRM Rev. 2/19/98 T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206-575-4404 • Fax: 206-575-4439 INSPECTION RECORD Retain a copy with pe INSPECTION NUMBERFILE COPY PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Ge.tie Sprinklers: Fire Alarm: Type of Inspection: FA Address: ce 30 Suite #: 5 m co l Contact Person: Chr; S tvi-1-1,re Special Instructions: Phone No.: ')-o (e —3'161— ')I S Approved per applicable codes. Corrections required prior to approval. COMMENTS: Pit -,de /oc& 1 GFt-P. Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 4-3 J 1 Date: Er --/q _09 Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TU .SLA FIRE PREVENTION BUREAU 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us . •FP I L CONTRACTORS MATERIAL AND TEST.CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS • E Fire, alarm System is ready for Fire Department acceptance testing. Failure of test:will result in termination of the testitig and additional fees will be assessed. -Contractor is.responsible fora supplying manpower. for Final Acceptance: Test with tvvo-way communications: • • itt,,c.wie-44. O - -113 Permit # t-+ zuzzzy • • Date 3/z3 )(..2vl Installing Company O[! y, rt Installing Contractor's Address PO 3 54-02- T., t ) cvm/'n•VN7•t -r, f,a 5/% r r» City A21.•t Norm, A Phone # 3G v, G 5' z ib Se) Installer's Name (PRINT) •; � ¢ F oto i> .:' License and/or Certificate '1 c955,,s cg 221 Name of Facility C► .Nc- # NC. Property Add%es > 633 Soy -ni City • Tukwila Zip Code Su r� zn� . Occupied as -e 4.4 Owner or Representative • General Contractor. • A K • 1.)e.5 Electrical Contractor Phone # PDLC-Ay e_ L- L7 2rc L:.._ 4.- FACP Equipment Manufacturer SI4er-sol" kN c,OP Model # S-1014 r3 This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by On (date) Circle all that a • . 1 and includes the devices listed on back. A 72, Chapter 1 2 4 5 6 73d/or Ur, S'11) 10-2:SBC L7.1.2, 1990 ED. NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions Manufacturer's Instructions Other (specify) N Tukwila City Ordinance Numbers 1900, 1901 UL Central Sta ' n Monitor 1-1-7 7 60 (1 System is monitored by iONC.A. SIGNED � yz .f Date V%�� System Firmware: Installed version Checksum Date Initial program Installation Revisions and Reasons . Date Tukwila Fire Prevention Bureau= Material and Test Certificate EQUIPMENT INSTALLED AND TESTED: Control Panel of Manual Station of Smoke Detectors of 1 Heat Detectors • of Duct Detectors ' ) of ,_(_• A/V Devices • of • Audio Devices of Visual Devices ! of i • Auto Door Release of Trouble Indictors of Make/Model�i �� n� KN/ c 'Pi 1. • • S/ 014 Make/Model- • Make/Model Make/Model • • Make/Model PH 1 O . •,DC.z.-P S s,vs(9/2 2 t, — 3. Make/Model Make/Model F pvG.cA rosz) Make/Model R -r 075 ' J 1 < Make/Model Make/Model Batteries • C - W.— 5 L' 1 7 Phil Readings Battery Full Load + 3 . i n Charge 1 .5 S Generator of Make/Model HVAC Controls _ of _ Make/Model Fire Alarm Dialer — of _ : Make/Model Monitored by N 'Act—. Annunciator of Make/Model • • • Sprinkler System. (Fire Alarm connections only) Water Flow Sw. _ of _ Make/Model Valve Tamper Sw. _ of Make/Model PIV _ of _ _ Make/Model ' Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible r quirements of WAC 51-44, UFC STD 10-2,1997 ED., and/or NFPA 72, 1999 edition; Chapter 6? Yes _ No — Test of alarm System on_erggnc,�i �t�wwer, satisfactory? Yes Test Witnessed by Comments: Title Date TFD FP Form 4110 2 1 INSPECTION NUMBER INSPECTION RECORD Retain a copy with p 013-- iq0 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project:r Li I r0K1/4,�- 6rv1ci/.e- Sprinklers: Type of Inspection: _,c1.• if ets Address: Suite #: 630 X n' % Contact Person: Special Instructions: 0 1 j� i- Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: t.' 0 1 j� i- CO (, e t r ' / --cJ/ c/ i S "k> i-sP "/ ; 'c' 1 T (a 4 2 ©h t -c: ,--epur .- horcil; d 6.4 4 too .vj Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: (% 2_ prni% g/1—%/Date: , Hrs.: , -- $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 z INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit 13 - «o X3--5- \1Z PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Type of Inspection: ,� Fire Alarm: Address: Suite #: (0 30 5,C., rv\ k.\ Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: o — v CDS- es— Needs Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: w\51 Date: (23( Z(4 `-- Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with pmt Di /10 Y2/ ex7q l 3— F-170 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Ycfnh ee- L, i/e/% Type of I pection: ri,-7at Address:f f Suite #: 6.35 56ni ce=-Tl-�!- Mat Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS:r Sprinklers: — tc..._ P,tei i .--t2 t/ .... Monitor: Pre -Fire: - Firz. 4/ct1 # f-egi -or Foci % "-. &fign r 7, irric4l —121e Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ' fp1 Z/ Date: ciA, /,3 Hrs.: I $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a. reinspection. Billing Address Attn: Address: Company Name: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION BUREAU 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdprv@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will he assessed. Contractor is responsible for supplying manpower for Final Acceptance Test with two-way communications. Date g/D/3 / Permit # /3 -c-/76 Property Address ‘730 S0v//f C«p///c AlMI L-- Suite # 20 City TUKWILA Zip Code Name of Facility ,'i -,//,Cc ,r 6-e2 e/ Occupied as CD �/� s7Zo/'t Owner or Representative 27i4 -i e Co n 404 '1 Phone # 4/13 - 5-7 S - .4 55— Installing SInstalling Company l� �/,�,�pi/f�t1 deo de /75, Sy S 4,4-, S Installing Contractor's Address /7413 / s t �dE. 5 . City 5-; )10- % Phone # Installer's Name (PRINT) // .e./€4 )24 7L// / j License and/or Certificate £4 -Ti % &/// / '3 General Contractor 747/�0/', Zovl 7//1/L Electrical Contractor 4/7a C 1/ S FACP Equipment Manufacturer 5/os r to r -is Model # X L S This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by On (date) and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter C6)56,7 and/or IFC SEC 907 X NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions x Manufacturer's Instructions Other (specify) Tukwila City Ordinance Numbers 2050, 2051 UL Central Station Monitor //%49/ _c System is monitored by /l%/f%,/1V_S SIGNED C'/��'� Date f//O//5 System Firmware: Installed version 570 Checksum /70/ Date Initial program Installation , i -e )/016‘17_2 Date ,97/.//_.? Revisions and Reasons Programmed by ✓C/70,r P 1-4�7` EQUIPMENT INSTALLED AND TESTED: Control Panel of Make/Model Manual Station of Make/Model Smoke Detectors of Make/Model Heat Detectors _ of _ Make/Model DuctDetectors/ off j Make/Model 5i eKPi? S /t D 2/fp / 12D- �# 5w_ i 9- ( _5.ekKektf --7—s ivl AN Devices .a of 3 Make/Model 5s 10i -ries" _s' — Z f% /f 1 -cot/ Audio Devices / of / Make/Model 5le.4-' eil S Z,e -%C - - a✓ Visual Devices of Make/Model Auto Door Release of Make/Model Trouble Indictors of Make/Model Batteries Readings Battery Full Load Charge Generator of Make/Model HVAC Controls / ofj Make/Model SeHe*115 /-/772/-/2- Fire Alarm Dialer of Make/Model Monitored by Annunciator of Make/Model ❑ Sprinkler System. (Fire Alarm connections only) Water Flow Sw. of Make/Model Valve Tamper Sw. of _ Make/Model PIV of Make/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed e— Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes,X No Test of alarm System on emergency power, satisfactory? Yeses No — Test Witnessed by , /%7Z/ Title ,4/,4-i i ev-i- Date 9/6// Comments: eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #110 93 INSPECTION NUMBER 'F A INSPECTION RECORD Retain a copy with permit 67 -s -P3( 1P06- /417 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: kJ/1011j/101, SPA c Type of Inspe ion: Hood & Duct: Address: s" --G Suite #: 5 , (.., , /vl /12. L Contact Pers n: Cyproi Special Instructions: Phone No.. 4(013—'7-76— &Tr?--/ 7 Approved per applicable codes. Corrections required prior to approval. COMMENTS: VOA.) Lk") Co( C 011 7)2,0 IC 1r) a ao 3 {`N( 5 limo Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: j5-1 (I Date: 619-40g Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit 09—s—i4y PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: L'6 c c 1 enc. Type of Inspection: 15C -ea 5oor,vs xL - Address: sc'5,a,11c,e01s.., 01,111 Suite #: Contact Person: tr. "4 Special Instructions: Phone No.: aoc - Gogr- ao5.2" Approved per applicable codes. Corrections required prior to approval. COMMENTS: ire e.1GL -�� 1 0 t Needs Shift Inspection: 5 4/ 01f) Sprinklers:/ Hrs.: Fire Alarm: / Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 5 4/ 01f) Date: 1I 1 c/c 5 Hrs.: / A $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from he City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with per o9_ -174/ PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: L ' o c c : +4,4c_ Pc ---,y, Type of Inspection: f,�.,e_., 4-44,-/..4,--7 Address: --ca SC- r4 ill LL Suite #: Monitor: Contact Person: /2Ag,' 4 Special Instructions: Occupancy Type: Phone No.: ZoC-- 3C7- iZGr Approved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ,5'w j,.(3 Date: ///7/Ls 9. Hrs.: / $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 2 INSPECTION NUMBER INSPECTION RECORD Retain a copy with ' - it 009 — 211 09-C- i7Y PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: L /0 cc i' Kyr1 c Pop - ‘, p Type of Inspection: /5.,' re_ .4/09,4n4 Address: 5-6a 5 G iv4/i Suite #: Contact Person: %l,¢d c i Special Instructions: Phone No.: ZPC — 359'- /ZGk Approved per applicable codes. Corrections required prior to approval. COMMENTS: Guard./ill Seer -)/4i 1793 1 �,qu .-5 Needs Shift Inspection: Sprinklers:/ Hrs.: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector -5 j in S3 Date: l/iG 4 9. Hrs.: v( $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION BUREAU 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206.575=4439 E-mail: tukfdprv@ci.tukwila.wa.us ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AN1D FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will resta in termination of the toting and additional felts will be assessed,, Contractor is responsible for supplying manpower for Final Acceptance Test with two-way communications. Date i 1 / 07/09 Permit # _ F 19 4 Property Address ___56 E Spin„ g: =,, 1 t ( Suite # S-66 City TUKWILA, . Zip Code `t l ' 1 Sc& Name of Facility L j O['Ci' �.t' - l..Jo�3 -- k �i Occupied as ___!5w sv�q Owner or Representative Phone # Installing Company if,Irtstaireti mac.,_ Gr,�.�A ar Installing. Contractor's Address 1'743 i j} AukS City Sf_3Phone # Installer's Name (PRINT) C r +S —o L 1 License and/or Certificate General Contractor Electrical Contractor cta- FACP Equipment Manufacturer S ► e-I,Pte.K_5 Model # XL This system has been installed, pre -tested and operates in accordance with the staridards listed below and - was inspected by C ,ter` 5 To 1 n o. On (date) 1 1 01-f0 and includes the devices listed op back. Circle all that apply: V NFPA 72, Chapter 12 4 5 6 7 and/or IFCSEC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions ivIanufacturer's Instructions Other (specify) Tukwila City Ordinance Numbers 2050, 2051 UL Central Station Monitor System is monitored by G ko.,--p a.t, SIGNED ' Date l 11 Q 7-/O'? System Firmware: Installed version Initial program Installation Revisions and Reasons Checksum Date Date Programmed by Ed Wd8T:M0 600E OT 'noN 066M -8E9 -90E: 'ON xdd J,l I Jr0SS Nu I U'd f9 : WOdd EQUIPMENT INSTALLED AND TESTED: Control Panel of Make/Model Manual Station of Make/Model Smoke Detectors of Make/Model Heat Detectors of _ Make/Model T Duct Detectors ofMake/Model 0,2,10 A/V Devices 2. of 5` 4'"`"S Make/Model 4 w. M C- C g Ne c -Svcs 43.E Audio Devices of Make/Model Visual Devices — of Make/Model Auto Door Releaseof Malce/Model Trouble Indictors of Make/Model 8aiteries Readings Battery Full Load Charge Generator of Make/Model HVAC Controls of Make/Model Fire Alarm Dialer Monitored by Annunciator of Make/Model of Make/Model ' ❑ Sprinkler System, (Fire Alarm connections only) Water Flow Sw. _ of Make/Model Valve Tamper Sw. of _ Make/Model FIV ofMake/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SBC 907., and/or NFPA 72 Chapter 6? Yes V- No Teat of alarm System on emergency power, satisfactory? Yes No Test Witnessed by Aft Title Date . Comments: kwwe--4. �1 eddins\Fire Alarm Certificate.doc 2d Wd6T :t'O 600E OT •noN Revigad: 40/28!04 TFD FP Form CIO O O6617-8E9-9OE : 'ON XUd J l I dfOdS WO Id INSPECTION NUMBER INSPECTION RECORD Retain a copy with per , 't /Ja9-2 J 04-s- >LY PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 7-1 Date: Type of Inspection: r) -4-1.-/C eno-."-v Address: 5 I 51,.+11)c Suite #: w mg,' Contact Person: j',rw) Special Instructions: Phone No.: c=ic) . ate.. Viltpproved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Date: Sprinklers:/ Hrs.: Fire Alarm: / Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: $Li- iv -; Date: / D/ 9J 1 Hrs.: / • $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 Number of Pages (Including Cover) ABEL FIRE PROTECTION 206 4:11 869* F'. ul FAX TRANSMITTAL Fax No. CROWN FIRE PROTECTION, INC. Compan MO: 09/06/00 Fire Prevention Bureau Tukwila Fire Department Demo Permit D Urgent ❑ For Review FILE 206.575.4439 ' 1 0 Please Comment Q Please Reply Jessica Robinson PH:42.5.481.7669 FX:425.481.8695 Comment. We need to get a demo permit to remove 8 1" drops that are in the way of the new walls at the Pacific Sunwear space at 800 Southcenter Mall. The building permit # is D2000-243. If you have any questions or need any additional information, please do not hesitate to call. TUKWILA FIRE DEPARTMENT Please call: 575-4407 and give this job and exact address for shut- down or restoration approval. P.O. BOX 12113 MILL CREEK, WA 98082 PH: 425.481.7669 FX1425.481.8695 City of Tukwila OCT Q 7 2000 Q3cso Steven M. Mullet, Mayor Fire Department Thomas P. Keefe, Fire Chief TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Project Name Address It. 1'14 ! I Permit No. Al )-outs j�. Retain current inspection schedule J Needs shift inspection Suite # Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: Ievit`► to— b—ok> Authorized Sigiature Date FINALAPP.FRM Rev. 2/19/98 T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206-575-4404 • Fax: 206-575-4439 � R Q City of Mkwila FILE Fire Department TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM John W. Rants, Mayor Thomas P. Keefe, Fire Chief Permit No. 2A0011,40—%19/ Project Name 6e/Oe011ie Address (O s -y S/ r i r1 1 Retain current inspection schedule VNeeds shift inspection Suite # Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: Authorized Signature FINALAPP.FRM ;D0 6/ 2 --- //301e)/ Do T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: (206) 575-4404 • Fax (206) 575-44139 r 0 I Cizj' of Tukwila Steven M. Mullet, Mayor Fire Department Thomas P. Keefe, Fire Chief TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Permit No. 01;0 FILE Project Name Address (c)-51 .S+ �� M A 1 Retain current inspection schedule Needs shit, inspection Ott 01 .1 Suite # Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: i( Hood & Duct: Halon: Monitor: 01 - Pre -Fire: Permits: ON`INa 5\b z240t Authorized Signature Date FINALAPP.FRM Rev. 2/19/98 T.F.D. Form F.P. 85 Headquarters Station `4144 Andover Park East • Tukwila, Washington 98188 • Phone: 206-575-4404 • Fax: 206-575-4439 HEEL FIRE PROTECTION 20.S 42.1 8695 ALE FAX TRANSMITTAL CROWN FIRE PROTECTION, INC. OEM gErn 09/29/00 Fire Prevention Bureau Tukwila Fire Department Derno Perrnit Number of Pages (Including Cover. 0 Urgent [roil Q For Review Jessica Robinson 1 Fax No. P.01 12.2!:52.422_9_2 ❑ Please Comment Q Please Reply PH:425.481.7669 FX:425.481.8695 We need a demo permit to remove four sprinkler heads that are in the way of framing at the Abercrombie $ Fitch project 651 Southc:enter,'slall, # 676. The building permit number is D2000-241. If you have any questions or need any additional information, please do not hesitate to call. TUKWILA FIRE DEPARTMENT Please call: 575.4407 and give this lob No. 00" and exact address for shut. down or restoration approval. P.O, BOX 12113 MILL CREEK, WA 98082 PH: 425.481.7669 EX:425. 481.8695 INSPECTION NUMBER INSPECTION RECORD Retain a copy with pernai�t (-,_,EO ) ��— a'7 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Cio.1441 y Tep,./j& Hrs.: t Type of Inspecti n: 7; $J it/le_cjek \ -c-/ "' -‘siert-- Address: Suite #: 45Y5' S C Contact Person: Monitor: Special Instructions: ) Pre -Fire: !J Phone No.: Permits: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Y Hrs.: t Fire Alarm: y yt&4-, c I,uyL- - e‹ Hood & Duct: N 4 4 SLi es -C. — Monitor: ..) L, co/4 ) Pre -Fire: !J Permits: #i Occupancy Type: Needs Shift Inspection: K Sprinklers: Y Hrs.: t Fire Alarm: y Hood & Duct: N Monitor: Lam,, ) Pre -Fire: !J Permits: #i Occupancy Type: t✓'- Inspector: /T/ Date: 7//7(e Hrs.: t $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F,.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Sprinklers: Type of Inspection: Hood & Duct: Address: Suite #: 5-g5 s -C.. /1102(.., Contact Person: Special Instructions: Phone No.: VI -Approved per applicable codes. I I Corrections required prior to approval. COMMENTS: ooec Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: /4. 9 y Date: --7// 7/d Hrs.: DU $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F,.D. Form F.P. 113 TUKWILA FIRE PREVENTION BuRBA.0 444 Andover. Pa:k East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST •CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will. b.e assessed. Contractor is responsible°for supplying manpower for Final Acceptance Test with two-way communications. • Date Property Address Pecpit# SOUTH C F P hZ. M ALL_ City Tukwila Code `M l 8 $ Suite # Name of Facility ( e ST , E- LD F-1/241:4.: Occupied as Owner or Representative ` Phone # . Installing Company r',UaiZD A � �ec L.� TY sys {-ewt S Installing Contractor's Address 1 -7 4 3 gT /�t U E . $, City SeATTL:C • Phone # 20 - Z 2- .- , .S 4-5 Installer's Name (PRINT) ( HDM A,S 1Z. pc -FL( F License and/or Certificate 12_. P T t_ I rri 3o V\l H • General Contractor Electrical Contractor FACP Equipment Manufacturer s'pe M eQ ., Model # jC L 5 This system has been installed, pre -tested and operates in 'accordance with the standards listed below and was inspected by ( HOON tiS -QIc-rt_ 1 F . On (date) and includes the devices listed on back. Circle all that apply: X NFPA 72, Chapters 6(fi:land/or IFC SEC 907 . NFPA 70, National Electrical Code, Article 760 Manufacturer's.Instructions X Manufacturer' s Instructions Other (specify) K. Tukwila City Ordinance Numbers 2050, 2051.. UL Cenral Station Monitor • System is monitored. by SIGNED Date System Firmware: Installed version Checksum Date EQUIPMENT INSTALLED AND TESTED: Control Panel Manual Station Smoke Detectors Heat Detectors Duct Detectors. A/V Devices Audio Devices Visual Devices Auto Door Release Trouble Indictors Batteries • Readings Battery of 1 of of of ofJ off..-. of of4 of of Generator Make/Model ,) i e m e r s •)(L S Make/Model Make/Model S ( e me n S N' P— 1 1 Make/Model Make/Model S i er t ens A D2 - P Cei int SET- M C- C.W oe. UJ Make/Model S t .P, me n• S Make/Model t„) A L L Make/Model 51 P WI Q RS Make/Model Make/Model 2R—•Mc—CWCct,t, Oa Ls 1 oad Charge • of e/Mo 1 HVAC Controls 4 of 4_ Make/Model `$L e. vte,A S —FR ti - Fire Alarm Dialer of _ , Make/Model . . Monitored by wes-r Ft ELDjutc u .ii4ty Annunciator _- of Make/Model L 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. Valve Tamper Sw. PTV Elec. Alarm Bell of of of of Make/Model Make/Model Make/Model Make/Model Automatic time Delay of Water now A_lairu seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NEPA 72 Chapter 6? Yes x No Test of alarm System on emergency power, satisfactory? Yes No Test Witnessed by Title Comments: Date a„ INSPECTION NUMBER INSPECTION RECORD Retain a copy with _permit 09- S -d81 b9Y7 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: C4k y 3. N Fire Alarm: Type of Inspection: /-fKb,o /CO(JfL Address: J,L Suite #: C Permits: Contact Person: rtbvi,\ Special Instructions: Phone No.: C1)-x-'-766—c?„0'Y11 FV..Approved per applicable codes. Corrections required prior to approval. COMMENTS: l+y a20 sly 0930 aao C-4):51, >/sa aao �v�22 o k� Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 31 ti Date: 6b q jeiJ Hrs.: vZ / 4 r1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit, JUN 1 9 2008 l>ag-zq:. PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: C471414 ga., Type of Inspection: Address: 5 -ifs- S . t°, niat4.Con�rson: Suite #: Hood & Duct: Special Instructions: Phone No.: Approved per applicable codes. nCorrections required prior to approval. COMMENTS: \Alo.p C ^e 0 Ili Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: ',Inspector: a.L( f51 L Date: G Ao /pg Hrs.:. s--' _ $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from e City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with rmit D'f - 3of -aFP PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project:Type Lo 5 L Sprinklers: of Inspection: S e CQ, v -f Address:C_ Suite #: Monitor: Contact Person: Special Instructions: Occupancy Type: Phone No.: [-Approved per applicable codes. Corrections required prior to approval. COMMENTS: 0 - Cu --€J Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: Date: i / t// Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip; Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Ls k £s ►JR�--S Tye of Inspection: F/1— h cs I 1 SPR.IC t=i hu 1 Address: 33) -2 Se_ ma ii Suite #: Contact Person: Special Instructions: Phone No.: VIApproved per applicable codes. Corrections required prior to approval. COMMENTS: SPk ic F,ti.�, I of Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 41115/ Date: //--A - / J Hrs.: f $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit 4c11- 3v4 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Lash Type of Inspection: /5.y--, F Address: Co7 5Grn4.14, Suite #: Contact Person: 8d40 - Special Instructions: Phone No.: 34-v VI 7 Approved per applicable codes. Corrections required prior to approval. COMMENTS: F- - 4,,1 Gs...764e_ 4f6 JT04) e,PC- 4. z Needs Shift Inspection: � 3 Sprinklers:/ Date: Fire Alarm: / Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: � 3 g 3 Date: `!`23`-1 Hrs.: / $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from ity of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 TUIMIA FIRE PREVENTION lilLWALT 444 Andover Park East, Tukwila; WA 98188 - Phone 206-575-4407 - Fax 206-5754439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will he assessed. Contractor is responsible for supplying man ower for Final Acceptance Test with two-way communications. Date /(// �( Property Address City TUKWILA Permit # 1'^ �- Suite # /! Ali( Code Name of Facility 0-(itc e4)42.. ex. All ( Occupied as L u St, Owner or Representative Installing Company &o J A2 t Sgt)r- r( • Installing Contractor's Address l s?' Ave City jG 7e__._ Installer's Name (PRINT) eYaitt2J— License and/or Certificate VEL r7 F 6 g Q General Contractor Phone # Phone # -- 6,2- as -c/_1 -- Electrical Contractor Se�.�CC_ L"er , FACP Equipment Manufacturer 3 iteetteit c Model # > e_ _S This system has been installed, pre-teste and/operates in accordance with the standards listed below and was inspected by s vi.J€ t ref-- On efOn (date) ithS7 <( and includes the devices listed on back. Circle all that apply: 14 NFPA 72, Chapter 1 2 4 5 6 7 and/or lFC SEC 907 1 NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions VManufacturer's Instructions Other (specify) / !/ Tukwila City Ordinance Nu hers 2050, 2051 UL Central S ; ion M • nitor ;ALS' tb System is monitored by /V J1 ,✓(' P IO Date /t/ 4!, Date ///er7/ Date SIGNED System Fi ware: Installed version / �l a Initial program Installation Checksum Revisions and Reasons l Programmed by L. w►Ier- EQUIPMENT INSTALLED AND TESTED: Control Panel Manual Station Smoke Detectors Heat Detectors Duct Detectors A/V Devices Audio Devices Visu ,Devise* j of ( A oor Release _ of uble Indictors of Batteries of of of of of j_ of Make/Model Make/Model Make/Model Make/Model Make/Model S (g 1( Make/Model Sc C .�tpn S "4 ^ C CJ Make/Model Make/Model $ J2 Gvte t S / 2 R- 1. J Make/Model Make/Model Readings Battery Full Load • Charge Generator of _ Make/Model HVAC Controls £ of A Make/Model ,led4-c4A / /17R e 1-- R Fire Alarm Dialer of Make/Model Monitored by Annunciator of Make/Model 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. _ of Valve Tamper Sw. _ of PIV of Elec. Alarm Bell of Make/Model Make/Model Make/Model Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes. No Test of alarm System on emergency power, satisfactory? Yes No Test Witnessed by Title Comments: Date eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #110 CITY OFTUKOLA Central Permit System Control No. '- 23 /5 Permit No c72-� FINAL APPROVAL FORM TO: 0 Building ❑ Planning ❑ Public Works ❑ Fire Dept. ❑ Police ❑ Parks /Recreation Project Name i' T"r'A1 Co Address (4 / - C, ,. Type of Permits) e14,01 -e ;efr%n, / This project is nearing completion. Please investigate your area of responsibility and indicate below either your final approval or necessary corrections. If no response is received within one week, it will be assumed that the project is of no concern to your department and a certificate of occupancy may be issued. 1 This project is NOT approved by this department; the following corrections are necessary: () O O () O i () Ir 1 Authorized Signature Date This project is approved by this department: Authorized Signature 7/3.. Date CPS Form 3 CITY OF TUK ILA Central Pe1r6t System P0511 Control No. Kms` f..? ermit No. F5 -"Z �.�' FINAL APPROVAL FOR TO: ❑ Building ❑ Planning 0 Public Works ❑ Fire Dept. ❑ Police 0 Parks /Recreation Project Name i'i Tc. �f� f � b , Address v c 11-1,41 Type of Permit(s) Pryode � J This project is nearing completion. Please investigate your area of responsibility and indicate below either your final approval or necessary corrections. If no response is received within one week, it will be assumed that the project is of no concern to your department and a certificate of occupancy may be issued. This project is NOT approved by this department; the following corrections are necessary: (i) Z-4„, 6-7 ( ( O ( ( O ( ( Authorized Signature Date This project is approved by this department: Date CPS Form 3 City of Tukwila FIRE DEPARTMENT 444 Andover Park East Tukwila, Washington 98188-7661 (206) 575-4404 FEB 2 5 1991 Gary. L. VanDusen, Mayor TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Control No. Permit No. / / Project Name %c-, C A,,4 ,0i')12 Address ///rte 5 te74;4 it ,, Suite # Retain current inspection schedule Needs shift inspection _ Approved without correction notice _ Approved with correction notice issued Sprinklers: Fire Alarm: Al Hood & Duct: ,V Halon: ,✓ Monitor: Pre -Fire: •• 4/ Permits: -/- 573 3 Authorized Signature Date FINALAPP.FRM T.F.D. Form F.P. 85 City of Tukwila FIRE DEPARTMENT 444 Andover Park East Tukwila, Washington 98188-7661 (206) 575-4404 FEB 2 5 1991 Gary L. VanDusen, Mayor TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Control No . 9} F 67-341 Permit No .4> 9' 5: - vi Project Name /c, /e4,,,-� Address •,‘,6" f )) Suite # Retain current inspection schedule Needs shift inspection Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm:! Hood & Duct: Halon: l Monitor: At Pre -Fire: 4% Permits: Authorized Signature FINALAPP.FRM Date T.F.D. Form F.P. 85 City of Tukwila Steven M. Mullet, Mayor Fire Department Thomas P. Keefe, Fire Chief TUKWILA FIRE DEPARTMENT FINAL'APPROVAL-FORM Project Name kACtt.ek (0.�4i0 < 4 � (n(a 0 56s YI C P -kr,. MO J� Address Permit No. 00)--00(4, Retain current inspection schedule Needs shift inspection Suite # K- Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: S7 / 'I -o-03 Authorized Signa' -cure Date FINALAPP.FRM Rev. 2/19/98 T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206-575-4404 • Fax: 206-575-4439 INSPECTION NUMBER INSPECTION RECORD Retain a copy with p PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575- Project: r/ , Sprinklers: Type of Inspection: Address: A5..) Suite #: a C. toALL Contact Person: Special Instructions: Occupancy Type: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ;__ Date: 7)2_5 II r Hrs.: 1 $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206 -575 - Project: C,i./, ,1 a; rc Type of Inspection: Address: 2 57 siC H*N Suite #: Contact Person: Special Instructions: Phone No.: �a Approved per applicable codes. Corrections required prior to approval. COMMENTS: in T Grr1.S E,:p t• eat a F e../. C.r.Q.. Needs Shift Inspection: Sprinklers:/ Date: jG//g/IZ_ Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: citl45-,3 Date: jG//g/IZ_ Hrs.: / $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 0 City of Tukwila Fire Department Project Name SEP 2 8 2001 John W. Rants, Mayor TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Permit N �-4/1'5 Cqvi,evrit Thomas P. Keefe, Fire Chief MG/- /4,,z) . CD ol- /Y6 Address (7- Sov?-►,cevtfv /o a Suite # Retain current inspection schedule XNeeds shift inspection Approved without correction notice Approved with correction notice issued Sprinklers: 4f Fire Alarm: Hood & Duct: Ai Halon: it/ Monitor: 40/ - Pre -Fire: Permits: /1A) 51/ Authorized Signature Date FINALAPP.FRM T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: (206) 575-4404 • Fax (206) 575-44,39 INSPECTION NUMBER INSPECTION RECORD Retain a copy with perJxttit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 4dlS c, Type of Inspection: Coves Address: Suite #:. e l SC m pea Contact Person: Special Instructions: Occupancy Type: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: ®X- C e,1 - Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ii. �g3 Date: 3/7/1 " Hrs.: /. d $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 TU WILA FIREBURSA PREVENTION 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdprv@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testin_g and additional fees will he assessed. Contractor is responsible for supplying manpower for Final Acceptance Test with two-way communications. Date fl — / Perini Property Address t�?( ,S51-01 Suite # City _TUKWILA,,,,— Zip Code eeCc la -1r//GJJ L.C k � r, Occupied as /a(/ at.crl e� Name of Facility Owner or Representative Installing Company 6 - Installing Contragto' Address /7'-( /S �Q Phone # City Phone # 4RsInstaller's Name (PRINT) —��� �/ r� License and/or Certificate General Contractor Electrical Contractor FACP Equipment Manufacturer k-- ('A S Model # C S This system has been installed, pre -tested and, oper es in accordance with the standards listed below and was inspected by ,j Gu,�G-�.cf— On (date) 1— ( t- ( U and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter 1 2 4 5 6 7 and/or IFC SEC 907 Y NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions Manufacturer's rnstructions .,-' Other (specify) Tukw. a City Ordinance Numbers 2050, 2051 UL Central Sir tion u•_onitor SIGNED rAP;•,„ System F ware: Installed version Initial program Installation System is monitored by Date Date Checksum Revisions and Reasons Date Programmed by EQUIPMENT INSTALLED AND TESTED: Control Panel _ of_ Make/Model Manual Station_ of — Make/Model Smoke Detectors_ of Make/Model Heat Detectors of _ Make/Model Duct Detectors / of ( Make/Model PMS / om (( AN Devices 3 of .S Make/Model SJe5 (zC - Cd Audio Devices of_ Make/Model Visual Devices of Make/Model Auto Door Release of Make/Model Trouble Indictors of Make/Model Batteries Readings Battery Full Load Charge Generator _ of Make/Model HVAC Controls j_ of j Make/Model SP GK–eAS / ,V77( R Fire Alarm Dialer of Make/Model Monitored by Annunciator of Make/Model El Sprinkler System. (Fire Alarm connections only) Water Flow Sw. of Make/Model Valve Tamper Sw. _ of Make/Model PIV _ of Make/Model Elec. Alarm Bell of Makeilodel Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes Se No Test of alarm System on emergenc po er, satisfactory? Yes" No ; Test Witnessed by ,,;�J - K - Title p �c� °".Date ( t• Comments: eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #I 10 INSPECTION NUMBER INSPECTION RECORD Retain a copy w -permit FOE1 Et, PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206 -575 - Project_ /� /,WZ C�m00'A Type of Inssppeection: 74 Address: Suite #: Ze/ � e- /y1,4j/ Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: nze re,410 '.-75' Pre -Fire: Permits: Occupancy Type: ‘„,x, J„.."6 -3e4-.e 76, -At 401 ,4- ig,'-,,,,-/ A "- hfrim?i 1.d y a,cote-/- -i!."jj,._ Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: �� ',��� Date: 3 z. Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with p — 037, 1t1-5-037 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188206-575- Pro je-ct: � , /, Cme14 Type of Inspection: 1%�/..G ,/i144-/ Address:Contact Suite #: Ze1/ niAzi.. Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: fir Needs Shift Inspection: /.0.-; Sprinklers: 74,5Fire Date:5/zil/V Alarm: �/�.1 Hood &Duct: „r�/,,,,., Monitor: .1�. Pre -Fire: Permits: Occupancy Type: 3 Inspector( . ii./l3 Date:5/zil/V Hrs.: /. o $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: 1 Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 City of Tukwila Fire Department AUG t 7 1994 John W. Rants, Mayor TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Project Name f) id Address (e, S A, /7-1 1,4 I Permit No. Thomas P. Keefe, Fire Chief Retain current inspection schedule Needs shift inspection Suite # Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: / Halon: Monitor: Pre -Fire: Permits: / Authori d Si4nature FINALAPP.FRM Date T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: (206) 575-4404 • Fax (206) 575-4439 ' r • • n ,,.1 ry • • rs, r ,74,44, sq, • ^ • • City of Tukwila Fire Department AUG 2 2 1994 John W. Rants, Mayor TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Project Name kh /I) I* /• Address "B 5/c 4411-// Thomas P. Keefe, Fire Chief Permit No. iql.-.04.713? Retain current inspection schedule >4( Needs shift inspection Suite # )4( Approved without correction notice Approved with correction notice issued •Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: CIA) Aut7E6rized ignature • Ea /2; /9 V FINALAPP.FRM T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: (206) 575-4404 • Fax (206)575-44,39 ... 'VIC.-••Tn...-.- e f 0 City of Tukwila �1 FEB 2 5 2000 John W. Rants, Mayor Fire Department Thomas P. Keefe, Fine Chief TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM. Project Name /1/414L) Lev Lev Permit No. , ©Li Lir Address C. Sv c �� ��% /44// Suite # Retain current inspection schedule Needs shift inspection yApproved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits:. Authorized Signa use Date FINALAPP.FRM T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: (206) 575-4404 • Fax (206) 575-4439 ABEL FIRE PROTECTION 206 481 8695 P.01 O FILE CROWN FIRE PROTECTION, INC. Dat Com - an Subjec 1. 4.20.01 Fire Prevention Bur€au "Tukwila Fire Department Demo Permit Nvmt r`of Pages (ln luding.Cover 0 Urgent C7 For Review Fax No. 1 206.575.4439 ❑ Please Comment ❑ Please Reply Fro Jessica Robinson PH:425.481.7669 FX:425.481.8695 Comment We need a permit to remove and reinstall pipe in the way of the new seismic upgrade for the following spaces: 1. Friedlanders Jewelers: 676 Southcenter Mail 2. Old Mariners Store: 672 Southcenter Mall 3. Naturaltizer Shoes: 66B Southcenter Mall 4. Carlton Cards: 664 Southcenter Mall 5. Mall Management Offices: 633 Southcenter Mall If you have any questions or need any additional information, please do not hesitate to call. TUKWILA FIRE DEPARTME.N Please call: 575-4407 and give this job q No. d �_Q /7 and exact address for shut- down or restoration aparoval. P.O. BOX 12113 Milt. CREEK, WA 98082 PH: 425.481.7669 FX:425.481.8695 JOHN J. ABEL FIRE PROTECTION COMPANY INC. 4932 PIONEER RD • BOTHELL, WASHINGTON 98012 • (206) 481-7669 FAX (206) 481-8695 September 29, 1988 TUKWILA FIRE DEPT 444 Andover Park Eas Tukwila, WA 98188 SUBJECT . RE ATTENTION : SPRINKLER DEMOLITION NEW SPACE - SEASONS SOUTHCENTER MALL, 635 SOUTHCENTER FIRE MARSHAL tW Wit.A FIRE DEPARTMak 4Q call: 575-4407 and : qve this job No, 88818; and exa t address for -shut• down o restoration approl We need to remove sprinkler piping that was under the old 2 story deck in the back half of the old Toy's Galore. This will not affect heads at the ceiling level. The new plans have been submitted to Factory Mutual and no work will be done without your approval. Sincerely, JOHN J. ABEL FIRE PROTECTION CO., INC. John J. Abel JJA:ro CITY OF TUI ILA Lvontrol No s- 7 -72 - Permit 7_Permit No. S - Central Permit System FINAL APPROVAL FORM NOV 1 0 1988 TO: ❑ Building ❑ Planning ❑ Public Works )K Fire Dept. ❑ Police El Parks/Recreation 1 Project Name Sc-- s Address , A ‘,/ Type of Permit(s) 7- J' This project is nearing completion. Please investigate your area of responsibility and indicate below either your final approval or necessary corrections. , If no response is received within one week, it will be assumed that the project is of no concern to your department and a certificate of occupancy may be issued. This project is ( ( () 1 ) c� � u� /nryl�G91%, iS /moiPPIi NOT approved by this department; the following corrections are necessary: ) Authorized Signature Date This project is approved by this department: t Authorized Signature Date CPS Form 3 P.O. Box 12113 Mill Creek, WA 98082 Phone: (425) 481-7889 Fax: (425) 481-8695 To: Tukwila Fire Department Attn: Fire Prevention Bureau From: Jessica Robinson Bate: October 21, 1998 Re; Demo Permit (425) 481-7669 Carz.14-Dn C s (e la 6{ ' 5 . C . rft a- '( 0 Urgent 0 For Review b Nesse Comment 0 Please. Reply 0 Please Recycle Pages Including Cover Sheet (1) Comments; We would appreciate a demo permit to remove sprinkler heads under existing mezzanine that is going to be removed. The building permit #is D 98-0320. If you have any questions or need any additional information, please do not hesitate to call. Thanks and have a great day! TWIVVU ARE E DEPAftr .:,=' Floe o call; 575-4410 Lind give this ijob No. g--5_'CV and exact address fa? i doral erresterdtion t, 1 41,aue2 D:0400 ABEL FIRE PROTECTION 206 421 8695 P.01 FILE CROWN FIRE PROTECTION, INC. Dat Compal vbjei 4:20.01 Fire Prevention Bureau Tukwila Fire Department Demo Permit Number °of Pages (induding.Couer 0 Urgent For Review '1 Fax No. C7 Please Comment 0 Please Reply Fro Jessica Robinson PH:425.481.7669 FX:425.481.8595 Comment We need a permit to remove and reinstall pipe in the way of the new seismic upgrade for the following spaces: 1. Friedlanders Jewelers: 676 Southcenter Mall 2. Old Mariners Store: 672 Southcenter Mall 3. Naturalizer Shoes: 668 Southcenter Mall 4. Carlton Cards: 664 Southcenter Mall 5. Mali Management Offices: 633 Southcenter Mall if you have any questions or need any additional information, please do not hesitate to call. TUKWILA FIRE DEPARTMENT Please call: 575.4407 and give this job q No. 1, S— O l7 and exact address for shut- down or restoration approval. P.O. BOX 12113 MILL CREEK, WA 98082 PH: 425.481.7669 FX:425. 481.8695 INSPECTION NUMBER INSPECTION RECORD Retain a copy with pe't FEB 5 2007 ,p04 -Lao 07- S- -o/S" PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: a 74114 c Type of Inspection: Co ' A -- Address: cebif S,G , (11/444____ Suite #: Contact Person: &e Wd) -Sc Special Instructions: PhoneNod: Ute' - 3i46-- /-)q3 Approved per applicable codes. rrections required prior to approval. COMMENTS: /4 iJ D 1 Pliarias e, r—to r rA-wt oue C nJ4 o,-4 04. o Kra e -4011-e-- le. e A�-tpf T' le by h e . Needs Shift Inspection: Sprinklers: 7' Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ,S.-/ 11 Date: a2121DAj Hrs.: K4_ $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with p FEB 1 5 2007 Dob - (-11.0 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Dire -e. sui; (As 1D Q Type of Inspection: seek:Mk'4.r1/4_ , ,./,pa___ Address: g S. L , tv\pcLl— Suite #:2 Contact Person: Special Instructions: Phone No.: g-ok-. ,I-2ns,C Approved per applicable codes. Corrections required prior to approval. COMMENTS: sviRirJ Kle,,c a L 0 kms -y Prov i�� apPr o f fil's Needs Shift Inspection: Sprinklers: Y Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: - S / LJ Date: Z// ,S�0 7 Hrs.: MIAs $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with per FEB 2 0 2007 �o6-`ILO 0-7- F - 03D. PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206 - Project: b'( rvi e 3 1 I k S Type of Inspection: p4 Hrs.: Address: go 8 Suite #: S , c . M vi L L - Contact Person: Glad"( tJ c, I .. Special Instructions: - .S- YS1M To Phone No.: 11.1,5'-3Y,- I-293 riApproved per applicable codes. orrections required prior to approval. COMMENTS: Sprinklers: Date: Fire Alarm: Hrs.: -a s 1.rbu c) Pcs : 1-r Dae -1,)1ii) s 6 -Ai - rs►'/.1-1„,,A,,,, - .S- YS1M To ik /C -La` 114 iC ' Sze .- -ct- Permits: k .P_ ge r✓l o 4L Leo 4,,,t___ / hJ/1-C_ r/o 1AJJ ILK(1) • J Needs Shift Inspection: N Sprinklers: Date: Fire Alarm: Hrs.: -a s Hood & Duct: aJ Monitor: L - bb-I_v\ Pre -Fire: Permits: k Occupancy Type: Inspector: On s ---it{ Date: ti/(0/o7 Hrs.: AJ)t4_ $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with per FEB 2 2 200Y p,- c/ges 0"7- / - p32 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206 -57S - Project: OJ ��e -31(.. it t. Sprinklers: Type of Inspection: F* `f v r01/4•Zi Address. gne - •Suite #:i/L)ol s . vm✓� L- Contact Person: r. Monitor: Special Instructions: o r ' Pre -Fire: Phone N .: X,? - 3`(6 -t'773 c" Approved per applicable codes. Corrections required prior to approval. COMMENTS: tJ Sprinklers: Fire Alarm: V Hood & Duct: 0 Monitor: t d o r ' Pre -Fire: XiZ_.- c" ZSkOccupancy Type: 5- 1;- --1-, v., o2 --N--,54- `1-z) IA f i 1.e. pzeF (71-0°4 °4 i5- i -N31 Needs Shift Inspection: tJ Sprinklers: Fire Alarm: V Hood & Duct: 0 Monitor: t d /414A Pre -Fire: Permits: ZSkOccupancy Type: Inspector: O t f Date: 2I 2,0/01„ hrs.. i r-qA- $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F„D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy withpermit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Type of Inspection: L , Address:",,,,Contact Suite #: S. C- )1401 - Person: Special Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Y Sprinklers: Y Hrs.: a Fire Alarm: f- Hood & Duct: Monitor: rJi,� r) Pre -Fire: t Permits: PA Occupancy Type: A a - Inspector: A 5-11 Date: 2/aa-(63 Hrs.: a 4E1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit ?Y n <Dg - S- 13'2, 5 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: a g !cue. c. &,r s k, Sprinklers: Type of Insp ction: 3 P L_ TA, tivtedk *(p s� Address: i- ` ,` 6 C., Suite #:=- `� Z� o vi I Contact Pers n: Special Instructions: Phone No.: pproved per applicable codes. Corrections required prior to approval. COMMENTS: e 4— Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: As -/t/ Date: -2,i1l Hrs.: r $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from he City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD. Retain a copy with permit "1.1-SOd PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, TukwilaLWa. 98188 206-575-4407 Project: �3\Lk C a - 5�1)., Type of Inspection: 1 1r C,� - Address: 6 C Suite #: 5 Monitor: Contact Person: Special Instructions: Occupancy Type: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Pe -QA j,J' /^y/ / c ol,N 5 P he rd i C®tp(rro2 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: �► y Date: Ja ( log Hrs.: � j� $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from a� " .. the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION BURBAD 444 Andover Park East,Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE *FIRE ALARM AND FLRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testingand additional fees will b.e assessed. Contractor is responsible'for supplying manpower for Final Acceptance Test with twowly communications. • Date J Pit# F- I' Properi Address. t{ [�. j SOUTH CE►.DTEX• M ALL. Suite # • City Tukwila Code `t' l 8 g • Name of Facility (13 e ST l E. Li) . 1` 1 Occupied as Owner or Representative Installing Company (2,0 U ART, i• A k \ Phone # Sec .) ct-k-r-Le Installing Contractor's Address 1-743 PT' AVE . 5: City 5-eATTc.E • Phone# 2 -foZZ-cS4-5 Installer's Name (PRINT) ( H O M A.S '[2 -rt._ ► F F License and/or Certificate -R. AT L I I'M 3OH • General Contractor covt‘ir Electrical Contractor e -S FACP Equipment Manufacturer Sip m e i3 S Model # S This system has been installed, pre -tested and operates in •accordance with the standards listed below and was inspected by `74rjlt4 ► "Qt>c-rt_.. I F �' On (date) and includes the devices listed on back. Circle all that apply: X NFPA 72, Chapter( 11)5 0:band/or IFC SEC 907 . • NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions X Manufacturer's Instructions Other (specify) K Tukwila City Ordinance Numbers 2050, 2051.. UL Central Station Monitor • System is monitored by SIGNED Date System Firmware: Installed version _. _____ Checksum Date EQUIPMENT INSTALLED AND TESTED: Control Panel Manual Station Smoke Detectors Heat Detectors Duct Detectors. A/V Devices Audio Devices . Visual Devices of 1 Make/Model .51 eve s •>C L S of Make/Model of Make/Model $temrnS kVP- 1 of • Make/Model 4_ Make/Model S ► elvt, e /AS A D 2 - F oto of of Auto Door Release of Trouble Indictors • of Batteries Readings Battery Generator HVAC Controls Fire Alarm Dialer G.eiins:) WALL Make/Model 5 y .P,m.e n s ET- M C.- C 11J O t2 (.) . Make/Model Make/Model Sie, wi ex ,s 2 k- ' M G " Make/Model • Make/Model Full Load . Charge of Make/Model of _ Make/Model of . Make/Model 5.1 Me\ S m1 - Monitored by (1JEs-7 F 1 EC.. D ILA tLL. PALE Annunciator of Make/Model 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw, Valve Tamper Sw. PIV Elec. Alarm Bell of of of of • Make/Model Make/Model Make/Model Make/Model Automatic time Delay of Water Flow Alariu seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? . Yes X No Test of alarm System on emergency power, satisfactory? Yes Test Witnessed by Title Comments: No Date 12 W (G„4c.(.. INSPECTION NUMBER INSPECTION RECORD Retain a copy with pterrnit. CI) MAY 12 2008 -Doe -ot10 o -5 - 43, PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: "EWE 0 g544/ Type f Inspection: Hood & Duct: Address: y6$ 6 , Suite #: 6. irizepu, Contact Person: (' -p - ji/' ;:;41D:? Special Instructions: Phone No.: .proved per applicable codes. Corrections required prior to approval. COMMENTS: O/? -/-a Co ✓eg.- Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 4...14)414„/ 5- , 2_ Date: ,5- s. Oe Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 2 - INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit Y 1 2 200B 1oz,-0t , oq,-5-i PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project:' uj G SJS th Type of Inspection: Address: Lt b ca. S, C. Mq-i,L, Suite #: Contact Person: Cw4:D • VI' CM-. Special Instructions: Phone No.: 92- - 334. -$71-C4- Approved per applicable codes. orrections required prior to approval. COMMENTS: Erierenb S P 02.444 1C-02:0-- (i JLUL- 11 -to Ut4is t• -t ex or4 QST W AAA., IW 04 IA (•4 11-411sirr — 5. gprn444Thvik. w V Nv rwr e.4 v4Au„. Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: j41 (SiZ- Date: 5.q..0$ Hrs.: j. $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit C APR 2 5 2009 P00- oll PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: `��u e C su60-t Type of Inspection: Fire Alarm: Address: y be. S,/. Suite #: in Conta Person: q ., /A /ems, vV -?(-W Special Instructions: Phone No.: 'Approved per applicable codes. Corrections required prior to approval. COMMENTS: (ALA) cr-A-0A_ Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: spector: 4/4)/6 /2. Date: yet, ifof Hrs.: 9 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from he City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit , �1 CITY OF TUKWILA FIRE DEPARTMENT Do-) -zgy PERMIT NUMBERS 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: -e-�S Sprinklers: Fire Alarm: Type of Inspection:// ?LheR ecam, It (( '1 Address: 467 Suite #: s, ,�i,(, Contact Pieesurson. J /V/ Special Instructions: Phone No.: ,,,t6 g- 33/-074.6 proved per applicable codes. nCorrections required prior to approval. COMMENTS: Ov\ QASQVL y k 1'9 &it_. Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ii" S V Date: d� 7p8 Hrs.: fia--E $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F, D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit P67 -'f5% r'1o3-27/ PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: w6ss Type of Inspection: r4-4 / /nee* -. Address: y63 S c, f ��c,.. Suite #: Contact Person: / /1/ fri Special Instructions: Phone No.: 2191— 331—Oyt94 Approved per applicable codes. Corrections required prior to approval. COMMENTS: — 0/6_— P61/16 /6_— P c6 c ,VVT #2 f Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: WA/ /,S/Z Date: 6/0 08 H rs.: r f $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with per -mit pog 7e5Zi PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 6v� • Type of Inspection: n%GN C4- -7----- /Address: Address:1/69 s, ti mq, Suite #: Contact erson: Pre -Fire: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: f�VOZ — d Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: f Inspector: *Wed /5/2 Date: 4/2e Mpg Hrs.: 1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from e City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: C:5 Type o Ins ection: sr , L Address: i 4 62 j . r` , vA Cony.pct Person: 1/ Suite #: Special Instructions: Phone 91 ---Approved per applicable codes. Corrections required prior to approval. COMMENTS: Se cliu oft- ole 2 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: kc,, j oi Date: 6/9 ; is 4 Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 02. INSPECTION NUMBER INSPECTION RECORD Retain a copy with per pit MAY 2 0 2008 C).? -5-/.63 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 6 5_5 Sprinklers: Fire Alarm: Typp Typeof Inspection: Address: ti b 7 Suite #: 3, C. Mitl-Lr. Contact Peron: , Special Instructions: DiU Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: DiU O s c9-g-s'—pe.4 / a 00 (qs zoo COJ 01 - Ne> -e__ SPAc GA( c1x.iti4-j 7(c_ouevbele.,) Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: S-/ ( Date: rllyive Hrs.: ik$80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with p�r`�'%r it �-n -MAY 16 2008 PoS PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Q S S Sprinklers: Fire Alarm: Type of Inspection: 5 0 Address: /.4 (o 7 S. (.. Suite #: yv1 r (r Contact ! erson: �:- a Special Instructions: Phone No.: pproved per applicable codes. Corrections required prior to approval. COMMENTS: Ss c*/41 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: -U, / Date: s— I v C? Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TUKWILA FM P TION BURBAIJ. 444 Andover Park East,•Tulcwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIALAlNID TEST .CERTIFICATE • FIRE ALARM AND FIRE DETECTION SYSTEMS • Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees willbe assessed. Contractor is responsible°for • supplying manpower for Finial Acceptance Test with two-way communications, • • Date ��ZSAX Permit# Og - F- 320 - Property Address. 4 627 • SOu T H M PLL. Suite # City Tukwila Zip Code 9175 l $ g Name of Facility (13 eST 1E. L > H A u_ Occupied as . t 5 S' ? Owner or Representative /Yfi4ie,< CG fOR7,I Phone # (u,z) 33/- 0?66 Installing Company ;uAZD i A \ Sec J cZ•�T� S -Y5 `%ewt S Installing Contractor's Address I-743 A u E. S; City SeA-rrLE 1 • Phone# 20 6- (ZZ - 6 S 4.5' Installer's Name (PRINT) —7—ROM A.% '(ZA Tc,. l F License and/or Certificate 1Z hT t. i 'Tw► 3Og ,N H General Contractor p i 4/4 Electrical Contractor G/r ve/ Crerr glee 1l/c FACP Equipment Manufacturer • s'r e Mel) S Model # L.5 • This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by —1-1.4(31 ,46_ -RoTL ! F On (date) GYZr/ g and includes the devices listed on back. Circle all that apply: X NFPA 72, Chapters 5 and/or IFC SEC 907 le— NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions X Manufacturer's Instructions Other (specify) K. Tukwila City Ordinance Numbers 2050, 2051. UL Central Station Monitor • System is monitored by SIGNED Date System Firmware: Installed version Checksum — Date EQUIPMENT INSTALLED AND TESTED: Control Panel of Manual Station of Smoke Detectors _X of Heat Detectors of Duct Detectors. of AIV Devices of 5 Audio Devices of Visual Devices �_ of 1 Auto Door Release of Trouble Indictors • of Batteries Readings B attery Make/Model 5i e nie h s Make/Model Make/Model Make/Model Make/Model S as A D2 - F S1ef+nPns Make/Model S i 2MQ n S Make/Model ICT -MC -(.U.3 o Make/Model SI e h1 Q r1.S Make/Model Make/Model 2R- MG-Gt,���,�� Full Load . Charge• Generator of Make/Model HVAC Controls of Make/Mo.del Si 2uKe,11 S —ng 1 - R Fire Alarm Dialer _ of . Make/Model . Monitored by Wes? Ft ELD iG1 1\L PA -10 Annunciator of . Make/Model D Sprinkler System. (Fire Alarm connections only) Water Flow Sw. of Make/Model Valve Tamper Sw. _ of Make/Model PIV of Make/Model Elec. Alarm B ell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, EEC SEC 907., and/or NFPA 72 Chapter 6? . Yes X_ No Test of alarm System on emergency power, satisfactory? Yes _ No Test Witnessed by Title Comments: 1721/ /1 Date w ALL L • / Jf/7'i , Re /4), TAeL ,4460 7 5TEII 012. G.J�w INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: orn / .1—(4 Sprinklers: Type of Inspection: Eliit .G5 /,r,k ' `..-7 Address: ocg Suite #: S c , /'4X1 -L Contact Person: Occupancy Type: Special Instructions: Phone No.: Approved per applicable codes. ections required prior to approval. COMMENTS: t4c 1 i .41)'D144 -Citioie. Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: p, c.64, Date: iJ/40/ Hrs.: f $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit S -30I PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 6- u/ --reAlK (e PU f5 0 _r c"c. Type of Inspection: .se co.iitc. III QLL `,,J 4 1.-- Address:Contact Suite#: cl'S-3 S`C` -C. Persor : Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: SP --oJ &ec.GL 0✓< Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: , c- i y Date: 7/0 /0?) Hrs.: n $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION' RECORD Retain a copy withipermit Y S-1 INSPECTION NUMBER PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project:* �LL Sprinklers: Fre Alarm: 5 Type of Inspection: lA )tibort_. Address: t 1 Suite #: "( 5.,C. _ yv1 1-- Contact Person: Special Instructions: Occupancy Type: /lam Phone No.: proved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: f Sprinklers: Fre Alarm: 5 Hrs.: Hood & Duct: Monitor: Cs9t\,r.% Pre -Fire: P Permits: N-0w-�. Occupancy Type: /lam Inspector: � 1/ Date: 7J/ gl®-� Hrs.: 1 4 n $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit bo - /s-3 0-&- -301 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 0€01S UMe_ko(4.52 Tye of Inspection: bee), )Cotiada___ Address: c}, 5. C C. Mvkl L— Suite #: Contact Person: Special Instructions: Phone N pproved per applicable codes. Corrections required prior to approval. COMMENTS: 0467 S /6°0 no 0 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector:4-j ty Date: �'//Wo Hrs.: LZ $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION' RECORD Retain a copy with permit INSPECTION NUMBERr rl \ 1 % PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT JUN 1 9 2008 : eve -153 ,00-9 - 3o( 444 Andover Park East, Tukwil pproved per applicable codes. Corrections required prior to approval. COMMENTS: Wait) G115e11^-6 Needs Shift Inspection: Sprinklers: Fire Alarm: Type of Inspection: VV J/ J . .../ Project: OW IBJ k Address: i./50 , Suite #: 6 . %q Contact Person: at114-0 - kb -5 TA -re Special Instructions: Phone No.: pproved per applicable codes. Corrections required prior to approval. COMMENTS: Wait) G115e11^-6 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: ector: 142111, //6a Date: (/r3 %o °v Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 i INSPECTION NUMBER INSPECTION RECORD Retain a copy with r`)/? -33e) a --s- 6C, Jvt- 1?.� PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206 -575 - Project: re(:>s S)-)' Fire Alarm: Type Inspection: S Address:ce Suite #: S C . ✓` ,� Contact Person: Special Instructions: Phone No.: FKIApproved per applicable codes. Corrections required prior to approval. COMMENTS: sP c',N _ nj< Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: L 5-2-- Date: /�cp p Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with per 't O - 3.p Meat_ /53 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Sprinklers: Fire Alarm: Type of Inspection: Address: Suite #: C� Permits: Contact Person: Special Instructions: 32bC lv coekr (' ) Phone No.: Approved per applicable codes. orrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: / . A op 32bC lv coekr (' ) a. 3� iC �,,\ p , (.�- Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ilk_4-. S?-- Date: /)2/ /3 Hrs.: / n $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with per it bl'a - 33-0 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: ��e Sprinklers: K Ty a of Insp n: , m- -4--- Address: sv Suite #: C ,L- C eta PPerson: % `�' �- Sc `'"t° 04 S Special Instructions: Pre -Fire: Phone No.: 9-s-3- 33a - '4k, proved per applicable codes. nCorrections required prior to approval. COMMENTS: r - - N -Art -, a(� Needs Shift Inspection: . v Sprinklers: K Fire Alarm: Y Hrs.: Hood & Duct: N Monitor: C tvet.) Pre -Fire: Permits: tgL Occupancy Type: /li. Inspector: /J c..".- g')--- Date: ///a//3 Hrs.: n $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 2 - INSPECTION NUMBER INSPECTION RECORD Retain a copy withit 13- �- eog 33(.) PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: -, c IA -0 J ''0 l' Type of Inspection: --14 c .19er-e- Address: iq? Suite #: ALL Contact Person: Special Instructions: Phone No.: nApproved per applicable codes. 14Corrections required prior to approval. COMMENTS: 1. 1 -P - o e pJ s 1-b b -& frc o- Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: SY Date: /// 7// a- Hrs.: n $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with - it r)la-33o I3_ F' oo, mca —Ia PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: P c -c, s S 591.0 - Sprinklers: Type of Inspection: Address: C 1.- Contact Person: q Suite #: Special Instructions: Phone No.: nApproved per applicable codes. Co rections required prior to approval. COMMENTS: 1. P40.- cam, Idret Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: f S e. Date: iii '//3 Hrs.: t $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with p MAR 2 8 2008 'Do4--3f) 1 o6-5 - d6(= PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Coame-5 f--1 peo clrp#2_,r dc 0.0 e 2- LO ri ---- Type of Inspection: SPQ.r,441.t Hood & Duct: Address:4y7- S•u Suite #: 6411G&- i,ti Contact Person: 'eTb DO N 6-I-.► to q. Special Instructions: kap op LI t4i Q.s-nao - - Lowave- that 2' H 4 u e -to 5' (o" lio u suz UP Phone No.: 112-5.- 3b- &t 014 or_ P--- '?/5-e riApproved per applicable codes. -orrecctions required prior to approval. COMMENTS: f--1 peo clrp#2_,r dc 0.0 e 2- LO ri ---- EMD e Rao e 2- Io r% (-)v, Hood & Duct: r 0 Olc 10 ��- Pckik- a c.,0021 - Pre -Fire: Permits: 4C Q gaD hoGP,Q. WA IN IL o Mt. 9010A, go:4- NA- kap op LI t4i Q.s-nao - - Lowave- that 2' H 4 u e -to 5' (o" lio u suz UP brS 'Io. Wont D it 4-tpru, °-t2 WvR-G. S-ro&M or_ P--- '?/5-e Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 0,14)4 / Date: 7126 iaq, Hrs.: Z $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: LTt I 1 4`'C'f(s Type of Inspection: , &M 4e.ti I� G�: e Address: �//� Suite #: ` 5-7 C,L L Contact Person / Special Instructions: Occupancy Type: Phone No.: EllApproved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: ..C --pr, Lej - fit, I) lint, A-toro volt— L -C i t,1-' w1 7-e, ell / -(3f-4,* -4,0&_ AJy . C fl SS A * wwti ere Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: tivk I y Date: Ve 5 Hrs.: 1 / $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TUKWILA FIRE P -\WIT QN BURBAlci. 444 Andover Park East, .T ulcwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE • FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will. b.e assessed. Contractor is responsible'for • supplying manpower for Final Acceptance Test with two-way communications. • • Date • 7/(5/o8 Permit # 05 ,E l 1 - Property Address. 45 7 SOUTH cee.7TEZ • M r‘u__. Suite # City Tukwila Zip Code 9,'TS 1$ $ Name of Facility (teST tE.Lt, Occupied as . 61LLy U.} C SGS Owner or Representative Phone # 0 Installing Company r;uAQm. ce-.t y6 4-e\ I S Installing Contractor's Address 17 4 3 1 °T AV E. s; City SeATTLE • Phone # Zvi --6:2z- +5. Installer's Name (PRINT) (,Ko M A,S '(Zf} Tt, I FF License and/or Certificate 'R AT L 1 -1--N1 3Og ,N H General Contractor /1/4 / tjit) j2,9/ ot/4 L#0? • edit./ .5 Electrical Contractor SES} -TRC, ESC Ern 1 c • • 7: FACP Equipment Manufacturer • 5 dm e s Model # X L 5 This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by _DHbr„ t ittS 1:ZrkrL f F On (date) and includes the devices listed on back. Circle all that apply: X NFPA 72, Chapter( 25 ((band/or IFC SEC 907 %C NFPA 70, National Electrical Code, Article 760 Manufacturer's.Instructions X. Manufacturer's Instructions Other (specify) Tukwila City Ordinance Numbers 2050, 2051. UL Central Station Monitor System is monitored by SIGNED Date System Firmware: Installed version Tnif 1 r,rnrn-a.,. Checksum Date EQUIPMENT INSTALLED AND TESTED: Contrrol Panel . of 1 Make/Model 5i e M e h s •)( L S Manual Station of Make/Model Smoke Detectors i of 1 Make/Model S ( e rvtP.rt S 1V P- 1 1 Heat Detectors _ of _ • Make/Model Duct Detectors. 44 of_l__ Make/Model Si t e ns A D2 - P 0 y) C:ei 1 int uz ALL AJV Devices tH of j Make/Model st?.I t e., I1 •S ;S ET- M C - C•1..) 0 2 UJ ' Audio Devices _ of Make/Model •(t0) (7) Visual Devices 17% of I* 17 Make/Model Si Q irvt CMS 2 12- • M G - G L�.c.,11 o e. k,,J (t,at., Auto Door Release _ of Make/Model Trouble Indictors — of Make/Model Batteries • Readings Battery Full Load . Charge Generator of Make/Model HVAC Controls 4 of y Make/Model 51. e. mat S —r—R 1- R Fire Alarm Dialer _ of — . Make/Model Monitored by u...)65-7- Ft ELD ILA PsLL. {p#kk. E Annunciator of . Make/Model D Sprinlder System. (Fire Alarm connections only) Water Flow Sw. of Make/Model Valve Tamper Sw. — of Make/Model PTV of Make/Model Elec. Alarm Bell of • Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? . Yes X No Test of alarm System on emergency power, satisfactory? Yes _ No — Test Witnessed by Title Date Comments: INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: c— I t (T f S Sprinklers: Y T of Inspection: Hood & Duct: N Address 3---? S. C . �2 Suite #: � Contact Person: Occupancy Type: /v\. Special Instructions: Phone No.: 60 -30- 760-/ proved per applicable codes. riCorrections required prior to approval. COMMENTS: itt- ye Needs Shift Inspection: Y Sprinklers: Y Fire Alarm: Y Hood & Duct: N Monitor: L41 ! lk n/ Pre -Fire: N Permits: nl Occupancy Type: /v\. Inspector: iL SW Date: --vgwa g Hrs.: j n $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION RECORD Retain a copy with permit INSPECTION NUMBER JERMIT NUMBERS, CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: --1 i y G.S TypeK IjEn� ss 1\5'P cost % ,rt1Af 4f;tA Address: c. s• , Suite #: S' .0 . ,- p L L Contact Person: J Special Instructions: Phone No.: ;(q- 3C)/ -7‘9-t 1E -Approved per applicable codes. FiCorrections required prior to approval. COMMENTS: P o V- • 6 - Ott 1-0 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: itav‘ ,f'/ y Date: '7 rl Y/o Hrs.: 1 pit n $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION ReCORD Retain a copy with permit D07- P31 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project• IlY I-l���S Type of Inspection: v/ .NU' at L Address. L L Suite #: 1451 ". L • IN1 Contact Person: Special Instructions: Phone No.: &14 -?)61 -7C1( LIApproved per applicable codes. R-Gerrections required prior to approval. COMMENTS: Emt-y-tikc 1E4Lt-;,q, - Q 1 !1gL4. ; 60,1.ck AAA, Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: VF".5- I Date: --) 1 i D 0 Hrs.: ( tiAl$80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from City of Tukwila Finance Department. Cali to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit r CITY OF TUKWILA FIRE DEPARTMENT PERMIT NUMBERS 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Sprinklers: K Fire Alarm: Type of Inspection: Address: t/36 S. L . Suite #: An L. Contact Person: Special Instructions: hS Occupancy Type: /t^ Phone No.: tLpproved per applicable codes. riCorrections required prior to approval. COMMENTS: Needs Shift Inspection: dr Sprinklers: K Fire Alarm: y Hood & Duct: N' Monitor: 6 ..rr),,r Pre -Fire: Permits: hS Occupancy Type: /t^ Inspector: lei— Date: 7) 9.2-1 o & Hrs.: ( e4ZEI $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit '3T PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: t e eit. Cerivvcoier Type of Ins sp.r,,,. ion: cos I i.:1 re45 6444..)1/4. Address• a uo 1,c, Suite #: t_ Contact Pe n: Special Instructions: Phone No.: ed per applicable codes. nCorrections required prior to approval. COMMENTS: S N,3/t.. — Needs Shift Inspection: Sprinklers: Fre Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: x-14 Date: 7 %/ (fo 3 Hrs.: 1 U4n $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION RECORD Retain a copy with permit INSPECTION NUMBER FELE COPY i-31-°3 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 5-e1ecr4--6...-P0A- Type of Inspection: EE..{,.. Lyc k. Address: ii 3 c., Suite #: S c- AA -et t/ _ Contact Person: El -tel G 134v41,. Special Instructions: Permits: Phone No.: 0)4A,,-'?]/—oj0 iyApproved per applicable codes. Corrections required prior to approval. COMMENTS: ® h 4 a k . O' Tts S+ac Needs Shift Inspection: Sprinlders: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: Aim 51 / Date: 7,/ 1_0 i Hrs.:, s $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit Cr�GI Do-) - 3Vig OR-$- /(95 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: se,1 e cA.. C,z,cont- Type of Inspection: Co v -e-(2.- \ t4 -`f (1Z.-eD Address: Suite #: U 3 (o S . C . „,w -LL Contact Person: Special P� Permits: Phone o.: ,, II `em'7310-3Wi tot ed per applicable codes. I I Corrections required prior to approval. COMMENTS: co li/r5 t /I 3D /41-,1 Hi b2o ok cB A,Li' ado PSS co.) t .7 ), D.0 'sr CA ktglig Hood & Duct: bk Tv C ' Pre -Fre: Permits: Occupancy Type: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fre: Permits: Occupancy Type: Inspector: s7 y Date: c/aVie g Hrs.: a $80.00 REINSPECTION FEE RETIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 1 INSPECTION NUMBER INSPECTION RECORD Retain a copy with MAY 2 2 2008 -001 -3�b r: -s— 165 - PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: S ta.,44-,A#,,,r— Type of Inspection: S PottiKg.c,c0-- Address:_ 43 4 Suite #: S. C. Ak.oewPerson: Ga Special Instructions: Permits: Phone No.: Approved per applicable codes. I I Corrections required prior to approval. COMMENTS: v.)4214 - U 1�— Needs Shift Inspection: Spry klers Fire Alarm: Hood & Dunt: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: `-ri aJ / G-17._ Date: 5h4 /OA Hrs.: 1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from e City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 88/38/99 14:83 NU. ULM F'L 1: aU1 E, RN STATES FIRE PROTE ION 7102180th Ave. N.E. Suite A-105 Redmond, WA 98052 (206) 881-0100 (206) 8814030 FAX FAX TRANSMITTAL SWEET fUKWILA FIRE DEPARTMENT Please call: 575-4407 and give this job No. 99 - � 72- TO 2 TO : Takwilla Fire Dept. ATTN : Fire Marshal and exact address for shut= down or rest. . '. FILE Date : August 30,1999 / CMC) ON/ FAX # : 206-575-4439 FROM : Steve Elliscr RE : Shut dowr, # TOTAL # OF PAGES : 1 ( INCLUDING COVER SHEET ) REMARKS To whom it may concern e 58 5/c i 1 Can we get a shut down # for Brook8tone [ South Center Mall Space # E 544; 633 South Center Blvd.; Tukwilia, WA 98188. The General Contractor is asking if we can demo out some Sprinkler piping that is in the way of work they are trying to perform. This work should take about 1 day. We will be submitting New Sprinkler drawings for this space some times this week. If you have any questions please call_ Thank you. Sincerely, Steve Eliisor Lic'' City of Tukwila Fire Department FILE TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Project Name CCX)V.SkQY) Q. OCT 1 8 1999 John W. Rants, Mayor Thomas P. Keefe, The Chief Permit No. D 1z\ -- oxo ` t'' -O\\°\ Address C.5(2), SU Gszliter- c Lk_ Retain cui'ent inspection schedule Needs siiftrinspection i5 Suite # Approved without correction notice x Approved with correction notice issued Sprinklers: Fire Alarm: g\AC. Hood & Duct: Halon: Monitor: Pre -Fire: Permits: 510 Authorized Signature FINALAPP.FRM Rev. 2/19/98 16 »(111 Date T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: (206) 575-4404 • Fax (206) 575-4439 CITY OF TUILA Central Permit System ontrol No 9c-ieo Permit No. FINAL APPROVAL FORM JUL 5 1990 TO: ❑ Building ❑ Planningyl ❑ Public Works Fire Dept. ❑ Police ❑ Parks/Recreation Project Name Address ` 7 Type of Permit(s) J This project is nearing completion. Please investigate your area of responsibility and indicate below either your final approval or necessary corrections. If no response is received within one week, it will be assumed that the project is of no concern to your department and a certificate of occupancy may be issued. This project is NOT approved by this department; the following corrections are necessary: () () () () ( ) () () ( ) Authorized Signature Date This project is -pproved by this department: %I /' Authoriz ignture ciO Date CPS Form 3 .01 ttiy Co1 February 6, 1995 Tukwila Fire Department 444 Andover Park West Tukwila, Washington 98188 Re: Mrs. Field's Cookies, Southcenter Mall Sprinkler for new cooler 612_ 5/c wtf BILE tUKWILA FIRE DEPARTMENT Please pall: 575-4407 and give this job No. gS =7s''d3 7 address for shut- odwrr . r restoration approval. On Wednesday, February 8, 1995, Mrs. Field's Cookies will be replacing their existing walk-in cooler with a new one. Please issue a "shut -down" number to allow us to remove the dry pendent sprinkler from the existing cooler and reinstall it in the new cooler. Thank you for your assistance in this matter. Brad Bull Project Manager Fire Protection Division 5005 3rd Ave. South . P.O. Box 24567 • Seattle, WA 98124-0567. 206 762-3511 Mc -k -N -372ND INSPECRON NUMBER INSPECTION RECORD Retain a copy with permit : APR 2 5 2008 -S-096 ba$ -oyb PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: rnt,' P �- a 4,14, i/F Type of Inspection: 7i/'e- i ni E L .s 2 Address* 7.Zg Suite #: S -G• watt Contact Person: geA-Z__ 4'2-5.'—(4204 -o G'.Qeev`t 7 -C)6 -3c14 — Slot cQo,-,v% Special Instructions: — /f e Jeup w• -r) +— 01M)r:n4k — Ato.,(d, Phone No.: 4 25=4 /— 5G6 `l --x. "'cq. nApproved per applicable codes. Corrections required prior to approval. COMMENTS: Ilydro Ole.- d4,,J- r;,ti,F ,mg ps; zr$ 0,4 -7---/a44 /VA PS/ Z s Es-- L-•/ 5 (.%i 7-S-iv#rr- grNeit Monitor: — Prov idixi_ A-5 bui 14-g .0 .r- C (Akv.W 4 5P r'retk!• - Si — /f e Jeup w• -r) +— 01M)r:n4k — Ato.,(d, Occupancy Type: -- ) 61,\" -- �l ap = Y 0 ' b i4A- 2C 5{y � gted PaoaY&A — tou i alt pro 4-ee.A:1G... a,c . - k IAkI.m.P Atte.? ,& ilir,,,,.u,, adv. G,. GO9 N digte-f- — 14(715.ee ty,244_ ap raA 9pr ak I a b $ tevalit.. ar•eak — tn) `7ka� o& d1,rop. p,.. '444_102,y. tz, cd,J &f 7 rtfai & AV tom. — Neeok c-ki- S ket4 ova pt y woad %.,-- c la %AAA_ W"4 2a 1 — 'At 5OrAl hj. tvaGt fsy aboJQ / L; G Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 47 N 570 Date: 112,,/6.5.* Hrs.: n $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 �1 INSPECTION RECORD Retain a copy with permit APR 2 5 2008 b —5-09(, PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 INSPECTION NUMBER Project: ..•-6-14E.../24/....0 iruf � oe ..E'raiNkL Type of Inspection: E,2 Address: —7--2 S Suite #: S. C. vet ate Contact Person: R ems► t. 4''/ «,"/ Special Instructions: Occupancy Type: Phone No.: (//g-'-- 6a y_ d3q/ 'z s- Y8/- 7669 -Approved per applicable codes. riCorrections required prior to approval. COMMENTS: bk.le4.- /A/5)07-70,1/ Needs Shift Inspection: Sprinklers: Fre Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: - j/4 -5—/e5 Date: ` f /z.th if Hrs.: 1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 a2 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit ( pyj o o8- F'- /4/ poi - 170 014 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: cove It 14,t a c: 4) 5,v,,0 t4N; e Type of Inspecti9n: Address: 7a4 S'. c . Me -LL Suite #: Contact Person: ta Prd' Special Instructions: Phone No.: 3, ars"- as-'f't 1A -Approved per applicable codes. Corrections required prior to approval. COMMENTS: se .P;Ntet-t, a K40 -y -hp skoe., . Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: f y _ Date: s?/ -7 /v8 Hrs.: i 4)`` $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from �� NN the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with pimit -DOS - efri� DFS—S— O4k, PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: ISM, vt CARII6.vv p- Type of Inspection: 3P14,04,I-t,E?i- Address: 72, h , t°, Motu" Suite #: Contact Person: 1 %iifoip Special Instructions: Phone No.: 23 - 31s- - 024 -ti Approved per applicable codes. Corrections required prior to approval. COMMENTS: —D( - CoVOZ- - rites - fm,L O Guu,4 I P. s W W -G. 0A41444,(.----5 Tb itut-crt-WK, t`lse0 C < 6/4 Rif4 -rte Pocwt)o) Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 4, Wa iit /5/7,... Date: 5.5'• 00 Hrs.: / $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from ity of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F, D. Form F.P. 113 INSPECTION RECORD Retain a copy with permit INSPECTION NUMBER yvl4,: - o017 Do -04/6 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project:Type ll CA:9 el* ‘.4..a.criiN ies'_ of Inspection: iikez-k. Address: aj2 b -G N L Suite #: Contact Person: Special Instructions: Phone No.: Approved per applicable codes. nCorrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: , s--jc/ Date: 7//,6,6 5 Hrs.: i $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TUKWILA FIRE ? T QN BUREAU. 444 Andover Park East,.Tulcwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tulcwila.wa.us CONTRACTORS MA:TERXAL AND TEST -CERTIFICATE • FIRE ALARM AND FIRE DETECTION SYSTEMS • Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will b.e assessed. Contractor is responsible°fox • supplying manpower for Finial Acceptance Test with two-way communications. • • Date • Permit# W - F— 169 - Property Address. 722 SOU T N i 1- Iz M s\LL Suite # City Tukwila Zip Code 9,$ i $ g • Name of Facility (13 e ST t E. LD . HA t_L.. Occupied as £rye {mice, Owner or Representative Installing Comp any("; y C. ; e A 1._\ s e c t/ cz. t -r-' S - Y S 1-e wt S Installing Contractor's Address 1-743 i' A t./ET . S; City SeA-r-rL-t Phone # Phone# 206,- CoZZ - 6.S +5 -- Installer's Name (PRINT) ( ROM f .S 'Riot TL I F License and/or Certificate General Contractor Electrical Contractor 01t`4.' NARifa FACP Equipment Manufacturer • S, v, m e s �2 AT 1- I Tr1 30$ NH model # X l S This system has been installed, pre -tested and operates in 'accordance with the standards listed below and was inspected by `-1-br4 its -Qtkrt_ On (date) and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter 5 0Cband/or IFC SEC 907 • %C- NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions X Manufacturer's Instructions Other (specify) Tukwila City Ordinance Numbers 2050, 2051. UL Central Station Monitor System is monitored by SIGNED Date System Firmware: Installed version . Checksum Date EQUIPMENT INSTALLED AND TESTED: Control Panel 1 of 1 Make/Model 51 e rvi e v S L S Manual Station of Make/Model Smoke Detectors -of A Make/Model 5 t ennen S N P– 1 1 Heat Detectors of • Make/Model Duct Detectors. J_ of J_ Make/Model S crvt e. VIS A P 2 - P Ger ATV Devices 2of Z Make/Model n. S ;SET- M Co e W Audio Devices of Make/Model Visual Devices /of,J Make/Model Ste v t eA,g 2 R- M G - C. W fit; 14nJ o t - Auto Door Release — of _ Make/Model • Trouble Indictors • of Make/Model Batteries • Readings Battery Full Load Charge Generator of Make/Model HVAC Controls L of I Make/Mo.del 51. Quvte n S -"'R 1 -R Fire Alarm Dialer _ of Make/Model Monitored by Wes,- Ft ELI) �..` 1\LL P#kL E Annunciator of Make/Model ❑ Sprinkler System. (Fire Alarm connections only) Water Flow Sw. of Make/Model Valve Tamper Sw. of Make/Model PIV of Make/Model Elec. Alarm B ell of • Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC' SEC 907., and/or NFPA 72 Chapter 6? . Yes X No Test of alarm System on emergency power, satisfactory? Yes _ No — Test Witnessed by Title Date Comments: INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: opkeKkilb,6 cType J'�w�oo"ife of Insption: f L -�sl iJkL Address:� Suite #: jz Contact Person: Special Instructions: Monitor: 64t1Rs1 Phone No.: F.tkpproved per applicable codes. nCorrections required prior to approval. COMMENTS: Needs Shift Inspection: y Sprinklers: r Fire Alarm: 1' , Hood & Duct: P Monitor: 64t1Rs1 Pre -Fire: /t -i Permits: N Occupancy Type: p — Inspector: r s ---t c/ Date: 7/ or 6-13 Hrs.: 1 it/ $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit Do -Mq' D$-S-Syp PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: M,bAop,`5/w¢., Tye of Inspection: Address: Sou Sc Suite #: DN., Contact Person: Special Instructions: Permits: Phone No.: I I Approved per applicable codes. Corrections required prior to approval. COMMENTS: - OI( -to wA-a-c tato Pro Sr lS VA% , PSS N to -to 3,ZPA-SGN (A145 5 vJ(N6��7 uovb Imo--1-o-rt-t4 1 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: J Spector: Lv( / g (.1 Date: 1 23. 1 b Hrs.: ( r 1 $8g.00 REINSPECTION FEE REQUIRED. You will receive an invoice from ity of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit oa-5 -51-10 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: hi $.41.A ,e --j -rep". c-rtryc, Type of Inspection: 5 e it ncIC.L./Ze--- Address: loo SC Mid Suite #: Contact Person: Special Instructions: Phone No.: ?---Irriproved per applicable codes. I I Corrections required prior to approval. COMMENTS: c$14 Com Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: .JI, via /5/2-- Date: i /i Joy Hrs.: / ik$80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from `M City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with 't DOW- C5q 1 -to " - oo �f PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: initititias ( S re Type of Inspection: 5e-P„„vic , fled 1 41 - Address: gy-0 S- r , mart -4— Suite #: Contact Person: Special Instructions: Phone No.: I I Approved per applicable codes. Corrections required prior to approval. COMMENTS: SP -0K l4.4.1.1-‘ - O K OK Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: % sw Date: 27i//O 7 Hrs.: n $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit Dob' -v 9 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: m 9-2,1n.e € s s7-1./Le..-. Type of Inspection: / Address: Poo -ram«-,- /134.11 Suite #: Contact Person: cj%GvL Special Instructions: Phone No.: 'LoG . ti5'/ — /Gqt RApproved per applicable codes. nCorrections required prior to approval. COMMENTS: E . L1 / 1 \d -s Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: J if) ir Date: 20//0 f Hrs.: / $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from ity of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit Dob- Y€39 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: P1 2-i» ,S?oege- Type of Inspection: iL/o- 15;�.."4.1 Address: avo Suite #: SG r,-sapt/ Contact Person: S%T Special Instructions: Hood & Duct: Phone No.: c2oC — `i?! -- 9496 F-qApproved per applicable codes. riCorrections required prior to approval. COMMENTS: 4 bop t* -).J Needs Shift Inspection: Date: / o f z0/6`f Sprinklers:/ Fire Alarm: / Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: M.1'3j Date: / o f z0/6`f Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with pit b/3 -c 333( 14-s—oFi6 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: I+ Sprinklers: Fire Alarm: Type of Inspection: se 0 -tall -"C" -- Address: G Civ Suite #: C . /viN t- Contact Person: Special Instructions: Phone No.: 1A -Approved per applicable codes. Corrections required prior to approval. COMMENTS: C9k_ - 1-t7 Cuv Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: Date: V/c9k// Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit F:. ciq ob'!J PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: .. I U 61-___.Typ_e�' At of Inspection: Address: Contact Person: Suite #: S- C. W1/414L' Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: - - r - -- dr& 5P �', w.�-t_- - OIL Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: //U1 .-2-- Date: 5----/ o2ejw Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip:. Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 2 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit Y"9— avec/ PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: ` PC3((i 1 C_ Type -+of Inspection: -. / /- -e___ -cr ►v ---- Address:s Suite #: , ( - 1,,,�,r�� Contact Person: Special Instructions: Occupancy Type: Phone No.: Approved per applicable codes. I I Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: rT tlat-e,k , 4_. a re L -c,' 4— "f'r, ,copy (-z P)6'14(J{.4,-li Occupancy Type: c 0 — O lC_ iMtc,L ckrr — OK Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: // Date: .SX j4/ Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 r INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit APR 14 2008 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: /6 rt.) Pu j4 mob), (., Type of Inspection: 5 Win,O Address: god S - C. N'I✓t-r..L Suite #: Contact Pe rkeri on: Special Instructions: Phone No.: Occupancy Type: r applicable codes. Corrections required prior to approval. COMMENTS: Or -Ay Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: A S7 y Date: Y/// iv Hrs.: ) $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 2 INSPECTION NUMBER • INSPECTION RECORD Retain a copy with permit APR 2 5 2008 D ti ag -6— OTS PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 1314%1141r ROO-PM Type of Inspection: Address: $,„ S . A Suite #: � w Contact Person: Special Instructions: Permits: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: fk onto s too?, e 7, - Lo ch, • (\.(- tt) END rzog 202) — -To edovecv 17¢oxi4oV tveurmeta -two ta/e/oT roe. -Pr O Ni Wm) D Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 8.41S 150_ Date: 1 / Z3 ) 00o Hrs.: Z U(i)/ $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION RECORD Retain a copy with permit o 7sr8 INSPECTION NUMBER ^i��� PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 134 roma p42494,1;c Type of Inspection: Se NRt, Address: &06 S -C• 'i 12-L_ Suite #: Contact Person: Special Instructions: Phone .: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: c7(/ Date: 6/008 Hrs.: ) n $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the Cityof Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit P*3-I-sem PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 601Q4 (4_pc.t(o)iv Type of Inspection: Address: >fiyac s.c. Mvii,L Suite #: Contact Person: Special Instructions: Phone No.: g-01, 713-3717 Vi.kproved per applicable codes. Corrections required prior to approval. COMMENTS: 445 J Needs Shift Inspection: Sprinklers: Fre Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: A 5)-i ' Date: 77'1/0/ Hrs.: e City of Tukwila $80.00 REINSPECFinanceTIONDepartmentFEE REQUIREDto.schedule You willa receivereinspectionan invoice from . Call . Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit o8 -ger o7 -F- /67 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project:nn 6ptivoi44- '` eP + L Tye of Inspection: , // ' 4. &^^1.R9ey, L-` 4 J a Address: '6 b1 SSuite #: C W1'r2 L Contact Person: Special Instructions: Occupancy Type: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: eP p (Al 1 J,,,}- ' 9k Tee bk Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: as,x.Thy Date: ? f a 4 Hrs.: n $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy withit rn U C .Do 7- :S j►no7., PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: grImo- p kt k i c, Type of Inspection: o* rrz, 5-4-bc� Address: ( 5. (. i c— Suite #: Contact Person: L t) Anv sr. n Special Instructions: Phone No.: 20C.- 79'5 - 3-7/1 1!4 Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: ©K. -\---19 5A-DcAC., -ev X c.4- r0 Glo -, Pre -Fire: j�i Occupancy Type: (4c/Acr Okoej Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ? - i if Date: 7/ No/ Hrs.: ri $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from ', the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit w boo -443* PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: '(�qr1, }-t‘ u,L Type of Inspection: R -44 -c. - Address' SC Contact Person: _ Suite #: Special Instructions: Phone No.: .....r," -k -proved per applicable codes. Corrections required prior to approval. COMMENTS: & L Needs Shift Inspection: y Sprinklers: y Fire Alarm:)( Hood & Duct: Y Monitor: Coklu,(Aiili4vJ IAtaA+4Nk itthilid Pre -Fire: t lew Permits: Occupancy Type: M Inspector:%Sri, Date: 71(7/08 Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TC LA KM ? VENTTQN BIJ BAU. 444 Andover Park East, Tukwila, WA. 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MA:TERLA.LAND TEST •CERTIFICATE • 'IRE ALARM AND FIRE DETECTION SYSTEMS • Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will b.e assessed. Contractor is responsible°for • supplying manpower for Final Acceptance Test with two-way communications. • Date IA De Permit# Property Address. SOu T H �.�u7'�-�• • M v\L.L Suite # City Tukwila Zip Code 9,$ 1$ g Name of Facility (13 e 5TE c -D tt MALL Occupied as �q A Fit t�,(31.' G . Owner or Representative ,L it n 9 „514_,Iroj Phone # . Installing Company C;uAQn i ?a L\ Sey •i-ew% S Installing Contractor's Address I-743 I -r RUE . 5: City SeATrt_:c Phone # ZO to !c Z Z 6S 4 -s - Installer's Nance (PRINT) ( K O M ISS iz ek TL I F F License and/or Certificate 'Z AT t- I Tw► 30$ 4'1 H General Contractor 44_4‘... 4 [ 1 1 cities. Electrical Contractor A S1-011 A 4£0 Elee FACP Equipment Manufacturer • Si ry eijS Model # X L S • This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by fl OF,./6 -Rrk-t-L ! F On (date) and includes the devices listed on back. Circle all that apply: X NFPA 72, Chapterd '2t5 &band/or IFC SEC 907 • NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions X. Manufacturer's Instructions Other (specify) Tukwila City Ordinance Numbers 2050, 2051. UL Central Station Monitor • System is monitored by SIGNED Date System Firmware: Installed version . Checksum Date EQUIPMENT INSTALLED AND TESTED: Control Panel J of 1 Make/Model 5i e rv1 e V1 s ' L.3 Manual Station of Make/Model Smoke Detectors J_ of j Make/Model 5 e me S -1 V P- 1 1 Heat Detectors of Make/Model Duct Detectors' — of Make/Model S e t. e, /As A D2 - F rr � �I�A/V Devices ALof Make/Model 5 2nn,e n •s Audio Devices of _ Make/Model Visual Devices 4 of 12_ Make/Model 5, P 1M Q rts' 2 -• M Auto Door Release of Make/Model 1 11 • Trouble Indictors • of Make/Model Batteries • Readings Battery Full Load . Charge C;118111.t ALL. ET - MC -•Woe w rr Generator _ of Make/Model HVAC Controls _j of '3 Make/Model 51 e.ipvteA s —(''R 1 - Fire Alarm Dialer of . . Make/Model , Monitored by l s1" Ft ELD -i A Ut. PA -k3 E L, Annunciator of Make/Model 0 Sprinkler System. (Fire Alarm. connections only) Water Flow Sw. of Make/Model Valve Tamper Sw. — of Mak,/Model PIV __ of Make/Model Elec. Alarm Bell of • Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC .SEC 907., and/or NFPA 72 Chapter 6? . Yes X No Test of alarrn System on emergency power, satisfactory? Yes _ No — Test Witnessed by Title Date Comments: INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit A -►3 -3o0 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: C oco%-die' .15/a e- Type of Inspection: Address: Suite #: SIO SG fwAf/ ./.bv'a Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Aef„,,t.,_ /I/a Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspecto ,x '4 3 Date: /04/d3 Hrs.: /. 0 $100.00 RIEINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit (4)197F� 1=t3 -3o& PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Projecctt� / 7417w--- l//.eGd ,/7/:€ Type of.1nspectio Address: Suite #: g/O %W"4- 7 Contact Person: Special Instructions: Occupancy Type: Phone No.: [,Approved per applicable codes. Corrections required prior to approval. COMMENTS: 10(;wr7 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: InspeEfo a---4 3 Date: ,f, ij /3 Hrs.: 7. a $100.00 RIEINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 ( INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit /-'- /cie PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Sprinklers: Fire Alarm: Type of Ins ection: Monitor: Address: wsgij Suite #: qip S ,C_ ,'vvj-t . Contact P rson: Special Instructions: Phone No.: V pproved per applicable codes. Corrections required prior to approval. COMMENTS: c; O C12-) Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ja.N. ,-s-- Date: V 5//( Hrs.: 1 $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION SEAQ 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will be assessed. Contractor is responsible for supplying anp wer for Final Acceptance Test with tvvo-way communications. Date O 3 7 Permit # g'/O, SCJ ` Suite # Property Address City TUKWILA Zip Code Name of Facility - r Occupied as y,.`_lh� Owner or Represen .tie Phone # Installing Company 6-1t�4 Installing Contrac 's Address (? 44e_c l City �-4__ Phone # Installer's Name (PRINT) License and/or Certificate General Contractor Electrical Contractor ►� �'c� FACP Equipment Manufacturer 5/eatvte.2< Model # e.- S This system has been installed, pre -tested an_ d eper es in accordance with the standards listed below and was inspected by On (date) cs-�:-. 1 -- and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter 1 2 4 5 6 7 and/or IFC SEC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Lnstructions Manufacturer's Instructions Other (specify) Tukwila City Ordinance Numbers 2050, 2051 UL Central Stat'.n Mo for System is monitored by SIGNED / Date Sys em Fi :t Nam: In ailed version Initial program Installation Checksum Revisions and Reasons Date Date Programmed by , AfreA.. - EQUIPMENT INSTALLED AND TESTED: Control Panel of Make/Model Manual Station of Make/Model Smoke Detectors of Make/Model Heat Detectors _ of Make/Model Duct Detectors _ of Make/Model A/V Devices l of / Make/Model�.,,c'N.P_,/(„S Audio Devices of Make/Model Visual Devices of Make/Model Auto Door Release of Make/Model Trouble Indictors of Make/Model Batteries Readings Battery Full Load Generator of Make/Model HVAC Controls of Make/Model Fire Alarm Dialer of Make/Model Monitored by Annunciator Charge of Make/Model 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. of Make/Model Valve Tamper Sw. — of _ Make/Model PIV of Make/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow AIarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes No Test of alarm System on emergency po er, atisfactory? Yes _ No _ Test Witnessed by ,y4e... Title Date Comments: eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #110 a INSPECTION NUMBER INSPECTION RECORD Retain a copy wit ' er 't Ja -$ - a r P/d– —o7, PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: n Sprinklers: Fire Alarm: Type of Inspection: Address: )0 Suite #: C ,6... r,47-1-e_L Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: 512 Cpiwc Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: L S 0 Date: '713p //cfra,Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 1 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit D>a - S- /5-1 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: .-- � �� A129 Al i PN Se h Type �of Inspection:� Address: ) D S, L Suite #: AAA- L L Contact Person: Special Instructions: Permits: Phone No.: pproved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ��7� .ily�-� Date: 7//,3// 7 Hrs.: l $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 i INSPECTION NUMBER INSPECTION RECORD Retain a copy with eermit 0 /7 -20 c7 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: T / n: Ty e of Inspectio//ka( Address: Suite #: 2/o S mat / % Contact Person: .4(Ipir G(414254 Special Instructions: Occupancy Type: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: No S,pc 1 /7l:4/ /0/07S j -i j h SpPGi 7.v',, Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: K. Date: 7% 1i -z_, Hrs.:. 24.--s $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit /D—S- D/o—e33 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: .S1,.�S� E es Type f Inspection: sr Address: q i S C_ �L,,�-& Suite #: Contact Person: Special Instructions: Phone No.: Approved per applicable codes. ►corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Esc a l i Yie_s+.e o,i -Q -ea Csa;\ 2. A erx5erS of Aa. cc' --n.s c, i /# (71- ,j) • S S /`'- e d eJ _ Jt._ e -G c -/A -,--Ip S ( u G ISO a f) c) 1 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 4 s—z__ Date: V/4 /U Hrs.: 4J,!/4/4$80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Sprinklers: Fire Alarm: Hood & Duct: Type of Inspection: Address:r- Suite #: I C ��,� Contact Person: Special Instructions: Phone No.: --approved per applicable codes. Corrections required prior to approval. COMMENTS: OL-` C&�-r Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 5-L,, Date: 406//o Hrs.: $80.RENT. You will receive an invoice from he City of 00 TukwilaIFinanceSPECDepartmentIONFEEREQUIRED. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 I INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit o' b PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: � I e-� � Type o f inspection: Address: q Sq s. c s Me1"-L-1 Suite #: Contact Person: Special Instructions: Phone No.: ISI, Approved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: A,, c.„,\ 5a, Date: Wayi/a Hrs.: r 4 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit '1D -033 10-F-osq /0 -5-05-3 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: > in: se 1<_1.A S Uto,�S Type of Inspection: // �{.k 14/-W �j „, Address: 9 F H Suite #: 5.c. 'MA Contact Person: Special Instructions: Pre -Fire: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: 10/•' l-1— F-411 0+� Needs Shift Inspection: Sprinklers: Hood & Duct: Fire Alarm: 1 Monitor: /. d Pre -Fire: Permits: Occupancy Type: Inspector: -A F,ylsy Date: 1//.46/16 Hrs.: /. d $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION BUREAU Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testin _ and additional fees will be assessed. Contractor is responsible for supplying manpower for Final Acceptance Test with two-way communications. r 2U - Date Permit # Property Address '1 em 5 Suite # City TUKWILA Name of Facility .eeJ S Occupied as Owner or Representative Phone # Installing Company �r°G.t_ -Sec cJ hJ Zip Code Installing Contractor's Address City Installer's Name (PRINT) Ja h r License and/or Certificate General Contractor Electrical Contractor FACP Equipment Manufacturer .. c-0cexc Model # S This system has been installed, pre -tested and operates in accordance with the standards listed below and - was inspected by On (date) and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter 12 4 5 6 7 and/or IFC'SEC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions Manufacturer's Instructions Other (specify) Tukwila City Ordinances umbers 2050, 2051 UL Central S SIGNED System Fi ware: I stalled versio Checksum Date Initial program Installation Date Phone# - 2c -� -� System is monitored by 6()6 )6>-- //CA Date Revisions and Reasons Programmed by ',vyi / e_ ,V c �— EQUIPMENT INSTALLED AND TESTED: Control Panel - of_ Make/Model Manual Station Make/Model Smoke Detectors of_ Make/Model Heat Detectors _ of Make/Model Duct Detectors I. of_i_ Make/Model ce,,t e4_ c /�— A/V Devices _ of_ Make/Model Audio Devices of Make/Model Visual Devices of Make/Model Auto Door Release _ of Make/Model Trouble Indictors of Make/Model Batteries Readings Battery Full Load Charge Generator — of _ Make/Model HVAC Controls _ of _ Make/Model. Fire Alarm Dialer of Make/Model Monitored by Annunciator of Make/Model • 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. _ of Make/Model Valve Tamper Sw. _ of _ Make/Model PIV _ of_ Make/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you et audible/visible requirements of WAG 51-20, IFC SBC 907., and/or NFPA 72 Chapter 6? Yes (/No Test of alarm System on emergency power, satisfactory? Yes _ No _ Test Witnessed by Title Date . Comments: eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #110 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit\ A u' Tc., D to —v3 /O -P--03-7 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: ,i fe It S Lt a e3 Type of Inspection: /c4- /=iieh L, % 1 eE F./AM 1. - Address: Address: 9IN Suite #: S .c . PlA.,1/ Contact Person: i.c, 4(� Y Special Instructions: Pre -Fire: Phone No.: 620 Z _ ,/ g- c6 1 f -)-A\%.1.2 ca -54 . 3 ijRIApproved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: les Hrs.: f,() Fire Alarm: le, Hood & Duct: FYC_ May vn g\no. t O w/ A iv,.,` 11- b Pre -Fire: Permits: 4"y,,,,,; /„ -. - Lou.)%• -vv.. s car... y/( /scop7 CAI CV k- 4 (i w.., i a r — 5ka445 sy1A.I.a.l - d%,% d '4c y, k'h w/ pt, „cJ A60$4,1 / v14 / 0-6 /6 -5:5 t.taS /) 4 /,vc a vac a5 y 3o id Needs Shift Inspection: r„, Sprinklers: les Hrs.: f,() Fire Alarm: le, Hood & Duct: Monitor: Cava iw,-. Pre -Fire: Permits: Occupancy Type: y/( InspectoriY __,,, f -i ls- Date: r 1;a l/0 Hrs.: f,() $80.00 REINSPECTION FEE REQIUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with pert 6 bi-( Oz7 / 3 -0/9 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 206-575-4407 Project/ 40� Type of Inspectio Address:^ Suite #: 9, 5.e) Al Contact Person: Special Instructions: Occupancy Type: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Cove 74e) -71-L_ Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: "/!‘/- c"? Date: /Z/fAy Hrs.: 4c) 6 / $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Address: Company Name: City: State; Zip: Word/Inspection Record Form.Doc 3/14/14 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION BUREAU 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination_of the testing and additional fees will he assessed. Contractor is responsible for supplying manpower for Final Acceptance Test with two-way communications. / 5,/ Date Permit # / L/ f-2 Property Address '7 $ 4 Soo4it L' eb v M GSL`, Suite # City _TUKWILA Zip Code (i i i Z Name of Facility 561 e Occupied as ca»4-a 11 5k Owner or Representative Installing Company (-)„r„ tz. q„ .5pe vz`, Installing Contractor's Address 17 43 1s1- AVE Phone # City 44.1t, installer's Name (PRINT) wt Pt+ 1 .-( License and/or Certificate ftp, -T1- 1 T f-1 Phone# 206-6 225 general Contractor Electrical Contractor FACP Equipment Manufacturer -e wt. e iti 3 Model # L-5 This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by fZ a -k , On (date) -7/1.s/1 and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter 1 086ond/or IFC SEC 907 X NFPA 70, National Electrical Code, Article 760 Manufacrurer's Instructions Manufacturer's Instructions Other (specify) Tukwila City Ordinance Numbers 2050, 2051 UL Central Station Monitor 770 V Vo System is monitored by SIGNED /� Date J2//, / 5x System Firmware: Installed version 5.0 Checksum Date Initial program Installation Date Revisions and Reasons Programmed by ck� ,7 Tei 4 EQUIPMENT INSTALLED AND TESTED: Control Panel Manual Station Smoke Detectors Heat Detectors Duct Detectors of of of of of A/V Devices E of 4' Audio Devices of Visual Devices of . Auto Door Release of Trouble Indictors of Batteries Readings Battery Generator HVAC Controls Fire Alarm Dialer Monitored by Annunciator of of of Make/Model Make/Model Make/Model Make/Model Make/Model Make/Model ,S'/ffifei /7-1-/ C'— G t✓' Make/Model Make/Model $/ertl6WS/ 2/Z - frt C - Cz.) Make/Model Make/Model Full Load Make/Model Make/Model Make/Model Charge of Make/Iviodel Ei Sprinkler System. (Fire Alarm connections only) ',Vater Flow Sw, of Valve Tamper Sw. of PTV of Elec. Alarm Bell of Make/Model Make/Model Make/Model Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes No Test of alarm System on emergency power, satisfactory? Yes No Test Witnessed by Title Date Comments: / /9e are y /s Av /14 71,es / 3 11-/;j14 e3-5/ )6S i , f zsc/ eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #11D 2 - INSPECTION NUMBER INSPECTION RECORD Retain a copy with 3 1� C� 62.-70 ZZZ PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 206-575-4407 Project C���PSS 0 e rot Type o Inspection: � Address: Suite #: /gY j gj¢// � G Contact Person: Special Instructions: Pre -Fire: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: fre ��rm — ertss ar,(, — ?Ass Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector:. 4 - Date: /Zlbh y Hrs.: /. 0 $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Address: Company Name: City: State: Zip: Word/Inspection Record Form.Doc 3/14/14 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with p ,mit oa:. _ O ?17 »y -S-a)7 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 206-575-4407 Project: Type of Inspection: Address: 9 t/ s.L. pi/1-U_ Suite #: Contact Person: Special Instructions: Phone No.: (JApproved per applicable codes. Corrections required prior to approval. COMMENTS: o/c Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: 1 Inspector: 40l S'd- Date: li peol' Hrs.: I / l ' $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 3/14/14 T.F.D. Form F.P. 113 Number of Pages (In • Mar 31 05 03:23p Crown Fire Protection Inc 4254818695 FILE CROWN FIRE PROTECTION, INC. CC: Compan Subject 3.31.05 Fire Prevention Bureau Tukwila Fire Department Demo Permit 0 Urgent luding Cover 1 I I For Review ❑ Please Comment Fax No. 0 Please Reply p. 1 206.575.4439 ®: Jessica Robinson PH:425.481.7669 FX:425.481.8695 Comments We need a demo per.init to remove two sprinkler heads in the store front that are in the way of the new framing. The project is Parfumerie @ 745 Southcenter Mall the building permit # D05-059. If you have any questions or need any additional information, please do not hesitate to call. fUKWILA FIRE DEPArt 1 matt Please call: 575.4407 and give this job No. ds—`05 is and exact address for shut. down or restoration approval. P.O. BOX 12113 MILL CREEK, WA 98082 PH: 425.481.7669 FX:425. 481.8695 TUKWILA FIRE PREVENTION BUREAU 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will be assessed. Contractor is responsible for supplying manpower for Final Acceptance Test with two-way communications. Date it,/ -- ©S` Property Address City Tukwila Permit # OSS- F (O Name of Facility Occupied as Suite # 6 3 Zip Code `$' ($ Owner or RepresentativeKen t<4(^ S Installing Company filar SPC. vjr 4— Installin Contractor's Address (7i' City 3o fie(f Installer's Name (PRINT) License and/or Certificate General Contractor Electrical Contractor Phone # Sew Ce S r{-�CneK P Kw Phone # 2 a D S'"'8, C t y.1) ,r - - . Ge•164-1£o�cktso-(o FACP Equipment Manufacturer fki7„s.0 t1 47 SVC , Model # 1.---11.,a0 M This system has been installed, re- ted and operates in accordance with the standards listed below and was inspected by c‘tr- . Lp r►. c..k On (date) r) .2; —0S— and includes the devices listed on back. Circle all that apply: L/ NFPA 72, Chapter 1 2 4 5 6 7 and/or IFC SEC 907 ___L NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions f Manufacturer's Instructions Other (specify) ✓ Tukwila City Ordinance Numbers 2050, 2051 UL Central S atio, Monitor System is monitored by A Y7 rec ‘.h(47 - Ser Le ( C es SIGNED System Firmw., e: In . led version el, Q Initial program Date ? ^, 9 --v S� Checksum Date Date 2 ., 0 g Installation /9 Q 1 S -cc v r, y S'.v.•• ref Revisions and Reasons n o ,‘.e Programmed by AO Sf C v r '-E- �Pv Ce s EQUIPMENT INSTALLED AND TESTED: Control Panel _t_ of __F- Make/Model Manual Station _ of _ Make/Model Smoke Detectors r of j Make/Model tipT Heat Detectors _ of _ Make/Model Duct Detectors L of Make/Model FI'rer £.1 Z. F20d PA - AIV Devices of Make/Model Audio Devices of Make/Model Visual Devices of Make/Model Auto Door Release of Make/Model Trouble Indictors of Make/Model Batteries / Readings Battery f L V Full Load Charge Generator of Make/Model HVAC Controls J_ of t Make/Model Fire Alarm Dialer of Make/Model Monitored by Annunciator of Make/Model ❑ Sprinkler System„ (Fire Alarm connections only) Water Flow Sw. of Make/Model Valve Tamper Sw. _ of _ Make/Model PIV of Make/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm • seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes No Test of alarm System on emergency power, satisfactory? Yes _ No _ Test Witnessed by Title Date Comments: eddins\Contractors Material & Test Certificate Revised: 10/28/04 TFD FP Form #110 City of Tukwila JUL 252n Steven M. Mullet, Mayor Fire Department Thomas P. Keefe, Fire Chief TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Project Name Pe q 4 :4 Permit No . ,J o) 07 ItT 0 - 1 Address -7415- —56-4-2---4e- 4 / Retain current inspection schedule Needs shift inspection Suite # Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: g ature Date i n Authorized FINALAPP.FRM Rev. 2/19/98 T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206-575-4404 • Fax: 206-575-4439 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit `,- 5— IYr' PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: G C 5 Type of Inspection: Sr w ii'..— /4/7d.G /C4-.,=,, . Address: 97 i S c •in 1" Suite #: Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: 5TAo 7-,;,,,,,_/..o-.. ,5i 'i �.ft) 7-,;,/,,, 1z :0 0 pst Z/Q___ Go L,-€4.— C s....., 44 Z. Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 6m,c3 Date: 7)/1/1/4j Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with per i W I FILE COPY O 0`15— PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: CZ -S Type of Inspection: /e .Fiha)tFA aJ Address: q S� Mc, it Suite #: Contact Person.. Pre -Fire: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: frle CIN �JN4, FA— F,u.I 0k Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector:Sij Date: e--/-/ / Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 TUKWILA FIRE PREVBNTIONBUREAU 444 Andover Park Basi, Tukwila, WA 98188 - Phone"20d 54407 = Fax 206.575=4439 E-mail: tukfdpry®ci.tukwila.Waus CONTRACTORS MA TERrAI4 ANDTEST CERTIFICATE ��� FIRE ALARM AND FIRE DETECTION SYSTEMS• Fire alarm System is ready for Fire Department accep'ance eating Failure of test will result in termination of the testing and additional fees will be a sensed. Contractor Is responsible. for supplying manpower for Final Acceptance Test with two-way communications. Date 747/// rennit # _ Property Address Suite # CityLTUKWILA Name of Facility 0...)e-6* Frue-i (Y, i• -/Q 1 Occupied as nc. Owner or Representative Installing Company Gu c rd. (cvn P c ` A r Installing.Contractor's Address 177/3 /s / ,4 . City ,Sena I Phone# (AN) 6 zz— c'5 Installer's Name (PRINT) F i c_ Lei License and/or Certificate I-0 k 9 R 3 ( General Contractor Electrical Contractor FACP Equipment Manufacturer 51-ejvice.12 S Model # XL -3 v This system has been in ailed, pre-tes d and operates in accordance with the standards listed below and' was inspected by On (date) 772-7/,/ and includes the devices listed on back. Circle all that apply: %C- NFPA 72, Chapter 12 4 5 6 7 and/or IFC•SBC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions 'Manufacturer's Instructions • Other (specify) Tukwila City Ordinance Numbers 2050, 2051 UL Central Station Monitor System is monitored by pA Id A M S SIGNED :Zip Code. Phone # System Firmware: Installed version Initial program _ Installation Revisions and Reasons _ Date �t (� Checksum 1 12- G Date 7/Z7�/ Date Programmed by : cZ- EQUIPMENT INSTALLED AND TESTED: Control Panel _ of Manual Station Smoke Detectors of Heat Detectors of Duct Detectors t.. of,�,_; Make/Model Maki/Model Make/Model .Make/Model Make/Model Slew _.S — l l ;� II P A/V Devices_, of_ Make/Model Audio Devices aof 3 . Mike/Model 5iP rvve r, s Visual Devices 1 of.4' Make/Model Ste_rvte,its Auto Door Release ofMake/Model • Trouble Indictors of _ Make/Model Batteries Readings Battery Full Load Charge Generator HVAC Controls Fire Alarm Dialer Monitored by Annunciator of j_ ofd of Make/Model Make/Model .5 i e ri p -r 5 i4TRI— R. Make/Model • 0 SprinklerSystem. Water Flow Sw. _ Valve Tamper Sw. of Make/Model ' (Fire Alarm connections only) of_ Make/Model of Make/Model of_ Make/Model of Make/Model PIV Elec. Alarm Bell Automatic time Delay of Water Flow Alarm seconds. None Installed Do you ,neat audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes No Test of alarm System on emergency power, satisfactory? Yes No — Test Witnessed by Title Date . Comments: eddinsWire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form 0110 INSPECTION RECORD Retain a copy with permit 0 cn INSPECTION NUMBER �` CITY OF TUKWILA FIRE DEPARTMENT ay\ - 033 Ak 45 .D\\- 13s PERMIT NUMBERS 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: cs Type of Inspection: ` Address: IRA 51c, Suite #: 0.l1 ci Contact Person: n 5C -e. A In Special Instructions: Phone No.: goS - 'n5 -Won Approved per applicable codes. Corrections required prior to approval. COMMENTS: 0 Z=, Clc F r\ a L o� a"F‘'r-1/4 Needs Shift Inspection: Sprinklers: tr't Date: i3s1 Z` \\ Fire Alarm: ►via„,,,,,(_, Hood & Duct: Monitor: c - C \ov. Pre -Fire: NO Permits: Occupancy Type: yvi Inspector: I Date: i3s1 Z` \\ Hrs.: ' $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 i INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit POSTEL. ;p lo— ow( PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Sprinklers: Fire Alarm: Type,g Inspection• Address: G 3 Suite #: S .c _ rtieZL Contact Person: Special Instructions: Phone No.: Approved per applicable codes. corrections required prior to approval. COMMENTS: 1. M,ov.� 8-) 4 s) S i A. 0.4 6,..44. cAsAtre - rVEzb y4Dbte- $ cm) t2g Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: s --D.._ Date: / -Z /4,/ / O Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 2 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit .D/D - Z9Y PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Gra�: Project: -7- -s Type of Inspection; 1 Address: 973 Suite #: 5. c.. „,,4. j, Contact Person: Special Instructions: Occupancy Type: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: r Fr'r 'r G. ....1.11, l( '1 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 1"r✓) SJ Date: / /iol r i Hrs.: / IN $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION RECORD j/ - - o g c_ Retain a copy with permit INSPECTION NUMBER t (6* PERMIT NUMBERS .00 CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park. East, Tukwila, Wa. 98188 206-575-4407 Project:Type c&G1 O - r I 16 of Inspection: s � _v.2,...„ --- Suit e#: �, ' Suite #: if - C �,,�L� Contact Person: Special Instructions: Phone No.: Approved per applicable codes. corrections required prior to approval. COMMENTS: Ot,( 4s -1C 1 te q Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector:%( iv) ----- Date: c"/, ?// Hrs.: r $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit CITY OF TUKWILA FIRE DEPARTMENT /fry _ I I/O f --/4- PERMIT NUMBERS 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Sprinklers: -II Type of In ection• , Q Monitor: Address: c�,---7 c Suite #: , z Y' LZ, Contact P rson: Special Instructions: Phone No.: proved per applicable codes. Corrections required prior to approval. COMMENTS: Q�c4 --0 (c Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: /, tea---- Date: G/v// '1___, Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit 1 5~ PIZ— )7/. N'l/Z — 1 2 Z PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: ✓10.0w. ,:3vr. Type of Inspection: Address: 97/ s'e""�n Suite #: Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Fm Sprinklers:/ 0 5p,-4/cice, ,r ?r -ir cool,A. Q /00,-I (7 Si.S ✓..c. AT V 01 c,4,4A A N f 0,:,#t'•' 0-g-' 7%vAtir.•4 Monitor: S- s.se-a v i t Pre -Fire: Permits: Occupancy Type: Needs Shift Inspection: Fm Sprinklers:/ Date: Fire Alarm: / Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: Fm 3-0 Date: ?/27//z. Hrs.: / $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from he City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION RECORD Retain a copy with permit Dt - - 17? INSPECTION NUMBER % is — • % -I PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 3 Project:rr A cA c.h c7 ll u. rrir 1 Sprinklers: Type f Insp ction: Cr�°�-/ teg 1 4- 1 Address: q.� l Suite #: S � �� Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: #04 C' b o — orms V(' 01 (__ /1/4_ro,pk) Hood & Duct: --FA — 01:. CI IJior4-- Pre -Fire: Permits: Occupancy Type: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: icS-r.,__S-<9-- Date: Q/ W1 Z Hrs.: $100.00 RIEINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 TUICWILA.PIREP vain_ A ..::..... . .. ... 444 Andover Park East, Tukwila; WA0.188 - Phene 206=575 4407- Fait 206=575-4439 E-mail: tukfdprv(ci.tiilkwila.waus CONTRACTORS.IIVJATEREAL .AND'TEST CERTIFICATE FIRE ALARM AND:DETECTION:SYSTEi S Fire alarm System is ready for Fire Department 'acceptance :testing. Failure: of estVill result in termination of the testing and additionalfees will be;a'ssessed.' CoiitraetOr is responsible for supplying anpo er for Final Acceptance Tett.witli two-wvay toniniuiticatioyis. Date -y Permit i . /9 ell Property Address City TUKWILA Name of Facility ./1/( Suite # Zip Code Occupied as Owner or Representative Installing Company Cf� .Sfaco, Installing Contract • r' ' dress L7 erS l S i 1. City = !iiwdlk Installer's Name (PRINT) License and/or Certificate General Contractor Electrical Contractor Phone # Ph ne # FACP Equipment Manufacturer This system has been Installed, ; re-teste was inspected by On (date) Circle all that apply: Model # opetes in accordance with the standards listed below and and includes the devices listed on back. NFPA 72, Chapter 12 4 5 6 7 and/or IFC SEC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions Manufacturer's Instructions Other (specify) Tukwila City Ordinance Numbers 2050, 2051 UL Central SIGNED atio System is monitored by 4 if/tf System rmware: stalled version Initial program Installation 1(7 Revisions and Reasons Programmed by Date 9' Checksum Date Date EQUIPMENT INSTALLED AND TESTED; Control Panel of Manual Station of Smoke Detectors of Heat Detectors of Duct Detectors of_ IvMake/Iviodel Make/Madel . Make/Mode1 Make/Ivioddl • Make/Model . Sd7'A44,P/L,S .. gcP A/V Devices 1_ of L Make/Model ‹Tf:� Audio Devices of Iviako/t odel � v4,2,'L ' .: m1 eetJ Visual Devices _ of _ Make/Model Auto Door Release — of Make/Model Trouble Indictors _ of _ Make/Model Batteries Readings Battery Full Load . • Charge Generator _ of _ Make/Model HVAC Controls J of L Make/Model �'S ihwt t9A. Fire Alarm Dialer of Make/Model Monitored by Annunciator of Make/Model 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. _ of _ Make/Model Valve Tamper Sw. _ of _ Make/Model PIV _ of _ Make/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes ( No Test of alarm System on emergency power, satisfactory? Yes _N No_ Test Witnessed by Title Date Comments: eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #110 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permitssl 0 m r PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project:. lc.oJ Lf O Cr. 6 Type of Inspection: S 1 pcoc -1--- Address: 9,-2 1 Suite #: S C iAM--L L Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: r 5.--e-- Date: 7/,cr/f'L Hrs.: t $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit /o -S- PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: �es ÷ rty Aos i tc Type of Inspection: 519104 C6 Vf Y - Address: Suite #: Sici 1 SL /44.61 Contact Person: 3,1-, Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: k -fu ,e-ovrt 0g4!- '1 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: /a ii Date: / 1 _ »,3 -- 6 Hrs.: / $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: �t��r • �/) rA ly too /l•� Type ofcInspection: �,/- J(P CdO�I Address: Suite #: 13 l 'S.C. wlo4Ll.- Contact Person: ..I rw-- Special Instructions: ;;i %, Phone No.: r_• Approved per applicable codes. Corrections required prior to approval. COMMENTS: DK - To coot ,-- Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: cc}— Date: / 2( z ((o Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: � Sprinklers: icy , •� Type of Inspection: f7/ e.... -c, LA4-L Address Suite#: 'YI 5,4-• 44441'(-- 4&_Special Contact Person: SpecialInstructions: Phone No.: [Approved per applicable codes. Corrections required prior to approval. COMMENTS: - A-'- - Ok Needs Shift Inspection: YS Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector:7k Si" s -g- Date: ) 2_ iv ..../0 Hrs.: 1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit i0 0 - -,77y4 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 1 /� e S+ t, / P164 L, Type of Inspection: -eq S -C r•t, ii✓t/�L �I Address: Suite #: 7l l C.C. /142L Contact Person: Special Instructions: Occupancy Type: Phone No.: FZIApproved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: - 0k S�- 0K � - /'t C -t •.'i ;v04, L — -� � G4 \/ c k-1 u Cw56('1-Ler Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector:s,-� Date: / Z _ // ..../e Hrs.: 47/,,/ fl $80.00 REIINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION BUREAU 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575=4439 E-mail: tukfdprv@ci.tulcwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System us ready for Fire Department acceptance testing. Failure of test will result in termination of the tasting and additional fees will lie assessed. Contractor is responsible for .. supplying manpower for Final Acceptance Test with two-way communications. Date�'oZ — S .2.0 i n Permit #_ .) 16- 24I Property Address 53' 3 j _qua -rsiea v r- /yl. �.__—_ Suite # S ' City TUKWILA • Zip Code 95? 5R, S? Name of Facility Y /YI o, > e. Occupied as ,41 s'i2 c.�ri► —, i' Owner o N, Z /nA Phone # - 2 a - / 5 413 Installing Company Installing. Contractor's Address 11— c.� i" City (_cut., -ci is s., Se cAA" Phone# 2. -co 6) 6 726S4S" Installer's Name (PRINT) 3-a-vux e- S License and/or Certificate GIA gD SS 2 T r c - General Contractor }/®,e. .me) ,J Electrical Contractor eA- f "t- T41L c.-'rJadd 17 r le c4 G FACP Equipment Manufacturer e ns ' Model # )C LS This system has been i tailed, pre-tes, a and perates in accordance with the standards listed below and' was inspected by �-yit I On (date) /�.� l'ip and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter 12 4 5 6 7 and/or'IFC-SEC 907 / NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions (*Manufacturer's Instructions • Other (specify) // Tukwila City Ordinance Numbers 2050, 2051 UL Central S on ) nitor SIGNED f System Fi ware: / Installed version / Checksum Date /- 7l/ d System is monitored by /l,/ Date l- 7 / Initial program Installation Revisions and Reason Programmed by Date EQUIPMENT INSTALLED AND TESTED: Control Panel _ of_ Make/Model Manual Station of_ Make/Model Smoke Detectors_ of _ Make/Model Heat Detectors _ of _ Make/Model Duct Detectors ,j.. of -i_ Make/Model ZJe'Ccyt A/V Devices• ofij Make/Model J�E?G�l("/(S / QeV( er l<7,e�' Audio Devices _of_ Mike/Model Visual Devices of Make/Model Auto Door Release_ of Make/Model Trouble Indictors _ of_ Make/Model Batteries �np / Readings Battery 2C ,( Full Load 4",. 2- Charge 27. (-7 ' • Generator_ of _ Make/Model HVAC Controls _ of _ Make/Model. Fire Alarm Dialer ( of ( Make/Model Sie Q.,&. -S Monitored by A )-4pi Annunciator of Make/Model 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. _ of_ Make/Model Valve Tamper Sw. _ of _ Make/Model PIV _ of _ Malce/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes No Test of alarm System on emergency power, satisfactory? Yes _ No Test Witnessed by Title Date . Comments: eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #110 as INSPECTION NUMBER INSPECTY'OP1 RECORD Retain a copy with permit 0)- 5-- 2.3/ DtA N7 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: wyt, er>u ,)- 5pA c e_ Type of Inspectio : / tie- It- Address:s.c. Suite #: �` >I metL. L Contact Person: C✓� Special Instructions: Permits: Phone No.: ?a- S- - 736- S?04 7 /—Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: bi)A1 Ulu) e a- Ce)2e. 1- Sike /) 41 t 6 I 5-k-0)- 2 og30 iv► 51,, _ia-2- a a o 1/30 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 579. Date: 0 6�a cI/6�f� Hrs.: 02 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit SEP 9 2008 b08- 339 oe-s -'t2S PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: M kec. Cuc-o Type of Inspection: Sp(I IAtL,02— Address: 533 c, C M. Suite #: Contact Person: 0,-- k 11 Special Instructions: Phone No.: ....--"A-pproved per applicable codes. Corrections required prior to approval. COMMENTS: OK Govl�(L Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 6uji40 Date: cj is io$ Hrs.: 1 �„ $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from �' - City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with penit QC SEP 2 2 2008 Dob-3a� tn,O8 - l 9.8 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: MSC �e.,cfa Sprinklers: Type of Inspection: g7LT --�c.�F Address: 33 S. C. Suite #: / . - Contact Person: , ss74- Special Instructions: Occupancy Type: Phone No.: /?- Zef - 6.77 -- Approved per applicable codes. Corrections required prior to approval. COMMENTS: �.n Zr /FT/CO 00- Ae4( 4.4Z -- IO - — �/— — - - or--- /`�jt/AZ - Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 1..ttlibi /5/2.. Date: i l l9 10$ Hrs.: t $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from ty of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 3 INSPECTION NUIMBER INSPECTION . RECORD Retain a copy with permit Dog -379 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: M,tk Ce-cLo Type of Inspection: FF /7:1— im— Address: ,f3.;-- Sew\ Suite #: Contact Person: Special Instructions: Phone No.: 7 ----- Approved per applicable codes. Corrections required prior to approval. COMMENTS: 01/._ P(,AN 5 ? 61e-.- - VL Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 4-u/ti•,itt /5) y Date: 6111 ioc2, Hrs.: j, J $50.00 REINSPECTION FEE REQUIRED. You will receive an invoice from e City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 City of Tukwila FIRE DEPARTMENT 444 Andover Park East Tukwila, Washington 98188-7661 (206) 575-4404 FILE TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM .S Fp t 2 1991 Gary L. VanDusen, Mayor Control No. 9/ -3.32 - Permit / .3„32 - Permit No. 4, y Project Name Snu f /i( /,jt MOO Address .e6, --. g (0 / d,'- P-1741// alatiL40/74-44(;*- Retain current inspection schedule X Suite # Needs shift inspection xApproved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: FINALAPP.FRM DaW/ T.F.D. Form F.P. 85 City of Tukwila FIRE DEPARTMENT 444 Andover Park East Tukwila, Washington 98188-7661 (206) 575-4404 NOV 1 9 t91 Gary L. VanDusen, Mayor TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Control N2/ 3 Permit No. FJ Project Name dA4Ylk:ski e&644/' Suite #f Address 40 ,549071 Yk14 t'Z Retain current inspection schedule Needs shift inspection ...e ---Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: Author FINALAPP.FRM // /9-91 gnature Date T.F.D. Form F.P. 85 ABEL FIRE PROTECTION FAX TRANSMITTAL 206 481 8695 P.01 Fax No. CROWN FIRE PROTECTION, INC. MEM MEM 12.5.02 Fire Prevention Bureau Tukwila Fine Department Demo Permit Number of Pages (Including Cover C7 Urgent B For Review i 1 Q Please Comment C3 Please Reply 206375.4439 Jessica Robinson PH:425.481.7669 FX:425.481.8695 Comments We need a demo permit to remove four sprinkler heads in the store front at the Whitehall Jewelers space 1030 Southcenter Mall. The building permit number is D02336. If you have any questions or need any additional information, please do not hesitate to call. Thanks! (UKWIIA FIRE 0EPAR IMEN1 Please call: 575.4407 and give this job No. d�"S'2y2 y and exact address for shutd down or restoration approval. For 0 .e-rvia on iy Q � 00 12_ 2 oaz FX.425. 481.8b95 P.O. 8Ox 72713 MILL CROK, WA 98082 PH: 423.481.7669 4 14,14 City of Tukwila* Fire Department Thomas P. Keefe, Rre Chief JAN 3 1 2003 John W. Rants, Mayor TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Project Name LL/h;-lelict I( 3R(4,eievs Address /D 30 )oAcc-,k- M41/ /1O-) Permit No. 00 "'" 3310 Retain current inspection schedule Needs shift inspection Suite # Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: A it -Jr// 3 Authorized S gnature Date FINALAPP.FRM T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: (206) 575-4404 • Fax (206) 575-4439 O INSPECTION RECORD Retain a copy with permit INSPECTION NUMBER FILE COPY PERMIT NUMBERS Olt - l' c CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Sprinklers: Type of Inspection: Sp. -4 C. -nutty t, Address: ?8). Ala 1 j Contact Person: S Suite #: /003 Special Instructions: Phone No.: ?- -Cosi - O O CC FrApproved per applicable codes. Corrections required prior to approval. COMMENTS: 0k -Iv :' p,.eAr- Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 3/1 Date: '-.w _ f 1 Hrs.: / $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit i/ -s-/66 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: TC_i 05 J r� Type of Inspection: r� - S0 - 4'rt TkAn4c, Address: / 3 S _ C._ ivilortL Suite #: Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: SP J it L. - OK Occupancy Type: 5`4 . 10,0kL - o k --�,r-e- . to AL, - ate /✓ltcL '-1)J-L., o K Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: Ute`ci,,k Sa Date: Vivi', Hrs.: L( pi ,‘„t) n $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION 11CREAU 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will be assessed. Contractor is responsible for supplying manpower for Final Acceptance Test with two-way communications. Date ci/5/// Permit # / / f -. Property Address KX,3 ..50(4-1,1 -1)/4 w� Suite # /Cc' 3 City _TUKWILA Zip Code ?P/'88 Name of Facility (14)GSf-2e/id HQ Occupied as r[ -; V c\ Owner or Representative Phone # Installing Company 6gard//vt _ eT c �•j Installing Contractor's Address /71/3 / f Arte s City Jecc the , Phone # C ?O6) L 2-- 4yS Installer's Name (PRINT) R`r - Lowe_ License and/or Certificate WWF R 7830 General Contractor Electrical Contractor Se_c,, 'kkC f k'.7/ c FACP Equipment Manufacturer 51 e y„te 5 Model # )14.. S U This system has beejk3�installed, pre -tested and operates in accordance with the standards listed below and was inspected by K I - c -AL L On (date) d/ij/ 1 / and includes the devices listed on back. Circle all that apply: ti/ NFPA 72, Chapter 12 4 5 6 7 and/or IFC SEC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Lnstructions Manufacturer's Instructions Other (specify) c/ Tukwila City Ordinance Numbers 2050, 2051 UL Central Station Monitor l kJ A-.'1 S SIGNED 77 Date f/$7// System Firmware: Installed version 5, 0 System is monitored by AP 5 ??Qt -1/0 Checksum /13 C Date /®n/ Initial program Installation Date Revisions and Reasons Programmed by g EQUIPMENT INSTALLED AND TESTED: Control Panel of Manual Station of Smoke Detectors of Heat Detectors of Duct Detectors t of L A/V Devices of Audio Devices of Visual Devices of Auto Door Release of Trouble Indictors of Batteries Make/Model Make/Model Make/Model Make/Model Make/Model . f 1'it:, VviP.0 S #FP- // Make/Model tewtPAaS Make/Model Make/Model Make/Model Make/Model Readings Battery Full Load Charge Generator HVAC Controls Fire Alarm Dialer Monitored by Annunciator of f of of Make/Model Make/Model j fp w(e_vi.S }/-%IQ / — f2 Make/Model of Make/Model El Sprinkler System. (Fire Alarm connections only) Water Flow Sw. Valve Tamper Sw. PIV Elec. Alarm Bell of of of of Make/Model Make/Model Make/Model Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes No Test of alarm System on emergency power, satisfactory? Yes No Test Witnessed by Title Date Comments: eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #110 CITY OF TUK1►.iLA ,,untrol No 771. ' Central Permit System Permit No Yiei 6 FINAL APPROVAL FORM TO: ❑ Building ❑ Planning ❑ Public Works 0 Fire Dept. ❑ Police ❑ Parks/Recreation J Project Name Address /4,---.1 Type of Permit(s) T / /67 This project is nearing completion. Please investigate your area of responsibility and indicate below either your final approval or necessary corrections. If no response is received within one week, it will be assumed that the project is of no concern to your department and a certificate of occupancy may be issued. J This project is NOT approved by this department; the following corrections are necessary: ( O () () () ( () () () () () () Authorized Signature Date This project is approved by this department: Authorized Signature Date CPS Form 3 1 CITY OFTUK1r.ILA ..ontrol No g(g''- 7 7 Central Permit System Permit No 57 7 ) FINAL APPROVAL FORM MAR } TO: ❑ Building ❑ Planning ❑ Public Works i Fire Dept. ❑ Police ❑ Parks /Recreation Project Name 51,6 /6 s s leu ,,°1,17/9 ---;ca ,� Address 3 �- �-�. /let. 4r' Type of Permit(s) This project is nearing completion. Please investigate your area of responsibility and indicate below either your final approval or necessary corrections. If no response is received within one week, it will be assumed that the project is of no concern to your department and a certificate of occupancy may be issued. This project is NOT approved by this department; the following corrections are necessary: (1) () () () /'4.4J �,, (803) 297-3"7Y O O (-) Authorized Signature - Date This project is approved by this department: FPS' S-/$ Authorized Signature 3—Z.z — Date CPS Form 3 1 City of Tukwila Fire Department ,41 FILE SEP 3 0 1999 John W. Rants, Mayor TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Thomas P. Keefe, Fire Chief Permit No. 0 99-0/.1,8'4 Project Name .5- ,5 4.3) / I Address .. .s�u"1 . Ee.-'f+.'. A44 / I Suite # Retain current inspection schedule Needs shift inspection Approved without correction notice Approved with correction, notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire:. Permits: FA) 75 sol / Authorized SignhLure Date FINALAPP.FRM Rev. 2/19/98 T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: (206) 575-4404 • Fax (206) 575-4439 City of Tukwila I - Lb 2 5 2005 Steven M. Mullet, Mayor Fire Department TUKWILA FIRE DEPARTMENT 'FINAL APPROVAL FORM Thomas P. Keefe, Fire Chief Permit No. Project Name SLIt1 6/cf 55 »i, 7 Address 'bit 110 ed/ x xX XRetain current -inspection schedule f Needs shift inspection Suite # Approved without correction notice. Approved with correction notice issued Sprinklers: rr`;m Fire Alarm: Hood & Duct: Quc± Halon: Monitor: 4fT Pre -Fire: Permits: TO14) Authorized Signature Date FINALAPP.FRM Rev. 2/19/98 T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206-575-4404 • Fax: 206-575-4439 Date: 10/30/14 Tukwila Fire Department OPERATIONAL PERMIT 728-14 By virtue of the provisions of the International Fire Code adopted by City of Tukwila Ordinance, Harry & David located at 251 Southcenter Mall having made application in due form, and as the conditions, surrounding, and arrangements are, in my opinion, such that the intent of the Ordinance can be observed, authority is hereby given and the PERMIT is granted to operate exhibits and trade shows per International Fire Code 105.6.13. This PERMIT is issued and accepted on condition that all Ordinance provisions now adopted, or that may hereafter be adopted, shall be complied with. THIS PERMIT IS VALID FOR -October 31, 2014 thru January 31, 2015 - This permit does not take the place of any License required by law and is not transferable. Any change in use or occunancv of nremises shall reauire a new nermit. Fire Marshal THIS PERMIT MUST BE POSTED ON THE PREMISES MENTIONED ABOVE. (7164,-- T.F.D./F.P. #2 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit 1 25--/ S C/ r '7zs- ref PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 206-575-4407 Project: r t� p,,,,,, Type of Inspection: C»& -A e r- ,,...7' Address: / Suite #: Zs -7 citA. ( Contact Person: Occupancy Type: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. CONMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector R,/ f/ Date: /OM/ Hrs.: / . O $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 3/14/14 T.F.D. Form F.P. 113 k .L 4r•1 JOHN J. ABEL FIRE PROTECTION COMPANY, INC. Y'. 101 :3(5- Aug 3/S Aug 4. , 1993 Tukwila Fire Dept, 444E Andover Park East Tukwila., wA 98188 ATTN FIRE •MARSHAL FILE SUBJECT: FIRE PROTECTION SHUTDOkN THE LIMITED AT SOUTHCENTE~R MALL . We need• a sprinkler shutdown so the Mall Duct. Company can add some:. -new trunk lines. We need to temporarily plug off four or five sprinkler drops. If you have any further questions, please feel free to call. incurely, Abel Fire Protection Co . , Py 3 h 3 . Abel , President TUKWILA FIRE DEPARTMENT Please call: 575.4407 and give this job No. address for shut- aUw►1 or restoration approval. ACCEPTED WITHOUT COMMENTS. AS NOTED IN RED . 0 PER THE ATTACHED LETTER The. drawings affixed hereto have been reviewed and accepted by the City of Tukvi1 Eire Dept. Additions, deletions or re'ision; to these drawings after this dat , ' :;rig . ccept...nce .and will requL •• . •s.:.J..ittal of revised drawings. 'Fin . .. i ,,.1'.*,';t to field• ins.• • ..;;,:tentative of this de;., DATE:,9- .(:..(1— CIi"Y F T •..,iLA 515 -440 4932 W. INTERURBAN BLVD. • BOTHELL, WASHINGTON 98012 WASH. CONTRACTOR'S #JJABEFP157KN • FAX: (206) 481-8695 • BUS: (206) 481-7669 City of Tukwila Fire Department ;xru:« •- � rr-� bx =+rte TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Project Name 7-h L; ►.,; cI Permit N NOV 1 8 1993 John W. Rants, Mayor Thomas P. Keefe, Fire Chief /493 _O/ a.0 Address 3iS' So ce,,44e✓ kilt Retain current inspection schedule Needs shift inspection Suite # )( Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: r Hi/AC.. Hood & Duct: Halon: Al Monitor: A-1Qr.., /r'7oh. Srrvg•Cf Pre -Fire: Permits: /aas 1/ // - 93 Authorized Signature Date FINALAPP.FRM T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • ,,Tukwila, Washington 98188 • Phone: (206) 575-4404 • Fax (206) 575-4439 City of Tukwila ° NOV i 8 1991' John W. Rants, Mayor Fire Department Thomas P. Keefe, Fire Chief TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Permit No. Project Name 144 Address 3 4r SchifSet4.1-ti— A4 4 / 1 Suite # Retain current inspection schedule > Needs shift inspection X Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: / Permits: 914;e2::, FPO W S1 Authorized SYgnature Date 1/- / 7- FINALAPP.FRM T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: (206) 575-4404 • Fax (206) 575-4439 FAX TRAN CROWN_FIRE_PR0TECTI0N 1 425 4R1 8695 P.01 FILE Fax No. CROWN FIRE PROTECTION, INC. am: 1.23.04 Attn IMMO: Subjec Fire Prevention Bureau Tukwila Fire Department Demo Permit Number of Pages (Ind ding Cover Q Urgent RI For Review 1 0 Plea a' Comment ❑ Please Reply From 206.575.4439 Jessica Robinson PH:425.481.7669 Comments FX:425.481.8695 We need a demo permit to remove fire sprin <ler lines that are in the way of the air conditioning unit at The limited Too — 315 Southcenter Mali. the building permit number is D03-326. If you have any questions or need any i.dditional information. please do not hesitate to call, fUKWILA FIRE DEPARTMLIaE1. Please call: 575-4402 and (give this job gi No. v I Sr and exact address for shuts down or restoration approve.: P.Q. BOX 2113 Mitt CREEK, WA 98082 111: 425.481.7669 _�_ 4� FX:425. 481.8695 .,s CIL,/ of Tukwila APR 1 9 2004 Steven M. Mullet, Mayor Fire Department TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Project Name ///-1- / C% k, 1 i) 0, Thomas P. Keefe, Fire Chief 0 Permit No. Address 67-3—* 34- MM -11 x 3(9' Retain current inspection schedule. Needs shift inspection Suite # YApproved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: h e2e, 1,/ e A 577— W'‹AZ Authorized Signature ' Date f FINALAPP.FRM Rev. 2/19/98 T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206-575-4404 • Fax: 206-575-4439 INSPECTION NUMBER INSPECTION RECORD Retain a copy with per l> - s-cel Du- o32-. PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project:��S G10\ J 5-A_ lo_e,i-. jw,,c 7 Type of Inspection: Fire Alarm: Address: a aZ 1 S . C _ riq irL L. Suite #: Contact Person: Ti ►,^ Pre -Fire: Special Instructions: Phone No.: De)4.- PS-Oc O Approved per applicable codes. Corrections required prior to approval. COMMENTS: 1. /1-6 G7 t -+S � - ✓ o•✓� 144,64 - Needs Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: p_- 2--- Date: S')/!o / /1 Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit 0\-5 - 0(6`) Dl1- c32. PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 1 vs La.vN �yeCv c.c 3 Fire Alarm: Type of Inspection: 5Q , cov-e...r Address: Suite #: 7_23i 57 . v\c.,\,\ Permits: Contact Person: C•l c.f\f\ Mc (-9_1 Special Instructions: Phone No.: 367o - 55(0 4\52_ Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: :ID OVC_ -.6, C.O.Ni•-e-C Ce, Lcv-tv ckc--e.."S , -Ca-c cV ;AC W 4o J-1,-,41` ` ` C" ) Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 'NF--ry l Date: 5\ 231 \\ Hrs.: 1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with pe t)/l- oga PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 10,5Cir0 SApAv ry Type of Inspection: "FA Address: ,2,91/4,1 S , , ,� A L L Suite #:i Contact Person: -ti''-e,sA Special Instructions: Phone No.: 953 - Approved per applicable codes. orrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Ua)Prkole- -to - re.§± . . 1, N© Cei/ ij Na boo oe 3 . C- loo 12 IvP0-4- (ieivLlo (el ..e G.-ervDrpL u RA-ck-or N 4- o 1D Cer--f,'o0ej 06 Iv 0 t 1 c -e., 0 ,c- CA. ac.e. k-iq 0IL% Pr, d r rra e -re -91" 1 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: r2— Date: sla7/// Hrs.: 1 J $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address orT, No Company Name: J A vh Co 5-1-g ,' o ►u - Address: i 2,3N (3eoa l<S ST Sti) City: 01 cp„,► p % pt Attn: r25 Pc T Word/Inspection Record Form.Doc State: 1n) Ver 6/11/10 Zip: el g T.F.D. Form F.P. 113 INSPECTION NUMBER CITY OF TUKWILA FIRE DEPARTMENT INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: JSG4,. sqh-ivcv ) Type of Inspection: r—lam, Address: --)Contact Suite #: } 1 S C Ma I ) Person: Special Instructions: Phone No.: <'Approved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Y Sprinklers: ( A Fire Alarm: jr Hood & Duct: ,tJ J Monitor: ketzW 6,.,1-,.. Pre -Fire: Permits: Occupancy Type: CI Inspector: / A Date: C -.L _ i , Hrs.: J $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 TUKWILA FIRE PRBVBNTIO BUREAU 444 Andover Park Bast, Tukwila, WA 98188 Phone20 — 407 = Pm 206575=4439 E-mail: tukfdprv@ci.tukwila.wa.us CONTRACTORS :MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS • Fire alarm System is ready for Fire Department aucep ance'testing• ,Failure of test will result in termination of the testing and additional has will be assessed: Contractor is responsible for supplying mellower for Final Acceptance Test with two-way communications. . . Date 6127; (( . . Permit # /7— f 8 Property Address Oa ( C•e&,4l'.tet .l'L.._.� Suite # City _TUKWII A • Zip Code. Name of Facility Occupied as a TusCt. _ Owner or Representative Installing Company rrueehe) e Installing. Contractor's Address / t / S . ._. City Serj-ilA__- Phone# - 6- 4---- Installer's Name (PRINT) 2\ .. e p License and/or Certificate General Contractor Electrical Contractor FACP Equipment Manufacturer S reM PA.S Moder # Xt-S This system has been installed, pre -tested d op r- t ' 1 ccordance with the sta tdards listed below and' was inspected by / On (date) 7 (( Circle all that apply: NFPA 72, Chapter 12 4 5 6 7 and/or IFCSEC 907 %f NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions 'Manufacturer's Instructions • Other (specify) Tukwil City Ordinance Numbers 2050,-2051 UL Central S;. �'on itor „ /e 5/ SIGNED 1 System F ware: Installed versio = Checksum Date Initial program Installation _ Date Revisions and Reasons • Phone and includes the devices listed op back. System is monitored by Date -� Programmed by EQUIPMENT INSTALLED AND TESTED: Control Panel•_ • of_ Make/Model Manual Station of Make/Model. Smoke Detectors I. ofj Make/Model fir rp , e 4 Heat Detectors of_ ,Make/Model Duct Detectors .1., of Make/Model _s f t t ,% jam , r .. A/V Devices , , ofb Make/Model Slee s Audio Devices of_ Mice/Model Visual Devices 4. of,..f Make/Model ,S,'r e,cS Auto Door Release . of_ Make/Model - Trouble Indictors . of j Make/Modei .S;&tens 446— `X kl,,wIL'. `r Batteries Readings Battery 026.. ( Full Load . 2S:- e Charge o2Z c • Generator _ of _ Make/Model MVAC Controls _ of_ Make/Modef Fire Alarm Dialer _ of_ Make/Model Monitored by 6-0c_re , t -S eC u - Annunciator of Make/Mod 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. of Make/Model Valve Tamper Sw. _ ofMake/Model PIV _ of Make/Model Blec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm - seconds. None Installed Do you meet audible/visible requirements of WAC 51.20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes No Test of alarm System on emergency power, satisfactory? Yes _ No Test Witnessed by Title Comments: Date . eddinalFire Alami Certificate.doc Revised: 10/28/04 TFD FP Fane 0110 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit PERMIT NUMBERS CITY OF TUKWILA FIRE DEPAR ENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: vccq -. $ h Ci ci. 7f ` Type^of Inspection: 1 4 e '- Si9,. < r/k F ',Is Address:. / Suite #: ;a- 1 SC Mc, /1 J t Contact Person: Special Instructions:', Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: A/Lec-L Fi -vd 0 S ✓K F-Ny CCK ©4‹.. Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: Al/ -)31 I Date: ,-�- j/ Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila,, Finance Department. Cali to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION RECORD Retain a copy with per cu INSPECTION NUMBER PERMIT NUMBERS 3-1 9- 1-S- /?? CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: C��� � Sprinklers: TyS � Inspection: Co -ti Address: ra,a1 Suite #: S v C_ (14-t L Contact Person: Special Instructions: Occupancy Type: Phone No.: pproved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ��n16;z4z,—? Date: 6AS-/3 Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit i`)i3:.J�- /3-s- /3, PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: Type of I spection: Address: ,Q.0.1 5 Suite #: rvi A- L Contact Person: Special Instructions: Occupancy Type: Phone No.: pproved per applicable codes. Corrections required prior to approval. COMMENTS: e Z„ )1.6-) Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: , ,tea--- Date: 772il/C Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit 013 13- i --. 316 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: J cc�: ? Q�. Type of Inspection: f F4 re,ri 1 Addie: Suite #: ZZ/ SO4-4c€ ,Ler /%a// Contact Person: Special Instructions: Phone No.: INApproved per; applicable codes. Corrections required prior to approval. COMMENTS: FP x,74/ - OK Needs Shift Inspection: Sprinklers: Fire Alarm: Hood -8( Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: P Fiiiic ii Date: 7/Mh7� Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: . City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 CITY OF TUKWILA Central Permit System Control No x '-0U 5 - Permit No. _`/5_S MAR „L,, O FINAL APPROVAL FORM TO: ❑ Building ❑ Planning ❑ Public Works Fire Dept. ❑ Police ❑ Parks /Recreation Project Name iii/4-7)/ 44 ..5-c,/1 7 / Address - ��, Li r i t " MA 11 Type of Permit(s) This project is nearing completion. Please investigate your area of responsibility and indicate below either your final approval or necessary corrections. If no response is received within one week, it will be assumed that the project is of no concern to your department and a certificate of occupancy may be issued. This project is NOT approved by this department; the following corrections are necessary: () ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) Authorized Signature Date This project is,approved by this department: Authorized Signature Date " CPS Form 3 INSPECTION NUMBER INSPECTION RECORD Retain a copy with p1t PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575- Project: G a J !cosi Type of Inspection: v 5, r.'re. tZ1,c e_ et -14" a•<. • Address: 2.1/ 5 Suite #: #74J/ Contact Person: Special Instructions: Monitor: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: fret e'.t. Govr v v.K Needs Shift Inspection: Sprinklers:/ Date: Fire Alarm: Hood & Duct: / Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ro/..C3 Date: 31«jiz Hrs.: / 1 the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD \$ Retain a copy with per pa�it12-5-051 12: - 6 (,,3 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: E� C�,�'\mac' Sprinklers: YAL,5 Type of Inspection •V 1 41 L rrvtr5,Av.to U S 3 (I Address: . Suite #: 2A \ 5o `01‘4.1 Contac Person: K \ c.‘c Lowe.. -er Special Instructions: Pre -Fire: Phone No.: D.A pproved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: YAL,5 Hrs.: \ `cam Fire Alarm: �‘.1....c-Vvi,r, vv\fl,.�Q`, 1 ) vYlA l--ka\',5v.y o k ‘ 2:4 -L-o \ ‘ "1 `ZG..ru. ,„ a.'10 ► a) Tr -.A , oL Q10 a.. ,=,...A.-....,-, Pre -Fire: 3.) V SQI=«, r. .:,,..,L a - Occupancy Type: r(\/\ 4) F v'(•"C ‘; %akL. &V.. Needs Shift Inspection: y es Sprinklers: YAL,5 Hrs.: \ `cam Fire Alarm: �‘.1....c-Vvi,r, vv\fl,.�Q`, Hood & Duct: Monitor: ,=,...A.-....,-, Pre -Fire: Permits: Occupancy Type: r(\/\ Inspector l��F� 76) Date: St's\` 4_ Hrs.: \ `cam $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 T t.. V IL ..FIRE I.IRMTNIPNIAJOAU:.... 444 Andover Park East, Tukwila; WA 98188 - Phone 206-575-4407- Fax 206=575-4439 E=mail: tukfdpry@ci.tukwila.wa.Us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND. FIRE DETECTION SYSTEMS Fire alarm System is ready. for Fire Department acceptance testing. Failure. of testwill result in termination of the testing and additional fees will be.assessed. Contractor is responsible for supplying manpower for Final Acceptance Test with two=way communications. Date 67/3//2_, a Permit .# Property Address, 1/ , u, chi, yam,+' . \ Suite # Zip Code ?evJ' e City TUKWILA Name of Facility tet -i Occupied as , Com+//4 r Owner or Representative Phone # Installing Company Installing Contractor's Address /7/ 3 /ft- ,ft -fie City ` ! Phone #�, ¢) X22---0�,5 Installer's Name (PRINT) "'tie u License and/or Certificate General Contractor Electrical Contractor5c,?23 c Ole-C.4"/C_ FACP Equipment Manufacturer _I ?-0"✓te_Model # XLdi' This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by ) 0 . Y�ueiz— On (date) ,/65-/ /ei and inaudei ti -w• tin 'u k. Circle all that apply: NFPA 72, Chapter 12 4 5 6 7 and/or IFC SEC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions tX, Manufacturer's Instructions Other (specify) - Tukwila City Ordinance Numbers 2050, 2051 0 _ UL Central Station onto System is monitored by A) 1A 4i'_5 SIGNED Date SA/ -7 /a System Firmware: , Installed version Checksum Date Initial program Installation Date Revisions and Reasons Programmed by EQUIPMENT INSTALLED AND TESTED: Control Panel — of Make/Model Manual Station - of _ 4 MVI IcejMiodel Smoke Detectors — of _ Make/Model Heat Detectors — of _ Make/Model Duct Detectors L ad_Make/Model ;ifet A/V Devices 3 of 3 Make/Model tAlkeeloc Audio Devices of Make/Model Visual Devices ) of f Make/Model /A Auto Door Release _ of Make/Model Trouble Indictors of Make/Model Batteries Readings Battery Full Load Charge Generator of Make/Model, HVAC Controls of Make/Model- Fire Alarm Dialer of Make/Model Monitored by Annunciator of Make/Model 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. of Make/Model Valve Tamper Sw. _ of _ Make/Model PIV of Make/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes i< No Test of alarm System o e ergen power, satisfactory? Yes :7C No Test Witnessed b Title e.„ _,4 Date Comments: eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #110 , WILA FIRE PREVENTION B1.�:.EAU 444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTIONSYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will be assessed. Contractor is responsible for supplying manpower for Final Acceptance Test with two-way communications. Date 0.572g/1-2- Permit# Property Address 2 11 So ..x#n Ce..-AeAr ' i1ule��S1#9 gt 8$ City TUKWILA Zip Code Name of Facility E,cc& lr S�cr - Ckk-e t+.&ct.f�Q . Occupied as Owner or Representative Q STYi CMoJISI Phone # F E Installing Company Gtko-noLia,A,. Installing Contractor's Address tltd 1 s: #V-4- City &City Sty / (AA Phone # C206)62-26--rqS Installer's Name (PRINT) s License and/or Certificate General Contractor Electrical Contractor FACP Equipment Manufacturer S iew.a,wS Model # This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by GuovrVa•. Sec, -, 4 Sect_ 40-c- E tecFr-`,c. On (date) 0 SY 2_ j / 1 and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter 1 2 4 5 6 7 and/or IFC SEC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions Manufacturer's Instructions Other (specify) Tukwila City Ordinance Numbers 2050, 2051 UL Central Station Monitor kW 1 oars. i S System is monitored by t SIGNED Date 0 S /2 3/ 1 2 System Firmware: Installed version Checksum Date Initial program Installation Date Revisions and Reasons Programmed by EQUIPMENT INSTALLED AND TESTED: Control Panel of Make/Model Manual Station of Make/Model Smoke Detectors _ of _ Make/Model Heat Detectors of Make/Model Duct Detectors I_ of Make/Model A 02 - P / S t ,,,,,.5 . A/V Devices 2 of _ Make/Model 7 N — P —Cw l s cams Audio Devices of Make/Model Visual Devices of Make/Model —w Auto Door Release of Make/Model Trouble Indictors of Make/Model Batteries Mailings Battery Full Load Charge Generator of Make/Model HVAC Controls _ of _ Make/Model Fire Alarm Dialer of Make/Model Monitored by ►`i vJ / 111413 tblr. Annunciator of Make/Model ❑ Sprinkler System. (Fire Alarm connections only) Water Flow Sw. _ of _ Make/Model Valve Tamper Sw. _ of _ Make/Model PIV _ of _ Make/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do youyieet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes 7 No Test of alarm System on emergency power, satisfactory? Yes _ No _ Test Witnessed by Title Date Comments: eddins\Fire Alarm Certificate.doc Revised: 10/28/04 TFD FP Form #110 INSPECTION NUMBER INSPECTION RECORD Retain a copy with perm -907-08n 01—S- 101 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, • Wa. 98188 206-575-4407 Project: /Y/4s702,s Type of Inspection: •SP,2in/AL— Address: / 9/ Scn1 Suite #: C ntact Peon: KiziS Special Instructions: Phone No.: 706.-71 b -3o8v Approved per applicable codes. Corrections required prior to approval. COMMENTS: b A Itch2Ainil b - T / 01,05t % Ft.6x-r o•rivi Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: c ia,61S,Z Date: I/8 joy Hrs.: 0 ' $80.00 REINSPECTION FEE REQUIRED.. You will receive an invoice from he City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit * cl' — aBo 61—S-101 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: / ots,m—r_ -$ Type of Inspection: �Pi2,F/!G/ __ ' Address: if/ -2 al Suite #: Con ct Person: (AIX/ Pre -Fire: Special Instructions: Phone No.: • Approved per applicable codes. Corrections required prior to approval. COMMENTS: %'b Co (%L r5rnSevt r OIC Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits:Occupancy Type: Inspector: 5)Q,,, ,, /6"a__ Date: VI to Hrs.: 1 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from nth City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with Do 7 - ogo o9- 7 PERMIT NUMBERS CITY OF TUKWILA FIRE -DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: m4srec. c,„a-3 Type of Inspection: Address: 151 5 c-1,-)Jei I Suite #: Contact Person: A'a o1 -- Special Instructions: Phone No.: 0-6 — 3 5-7-- , Zts-- [ 1 Approved per applicable codes. Corrections required prior to approval. COMMENTS: 4-49a,44 ''e,, a I o/<- 41V4c_ .d. / /sly Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 51,7 51 S Date: 7/J,5"/ 09 Hrs.: 11,1P4 $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit O,, ? t 8d PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: ,r1.9sr',4 c 4 4- 5 te.9 $7 s .r✓I C/2)c GL `i�' %>7- rJ,5 .fGe .'J- f4 Type of Inspection: Fire Alarm: Address: 1 9 1 Sc. Suite #: -.,. e4 -,ti --i Contact Person: aQ,4-cir-,-� Ganail CA, 30.5`1-0 Special Instructions: ' Permits: Phone No.: ' — 367— J248 Approved per applicable codes. Corrections required prior to approval. COMMENTS: 5 te.9 $7 s .r✓I C/2)c GL `i�' %>7- rJ,5 .fGe .'J- f4 % L .'S h/S PvG.¢ 7 z m id `ria 7 Fire Alarm: 7Ztgg Consirt4 d, o r o .7.7-4c- � 4G. 31439 31439 i3earcAc�ka,. Monitor: Ganail CA, 30.5`1-0 Pre -Fire: Permits: Occupancy Type: Needs Shift Inspection: 5 te.9 $7 s Sprinklers:/ 7/Zcs1/4 Fire Alarm: / Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 5 te.9 $7 s Date: 7/Zcs1/4 Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with p 0c9 - o8° PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 117,4.sre e Gci7— Type of Inspection: �,v)-c,--5.e,z7 C, //5/27.f:/5 :-":7-c 1 ;1�) Address: / 97 S C 141.41 1 Suite #: f Contact Perso : 749d;! 01 T t'4 a.1 Special Instructions: Phone No.: 020c— 3S'- J2 ? 7 /i2 Coo 5tru ,+1 vrt Ca. Z'r c_ 3 7 9.9 a e -of i ;tzzte Approved per applicable codes. Corrections required prior to approval. COMMENTS: Sprinklers: Fire Alarm: S�.1-) e -r ev1 c7 % iqt-'0 Monitor: ) 01 T t'4 a.1 7 /i2 Coo 5tru ,+1 vrt Ca. Z'r c_ 3 7 9.9 a e -of i ;tzzte i2,, - aa na- G+. 306" Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: .5~4/ 57S' Date: 7/0,0/6,s Hrs.: / $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record-Form.Doc 1/13/06 TFD.Form F.P.113 t f . t... ,or • City of Tukwila Fire Department. Project Name Address F L, TUKWILA FIRE DEPARTMENT FINAL APPROVAL FORM Steven M. Mullet, Mayor Thomas P. Keefe, Fire. Chief Permit No. 1�# //(0' TT I E I r 5 I"'i C11" (0l0 /. ,/ Retain current inspection schedule J( Needs shift inspection Suite # Approved without correction notice Approved with correction notice issued Sprinklers: Fire Alarm: Hood & Duct: Halon: Monitor: Pre -Fire: Permits: a� UR`Z'i Authorized Signature FINALAPP.FRM Rev. 2/19/98 75-4 / OS, Date T.F.D. Form F.P. 85 Headquarters Station: 444 Andover Park East • Tukwila, Washington 98188 • Phone: 206-575-4404 • Fax: 206-575-4439 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit Dog- 19/ 09 - S- /Cf PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park: East, Tukwila, Wa. 98188 206-575-4407 Project: S'et 44-14, G4„,,, 5)2 01.0 Type of Inspection: 40i-.:ylGt. Cc:we-4%, • Address: i6 Z Suite #: S c- 1a -7t} 1 1 Contact Person: 4r v)/�44.) Special Instructions: Monitor: Phone No.: ZefG • 39G— kZol [ Approved per applicable codes. Corrections required prior to approval. COMMENTS: Di< 4o Co�cc. /.401'; 14&e is/44 c•S e 1 /Vf4A /3 Needs Shift Inspection: Sprinklers:/ Hrs.: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 5() m C2 Date: II //8/a 7 Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from �e City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 3 INSPECTION NUMBER INSPECTIbN RECORD Retain a copy with permit E Doer—/a1 oR-F-1cri oq PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: 5 ecd+L .Tec 1.1 S 11 of Type of Inspection: FA- Fi'1a / F; re_ Fotia, I k Address: ! cel- S c._ Ma i J Suite #: Contact Person: Sp 12401, Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: F1 re_ A-14 1.,,. C-1 -tc„ ( Ok 01< .5 ',lc Needs Shift Inspection: 'r Sprinklers: Y Fire Alarm: Y Hood & Duct: N Monitor: Cr-ft.44 t 4. h Pre -Fire: Permits: NA Occupancy Type: /t' Inspector: s7 j Date: o- -0 9 Hrs.: / $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 HEEL FIRE PROTECTION 206 481 869 P.01 FOLE Fax No. CROWN FIRE PROTECTION, INC. Oat Cont • an Sub'ec 4.8.02 Fire Prevention Bureau Tukwila Fire Department Clerno Permit Nurber of Pa es (Including Cover 0 Urgent El For Review 1 206.575.443 0 Please Comment 0 Please Reply Fro Jessica Robinson Comments PH:425.481.7669 FX:425.481.8695 We need a demo permit to remove four sprinkler heads in the storefront at Spencer Gifts 614 Southcenter Mall, #F612. The building permit number is D01380. If you have any questions or need any additional information, please da not hesitate to call. FUKWILA FIRE DEPARTM.N1, Pip se call: 575-440Z cnu ;ve this job Gr,_, 7 t address for shuti down Jr restoration approval) IdC. P.O. BOX 12113 MILL CREEK, WA 98082 PH: 425.481.7669 FX`.425. 481.8695 INSPECTION NUMBER INSPECTION RECORD Retain a copy with p,x> it 0/2 aty 12—s—loY PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: ,viii-; .„.,.,,, i (4,,,,. 0.,„..„;.ly Type of Inspection: s fv., -, 1.c..... c,.� . Address: /.sZ- sc_.-s-7.t/, Suite #: Contact Person: ,117111 Pre -Fire: Special Instructions: Phone No.: .20‘.. T- aa.s----z' HI -proved per, applicable codes. Corrections required prior to approval. COMMENTS: ale �o Ci vL,� Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: , 4S) Date: 57Z$Z/Z Hrs.: / 4 $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION RECORD Retain a copy with permit DIS -o/y S - Jv / INSPECTION NUMBER CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 PERMIT NUMBERS Project: °"k2"' 6W/ i'5 Type of Inspection: Sim<Nfq� ��jr Ad ress: Suite #: / S3 S- C_ Mitt__ Contact Person: Occupancy Type: Special Instructions: iA Phone No.: IiJ I.epproved per:, applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: ' T-,9____Date: 2 /( Hrs.: 1 $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with perm t Q. 0 NUMBER P6' CITY OF MKJI 444 Andover Park East, Tukwila, Wa. 98188 PERMIT NUMBERS EPARTMENT 206-575-4407 Project:, 1t/c i c,� bvt,..,,1-1 Sprinklers: Y of Inspection: I F t,c..,J Address: !S)_ 5w4,_ Suite #: / it Contact Person: Special Instructions:. Permits: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: f it't I r c..J Ok Needs Shift Inspection: `( Sprinklers: Y (o..a 7_1 a. Fire Alarm: y Hood & Duct: ,/ Monitor:6,4‘,1,4.,Pre-Fire: Permits: Occupancy Type: I2 Inspector: 1Date: (o..a 7_1 a. Hrs.: / $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila;, Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 2 - INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit 'A /1I)--o/� PERMIT NUMBERS CITY OF 1JKWILA FIRE DEPARTMENT 444 Andover Park. East, Tukwila, Wa. 98188 206-575-4407 r Project: N4+7,0tiw i vim,, ; I) i, Sprinklers: Type of Inspection: /14-eti., . P; t -lc, i , FA- F, A4.1 Address: /5--_ yo,A-i. -.- Suite #: M„ L I Contact Person: Special Instructions:: Occupancy Type: Phone No.: (Approved per applicable codes. Corrections required prior to approval. COMMENTS: F 14 c I ok Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: Avvy,ri ( Date: G -.1_1_41._ Hrs.: $100.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Billing Address Attn: Company Name: Address: City: State: Zip: Word/Inspection Record Form.Doc 6/11/10 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION BUREAU dover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439 E-mail: tukfdpry@ci.tukwila.wa.us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Department acceptance testing. Failure of test will result in termination of the testing and additional fees will be assessed. Contractor is responsible for supplying manpower for Final Acceptance Test with two-way communications. Date L9 - 7—S --l 2_ psfJ Permit # % Property Address kij e S-=��.11� b&-kc,t ( Suite # AS" --02_ City _TUKWILA Zip Code Name of Facility C / Aim r •e 14 rz�y� ✓S d Occupied as A Is Owner or Representative Phone # Installing Company (( a, k- S G_Vir Installing Contractor's Address 1-7 L-1. t S ►— letae S City ' Le— Phone # C7 0 (o) Cn 2Z --L S!`'f Installer's Name (PRINT) �c� ✓�,.. Ilse -u_ , License and/or Certificate INsta, 4.,.s * A 4- Ct 2_P A - General Contractor Electrical Contractor Sew�— FACP Equipment Manufacturer CJ`ww_w 5 Model # L_ S " V This system has been installed, pre -tested and operates in accordance with the standards listed below and was inspected by w 1%4 -AA -A- S On (date) le 17,S l r and includes the devices listed on back. Circle all that apply: NFPA 72, Chapter 1 2 4 5 6 7 and/or IFC SEC 907 7C NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions "IC Manufacturer's Instructions Other (specify) Tukwila City Ordinance Numbers 2050, 2051 UL Central Station Monitor System is monitored by, SIGNED Date System Firmware: Installed version Initial program Installation Checksum Date Date Revisions and Reasons 11 (o 0- t -c . a- 6.-1.1 S JV . s4.) I % 4L...t Programmed by EQUIPMENT INSTALLED AND TESTED: Control Panel - of Make/Model Manual Station of _ Make/Model Smoke Detectors — of Make/Model Heat Detectors of Make/Model . . Duct Detectors of t Make/Model SI mow.• s - Alt. .2 - P/ FP~if A/V Devices of e. Make/Model Audio Devices of _ Make/1VIode1 Visual Devices of Make/Model 9 „-e‘... 5 Auto Door Release of Make/Model Trouble Indictors of Make/Model Batteries Readings Battery Full Load Charge Generator - of Make/Model HVAC Controls of Make/Model Fire Alarm Dialer of Make/Model Monitored by Annunciator of Make/Model 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. of Make/Model Valve Tamper Sw. _ of _ Make/Model PN - - of Make/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you}meet audible/visible requirements of WAC 51-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes ✓ No Test of alarm System on emergency power, satisfactory? Yes _ No _ Test Witnessed by Title Date Comments: eddins\Fire Alarm Certificate:doc Revised: 10/28/04 TFD FP Form #110 INSPECTION NUMBER INSPECTION RECORD Retain a copy with per IV/ / -- 402 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: p .tV/L PGo Pfe T��G I Type of Inspection: , -.'eve- 4a1sier44 /1. 12,•4 c - Address: it I 5 G Suite #: Contact Person: .3ornie Special Instructions: • Phone No.: aDG ., 3 Y t -- G'141"L - qApproved per applicable codes. Corrections required prior to approval. COMMENTS: 45-3 Sprinklers: Hrs.: Fire Alarm: Hood & Duct: Monitor: / 0 JW4c-- /2�100 0C. -iv 44,,,E t tps, V S fae,s coils OK _ _. 0 HJ(✓Y > ,Ob S Vol--�09-' d Needs Shift Inspection: 45-3 Sprinklers: Hrs.: Fire Alarm: Hood & Duct: Monitor: / Pre -Fire: Permits:/ Occupancy Type: Inspector: ,, 45-3 Date: Zjjrjll Hrs.: [5' $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from he City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit DV- 313 003 di—F.— a V Z. PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: e)rch,te_ Pcop1G- Type of Inspection: Address: 111 5c. 41.1.— Suite #:..t Contact Person: Monitor: Special Instructions: Phone No.: Occupancy Type: I Approved per applicable codes. Corrections required prior to approval. COMMENTS: 0 l3I lirms s- �1r lam', Ib3 Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: fry) s3 $80.00 Date: vjjjlit Hrs.: Ar— ,f $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 TUKWILA FIRE PREVENTION BUREAU 444 Andover Park East, Tukwila, WA 98188 Phone''206-575407 Fax 206-5754439 E-mail: tukfdprv@ci.tukwila.wa,us CONTRACTORS MATERIAL AND TEST CERTIFICATE FIRE ALARM AND FIRE DETECTION SYSTEMS Fire alarm System is ready for Fire Departtnent acceptance testing. Failure of test will result in termination of the testine and additional fees will be assessed: Contractor is responsible for supplying manpowr for Final Acceptance Test with two-way communications. Date /� Pemut# __ / Property Address Suite # 7 . City TUKWILA _ Zip Code Name of Facility IJ s Occupied as PC O i' j(� i''r� / 6 Owner or Representative __ ��11 A Installing Company or ae Installing .Contract is Address /7e( City �'��i�--- Phone # c ` �It .acs Installer's Name (PRINT) License and/or Certificate General ContractorE _ Electrical Contractor -el / -_ FACP Equipment Manufacturer _5 fie evi e 4. ( • Model #k L SC,) r gi,td/41-- This system has been installed, pre -tested aperat in a cordance with the standards listed below and - was inspected by 7 c..� Z On (date) 9-(/‘' ( 7/ and includes the devices listed on back. Circle all that apply: iJ NFPA 72, Chapter 12 4 5 6 7 and/or ' IFC -SBC 907 NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions (/ Manufacturer's Instructions • Other (specify) i/ Tukwila City Ordinance Numbers 2050, 2051 gec. System is monitored b Sec) j UL Central S ; lion Monitor i/ - y SIGNED /M Date c� System 17 ware: Installed version Initial program _ Installation Revisions and Reasons _ Checksum Date Date Programmed by re_ cA ZC EQUIPMENT INSTALLED AND TESTED: Control Panel _ of Manual Station of_ Smoke Detectors of Heat Detectors of_ Duct Detectors / .. of l . A/V Devices _EA of_q. Audio Devices of Visual Devices of±` Auto Door Release of Trouble Indictors of Batteries 3 Make/Model Make/Model Make/Model Make/Model Make/Modlel Make/Model Mdke/Model Make/Model vvL.e A S / Make/Model Make/Model /-b--p_/ (MO sAs / .S�` 7 ir- (cj Readings Battery .97,c Full Load /v Charge 7, Generator of _ Make/Modell HVAC Controls J ofj Make/Model- .S)r vw en S / /47-PT—K. Fire Alarm Dialer_ of_ Make/Model • Monitored by Annunciator of Make/Model! ' 0 Sprinkler System. (Fire Alarm connections only) Water Flow Sw. _ of Make/Model Valve Tamper Sw. _ of _ Make/Model PIV _ of_ Make/Model Elec. Alarm Bell of Make/Model Automatic time Delay of Water Flow Alarm seconds. None Installed Do you meet audible/visible requirements of WAC 5I-20, IFC SEC 907., and/or NFPA 72 Chapter 6? Yes '!5 No Test of alarm System on emergency power, satisfactory? Yes No Test Witnessed by Title Date . Comments: eddins\Fire Alam Certificate.doc Revised: 10/28/04 TFD FP Form #110 INSPECTION NUMBER INSPECTION RECORD Retain a copy with pe mit 1 t S - Oc77 Dl� . 36c— Du) - 3 13 65^ Duo-313 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 PrInspection: ec : ri`CLr et.c4 Type of , 3/COv�/ c,1046, Address: 1 1 1 Suite#: Contact Person: lh,.. Special Instructions:„ Phone No.: b - bas- - ops D g -Approved per applicable codes. Corrections required prior to approval. COMMENTS: oK -� tet_ Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: 1/�/'"Th 52- Date: 2,- 1 u - 1 \ Hrs.: tki4' $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. CaII to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit ;/o 3i� !�- -01 PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: .G� � Pio Pim Sprinklers: Type of Inspection: So CoL �,, Address: / I f aC- Suite #: A>,, Contact Person: i w, Special Instructions: Occupancy Type: Phone No.: y—Approved per applicable codes. Corrections required prior to approval. COMMENTS: Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector: i%Fvx„c--� Date: 2_1(._ / t H rs.: ( r Rd—El- $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113 INSPECTION NUMBER INSPECTION RECORD Retain a copy with permit 1/- 5-6o7 pju 31-1) PERMIT NUMBERS CITY OF TUKWILA FIRE DEPARTMENT 444 Andover Park East, Tukwila, Wa. 98188 206-575-4407 Project: OVICCepoA/pcL Vc- t op(e Type of Inspection: 5t COv'Ca— Address: / j 1 C /vioL, Suite #: Contact Person: Special Instructions: Phone No.: Approved per applicable codes. Corrections required prior to approval. COMMENTS: Cove g S sLre - ✓'o Needs Shift Inspection: Sprinklers: Fire Alarm: Hood & Duct: Monitor: Pre -Fire: Permits: Occupancy Type: Inspector:4.1"1 Date: ///17/ Hrs.: $80.00 REINSPECTION FEE REQUIRED. You will receive an invoice from the City of Tukwila Finance Department. Call to schedule a reinspection. Word/Inspection Record Form.Doc 1/13/06 T.F.D. Form F.P. 113