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ASSOCIATED PERMITS
03-F-156 D03-255
TUKWILA FIRE PREVENTION BUREAU
444 Andover Park East, Tukwila, WA 98188 - Phone 206-575-4407 - Fax 206-575-4439
-mail: tukfdpry@ci.tukwila.wa.us
1
CONTRACTORS MATERIAL AND TEST. CERTIFICATE
FIRE ALARM AND FIRE DETECTION SYSTEMS
00 ,-C
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 /A::5----.2003 • Permit # O 3 /-
Installing Company 72c
Installing Contrac or's Address C % S o . (c-. c'
City �i''t 7° ( Phone Ge.) 74..2 /.S -a
Installer's Name (PRINT) Fut 774-0t4
License and/or Certificate 7:ozZ-7g
•
Name of Facility al jjfi jra�-e c 7.� J �L, /J,1 -L 3
Property Address 7/ _ Lh-U I 2t
City . Tukwila Zip Code 9 Pl
Occupied as "17,...,/-7i Tl�"s
Owneror Representative C 2,..)rf4— �� G� b1 Phone # 429 os--7.5--
General
S7j -General Contractor. (...X.71?__ '2.04 .
Electrical Contractor
FACP Equipment Manufacturer f1 kr) Model # J-2 D 7
This system has been in led, pre -tested and operates in accordance with the standards listed below and
was inspected by rs 6-z,
On (date)
Circle all that apply:.
NFPA 72, Chapter 12 4 5 6 7 and/or UFC STD 10-2:SBC L7.1.2, 1997 ED.
NFPA 70, National Electrical Code, Article 760 Manufacturer's Instructions
Manufacturer's Instructions
Other (specify) .
Tukwila City Ordinance Numbers 1900, 1901
UL Central Station Monitor S 7System is monitored by ( /Ark Ce, er
SIGNED (9 Date /7 X -2o 3
and includes the devices listed on back.
System Firmware:
Installed version Checksum Date
Initial program
Installation Date
Revisions and Reasons
Programmed by
Tukwila Fire Prevention Bureau- Material and Test Certificate
EQUIPMENT INSTALLED AND TESTED:
I -R
Control Panel . of Make/Model
Manual Station _ of Make/Model
Smoke Detectors ._t__ of ( Make/Model n k--)6(
Heat Detectors - of Make/Model
Duct Detectors of Make/Model
AN 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
r•
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 audible/visible requirements 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 emergency power, satisfactory? Yes
Test Witnessed by Title Date
Comments:
TFD FP Forth #110 2
City of Tukwila �
L E NOV 7 2033
Steven M. Mullet, Mayor
Fire Department � s' Thomas P. Keefe, Fire Chief
`U
TUKWILA FIRE DEPARTMENT
FINAL APPROVAL FORM
Project Name `q / Wes+` V Pvt r
Address /had' 1h did,4%.,i Or
Permit No. 003 -Z -5 -
Address
03-°+-S5-
Retain current inspection schedule
_X Needs shift inspectonr
•
Suite # •
Approved without correction notice
Approved with correction notice issued
Sprinklers:
Fire Alarm:
Hood & Duct:
Halon:
Monitor:
Pre -Fire:
Permits:
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