The URL can be used to link to this page

Home My WebLink AboutB19-4061 CF Overhead Sprinkler/Spray Booth 1 SYSTEM RECORD OF COMPLETION This form is to be completed by the system installation contractor at the time of system acceptance and approval. It shall be permitted to modii 'this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Attach additional sheets,data,or calculations as necessary to provide a complete record. Form Completion Date: 4/1/2020 Supplemental Pages Attached: Yes 1. PROPERTY INFORMATION Name of property: RT Auto Body Address: 801 Washington St. Gridley, CA. Description of property: B occupancy Name of property representative: Kevin Address: 801 Washington St. Gridley, CA. Phone: 530.693.0156 Fax: E-mail: rtauto@sbcglobal.net 2. INSTALLATION, SERVICE,TESTING,AND MONITORING INFORMATION Installation contractor: Foothill Fire Alarm &Security, Inc. Address: 170 Erma Ct. Chico, CA. 95928 Phone: 530.826.3013 Fax: 530.893.3013 E-mail: alarms@ffprotection.com Service organization: Foothill Fire Alarm&Security, Inc. Address: 170 Erma Ct. Chico, CA. 95928 Phone: 530.826.3013 Fax: 530.893.3013 E-mail: alarms@ffprotection.com Testing organization: Foothill Fire Alarm&Security, Inc. Address: 170 Erma Ct. Chico, CA. 95928 Phone: 530.826.3013 Fax: 530.893.3013 E-mail: alarms@ffprotection.com Effective date for test and inspection contract: Monitoring organization: Foothill Fire Alarm &Security, Inc. Address: 170 Erma Ct. Chico, CA. 95928 Phone: 530.826.3013 Fax: 530.893.3013 E-mail: alarms@ffprotection.com Account number: 2570166 Phone line 1: N/A Phone line 2: N/A Means of transmission: Cellular Entity to which alarms are retransmitted: Butte County Cal Fire Phone: 530.538.7322 3. DOCUMENTATION On-site location of the required record documents and site-specific software: Document Box 4. DESCRIPTION OF SYSTEM OR SERVICE This is a: ®New system 0 Modification to existing system Permit number: NFPA 72 edition: 2016 4.1 Control Unit Manufacturer: POTTER Model number: PFC-6006 4.2 Software and Firmware Firmware revision number: N/A 4.3 Alarm Verification e This system does not incorporate alarm verification. Number of devices subject to alarm verification: Alarm verification set for seconds Copyright®2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. SYSTEM RECORD OF COMPLETION(continued) 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: 120VAC Control panel amps: 3 Overcurrent protection:Type: Circuit Breaker Amps: 20 Branch circuit disconnecting means location: House Panel Number. 5.1.2 Secondary Power Type of secondary power: Sealed Lead Acid Batteries(12V 8Ah) Location,if remote from the plant: N/A Calculated capacity of secondary power to drive the system: In standby mode(hours): 24 In alarm mode(minutes): 5 5.2 Control Unit I This system does not have power extender panels ❑Power extender panels are listed on supplementary sheet A 6. CIRCUITS AND PATHWAYS Pathway Type Dual Media Pathway Separate Pathway Class Survivability Level Signaling Line X B 0 Device Power X B 0 Initiating Device X B 0 Notification Appliance X B 0 Other(specify): 7. REMOTE ANNUNCIATORS Type Location NONE 8. INITIATING DEVICES Addressable or Type Quantity Conventional Alarm or Supervisory Sensing Technology Manual Pull Stations 1 C A N/A Smoke Detectors 1 C A PHOTOELECTRIC Duct Smoke Detectors 0 Heat Detectors 0 Gas Detectors 0 Waterflow Switches 1 C A N/A Tamper Switches 3 C S N/A Copyright C 2012 National Pare Protection Aasociaaon This form maybe copies for inaiviauel use other man for resale.It may not be copied for commercial sale or distribution. SYSTEM RECORD OF COMPLETION (continued) 9. NOTIFICATION APPLIANCES Type Quantity Description Audible Visible Combination Audible and Visible 1 HORN STROBE 10. SYSTEM CONTROL FUNCTIONS Type Quantity Hold-Open Door Releasing Devices 0 HVAC Shutdown 0 Fire'Smoke Dampers 0 Door Unlocking 0 Elevator Recall 0 Elevator Shunt Trip 0 11. INTERCONNECTED SYSTEMS ❑ This system does not have interconnected systems. ❑ Interconnected systems are listed on supplementary sheet 12. CERTIFICATION AND APPROVALS 12.1 System Installation Contractor This system as specifiedGherein }hags been installed according to all NFPA standards cited herein. Signed: c5"ia- 14 Val/a/Q . - Printed name: Shane DeValera Date: 4/1/2020 Organization: Foothill Fire Protection Title: Manager Phone: 530.826.3013 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed: c 2.yl� Z2Q.1/a Printed name: Shane DeValera Date: 4/1/2020 Organization: Foothill Fire Protection Title: Manager Phone: 530.826.3013 12.3 Acceptance Test Date and time of acceptance test: 4/1/22020, 11 :00 am Installing contractor representative: cWady.4., Z7Q 1/ 1 Testing contractor representative: c 5'I ZK.42. ,70..1/Lr h4.. c. Property representative: AHJ representative: Copyright©2012 National Fire Protection Association. This form may be copied for individual use other than for resale It may not be copied for commercial sale or distribution.