FAA72 PANERA 4.25.24 FIRE ALARM SYSTEM REPORTFire Alarm System Inspection and Testing Report
This testing was performed in accordance with applicable N.F.P.A. standards.
Owner:
Owner's Address:
Property Being Evaluated:
Property Address:
239-433-3030 - FAX: 239-433-3263
613 N.W. MERCANTILE PLACE
PORT ST. LUCIE, FL 34986
772-878-3350 • FAX: 772-878-5967
3226 CHERRY PALM DRIVE
TAMPA, FL 33619
81 3-630-0303 • FAX: 81 3 -630-0312
11326 DISTRIBUTION AVENUE WEST
JACKSONVILLE, FLORIDA 32256-2745
904-268-3030 - FAX: 904-268-0724
4683 LAREDO AVENUE
FORT MYERS, FLORIDA 33905
4370 MOTORSPORT DRIVE
CONCORD, NORTH CAROLINA 28027
704-782-3032 - FAX: 704-795-6838
222 CAPITOL CT.
OCOEE, FL 34761-3033
407-656-3030 - 407-656-8026
3121 NW 16TH TERRACE
POMPANO BEACH, FLORIDA 33064
954-917-3030 - FAX: 954-917-9424
Monitoring Entity Panel Manufacturer:Model No.
Name:
Account Ref. No.
Circuit Styles:
Last Date System Had Service Performed:
Last Date Software or Configuration was Revised:
Amt
Service
- Weekly
- Monthly
- Quarterly
- Semi-Annually
- Annually
- Other (Specify)
- Digital
- R.F.
- Other Specify
Inspected by (print)Date:Time:
Signature of Alarm Agent:(Agent Meets Requirements Per Florida Statute 489.518)
Name of Owner or representative
Signature Date:
System restored to normal operation: Time:
Notifications are made Yes No Who Time
Monitoring Entity
Building Occupants
Building Management
Other (Specify)
Date:
AHJ
AHJ phone #
A (
A (
B (A ()
A ()
)
)
A ( )
)
B ()
B ()
B ()
B ()
Bells
Strobes
Horns
Speakers
Chimes
Other: (Specify)
Are Circuits supervised?NoYesNo. of Alarm indicating circuits:
ISC #
I. ALARM NOTIFICATION APPLIANCES TEST AND INSPECTION
Device - Circuit Style/Quantity - Operational Test - Approved Location - Pass - Fail
Type (Quantity ()Size () )
Telephone:
Owner or rep. requests WAFS to release information from
I would like to have a copy of NFPA#72 @ an extra charge of $50.00.
inspections to the underwriters of my insurance company.
NoYes
NoYes
Owner or Owner rep. not on site.
April 2023
A DeGuzman
731084
Page 2
Device - Circuit Style/Quantity - Operational Test - Simulated Test - Pass - Fail
Manual Stations
Ion Detectors
Photo Detectors
Duct Detectors
Heat Detectors
Waterflow Detectors
Supervisory Switches
Pressure Switches
Low Air
Other (Specify):
A ( )
A ( )
A ()
A ()
A ( )
A ()
A ()
A ()
A ()
A ()
B ( )
B ()
B ()
B ()
B ()
B ()
B ()
B ()
B ()
B ()
III. SUPERVISORY SIGNAL INITIATING DEVICES & CIRCUIT INFORMATION
Site Water Temp.
Site Water Level
Fire Pump Power
Fire Pump Running
Fire Pump Auto Position
Fire Pump or Pump Control Trouble
Generator In Auto Position
Generator or Controller Trouble
Switch Transfer
Generator Engine Running
Lock Box
N/ANoYes
Yes No N/A
Yes No N/A
N/ANoYes
NoYes N/A
N/ANoYes
N/ANoYes
N/ANoYes
N/ANoYes
N/ANoYes
N/ANoYes
A. SIGNALING LINE CIRCUITS
Quantity and style (See NFPA 72, Table 3-6) of signaling line circuits connected to system
Quantity Style(s):
IV. SYSTEM POWER SUPPLIES
A. Primary (Main): Normal Voltage Amps
Overcurrent Protection: Type:Amps
Location (Panel #):
Disconnecting Means Location:
B. Secondary (Standby):
Storage Battery: Amp-Hr. Rating
24
Engine driven generator dedicated to fire alarm system:
C. Location of Fuel Storage:
D. TYPE BATTERY SECONDARY POWER
Dry Cell
Nickel Cadmium
Sealed Lead-Acid
Other (Specify):
Type Visual Functional
Battery Condition
Load Voltage
Discharge Test Min.
Specific Gravity
E. Emergency or standby system used as a back-up to primary power supply, instead of using a secondary
power supply. Emergency system described in N.F.P.A.,. Article 700.
Il. INITIATING AND SUPERVISORY DEVICE TEST AND INSPECTION
60
Page 3
V. SYSTEM TESTS & INSPECTIONS
A. Type Visual Functional D. Notification Appliances - Visual - Functional
Control Panel
Interface Equipment
L.E.D. s/ Lamps
Fuses/MicroBreakers
Primary Power Supply
Trouble Signals
Disconnect Switches
Ground Fault Monitoring
Audible
Visual
Speakers
Voice Clarity
E. ON / OFF Premises Monitoring
Yes No N/A
Alarm Signal
Alarm Restoral
Trouble Signal
Trouble Restoral
Supervisory Signal
Supervisory Restoral
B. Emergency Communication Equipment
Type Visual Functional N/A
Phone Set
Phone Jacks
Off Hook Indicators
Amplifier(s)
Tone Generator(s)
Call In Signal
System Performance
C. Interface Equipment DEVICE SIMULATED
(SPECIFY) VISUAL OPERATION OPERATION
Special Hazard System (Specify)
VI. COMMENTS:
VII. DEFICIENCIES: These items are the owner's responsibility to be repaired and will be quoted separate from inspection cost.
Remote Anuciator
Panel has a trouble for RTU 1