333-339 Ahern St Fire Sprinklers ;s-=���r„ City of Atlantic Beach APPLICATION NUMBER
Building Department
(To be assigned by the Building Department.)
J � 800 Seminole Road
�r Atlantic Beach, Florida 32233-5445 ?j 3r1
Phone(904)247-5826 • Fax(904)247-5845
J;311A E-mail: building-dept@coab.us Date routed: L
16
City web-site: http://www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: 333-33 vl N-r✓n S+ ment review required Yes No
Buildin
Applicant: Wog -r_j2\u+ i\ Fi r(!, Planning &Zoning
yl ,,,ITree Administrator
Pr : r�S kJbp Public Works
u Public Utilities
�r $p Lkf
u � Safet
lI Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit Verified B
Florida Dept. of Environmental Protection
Florida Dept. of Transportation
St. Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: [—]Approved. ❑Denied.
(Circle one.) Comments:
CE
PLANNING &ZONING Reviewed by: Date:
TREE ADMIN. Second Review: A roved as revised.
❑ pp ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 05/14/09
Graham Shirley
From: Graham Shirley
Sent: Monday, December 16, 2013 2:41 PM
To: 'Ratliff, Bob'
Cc: Groff, James; 'jwalker@coab.us'; Jones, Mike; Griffin, Michael
Subject: 333-339 Ahern St
Bob,Jenny said you picked up these plans last week when I was out, do you have any comments?
sh�rLed c,raham
Building Department
800 Seminole Rd
Atlantic Beach, Fl 32233
904 247 5800
sgraham@coab.us
1
613 N.W.MERCANTILE PLACE - F 3226 CHERRY PALM DRIVE
PORT ST.LUCIE, FL 34986 r TAMPA,FL 33619
772-878-3350•FAX:772-878-5967 \VVVWAZNE 81 3-630-0303•FAX:81 3-630-0312
11326 DISTRIBUTION AVENUE WEST 4683 LAREDO AVENUE
JACKSONVILLE,FLORIDA 32256-2745 Automatic Fire Sprinklers, Inc. FORT MYERS, FLORIDA 33905
904-268-3030-FAX:904-268-0724 222 CAPITOL CT. 239-433-3030-FAX: 239-433-3263
4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW 16TH TERRACE
CONCORD,NORTH CAROLINA 28027 407-656-3030-407-656-8026 POMPANO BEACH, FLORIDA 33064
704-782-3032-FAX:704-795-6838 954-917-3030-FAX:954-917-9424
NFPA-25 Inspection, Testing and Maintenance of Wet Pipe Fire Sprinkler Systems
Information on this form covers the minimum requirements of NFPA 25-2002 for fire sprinkler systems connected to distribution systems without supplemental tanks or fire pumps.
Separate forms are available to inspect, test and maintain fire pumps,water tanks and other fire protection systems. More frequent inspection,testing and maintenance may be
necessary depending on the conditions of the occupancy and the water supply.
Owner: VIA MARE CONDO ASSOCIATION ISC#: J00736 Report#: 1 OF 4
Owner's Address: 1635 EAGLE HARBOR PRKWY E STE 4 FLEMING IS., FL 32003 Owner's Phone Number: 904-651-2707
Property Being Evaluated: VIA MARE BUILDING 1
Property Address: 333-339 AHERN STREET ATLANTIC BEACH,FL.32233
Date of Work: 2013-10-29 All responses refer to the current work(inspection,testing and maintenance)performed on this date.
This work is(check one). O Monthly O Quarterly Q Annual O Third Year O Fifth Year
Part I-Owner's Section
A.Is the building occupied? OYes ONO 4.Annual Inspection Items(in addition to above items)
B.Has the occupancy classification and hazard of contents remained the same A.Proper number and type of spare sprinklers? OYes ONo ON/A
since the last inspection? OYes ONO B.Visible sprinklers:
C.Are all fire protection systems in service? Oyes ONO 1.Free of corrosion and physical damage? OYes ONO @N/A
D.Has the system remained in service without modification since the last inspection? Oyes ONO 2.Free of obstructions to spray patterns? OYes ONO @N/A
E. Was the system free of actuation of devices or alarms since the last OYes ONO 3.Free of foreign materials including paint? OYes ON. @N/A
inspection? 4.Liquid in all glass bulb sprinklers? OYes ONO Ohl/A
F.Weekly logs of inspections required by NFPA#25 on file? OYes ONO
C.Visible pipe.
G.All deficiencies reported at last inspection corrected? OYes ONO 1 In good condition/no external corrosion? @Yes ONO ON/A
H.I know the location and understand the operation of all control valves. Oyes ONO 2 No mechanical damage and no leaks? @Yes ONO O N/A
J.I would like to have a copy of NFPA#25 @ an extra charge of$50.00. OYes ONO 3.Property aligned and no external loads? @Yes ONO ON/A
K.Owner or rep.requests WAFS to release information from D.Visible pipe hangers and seismic braces not damaged or loose? @Yes ONO ON/A
inspections to the underwriters of my insurance company. Oyes ONO E.Hose,hose couplings and nozzles on sprinkler system passed
inspection in accordance with NFPA 1962? ONIC OYes ONO @N/A
2013-10-29 F.Adequate heat in areas with wet piping? @Yes ONO ON/A
Owner or representative(print name) Signature Date G.Has an internal inspection of the pipe been performed by removing
Part II-Inspector's Section r Owner or Owner rep.not on site. the flushing connection and one sprinkler near the end of a branch
A.Inspections line within the last 5 years? @NIC OYes ONO ON/A
1.Daily and Weekly Items (If the answer was"No".conduct an internal inspection.)
A.Control valves supervised with seals in correct(open or closed) 5.Fifth Year Inspection Items(in addition to above items)
position? @Yes ONO ON/A A.Alar valves and their associate strainers,filters and restriction
B.Backflow Preventers: orifices passed internal inspection? ONIC OYes ONO @N/A
I.Valves in correct(open or closed)position? @Yes ONO ON/A B.Check valves internally inspected and all parts operate propedy,move
2.Sealed locked or supervised 8 accessible? OYes ONO ON/A freely and are in good condition? ONIC OYes ONO @N/A
B.Testing
3.Relief port on RPZ device not discharging? OYes ON. @N/A The follovdng tests are to be performed at the noted intervals.Report any failures on Part III of this form.
C.For freezer systems,is the gauge near the compressor reading the 1.Quarterly Tests
same as the gauge near the dry-pipe valve? OYes ONO @N/A
A.Mechanical water flow alarm devices passed tests by opening the
2.Monthly Inspection Items(in addition to above items) inspector's test connection or bypass connection with alarms actuating
A.Control valves with locks or electrical supervision in correct(open or and flow observed? OYes ONO @N/A
closed)position? @Yes ONO ON/A B.Post indicating valves opened until spring or torsion is felt in the rod,
B.Sprinkler wrench with spare sprinklers? OYes (E)No (:)N/A then closed back one-quarter turn? OYes ONO @N/A
C.Gauges on wet-pipe system in good condition and showing normal C.Main drain test for system downstream of backflow or pressure reducing valve:
water supply pressure) 1.Record Static Pressure psi and Residual psi
pp y p OYes ONo ON/A Pressure
D.Alarm Valves: r See comments-on page 2
Gauges show normal supply water pressure,free from physical 2.Was Flow observed? OYes ONO @N/A
damage,valves in correct(open or closed)position and no leakage
Are results comparable previous test? OYes ONO @N/A
from retarding chamber or drains? OYes ONO ON/A
2.Semiannual Test(in addition to previous items)
3.Quarterly Inspection Items(in addition to above items) A.Valve supervisory switches indicate movement? @Yes ONO ON/A
A.Pressure Reducing Valve:In open position,not leaking,maintaining OYes ONO B.Electrical waterflow alarm devices passed tests by opening the
downstream pressure per design criteria,and in good condition with @Not installed inspector's test connection or bypass connection with alarms actuating
handwheels not broken? O Design criteria is not available and flow observed? OYes @No ON/A
B.Hydraulic nameplate(calculated systems)securely attached to riser 3.Annual Test(in addition to previous items)
A.Main drain test:
and legible? OYes ONo 1.Record Static Pressure 50 psi and Residual 40 psi
C.Fire Department Connection: Pressure
Visible,accessible,couplings and swivels not damaged and rotate r See comments-on page 2
smoothly,plugs or raps in place and undamaged,gaskets in place and 2.Was flow observed)
@Yes ON. ONIA
in good condition,identification sign(s)in place,check valve is not 3.Are results comparable to previous test? @Yes ON. ON/A
leaking,clapper is in place and operating properly and automatic drain B.Are all sprinklers date 1920 or later? @ Unable to determine.OYes ONO
valve in place and operating property? @Yes ONO ON/A C.Fast response sprinklers 20 or more years old replaced or successfully
(If plugs or caps are not in place,inspect interior for obstructions.) @NIC OYes ONO
ONo sample tested within last 10 years?
D.Alarm devices free from physical damage? @Yes IA
Report#: 1 OF 4
Part III-Comments (any"No"answers, test failures or other problems found with the sprinkler
Wet Pipe Report page 2 system must be explained here. All items that need repaired or replaced are the owners
responsibility and are not included in the price of inspection.
D.Standard response sprinklers 50 or more years old replaced or
successfully sample tested within last 10 years? @NIC OYes ONO
E.Standard response sprinklers 75 or more years old replaced or
successfully sample tested within last 5years? @NIC OYes ONO MAIN CTRL VALVE TAMPER SEAL#0760807
F.Dry-type sprinkler replaced or successfully sample tested
within last 10 years? ONIC Oyes ONO @N/A BACKFLOW TAMPER SEAL#'s 0760804 0760806
G.Specific gravity of antifreeze correct? OYes ONO @N/A
H.All control valves operated through full range and returned to normal
position? @Yes ONO ON/A DEFICIENCIES:
I.Backflow devices passed backflow test? ONIC @Yes ONO I
J.Backflow devices passed full flow test?@Provisions not provided. @NIC Oyes ONO ON/A (1)GAUGES OUT OF DATE;TWO GAUGES
K.Pressure reducing valves passed partial
flow test? OProvisions not provided. ONIC OYes ONO @N/A
4.Test to be done every third year: (2)WATER FLOW SWITCH INOP;POTTER VSC
Hose(more than 5 years old)connected to the system has been service tested in accordance with
NFPA 1962.Water discharged and water flow alarms operated? ONIC OYes ONO @N/A (3)FIRE BACKFLOW FAILED ANNUAL INSPECTION;SEE REPORT
5.Test to be done every 5th year
A.Sprinklers rated aboveHigh temperature tested? 1 OYes ONO @N/A (4)SYSTEM IMPAIRED;TAG#06863
B.Gauges checked by calibrated gauge or replaced? OYes ONO (5)HEADBOX,SPARE HEADS&WRENCH MISSING
C.Pressure reducing valves passed full flow test? ONIC OYes ONO (F)N/A
C.Maintenance
1.Regular Maintenance items
A.If sprinklers have been replaced,were they proper replacements? OYes ONO
B.Used hose was cleaneddrained and dried before being placed back in @Cannot be determined.
service?Hose exposed to hazardous materials was disposed of or
decontaminated in an approved manner? OYes ONO @N/A NOTE:
C.Systems normally filled with fresh water were drained and OCannot be determined.
refilled twice if raw water got into the system? Oyes ONO (1)INSPECTION IS COMMON AREA ONLY. DID NOT GAIN ACCESS
D.If any of the following were discovered.was an obstruction investigation @Cannot be determined.
conducted? ONIC OYes ONO @N/A TO INSPECT INTERIOR HEADS PER PROP MGR
Explain reason(s)and obstruction investigation finding in Part 111
1.Defective intake screen on pump with suction from open sources.
2.Obstructive material discharged during water flow tests.
3.Foreign materials found in dry-pipe valves,check valves or pumps.
4.Foreign material in water during drain test or plugging of inspectors test connection.
5.Plugging of pipe or sprinklers found during activation or alteration.
6.Failure to flush yard piping or surrounding public mains following new installation or repairs.
7.Record of broken mains in the vicinity.
8.Abnormally frequent false-tripping of dry-pipe valves. Part IV-Observations: Not a part of the NFPA-25 inspection, the following items may need to
9.System is returned to service after an extended period out of service(greater than one year). be reviewed by a fire protection engineer.
10.There is reason to believe the system contains sodium silicate or its derivatives or highly
corrosive Auxes in copper pipe systems.
E.If conditions were found that required flushing.was flushing of system
conducted? ONIC OYes ONO @',/A
2.Annual Maintenance items(in addition to previous items)
A.Operating stem of all OS&Y valves lubricated completely closed,and
reopened? @Yes ONO ON/A
B.Sprinklers and spray nozzles protecting commercial cooking equipment
and ventilating systems replaced except for bulb-type which show no
signs of grease buildup? OYes ONO (DIVA
3.Regular Maintenance items
A.Alarm panel clear? @Yes ONO ON/A
B.System left in service? IF)Yes ONO ON/A
C.Is system impaired?(Impairment program put into place per NFPA-25 and
Wayne Automatic Fire Sprinklers protocols) OYes @No Part IV -Inspector's Information
I state that the information on this form is correct at the time and place of my inspection and that all
equipment tested at this time was left in operational condition upon completion of this inspection except
as noted in Part III above.
The scope of work preformed does not include a review of fire sprinkler or fire alarm system design.
Date: 2013-10-29
Signature of Inspector:
Print Name: MICHAEL TAUVELL
License or Certification Number(if applicable): 11081600012008
Color of tag placed on system:
IF'Red
Green
613 N.W.MERCANTILE PLACE -� 3226 CHERRY PALM DRIVE
PORT ST.LUCIE, FL 34986 TAMPA,FL 33619
772-878-3350•FAX:772-878-5967k 81 81 3-630-0303•FAX:81 3-630-0312
NAI'm
11326 DISTRIBUTION AVENUE WEST 4683 LAREDO AVENUE
JACKSONVILLE,FLORIDA 32256-2745 Automatic Eire Sprinklers, Inc. FORT MYERS,FLORIDA 33905
904-268-3030-FAX:904-268-0724 222 CAPITOL CT. 239-433-3030-FAX: 239-433-3263
4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW 16TH TERRACE
CONCORD,NORTH CAROLINA 28027 407-656-3030 -407-656-8026 POMPANO BEACH,FLORIDA 33064
704-782-3032-FAX:704-795-6838 954-917-3030-FAX: 954-917-9424
NFPA-25 Inspection, Testing and Maintenance of Wet Pipe Fire Sprinkler Systems
Information on this form covers the minimum requirements of NFPA 25-2002 for fire sprinkler systems connected to distribution systems without supplemental tanks or fire pumps.
Separate forms are available to inspect, test and maintain fire pumps, water tanks and other fire protection systems. More frequent inspection,testing and maintenance may be
necessary depending on the conditions of the occupancy and the water supply.
Owner: VIA MARE CONDO ASSOCIATION ISC#: J00736 Report#: 2 OF 4
Owner's Address: 1635 EAGLE HARBOR PRKWY E STE 4 FLEMING IS.,FL 32003 Owner's Phone Number: 904-651-2707
Property Being Evaluated: VIA MARE BUILDING 2
Property Address: 341 -347 AHERN STREET ATLANTIC BEACH,FL.32233
Date of Work: 2013-10-29 All responses refer to the current work(inspection,testing and maintenance)performed on this date.
This work is(check one): O Monthly O Quarterly Annual O Third Year O Fifth Year
Part I-Owner's Section
A.Is the building occupied? OYes ONO 4.Annual Inspection Items(in addition to above items)
B.Has the occupancy classification and hazard of contents remained the same A.Proper number and type of spare sprinklers? OYes @No ON/A
since the last inspection? OYes ONO B.Visible sprinklers:
C.Are all fire protection systems in service? Oyes ONO 1.Free of corrosion and physical damage? OYes ONO @N/A
D.Has the system remained in service without modification since the last inspection? OYes ONO 2.Free of obstructions to spray patterns? Oyes ONO ON/A
E. Was the system free of actuation of devices or alarms since the last OYes ONO 3.Free of foreign materials including paint? OYes ONO @N/A
inspection? 4.Liquid in all glass bulb sprinklers) O
klers? OYes ONO N/A
F.Weekly logs of inspections required by NFPA#25 on file? Oyes ONO
C.Visible pipe.
G.All deficiencies reported at last inspection corrected? OYes ONO 1.In good condition/no external corrosion? @Yes ONO ON/A
H.I know the location and understand the operation of all control valves. OYes ONO
2.No mechanical damage and no leaks? (j)Yes ONO O N/A
J.I would like to have a copy of NFPA#25(P an extra charge of$50.00. OYes ONO 3.Property aligned and no external loads? @Yes ONO ON/A
K.Owner or rep.requests WAFS to release information from D.Visible pipe hangers and seismic braces not damaged or loose? @Yes ONO ON/A
inspections to the underwriters of my insurance company. OYes ONO E.Hose,hose couplings and nozzles on sprinkler system passed
inspection in accordance with NFPA 1962? ONIC Oyes ONO @N/A
2013-10-29 F.Adequate heat in areas with wet piping? @Yes ONO ON/A
Owner or representative(print name) Signature Date G.Has an internal inspection of the pipe been performed by removing
Part II-Inspector's Section r',Owner or Owner rep.not on site. the flushing connection and one sprinkler near the end of a branch
A.Inspections line within the last 5 years? @NIC OYes ONO OWA
1.Daily and Weekly Items (If the answer was"No".conduct an internal inspection.)
A.Control valves supervised with seals in correct(open or closed) 5.Fifth Year Inspection Items(in addition to above items)
position? @Yes ONO ON/A A.Alarm valves and their associate strainers,filters and restriction
B.Backflow Preventers. onfces passed internal inspection? ONIC Oyes ONO @N/A
1.Valves in correct(open or closed)position? @Yes ONO ON/A B.Check valves internally inspected and all parts operate properly,move
2.Sealed,locked or supervised&accessible? @Yes ONO ON/A freely and are in good condition? ONO Oyes ONO @N/A
3.Relief port on RPZ device not discharging? Oyes ON. @N/A B.Testing
C.For freezer systems,is the gauge near the compressor reading the The following tests are to be performed at the noted intervals.Report any failures on Part III of this form.
Yes ONO @N/A 1.Quarterly Tests
same as the gauge near the dry-pipe valve O A.Mechanical water flow alarm devices passed tests by opening the
2.Monthly Inspection Items(in addition to above items) inspector's test connection or bypass connection with alarms actuating
A.Control valves with locks or electrical supervision in correct(open or and flow observed? OYes ONO @N/A
closed)position? @Yes ONO ON/A B.Post indicating valves opened until spring or torsion is felt in the rod,
B.Sprinkler wrench with spare sprinklers? OYes @No ON/A then closed back one-quarter tum? Oyes ONO @N/A
C.Gauges on wet-pipe system in good condition and showing normal C.Main drain test for system downstream of backflow or pressure reducing valve.
water supply pressure? OYes @No ON/A 1.Record Static Pressure psi and
ddre Residual psi
D.Alarm Valves:
r See comments-on page 2
Gauges show normal supply water pressure,free from physical
damage,valves in correct(open or closed)position and no leakage 2.Was flow observed? OYes ONO @�N,/A
from retarding chamber or drains? OYes ONO @N/A 3.Are results comparable previous test? OYes ONO V'/A
2.Semiannual Test(in additioo n to previous items)
3.Quarterly Inspection Items(in addition to above items) A.Valve supervisory switches indicate movement? @Yes ONO ON/A
A.Pressure Reducing Valve:In open position,not leaking,maintaining OYes ONO
B.Electrical waterflow alarm devices passed tests by opening the
downstream pressure per design criteria.and in good condition with @ Not installed inspector's test connection or bypass connection with alarms actuating
handwheels not broken? O Design criteria is not available and flow observed? @Yes ONO ON/A
B.Hydraulic nameplate(calculated systems)securely attached to riser 3.Annual Test(in addition to previous items)
A.Main drain test:
and legible? Oyes O.No 1.Record Static Pressure 50 psi and Residual 40 psi
C.Fire Department Connection. Pressure
Visible,accessible,couplings and swivels not damaged and rotate r'I See comments-on page 2
smoothly,plugs or raps in place and undamaged,gaskets in place and 2.Was flow observed? @Yes ON. ONIA
in good condition,identification sign(s)in place,check valve is not 3.Are results comparable to previous test? @Yes ONO ON/A
leaking,clapper is in place and operating properly and automatic drain B.Are all sprinklers date 1920 or later?
@ Unable to determine.OYes ONO
valve in place and operating property? @Yes ONO ON/A
(If plugs or caps are not in place,inspect interior for obstructions.) C.Fast response sprinklers 20 or more years old replaced or successfully
D.Alarm devices free from physical damage? @Yes ONO ON/A
sample tested within last 10 years? @NIC OYes ONO
Report#: 2 OF 4
Part III-Comments(any"No"answers, test failures or other problems found with the sprinkler
Wet Pipe Report page 2 system must be explained here. All items that need repaired or replaced are the owners
responsibility and are not included in the price of inspection.
D.Standard response sprinklers 50 or more years old replaced or
successfully sample tested within last 10 years? @NIC QYes ONO
E.Standard response sprinklers 75 or more years old replaced or
successfully sample tested within last 5 years? @NIC OYes ONO MAIN CTRL VALVE TAMPER SEAL#0760808
F.Dry-type sprinkler replaced or successfully sample tested
within last 10 years? ONIC OYes ONO @N/A BACKFLOW TAMPER SEAL#'s 0760804 0760806
G.Specific gravity of antifreeze correct? OYes ONO (E N/A
H.All control valves operated through full range and returned to normal
position? Wes ONO ()N/A DEFICIENCIES:
I.Backflow devices passed backflow test? ONIC OYes ONo ON/A
J.Backflow devices passed full flow test?@Provisions not provided. @NIC Oyes ONO ()N/A (1)GAUGES OUT OF DATE;TWO GAUGES
K.Pressure reducing valves passed partial
flow test? OProvisionsnot provided. ONIC OYes ONO @N/A (2)FIRE BACKFLOW FAILED ANNUAL INSPECTION:SEE REPORT
4.Test to be done every third year:
Hose(more than 5 years old)connected to the system has been service tested in accordance with (3)HEADBOX,SPARE HEADS&WRENCH MISSING
NFPA 1962.Water discharged and water flow alarms operated? ONIC @Yes ONO @N/A
5.Test to be done every 5th year ��
A.Sprinklers rated aboveHigh temperature tested? ONIC OYes ONO CJ'
/A
B.Gauges checked by calibrated gauge or replaced? @Yes ONO
C.Pressure reducing valves passed full flow test? ONIC OYes ONO @N/A
C.Maintenance
1.Regular Maintenance Nems
A.If sprinklers have been replaced,were they proper replacements? OYes ONO
B.Used hose was deaned.drained and dried before being placed back in @Cannot be determined.
service?Hose exposed to hazardous materials was disposed of or
decontaminated in an approved manner? OYes ONO @N/A NOTE:
C.Systems normally filled with fresh water were drained and @Cannot be determined.
refilled twice if raw water got into the system? QYes ONO (1)INSPECTION IS COMMON AREA ONLY.DID NOT GAIN ACCESS
D.If any of the following were discovered.was an obstruction investigation @Cannot be determined.
conducted? ONIC QYes ONO @N/A TO INSPECT INTERIOR HEADS PER PROP MGR
Explain reason(s)and obstruction investigation finding in Part 111
1.Defective intake screen on pump with suction from open sources.
2.Obstructive material discharged during water flow tests.
3.Foreign materials found in dry-pipe valves,check valves or pumps.
4.Foreign material in water during drain test or plugging of inspectors test connection.
5.Plugging of pipe or sprinklers found during activation or alteration.
6.Failure to flush yard piping or surrounding public mains following new installation or repairs.
7.Record of broken mains in the vicinity.
Part IV-Observations: Not a part of the NFPA-25 inspection, the following items may need to
8.Abnormally frequent false-tripping of dry-pipe valves.
be reviewed by a fire protection engineer
9.System is returned to service after an extended period out of service(greater than one year).
10.There is reason to believe the system contains sodium silicate or its derivatives or highly
corrosive vluxes in copper pipe systems.
E.If conditions were found that required flushing,was flushing of system
conducted? ONIC QYes ONO @N/A
2.Annual Maintenance Items(in addition to previous items)
A.Operating stem of all OS&Y valves lubricated completely closed,and
reopened? @Yes ONO ON/A
B.Sprinklers and spray nozzles protecting commercial cooking equipment
and ventilating systems replaced except for bulb-type which show no
signs of grease buildup? QYes ONO @N/A
3.Regular Maintenance items
A.Alarm panel dear? @Yes ONO ON/A
B.System left in service? @Yes ONO ON/A
C.Is system impaired?(Impairment program put into place per NFPA-25 and
Wayne Automatic Fire Sprinklers protocols) @Yes ONO Part IV -Inspector's Information
I state that the information on this form is correct at the time and place of my inspection and that all
equipment tested at this time was left in operational condition upon completion of this inspection except
as noted in Part III above.
The scope of work preformed does not include a review of fire sprinkler or fire alarm system design.
Date: 2013-10-29
Signature of Inspector:
2L
Print Name: MICHAEL TAUVELL
License or Certification Number(if applicable): 11081600012008
Color of tag placed on system:
F—Red
Green
613 N.W.MERCANTILE PLACE 3226 CHERRY PALM DRIVE
PORT ST. LUCIE,FL 34986 TAMPA,FL 33619
772-878-3350•FAX:772-878-5967 \"A04'qAmYME 81 3-630-0303•FAX:81 3-630-0312
11326 DISTRIBUTION AVENUE WEST 4683 LAREDO AVENUE
JACKSONVILLE,FLORIDA 32256-2745 Automatic Fire Sprinklers, Inc. FORT MYERS, FLORIDA 33905
904-268-3030-FAX: 904-268-0724
222 CAPITOL CT. 239-433-3030-FAX: 239-433-3263
4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW 16TH TERRACE
CONCORD, NORTH CAROLINA 28027 407-656-3030 -407-656-8026 POMPANO BEACH,FLORIDA 33064
704-782-3032-FAX:704-795-6838
954-917-3030-FAX:954-917-9424
NFPA-25 Inspection, Testing and Maintenance of Wet Pipe Fire Sprinkler Systems
Information on this form covers the minimum requirements of NFPA 25-2002 for fire sprinkler systems connected to distribution systems without supplemental tanks or fire pumps.
Separate forms are available to inspect,test and maintain fire pumps,water tanks and other fire protection systems. More frequent inspection,testing and maintenance may be
necessary depending on the conditions of the occupancy and the water supply.
Owner: VIA MARE CONDO ASSOCIATION ISC#: J00736 Report#: 3 OF 4
Owner's Address: 1635 EAGLE HARBOR PRKWY E STE 4 FLEMING IS.,FL 32003 Owner's Phone Number: 904-651-2707
Property Being Evaluated: VIA MARE BUILDING 3
Property Address: 349-355 AHERN STREET ATLANTIC BEACH, FL.32233
Date of Work: 2013-10-29 All responses refer to the current work(inspection,testing and maintenance)performed on this date.
This work is(check one). O Monthly O Quarterly O Annual O Third Year O Fifth Year
Part I-Owner's Section
A.Is the building occupied? OYes ONO 4.Annual Inspection Items(in addition to above items)
B.Has the occupancy classification and hazard of contents remained the same A.Proper number and type of spare sprinklers? OYes @No ON/A
since the last inspection? OYes ONO B.Visible sprinklers:
C.Are all fire protection systems in service? OYes ONO 1.Free of corrosion and physical damage? OYes ONO ON/A
D.Has the system remained in service without modification since the last inspection? Oyes ONO 2.Free of obstructions to spray patterns? OYes ONO ON/A
E. Was the system free of actuation of devices or alarms since the last Oyes ONO 3.Free of foreign materials including paint? OYes ONO @N/A
inspection? 4.Liquid in all glass bulb sprinklers? OYes ONO @Nl/A
F.Weekly logs of inspections required by ion file? Oyes ONO
C.Visible pipe:
G.All deficiencies reported at last inspection corrected? Oyes ONO 1 In good condition/no external corrosion? (j)Yes ONO ON/A
H.I know the location and understand the operation of all control valves. Oyes ONO 2 No mechanical damage and no leaks? @Yes ON. O N/A
J.I would like to have a copy of NFPA#25 @ an extra charge of$50.00. Oyes ONO 3.Property aligned and no external loads? @Yes ONO ON/A
K.Owner or rep.requests WAFS to release information from D.Visible pipe hangers and seismic braces not damaged or loose? @Yes ONO ON/A
inspections to the underwriters of my insurance company. Oyes ONO
E.Hose,hose couplings and nozzles on sprinkler system passed
inspection in accordance with NFPA 1962? ONIC OYes ONO @N/A
2013-10-29 F.Adequate heat in areas with wet piping? @Yes ONO ON/A
Owner or representative(print name) Signature Date G.Has an internal inspection of the pipe been performed by removing
Part II-Inspector's Section rrx Owner or Owner rep.not on site. the flushing connection and one sprinkler near the end of a branch
A.Inspections line within the last 5 years? @NIC OYes ONO ON/A
1.Daily and Weekly Items (If the answer was"No",conduct an internal inspection.)
A.Control valves supervised with seals in correct(open or closed) 5.Fifth Year Inspection Items(in addition to above items)
position? @Yes ONO ON/A A.Alarm valves and their associate strainers,filters and restriction
B.Backflow Preventersorifices passed internal inspection? ONIC OYes ONO @N/A
1.Valves in correct(open or closed)position? @Yes ONO ON/A B.Check valves internally inspected and all parts operate properly,move
2.Sealed,locked or supervised&accessible? @Yes ONO ON/A freely and are in good condition? ONIC OYes ONO @N/A
3.Relief port on RPZ device not discharging? Yes No B.Testing
C.For freezer systems,is the gauge near the compressor reading the
@NSA The following tests are to be performed at the noted intervals.Report any failures on Part III of this form.
/A 1.Quarterly Tests
same as the gauge near the dry-pipe valve OYes ONO C A.Mechanical water flow alarm devices passed tests by opening the
2.Monthly Inspection Items(in addition to above items) inspectors test connection or bypass connection with alarms actuating
A.Control valves with locks or electrical supervision in correct(open or and flow observed? OYes ONO @N/A
closed)position? @Yes ONO ON/A B.Post indicating valves opened until spring or torsion is felt in the rod,
B.Sprinkler wrench with spare sprinklers? OYes ONO V(:)N/A then closed back one-quarter turn? OYes ONO @N/A
C.Gauges on wet-pipe system in good condition and showing normal C.Main drain test for system downstream of backflow,or pressure reducing valve.
water supply pressure? OYes ONO ON/A 1.Record Static Pressure psi and Residual psi
Pressure
D.Alarm Valves
See comments-on page 2
2.W
Gauges show normal supply water pressure,free from physical
W
damage,valves in correct(open or closed)position and no leakage as flow observed? OYes ONO @N/A
from retarding chamber or drains? OYes ONO @N/A 3.Are results comparable to previous test? OYes ON. @N/A
2.Semiannual Test(in addition to previous items)
3.Quarterly Inspection Items(in addition to above items) A.Valve supervisory switches indicate movement? @Yes ONO ON/A
A.Pressure Reducing Valve.In open position,not leaking,maintaining OYes ONO
B.Electrical waterflow alarm devices passed tests by opening the
downstream pressure per design criteria,and in good condition with @ Not installed inspector's test connection or bypass connection with alarms actuating /�
handwheels not broken? O Design criteria is not available and flow observed? OYes @No V-/A
B.Hydraulic nameplate(calculated systems)securely attached to user 3.Annual Test(in addition to previous items)
A
and legible? OYes @No
A.Main drain test.
C.Fire Department Connection: 1.Record Static Pressure 50 psi and Residual 35 psi
Pressure
Visible,accessible,couplings and swivels not damaged and rotate See comments-on page 2
smoothly,plugs or caps in place and undamaged,gaskets in place and 2.Was flow observed? @Yes ONO ON/A
in good condition,identification sign(s)in place,check valve is not 3.Are results comparable to previous test? @Yes ONO ON/A
leaking,clapper is in place and operating properly and automatic drain
B.Are all sprinklers date 1920 or late(? @Unable to determine.OYes (:)NO
valve in place and operating properly? @Yes ONO ON/A
C
itt plugs or caps are not in place,inspect interior for obstructions.) C.Fast response sprinklers 20 or more years old replaced or successfully
sample tested within last 10 years? @NIC Oyes ONO
D.Alarm devices free from physical damage? @Yes ONO ON/A
Report#: 3 OF 4
Part III -Comments (any "No"answers, test failures or other problems found with the sprinkler
Wet Pipe Report page 2 system must be explained here. All items that need repaired or replaced are the owners
responsibility and are not included in the price of inspection.
D.Standard response sprinklers 50 or more years old replaced or
successfully sample tested within last 10 years? @NIC OYes ONO
E.Standard response sprinklers 75 or more years old replaced or
successfully sample tested within last 5 years? @NIC OYes ONO MAIN CTRL VALVE TAMPER SEAL#0760801
F.Dry-type sprinkler replaced or successfully sample tested
within last 10 years? ONIC Oyes ONO (E)N/A BACKFLOW TAMPER SEAL#'s 0760804 0760806
G.Specific gravity of antifreeze correct? OYes ONO @N/A
H.All control valves operated through full range and returned to normal
position? @Yes ONO O�N,/A DEFICIENCIES:
V
I.Backflow devices passed backflow test? ONIC OYes @No '/A
J.Backflow devices passed full flow test?@Provisions not provided. @NIC OYes ONO ()N/A (1)WATER FLOW SWITCH INOP;POTTER VSC
K.Pressure reducing valves passed partial
flow test? OProvisions not provided. ONIC OYes ONO @N/A (2)GAUGES OUT OF DATE;TWO GAUGES
4.Test to be done every third year:
Hose(more than 5 years old)connected to the system has been service tested in accordance with
(3)FIRE BACKFLOW FAILED ANNUAL INSPECTION;SEE REPORT
NFPA 1962.Water discharged and water flow alarms operated? ONIC OYes ONO @N/A
5.Test to be done every 5th year (4)SYSTEM IMPAIRED;TAG#06862
A.Sprinklers rated above High temperature tested? ONIC OYes ONO @N/A
B.Gauges checked by calibrated gauge or replaced? OYes ONO (5)HEADBOX,SPARE HEADS&WRENCH MISSING
C.Pressure reducing valves passed full flow test? ONIC OYes ONO @N/A
C.Maintenance
1.Regular Maintenance Items
A.If sprinklers have been replaced,were they proper replacements? OYes ONO
B.Used hose was cleaneddrained and dried before being placed back in @Cannot be determined.
service?Hose exposed to hazardous materials was disposed of or
decontaminated in an approved manner? OYes ONO @N/A NOTE:
C.Systems normally filled with fresh water were drained and OCannot be determined.
refilled twice if raw water got into the system? Oyes ONO (1)INSPECTION IS COMMON AREA ONLY. DID NOT GAIN ACCESS
D.If any of the following were discovered,was an obstruction investigation @Cannot be determined.
conducted? ONIC OYes ONO @NIA TO INSPECT INTERIOR HEADS PER PROP MGR
Explain reason(s)and obstruction investigation finding in Part III
1.Defective intake screen on pump with suction from open sources.
2.Obstructive material discharged during water flow tests.
3.Foreign materials found in dry-pipe valves,check valves or pumps.
4.Foreign material in water during drain test or plugging of inspectors test connection.
5.Plugging of pipe or sprinklers found during activation or alteration.
6.Failure to flush yard piping or surrounding public mains following new installation or repairs.
7.Record of broken mains in the vicinity.
Part IV-Observations: Not a part of the NFPA-25 inspection, the following items may need to
B.Abnormally frequent false-tripping of dry-pipe valves.
be reviewed by a fire protection engineer.
9.System is returned to service after an extended period out of service(greater than one year).
10.There is reason to believe the system contains sodium silicate or its derivatives or highly
corrosive Auxes in copper pipe systems.
E.If conditions were found that required flushing.was flushing of system
conducted? ONIC OYes ONO @N/A
2.Annual Maintenance Items(in addition to previous items)
A.Operating stem of all OS&Y valves lubricated completely closed,and
reopened? ONO No /A
B.Sprinklers and spray nozzles protecting commercial cooking equipment
and ventilating systems replaced except for bulb-type which show no
signs of grease buildup? OYes ONO (DIVA
3.Regular Maintenance Items
A.Alarm panel clear? @Yes ONO /A
B.System left in service? @Yes ONO ON/A
C.Is system impaired?(Impairment program put into place per NFPA-25 and
Wayne Automatic Fire Sprinklers protocols) @Yes ONO Part IV -Inspector's Information
I state that the information on this form is correct at the time and place of my inspection and that all
equipment tested at this time was left in operational condition upon completion of this inspection except
as noted in Part III above.
The scope of work preformed does not include a review of fire sprinkler or fire alarm system design.
Date: 2013-10-29
Signature of Inspector:
Print Name: MICHAEL TAUVELL
License or Certification Number(if applicable): 11081600012008
Color of tag placed on system:
Red
FGreen
613 N.W.MERCANTILE PLACE 3226 CHERRY PALM DRIVE
PORT ST.LUCIE,FL TAMPA,FL 33619 34986 ��
772-878-3350•FAX:772-878-5967 VI/gYNE 81 3-630-0303•FAX:81 3-630-0312
11326 DISTRIBUTION AVENUE WEST \"V4683 LAREDO AVENUE
JACKSONVILLE, FLORIDA 32256-2745 Automatic Fire Sprinklers, Inc. FORT MYERS,FLORIDA 33905
904-268-3030-FAX:904-268-0724 222 CAPITOL CT. 239-433-3030-FAX: 239-433-3263
4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW 16TH TERRACE
CONCORD,NORTH CAROLINA 28027 407-656-3030-407-656-8026 POMPANO BEACH, FLORIDA 33064
704-782-3032-FAX:704-795-6838 954-917-3030-FAX:954-917-9424
NFPA-25 Inspection, Testing and Maintenance of Wet Pipe Fire Sprinkler Systems
Information on this form covers the minimum requirements of NFPA 25-2002 for fire sprinkler systems connected to distribution systems without supplemental tanks or fire pumps.
Separate forms are available to inspect,test and maintain fire pumps,water tanks and other fire protection systems. More frequent inspection,testing and maintenance may be
necessary depending on the conditions of the occupancy and the water supply.
Owner: VIA MARE CONDO ASSOCIATION ISC* J00736 Report* 4 OF 4
Owner's Address: Owner's Phone Number: 904-651-2707
1635 EAGLE HARBOR PRKWY E STE 4 FLEMING IS., FL 32003
Property Being Evaluated: VIA MARE BUILDING 4
Property Address: 357-363 AHERN STREET ATLANTIC BEACH,FL. 32233
Date of Work: All responses refer to the current work(inspection.testing and maintenance)performed on this date.
2013-10-29
This work is(check one): Q Monthly Q Quarterly Annual O Third Year O Fifth Year
Part I-Owner's Section
A.Is the building occupied? OYes ONO 4.Annual Inspection Items(in addition to above items)
A.Proper number and type of spare sprinklers? OYes ONo ONIA
B.Has the occupancy classification and hazard of contents remained the same P
since the last inspection? OYes ONO B.Visible sprinklers.
Oyes ONO 1Free of corrosion and physical damage? OYes ONO @N/A
.
C.Are all fire protection systems in service? Yes ONO @N/A
D.Has the system remained in service without modification since the last inspection? Oyes ONO 2.Free of obstructions to spray patterns? O
3.Free of foreign materials including paint? OYes ONO @N/A
E. Was the system free of actuation of devices or alarms since the last Oyes ONO
inspection? 4.Liquid in all glass bulb sprinklers? OYes ONO @N/A
OYes ONO
F.Weekly logs of inspections required by NFPA#25 on file? C.Visible pipe:
G.All deficiencies reported at last inspection corrected? Oyes ONO 1,In good condition/no external corrosion? @Yes ONO ON/A
H.I know the location and understand the operation of all control valves. Oyes ONO 2.No mechanical damage and no leaks? @Yes ONO O N/A
J.I would like to have a copy of NFPA#25 @ an extra charge of$50.00. Oyes ONO 3.Properly aligned and no external loads? @Yes ONO ON/A
K.Owner or rep.requests WAFS to release information from D.Visible pipe hangers and seismic braces not damaged or loose? @Yes ONO ON/A
inspections to the underwriters of my insurance company. OYes ONO E.Hose.hose couplings and nozzles on sprinkler system passed
inspection in accordance with NFPA 1962? ONIC OYes ONO @N/A
2013-10-29 F.Adequate heat in areas with wet piping? @Yes ONO ON/A
Owner or representative(print name) Signature Date G.Has an internal inspection of the pipe been performed by removing
Part II-Inspector's Section In Owner or Owner rep.not on site. the flushing connection and one sprinkler near the end of a branch
A.Inspections line within the last 5 years? @NIC OYes ONO ON/A
1.Daily and Weekly Items (If the answer was"No conduct an internal inspection.)
A.Control valves supervised with seals in correct(open or closed) S.Fifth Year Inspection Items(in addition to above items)
position? @Yes ONO ON/A A.Alarm valves and their associate strainers,filters and restriction
orifices passed internal inspection? ONIC OYes ONO @N/A
B.Backfiow Preventers.
B.Check valves internally inspected and all parts operate propedy,move
1.Valves in correct(open or closed)position? @Yes ONO ON/A Yes ONO @N/A
2.Sealed,locked or supervised&accessible? @Yes ONO ON/A freely and are in good condition? ONIC O
B.Testing
3.Relief port on RPZ device not discharging? OYes ONo @N/A The following tests are to be performed at the noted interyals.Report any failures on Part III of this form.
C.For freezer systems,is the gauge near the compressor reading the • /A 1.Quarterly Tests
O
same as the gauge near the dry-pipe valve? Yes O No A.Mechanical water now alarm devices passed tests by opening the
2.Monthly Inspection Items(in addition to above items) inspector's test connection or bypass connection with alarms actuating
A.Control valves with locks or electrical supervision in correct(open or and flow observed? Oyes ONO @N/A
closed)position? @Yes ONO ON/A B.Post indicating valves opened until spring or torsion is felt in the rod,
Yes @No ON/A OYes ONO @NIA
B.Sprinkler wrench with spare sprinklers O then closed back one-quarter turn?
C.Gauges on wet-pipe system in good condition and showing normal C.Main drain test for system downstream of backflow or pressure reducing valve:
1.Record Static Pressure psi and Residual psi
water supply pressure? OYes @No ON/A Pressure
D.Alarm Valves: r See comments-on page 2
Gauges show normal supply water pressure,free from physical 2.Was flow observed? OYes ONO @N/A
damage,valves in correct(open or closed)position and no leakage 3.Are results comparable to previous test? OYes ONO @N/A
from retarding chamber or drains? OYes ONO @N/A
2.Semiannual Test(in addition to previous items)
3.Quarterly Inspection Items(in addition to above items) A.Valve supervisory switches indicate movement? (E)Yes ONO ON/A
A.Pressure Reducing Valve.In open position,not leaking,maintaining OYes ONO B.Electrical waterflow alarm devices passed tests by opening the
Not installed
• inspectors test connection or bypass connection with alarms actuating
downstream pressure per design criteria,and in good condition with O P @Yes ONO ON/A
handwheels not broken? O Design criteria is not available and flow observed?
3.Annual Test(in addition to previous items)
B.Hydraulic nameplate(calculated systems)securely attached to user A.Main drain test.
and legible? OYes @No 1.Record Static Pressure 50 psi and Residual 35 psi
C.Fire Department Connection: Pressure
Visible,accessible,couplings and swivels not damaged and rotate r See comments-on page 2 @Yes ONO ON/A
smoothly,plugs or caps in place and undamaged,gaskets in place and 2.Was flow observed?
@Yes ONO ONIA
in good condition,identification sign(s)in place,check valve is not 3.Are results comparable to previous test?
leaking,clapper is in place and operating property and automatic drain B.Are all sprinklers date 1920 or later) @ Unable to determine.Dyes ONO
valve in place and operating properly? @Yes ONO ON/A
C.Fast response sprinklers 20 or more years old replaced or successfully
(If plugs or caps are not in place,inspect interior for obstructions.) @NIC Oyes ONO
D.Alarm devices free from physical damage? @
Yes ONO ONIA sample tested within last 10 years?
Report#: 4 OF 4
Part III-Comments (any"No"answers, test failures or other problems found with the sprinkler
Wet Pipe Report page 2 system must be explained here. All items that need repaired or replaced are the owners
responsibility and are not included in the price of inspection.
D.Standard response sprinklers 50 or more years old replaced or
successfully sample tested within last 10 years? @NIC(Yes ONO
E.Standard response sprinklers 75 or more years old replaced or
successfully sample tested within last 5years? @NICOYes ONO MAIN CTRL VALVE TAMPER SEAL#0760805
F.Dry-type sprinkler replaced or successfully sample tested
within last 10 years? ONIC OYes ONO (F)N/A BACKFLOW TAMPER SEAL#'s 0760804 0760806
G.Specific gravity of antifreeze correct? (Yes ONO ON/A
H.All control valves operated through full range and returned to normal
position? @Yes ONO ON/A
I.Backflow devices passed backflow test? ONIC OYes @No N/q DEFICIENCIES:
O
J.Backflow devices passed full flow test?@Provisions not provided. (j)NIC Oyes ONO ON/A (1)GAUGES OUT OF DATE;TWO WATER GAUGES
K.Pressure reducing valves passed partial
flow test? (Provisions not provided. ONIC (Yes ONO ( N/A
4.Test to be done every third year: (2)FIRE BACKFLOW FAILED ANNUAL INSPECTION;SEE REPORT
Hose(more than 5 years old)connected to the system has been service tested in accordance with
NFPA 1962.Water discharged and water flow alarms operated? ONIC (Yes ONO @N/A (3)HEADBOX, SPARE HEADS&WRENCH MISSING
5.Test to be done every 5th year
A.Sprinklers rated aboveHigh temperature tested? ONIC OYes ONO @N/A
B.Gauges checked by calibrated gauge or replaced? OYes ONO
C.Pressure reducing valves passed full flow test? ONIC OYes ONO @N/A
C.Maintenance
1.Regular Maintenance Items
A.If sprinklers have been replaced,were they proper replacements? �OYes ONO
B.Used hose was cleaned.drained and dried before being placed back in @Cannot be determined.
service?Hose exposed to hazardous materials was disposed of or
decontaminated in an approved manner? OYes ONO @N/A NOTE:
C.Systems normally filled with fresh water were drained and (Cannot be determined.
refilled twice if raw water got into the system? (Yes ONO (1)INSPECTION IS COMMON AREA ONLY.DID NOT GAIN ACCESS
D.If any of the following were discovered,was an obstruction investigation @Cannot be determined.
conducted? ONIC (Yes ONO @N/A TO INSPECT INTERIOR HEADS PER PROP MGR
Explain reason(s)and obstruction investigation finding in Part III
1.Defective intake screen on pump with suction from open sources.
2.Obstructive material discharged during water flow tests.
3.Foreign materials found in dry-pipe valves,check valves or pumps.
4.Foreign material in water during drain test or plugging of inspector's test connection.
5.Plugging of pipe or sprinklers found during activation or alteration.
6.Failure to flush yard piping or surrounding public mains following new installation or repairs.
7.Record of broken mains in the vicinity.
B.Abnormally frequent false-tripping of dry-pipe valves. Part IV-Observations: Not a part of the NFPA-25 inspection, the following items may need to
9.System is returned to service after an extended period out of service(greater than one year). be reviewed by a fire protection engineer
10.There is reason to believe the system contains sodium silicate or its derivatives or highly
corrosive Auxes in copper pipe systems.
E.If conditions were found that required flushing,was flushing of system
conducted? ONIC (Yes ONO @N/A
2.Annual Maintenance Items(in addition to previous items)
A.Operating stem of all OS&Y valves lubricated completely closed,and �
reopened? (j)Yeses ONO V',I
/A
B.Sprinklers and spray nozzles protecting commercial cooking equipment
and ventilating systems replaced except for bulb-type which show no
signs of grease buildup? OYes ONO (E)N/A
3.Regular Maintenance Items
A.Alarm panel Gear? @Yes ONO ON/A
B.System left in service? @Yes ONO V'/A
C.Is system impaired?(Impairment program put into place per NFPA-25 and
Wayne Automatic Fire Sprinklers protocols) (Yes @No Part IV -Inspectors Information
I state that the information on this form is correct at the time and place of my inspection and that all
equipment tested at this time was left in operational condition upon completion of this inspection except
as noted in Part III above.
The scope of work preformed does not include a review of fire sprinkler or fire alarm system design.
Date: 2013-10-29
Signature of Inspector:
Print Name: MICHAEL TAUVELL
License or Certification Number(if applicable): 11081600012008
Color of tag placed on system:
R Red
Green
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613 N.W.MERCANTILE PLACE _- 3226 CHERRY PALM DRIVE
PORT ST. LUCIE, FL 34986 STAMPA, FL 33619
772-878-3350•FAX:772-878-5967 �YNE 81 3-630-0303•FAX:81 3-630-0312
11326 DISTRIBUTION AVENUE WEST 4683 LAREDO AVENUE
JACKSONVILLE,FLORIDA 32256-2745 Automatic Fire Sprinklers, Inc. FORT MYERS, FLORIDA 33905
904-268-3030-FAX:904-268-0724 239-433-3030-FAX: 239-433-3263
222 CAPITOL CT.
4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW 16TH TERRACE
CONCORD,NORTH CAROLINA 28027 POMPANO BEACH, FLORIDA 33064
704-782-3032-FAX:704-795-6838 407-656-3030 -407-656-8026 954-917-3030-FAX:954-917-9424
Fire Alarm System Inspection and Testing Report
This testing was performed in accordance with applicable N.F.P.A.standards.
Owner: VIA MARE CONDO ASSOCIATION ISC# J00736 Date: 2013-10-29
Owner's Address: 1635 EAGLE HARBOR PRKWY E STE 4 FLEMING IS., FL 32003
Property Being Evaluated: VIA MARE
Property Address: 331 AHERN STREET ATLANTIC BEACH, FL.32233
Monitoring Entity Panel Manufacturer: SILENT KNIGHT Model No. 5700
Name: COPS Circuit Styles: 4.0 Amt 1(SLC)
Telephone: 1-800-934-2527 Last Date System Had Service Performed: DECEMBER 2012/WAFS
Account Ref.No. 3258128
Last Date Software or Configuration was Revised: V9.04 AUGUST 2006
Service AHJ
(7-Weekly
(`-Monthly AHJ phone# 904-630-0445
Quarterly
Digital
(1-Semi-Annually
(i;-Annually
(�+ -Other Specify
r-Other(Specify) DECEMBER 2012/WAFS
Inspected by(print) MICHAEL TA ELL Date: 2013-10-29 Time: 1030
E2
Signature of Alarm Agent: (Agent Meets Requirements Per Florida Statute 489.518)
Name of Owner or representative
Signature Date: 2013-10-29 R,Owner or Owner rep.not on site.
I would like to have a copy of NFPA#72 @ an extra charge of$50.00. Oyes ONO
Owner or rep.requests WAFS to release information from
inspections to the underwriters of my insurance company. QYes ONO System restored to normal operation:Time: 1300
Notifications are made Yes No Who Time
Monitoring Entity (X F OPERATOR 4057 1014
Building Occupants F
F, r TONY GORIA ADV SCHED
Building Management
Other(Specify) F r
I. ALARM NOTIFICATION APPLIANCES TEST AND INSPECTION
Device - Circuit Style/Quantity Operational Test - Approved Location - Pass Fail
Bells Quantity( 4 ) Size(6.00) Type(120VAC ) r ri 1
X'
Horns A( ) B( > F r r r:
Speakers A( ) B( ) F F f F
Chimes A( ) B( ) ! r r r
Strobes A( ) B( ) r
Other:(Specify) A( ) B( ) F
No.of Alarm indicating circuits: Are Circuits supervised? (-';Yes (`rNo
Page 2
II.INITIATING AND SUPERVISORY DEVICE TEST AND INSPECTION Pass - Fail
Device - Circuit Style/Quantity Operational Test - Simulated Test tt7� r
Manual Stations A( ) B( ) r r 1.......
17 F
Ion Detectors A( ) B( ) 1 F
Photo Detectors A( ) B(1 ) !^ r r.
Duct Detectors A( ) B( > r rr
Heat Detectors A( ) B( ) F
Waterflow Detectors A( ) B(4 ) 17 17
Supervisory Switches A( ) B(4 ) Pk fX-- F r
Pressure Switches A( ) B( ) r
Low Air A( ) B( ) r7 F !
Other(Specify): A( ) B( )
F r r
Ill. SUPERVISORY SIGNAL INITIATING DEVICES&CIRCUIT INFORMATION
Site Water Temp. (-Yes (`No (*—N/A
Site Water Level C Yes r No lljq-�N/A
Fire Pump Power C+Yes �`=No ;N/A
Fire Pump Running C Yes (`No N/A
Fire Pump Auto Position (',,Yes ( No (�`N/A
Fire Pump or Pump Control Trouble (-Yes �`No N/A
Generator In Auto Position ('Yes (rNo (�`N/A
Generator or Controller Trouble Yes C No (�"N/A
Switch Transfer ( Yes C�No 1 N/A
Generator Engine Running ( ;Yes (`No =N/A
Lock Box Yes No N/A
A.SIGNALING LINE CIRCUITS
Quantity and style(See NFPA 72,Table 3-6)of signaling line circuits connected to system
Quantity 1 Style(s): 4.0
IV.SYSTEM POWER SUPPLIES
A.Primary(Main): Normal Voltage 120VAC Amps 3
Overcurrent Protection:Type: CKT BRK Amps 20
Location(Panel#): HOUSE PANEL TO RIGHT OF FACP UNDER STAIRS
Disconnecting Means Location: CKT 9
B.Secondary(Standby): 24VDC(INSTALLED JUNE 2012)
Storage Battery:Amp-Hr.Rating 8Ah
Calculated capacity to operate system,in hours: (X(, 24 r 60
NA Engine driven generator dedicated to fire alarm system:
C.Location of Fuel Storage: NA
SECONDARY POWER
D.TYPE BATTERY
Type Visual Functional
F_ Dry Cell Battery Condition (X r
I— Nickel Cadmium Load Voltage 1`
F Sealed Lead-Acid
Discharge Test Min.
r Other(Specify):
Specific Gravity r
E.Emergency or standby system used as a back-up to primary power supply,instead of using a secondary
power supply. NA Emergency system described in N.F.P.A.,.Article 700.
Page 3
V.SYSTEM TESTS&INSPECTIONS
A.Type Visual Functional D.Notification Appliances - Visual - Functional
Control Panel r r Audible 1x—
Interface
Interface Equipment X r Visual F r
L.E.D.s/Lamps r Speakers (— r
Fuses/MicroBreakers r Voice Clarity F r
Primary Power Supply (X
Trouble Signals )( r
Disconnect Switches r
Ground Fault Monitoring r F E.ON/OFF Premises Monitoring
Yes No NIA
B.Emergency Communication Equipment Alarm Signal C- C
Type Visual Functional NIA Alarm Restoral C>
Phone Set F t� K Trouble Signal
Phone Jacks r 1........ OW Trouble Restoral M
Off Hook Indicatorsr
�! � Supervisory Signal ce; (�
Amplifier(s) r r
Supervisory Restoral (�`, C
Tone Generator(s) r 1........; r. Remote Anuciator
{" C
Call In Signal E. 17, r.
System Performance r r.
C.Interface Equipment DEVICE SIMULATED
(SPECIFY) VISUAL OPERATION OPERATION
WAYNE NET F r— r
17 F.
r F
Special Hazard System(Specify) rr
r r
VI.COMMENTS:
(1)BATT LOAD LEFT 12.58VDC 5.2Ah RIGHT 12.46VDC 4.5Ah
(2)WAYNE NET BATT LOAD 12.82VDC 3.2VDC
SIGNALS RECEIVED&RESTORED W/OPERATOR 3813
VII.DEFICIENCIES: These items are the owner's responsibility to be repaired and will be quoted separate from inspection cost.
2)BUILDING ONE&THREE FLOW SWITCHES INOP;POTTER VSC. BUILDINGS ARE IMPAIRED;TAG#'s 06863&06862