253 Royal Palms Dr Planet Fitness Fire Alarm Notes FUNDAMENTALS OF FIRE ALARM sYsTEMS 72-31
FIRE ALARM SYSTEM
RECORD OF COMPLETION
Name of protectedroperty: s.�Q T �--`�-..�,tee
j Address: �S 3 s.% 9�'�P�„�..e��c� 3"33
i Representative of protected property(name/phone): �.aa►e�� d.drt:.b.. Wy—yp'3y
Authority having jurisdiction:Qr�\�= a�•�`.� F�.� � \--��y (x'30^U-1
Address/telephone number: $Op ev.`�.�,t _'tea. fN � -4 'Vt
Organization name;phase Representative name/phone
Installer Augustine Alarm Fire & Sound Inc Tyler Halbrooks 904-825-0030
Supplier ugus ]ne Alarm, Fire & Sound, Inc. Tyler Halbrooks 904-825-0030
Service organization Au ustine Alarm Fire & Sound Tyler Halbrooks 904-825-0030
i
Location of record(as-built)drawings:
Location of operation and maintenance manuals: AUP
Location of test reports: AT THE FACP
A contract for test and inspection in accordance with NFPA standar s) /.
Contract No(s): N/A Effective date: ��— �'c �%� Expiration date:
System Software
(a)Operating system(executive)software rey tr 1 v�(s):
(b)Site-specific software revision datN U�
(c)Revision completed by: " , U
( m (firm)
1.Type(s)of System or Service
I
NFPA 72,Chapter 6—Local
If alarm is transmitted to location(s)off premises,list where received:
Je� NFPA 72,Chap r 8—Remote Station
Telephone nu rs of the organization receiving alarm:
Alarm:
Supervisory:
Trouble:
If alarms are retransmitted to public fire service communications centers or others,indicate location and telephone
I numbers of the organization receiving alarm:
i Indicate how alarm is retransmitted:
j NFPA 72,Chapter 8—Proprietary
Telephone numbers of the organization receiving alarm:
Alarm:
I Supervisory:
Trouble:
If alarms are retransmitted to public fire service communications centers or others,indicate location and telephone
i
numbers of the organization receiving alarm:
i
Indicate how alarm is retransmitted:
i
NFPA 72, Chapter 8—Central Station
Prime contractor:
l Central station location:
i
i
(NFPA 72,1 of 4)
FIGURE 4.5.2.1 Record of Completion.
2002 Edition
72-32 NATION.AI.FIRE ALARM CODE
Means of transmission of signals from the protected premises to the central station:
cCulloh Multiplex One-way radio
Digital alarm communicator Two-way radio Others
Means of transmissOn lA to the public fire servic 7communications center:
(b)
System location
NFPA 72,Chapter 9—Auxillary /
Indicate type of connection: po Local energy Shunt Parallel telephone
Location of telephone number for receipt of signals:
2.Record of System Installation
(Fill out after installation is complete and wiring is checked for opens,shorts,ground faults,and improper branching,
but prior to conductinf operational acceptance tests.)
This syste has b in led ftyaccordance with the NFPA s as sh wn below was inspected by
S/OG% S on O / rj includes the devices shown
in 5 add 6,and as been in service since
_i 1VFPA 72,Chapters 1 2 30(906"
11 (circle all that apply)
_ "SPA 70,National Electrical Code.Article 760
�Manufacturer's instructions
Other(specify):
Signed: Date: L✓ —
i
Organza '
3.Record of System Operation
Documentation in accordance with Inspection Testing Form,Figure 10.6.2.3,is attached
All operational features and functions of this system were tested by date
and found to be operating properly in accordance with the requirements of:
_4Z- FPA 72, Chapters 1 2 36? PC668000 11 (circle all that apply) I
FPA 70,National Electrical Cate,Article 760
�-�anufacturer's
instructions
Other(spec'
Signed: Date: —
Q
Organiza
4.Signaling Line Circuits
Quantity and clas of signaling line circ 't connected to system(see NFPA 72 ble 6.6.1):
Quantity:_ 0 Style: Class:
(NFPA 72,2 of 4)
FIGURE 4.5.2.1 Continued
2002 Edition
FL`NDAMENTAI.S OF FIRE ALARM SYS IENIS 72-33
i
i5.Alarm-Initiating Devices and Circuits
Quantity and class of initiating device circuits(see NFPA 72,Table 6.5):
i
Quantity: Style: Class:
MANUAL
i
(a)Manual.stations Noncoded Transmitters Coded Addressable
(b)Combination manual fire alarm and guard's tour coded stations
i
AUTOMATIC /
Coverage: Complete f/ Partial
Selective Nonrequired
(a)Smoke detectors 43 Ion Photo k1f- _ Addressable_
(b)Duct detectors Ion Photo Addressable
(c)Heat detectors FT RR FT/RR RC Addressable
(d)Sprinkler waterflow indicators: Transmitters Noncoded Coded Addressable
(e)The alarm verification feature is disabled or enabled ,changed from seconds to seconds.
(fl Other(list):
i
6.Supervisory Signal-Initiating Devices and Circuits(use blanks to indicate quantity of devices)
GUARD'S TOUR
j (a) Coded stations
(b) Noncoded stations
I (c) Compulsory guard's tour system comprised of transmitter stations and intermediate stations
i Note:Combination devices are recorded under 5(b),Manual,and 6(a),Guard's Tour.
SPRINKLER SYSTEM
Check if ovided
(a) Valve supervisory switches
(b) Building temperature points
(c) Site water temperature points
(d) Site water supply level points
Electric fire pump:
(e) Fire pump power
M Fire pump running
(g) Phase reversal
I
Engine-driven fire pump:
(h) Selector in auto position
(i) Engine or control panel trouble
G) Fire pump running
ENGINE-DRIVEN GENERATOR:
(a) Selector in auto position
(b) Control panel trouble
(c) Transfer switches
(d) Engine running
Other supervisory function(s)(specify):
(NFPA 72,3 of 4)
FIGURE 4.5.2.1 Continued
2002 Edition
72-34 _ NATIONAL FIRE MARNI CODE.
7.Annunciator(s) /
Number: �_— Type: / 1`Location:
8.Alarm Notification Appliances and Circuits
NFPA 72,Chapter 6—Emergency Voi Alarm Service
Quantity of voicelalarm channels: Single: Multiple:
Quantity of speakers installed:
Quantity of speaker zones:
Quantity of telephones or telephone jacks included in system:
Quantity and the lass of notification appli ce circuits connected to sys (see NFPA 72,Table 6.7):
Quantity: 94
Style; Class:
c
Types and quantities of notification appliances installed:
(a)BellsWith Visible
ers
(b)SpeakWith Visible
(c) Horns With Visible
(d)Chimes With Visible
(e) Other: With Visible
(fl Visible appliances without audible:
9.System Power Supplies n
(a)Fire Alarm Control Panel: Nominal voltage: �(7 Current rating: o�.Q
Overcurrent protection: Type: Curr t at ng: �J
Location:
(b)Secondary(standb
Storage battery: °
g rY� Amp-hour rating:
Calculated capacity to drive system,in hours:
Engine-driven generator dedicated to fire alarm system:
Location of fuel storage:
(c) Emergency system used as backup to primary power supply:
Emergency system described in NFPA 70,Article 700:
10.Comments
Frequency of routit>1tests and in/j1@Ctions,if other than in accordance with the referenced NFPA standard(s):
System deviations from the referAced NFPA standard(s)are:
g to s Ila ion co ctor/ pp' It e) (date)
(s a {fide) (date) p Q
can ral stab
e) (date)
pon completion of the system(s)satisfactory test(s)witnessed(if required by the authority having jurisdiction):
(signed)representative of the authority having jurisdiction (fide) (date)
(NFPA 72,4 of 4)
FIGURE 4.5.2.1 Cmttinued
2002 Edition
JJ�X /lym/ �*7
1
INSPECTION,TESTING, ` h A[ TE1 72-101
INSPECTION AND TESTING F//ORM /
DATE:
TIME:�LL_,1. _1Z_ -
SERVICE ORGANIZATION PROPERTY NAME(USER)
Name: Augustine Alarm, Fire & Sound, Inc. _ Name C —
Address: PO BOX 1104, St. Augustine, FL 32085 Address: /CO y/lU. _
p
Representative:John Tyler Halbrooks_ _ Owner Contact: F�/
License No.:F—F2004$7__. _-_._-- __ Telephone:
Telephone: 904-825-0030
MONITORING ENTITY APPROVING AGENCY
Contact:—A11American._M9nitoTft.......... ._ Contact:1�4 p.w�:_s� 44L�►R, �c
Telephone: 1-800-318-9486 Telephone:- CQtA %,-1,O — 05
Monitoring Account Ref No.:
TYPE TRANSMISSION SERVICE
7 McCulloh ❑ Weekly
J Multiplex :1 Monthly
J Digital ❑ Quarterly
• Reverse Priority ] Seyidiinually
�7 c n l Annually
ii Other(Specify)_ G�a.._...__I���'........._ ._._`� ��'`_G..Nk7 Other(Specify) -- - -- ..............
- 1
Control Unit Manufacturer: S il-If'V 7_/<&j Model Model No.:
Circuit Styles:
Number of Circuits:
Software Rev.: if 1 -
Last Date System Had Any Service Performed:
Last Date that Any Software or Configuration Was Revised: --
ALARM-INITIATING DEVICES AND CIRCUIT INFORMATION
Quantity Ci Style
Manual Fire Alarm Boxes
...... Ion Detectors
Photo Detectors
Duct Detectors
_ Heat Detectors
Waterflow Switches
Supervisory Switches
Other(Specify):
Alarm verification feature is disabled enabled
(NFPA Inspection and Testing,1 of 4)
FIGURE 10.6.2.3 Example of an Inspection and Testing Form.
f _L� 2002 Edition
72-1U° NATIONAI.FIRE ALARM CODE
ALARM NOTIFICATION APPLIANCES AND CIRCUIT INFORMATION
Quantity Circui Style
Bells
Horns
_ Chimes
_ Strobes
_........_...._...___ - Speakers
Other(Specify):
No.of alarm notification appliance circuits:
Are circuits monitored for integrity? es _j N;
SUPERVISORY SIGNAL-INITIATING DEVICES AND CIRCUIT INFORMATION
Quantity Circuit Style
Building Temp.
Site Water Temp.
Site Water Level
-- Fire Pump Power
Fire Pump Running
Fire Pump Auto Position
_ Fire Pump or Pump Controller Trouble
Fire Pump Running
Generator In Auto Position
Generator or Controller Trouble
Switch Transfer
Generator Engine Running
Other:
SIGNALING LINE CIRCUITS
Quantity and style of signaling line circuits connected to system(see NFPA 72,Table 6.Cy�:
Quantity Style(s) 7
SYSTEM POWER SUPPLIES
(a)Primary(Main): Nominal Voltage f�OVA._e-- Amps
Overcurrent Protection: Type '0-KF R Amris n __
Location(of Primary Supply Panelboard): t
Disconnecting Means Location: ARUbfn
(b)Secondary(Standby):
� Q
1L 12 ✓10 L Storage Battery: A
Hr.Rating /
Calculated capacity to operate system,in hours: � 60
Engi -driven generator dedicated to fire alarm system:
Location of fuel storage:
TYPE BATTERY
O Dry Cell
❑ N el-Cadmium
QV"Sealed Lead-Acid
❑ Lead-Acid
0 Other(Specify):
(c) Emergency or standby system used as a backup to primary power supply,instead of using a secondary power supply:
Emergency system described in NFPA 70,Article 700
Legally required standby described in NFPA 70,Article 701
Optional standby system described in NFPA 70,Article 702,which also meets the performance
requirements of Article 700 or 701.
(NFPA Inspection and Testing,2 of 4)
FIGURE 10.6.2.3 Continued
2002 Edition
INSPECTION,TESTING,AND MAINTENANCE. 72-103
PRIOR TO ANY TESTING
NOTIFICATIONS ARE MADE Yes/ No Whonn 'rime
Monitoring Entity YY J AU— AMf a�CAN - 0`-13 a
Building Occupants '/ 7 r u— -a• 0 -
Building Management Y J
Other(Specify) J1 �-
AHJ Notified of Any Impairments J J
SYSTEM TESTS AND INSPECTIONS
TYPE Vis ua Functio Comments
Control Unit
Interface Equipment1�1+///
Lamps/LEDS R _
Fuses U J
Primary Power SupplyIYoublAe Signals
Disco
- - -
Disconnect Switches
Ground-Fault Monitoring �pf�
SECONDARY POWER
TYPE Visual Functional Comments
Battery Condition �y -
Load Voltage
Discharge Test
--
Charger Test _
Specific Gravity J ...._...—_..... __-- . .
TRANSIENT SUPPRESSORS J
REMOTE ANNUNCIATORS MM
NOTIFICATION APPLIANCES /
Audible ems/
Visible A�S
Speakers �/ �/ ,q-SS
Voice Clarity J /7
INITIATING AND SUPERVISORY DEVICE TESTS AND INSPECTIONS
Device Visual Functional Factory Measured
Loc.&S/N Type Check Test Setting Setting Pass Fail
U ❑ U J
..l U U J
-- J D ❑ O
---- J U U U
J U U ❑
Comments:
(NFPA Inspection and Testing,3 of 4)
FIGURE 10.6.2.3 Onitineed
2002 Edition
72-104 NATIONAL.FIRE ALARM CODE
EMERGENCY COMMUNICATIONS EQUIPMENT Visual Functional Comments
Phone Set , ❑
Phone Jacks ❑ ❑
Off-Hook Indicator ❑ ❑
Amplifier(s) ❑ ❑
Tone Generator(s) ❑ ❑
Call-in Signal ❑ ❑
System Performance ❑ ❑
Device Simulated
Visual Operation Operation
INTERFACE EOUI�PMENT
(Specify) :5 11;
(Specify) voit U
(Specify)-- -- ._......._.....---- — J J ❑
SPECIAL HAZARD SYSTEMS
(Specify),-.. -._ ❑ ❑
(Specify)_- J ❑ ❑
(Specify) _ ___._....._._.__ _ ❑ ❑
Special Procedures: -_-
Comments:
SUPERVISING STATION MONITORING Ye, No Time Comments
Alarm Signal d ❑ Q
Alarm Restoration ❑
Trouble Signal ❑ • S O
Supervisory Signal /� ❑ r �6
Supervisory Restoration f3 ❑
NOTIFICATIONS THAT TESTING IS COMPLETE Yes No Who Time
Building Management ] ,Q,10 W'&6
Monitoring Agency ALL AP14C MwI ;DO
Building Occupants A 3
Other(Specify) J J
The following did not operate correctly: - ___........---.._..---
------ ......... ....................... ---- -
System restored to normal operation: Date: Time: ....t.._0 .
THIS TESTING WAS PERFORMED IN ACCORDANCE WITH APPLICABLE NFPA STANDARDS.
Name of Inspector: ';' �g_ Date: (w `7"�5 Time:
Signature:
Name of Owner or Represe tative:_
Date: Time:
Signature:
(NFPA Inspection and Testing,4 of 4)
FIGURE 10.6.2.3 Continued
2002 Edition