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BLD04-204
~ • CITY OF PORT TOWNSEND AUTOMATIC FIRE SPRINKLER SYSTEIVI PERMIT & INSPECTION RECORD THIS CARD MUST BE POSTED AT CONSTRUCTION SITE CALL 385-2626 FOR INSPECTION Permit Number: BLD04-204 Issued: 08/04/04 Job Address: 2000 West Sims Way Zoning: C-II Nature of Work: Install Automatic Fire Sprinkler System Use of Building: B/M/F-1/S-1/S-2 ~- Retail/Warehouse/Storage Owner: Ken Kelly Licensed Contractor: FSI Fire Sprinklers Inc. - FIRESI*988RJ INSPECTIONS AND TESTS LOCATE(S) Pass Fail N/A ^ ^ ^ Fire Department Connection (Storz) ^ ^ ^ Vault(s) ^ ^ ^ Post Indicator Valve Inspector Date SYSTEM TEST(S) & INSPECTIONS Pass Fail N/A ^ ^ ^ Piping, Bracing, Valve Installations ^ ^ ^ Back Flow Prevention Inspection (Public Works Department) ^ ^ ^ Drain and drip device between FDC and Check Valve ^ ^ ^ Approval for Cover (except @ joints when prior to flow tests) ^ ^ ^ Hydrostatic Test (2 hour, 200 psi minimum 13, 13R; Static @ 13D) ^ ^ ^ Pressurized Air Test (24-hour dry test to 40 psi) ^ ^ ^ Flush with sieve with De-Chlorination tablet (to sewer manhole only) ^ ^ ^ Flow Test: Water Pressure Gauge Reading: psi static to psi flow reading ^ ^ ^ Fire Alarm System Inter-tie with Sprinkler System Test seconds to alarm initiation ^ ^ ^ Sprinkler Head installation ^ ^ ^ Piping, bracing, system installation See Next Page Page 1 of 2 • SYSTEM TEST(S) & INSPECTIONS continued Pass Fail N/A • Permit #131.1704204 ^ ^ ^ Labeling (Control valves, drains, etc.) ^ ^ ^ Sprinkler Box Contents ^ ^ ^ Water Motor Alarm (required for 25 heads or more) (Tamper and flow): Seconds to alarm initiation ^ ^ ^ Fire Department Connection (4" Storz only) ^ ^ ^ Adequate heat provision for piping protection Inspector CERTIFICATE(S) OF MATERIAL & TEST Pass Fail N/A Date ^ ^ ^ Back Flow Prevention Material & Test Certificate filed with Public Works ^ ^ ^ Sprinkler Contractor's Material & Test Certificate -Level U ^ ^ ^ Sprinkler Contractor's Material & Test Certificate -Above Ground ^ ^ ^ Private Fire Service Main Contractor's Material & Test Certificate ^ ^ ^ As-Built Plans/Instructions in Plan Box ^ ^ ^ Fire Department Final Inspection Approval Inspector Sprinkler Maintenance Company (if known): Name Address Contact Number L&I Number Date Page 2 of 2 Back Flow Prevention Device Maintenance Company (if known): Name Address Contact Number L&I Number NOTES: a2ood ~- S%r~s ~Q~/ _oF"°RTr°~,ry~~ ITY OF PORT TOWNSEN PUBLIC WORKS DEVELOPMENT SERVICES DEPARTMENT 9 `'n .~. ~ ,~O ~~'C WA5H~aG INSPECTION REPORT PERMIT NUMBER: ~G~ 4~ -" ~©~ Address ~©°° ~~~~J ~~`¢"~ Contractor ~-5l Owner /~.rti! Date of Inspection ~ ~ ?.~" " '¢-"' Warksite or Cell Phone# Erosion/Sedimentation ^ Setbacks/Footings/LIFER ^ Foundation Walls ^ Slab Interior Footing/Insulation ^ Groundwork/Plumbing Test ^ Underfloor Framing ^ Shear Wall/Holdowns ^ Plumbing/Top Out ^ Drywall/Fire Wall u Gas Pipe/Pressure Test ^ Gas/Wood Appliance ^ Propane Tank/Line ^ Manufactured Home Set-up ^ Mechanical `J Pubic Works ^ Framing ther/Consultation ^ Insulation S,f~~/~V~L~/~- „~ ^ Interior Shear/BWP Nail i.J FINAL If corrections required, re-inspection must be done prior to covering or concealing areas of construction. Additional fees may be assessed for multiple re-inspections. For Re-inspection, call Inspection Message Line at (360) 385-2294 prior to 8:00 AM. NO OCCUPANCY UNTIL FINALIZED BY BUILDING AND, IF APPLICABLE, PUBLIC WORKS. L] VIOLATION ~ PPROVAL ^ CORRECTION REGIUIRED ^ APPROVED WITH CORRECTION L.I NEED APPROVED PLANS & PERMIT ON SITE ,~l/eE J~i~.~ !/i~.~[L. ~Ie ~//. f"7~' L-L~TT!>/V ~ ~i~ ~~ ~!//~~ ~~ ~ T ~~~ ~~~ -~~ C~i~ 7~ ~ ~-05~ ~iG-l~fC S ~~~ IoM ~ Approved ans a permit card ust be on-site and available at time of inspection. Inspec _ _- -... ... ----.....w -- ..- _ Date ~~' ._~~