HomeMy WebLinkAbout2002-05-14 MN Dept of Administration Hydraulic Passenger Eleveator Compliance Letter 1 SO Department of Administration
Ivi/-; 17
May 14, 2002
Valley Senior Services
P.O. Box 9377
Minneapolis MN 55440
RE: Hydraulic Passenger - Elevator ID# - 07949PT01 -01
Site: Boutwells Landing 5( 9 r
Oak Park Heights 55082
Dear Sir /Madam:
Minnesota Statutes Chapter 16B provides that the Department of Administration, Building,
Codes and Standards Division, Elevator Safety Section, inspect and approve elevators and
manlifts (endless belt lifts) before they can be legally used in Minnesota. An Inspector from
the Elevator Safety Section recently inspected your facility and determined it meets
requirements of the Minnesota Elevator Safety Code.
NOTE: Compliance with Minnesota Rules and the ANSI /ASME A17.1, Safety Code for
Elevators and Escalators does not necessarily assure compliance with the
Americans With Disabilities Act of 1990.
REFUND OF PERMIT OVERPAYMENT OF $14.00 ON JANUARY 18, 2002.
Sincerely,
BUILDING CODES AND STANDARDS
ear
Bill J. Reinke
State Elevator Inspector
bjr /kad (CE -2)
c: Butler, Jimmy Allen, BO, City of Oak Park Heights
Schindler Elevator Corp.
Adolfson & Peterson, Inc.
ElFormCE2
Building Codes and Standards Division, 408 Metro Square Building, 121 7th Place East, St. Paul, MN 55101 -2181
Voice: 651.296.4639, Fax: 651.297.1973; TTY: 1.800.627.3529 and ask for 296.9929
---4IFP RECORD 9F COMP ETIO
Name of Protected Property: l 4c.7 . -' ef � � 1 / r\ - 3 ) CC9_
Address: L
Rep. of Protected Prop. (name /phone): /
Authority Having Jurisdiction: /31Li[ (' L -
Address /Phone Number:
1. Type(s) of System or Service
n N FPA 72, Chapter 3 - Local
If alarm is transmitted to location(s) off premises, list where received:
n N FPA 72, Chapter 3 - Emergency Voice /Alarm Service
Quantity of voice /alarm channels: Single: Multiple:
Quantity of speakers installed: Quantity of speaker zones:
Quantity of telephones or telephone jacks included in system:
n N FPA 72, Chapter 4 - Auxiliary
Indicate type of connection:
Local energy: Shunt: Parallel telephone:
Location and telephone number for receipt of signals:
n N FPA 72, Chapter 4 - Remote Station
Alarm:
Supervisory:
n N FPA 72, Chapter 4 - Proprietary
If alarms are retransmitted to public fire service communications center or others, indicate location and telephone number
of the organization receiving alarm:
Indica ow alarm is retransmitted:
NFPA 72, Chapter 4 - Central Station - /
The Prime Contractor: 5/'ft,/ �"�!�'�.�t+'t G it
Central Station Location:
Means of transmissio f signals from the protected premises to the central station:
ulloh Multiplex One -Way Radio
Digital Alarm Communicator Two -Way Radio Others
Means of transmission of alarms to the public fire service communications center:
(a)
(b)
System Location:
Organic ationn Name /Phone epresentative Name Phone
Installer fi /C "—i^; rulelf .c
Supplier / /
Service Organization 1 4�
Location of Record (As- Built) Drawings: f/
Location of Owners Manuals: 5'/ . _/ ,[ -e,
Location of Test Reports: 5 / 7 ----
A contract, dated , for test and inspection in accordance with NFPA standard(s)
No(s). dated , is in effect.
2. Record of System Installation
(Fill out after installation is complete and wiring checked for opens, shorts, ground faults, and improper branching,
but prior to conducting operational acceptant tests.)
This system has been i talled irl accordan with g pl PA stand r as own below,
was inspected by / -�iGr, f � / / - on, 6/ Z includes the devices shown below,
and has in si vice since .
NFPA 72, Chapters 1 3 7 circl- :I at apply)
NFPA 70, National Electrical •..e, • cl:
Manufacturer's Insfruc'>.• -
Other (specify): f //1 47 — /Air
Signed: ���' 117 Date: 1
Organization:
AHJ - White; Owner - Canary; Branch - Pink; Site Copy - Goldenrod
MC24 -2 -014 Part 1 of 3
3. Record of System Operation
All operational fe tures and functions of this system were tested by tte •
and found operating properly in accor ance with the requirements of:
NFPA 72, Chapters 1 3 6 7 (. - all that apply)
NFPA 70, National Electrical C. - -, • /60
Manufacturer's Instructs..
Other (specify): /
/AV
Manufacturer's
Signed: / ��r`�� Date: L
Organization: )14
4. Alarm- Initiating Devices and Circu' s (use blanks to Indic: e quantity of devices)
MANUAL
(a) Manual Stations Non coded, Activating Transmitters Coded
(b) Combination Manual Fire Alarm and Guard's Tour Coded Stations
AUTOMATIC
Coverage: Complete: Partial:
(a) Smoke Detectors Ion Photo
(b) Duct Detectors Ion Photo
(c) Heat Detectors FT RR FT /RR RC
(d) Sprinkler Waterflow Switches: Transmitters Non coded, Activating Coded
(e) Other (list):
5. Supervisory Signal- Initiating Devices and Circuits (use blanks to indicate quantity of devices)
GUARD'S TOUR
(a) Coded Stations
(b) Non coded Stations, Activating Transmitters
(c) Compulsory Guard Tour System Comprised of Transmitter Stations and Intermediate Stations
NOTE: Combination devices recorded under 4(b) and 5(a).
SPRINKLER SYSTEM
(a) Coded Valve Supervisory Signaling Attachments
Valve Supervisory Switches, Activating Transmitters
(b) Building Temperature Points
(c) Site Water Temperature Points
(d) Site Water Supply Level Points
Electric Fire Pump:
(e) Fire Pump Power
(f) Fire Pump Running
g) Phase Reversal
Engine- Driven Fire Pump:
(h) Selector in Auto Position
(1) Engine or Control Panel Trouble
(j) Fire Pump Running
Engine- Driven Generator:
(k) Selector in Auto Position
(1) Control Panel Trouble
(m) Transfer Switches
(n) Engine Running
Other Supervisory Function(s) (specify):
6. Alarm Notification Appliances and Circuits
Quantity of indicating appliance circuits connected to the system:
Types and quantities of alarm indicating appliances installed:
(a) Bells Inch
(b) Speakers
(c) Horns
(d) Chimes
(e) Other:
(f) Visual Signals Type: with audible w/o audible
(g) Local Annunciator
7. Signaling Line Circuits
Quantity and Styl (see NFPA 72, Table 3 -6) of signaling line circuits connected to system:
Quantity: Style:
AHJ - White; Owner - Canary; Branch - Pink; Site Copy - Goldenrod MC24 -2 -014 Part 2 of 3
/"'"
8. System Power Supplies /
(a) Primary (Main): Nominal Voltage: ` . rrent Rating:
Overcurrent Protectio . ype: ! . , . . Current Rating: 2-C •—
Location:
(b) Secon (Standby):
Storage Battery: Amp -Hour Rating
Calculated capacity to drive system, in hours: 24 60
Engine- driven generator dedicated to fire alarm system:
Location of fuel storage:
(c) Emergency or Standby System used as backup to Primary Power Supply, instead of using a Secondary Power Supply:
- Emergency System described in NFPA 70, Article 700
Legally Required Standby System 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
9. System Software
(a) Operating System Software Revision Level(s):
(b) Application Software Revision Level(s): / L,
(c) Revision Completed by:
(name) (firm)
10. Comments:
(signed) for Central Station or Alarm Service Company (title) (date)
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standards(s):
System deviations from the referenced NFPA standard(s) are:
(signed) for Central Station or Alarm Service Company (title) (date)
Upon completion of the system(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction):
) 6.4 1 I
representative of the authority having jurisdiction (title) (date)
P tI/ 91 t
(� j ( )
AHJ - White; Owner - Canary; Branch - Pink; Site Copy - Goldenrod
MC24 -2 -014 Part 3 of 3