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i � � ' <br /> . _ • . I� <br /> I <br /> • • � <br /> �� Fort Knox ���� & Communications, Inc. '; <br /> �''^'`�G�111eW��� 4517 George Road,Suite 240,Tampa,Florida 33634 ; si�uvr <br /> � � xrrtc;ftr <br /> � �� Office:(813)653-1605 Fax:(813)653-1710 � <br /> 6y Naneywell <br /> t..__.__..____...______.. <br /> �by Honeywell FL.License#:EF20000876 GA.License#:LUV406140 Far�enhyC <br /> f' FUNDAMENTALS 72-41 <br /> � FIRE ALARM AND EMERGENCY COMMUNICATIONS SYSTEM RECORD OF COMPLETION <br /> To be completed by the installation contractor at the time of system acceptance and approval.It shall 6e permifted <br /> to modify this form as needed to provide a more complete and/or clear record. Aftach additional sheets,data or <br /> or calculations as necessary to provide a complete record. Insert N/A in all unused lines. <br /> 1. � PROPERTY INFORMATION <br /> , Nameofproperty: �Florida Medical Clinic <br /> Address: 38135 Market Square Drive, Zephyrhills, FL 33540 Permit# s7654/17523 <br /> �' Occupancy type: <br /> Description of property: HealthCaYe Job# <br /> � Name of property representative: Address: <br /> ,, <br /> '' Phone: Fax: E-mail: <br /> ! Authority having jurisdiction over this property: City Of Z2phyYills <br /> � Phone: 813-780-0020 Fax: E-mail: <br /> 2. INSTALLATION,SERVICE,AND TESTING CONTRACTOR INFORMATION I <br /> Installation contractor for this equipment: FOYt KriOX F1Y6 & COYriYYtUriICGitIOt2S, Inc. � <br /> Address: 45I7 Georqe Road, Suite 240, Tampa, FL. 33634 License or Certification: EF-20000876 , <br /> Phone: (gI3) 653-1605 Fax: (g13) 653-1710 E-mail: acollins@fortknoxfire.com � <br /> Service Organization for this equipment: FOYi'KriOX F1Y2 & COYilYriunlCGit'IOY1S, Inc � <br /> Address: 4517 GeoY9e Road, Suite 240, Tampa, FL. 33634 License or Certification: EF-20000876 <br /> ^ Phone: �g13) 653-1605 Fax: �g13) 653-1710 E-mail: acollins@fortknoxfire.com <br /> ' A contract for test&inspection in accordance with NFPA standards is in effect as of: <br /> �� Contracted testing company: <br /> Address: ' <br /> „�� Phone: (g13) 653-1605 Fax: (813) 653-1710 E-mail: I <br /> Contract expires: - Contract number: Frequency of routine inspections: ; <br /> � <br /> � <br /> 3.� DESCRIPTION OF SYSTEM OR SERVICE <br /> � � Fire Alarm system(non-voice) <br /> ,, �j Fire Alarm with building Fire Emergency voice alarm communication system(EVACS) <br /> � �; Mass Notification system(MNS) � <br /> � <br /> � Combination system,with the following components: <br /> �; Fire Alarm �! EVACS C' MNS �� Two-way,in building,emergency communication system I <br /> � Other(specify): � <br /> � I <br /> NFPA 72 edition: 2010 Additional description of system(s): <br /> FIGURE 10.18.2.1.1 Record of Completion (2010 Edition) NFPA 72(pg.l of 12) <br /> �� 2010 Edition n, <br /> � NFPA <br /> 14r • <br /> 9 <br />