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, 109-B Concord Drive <br /> � �yn�a Fi re ","`'� ` �` Casselberry, FL 32707 <br /> � �' Phone. 407-830-6500 <br /> Lic #EF20000528 Fax: 407-831-1347 <br /> Page 2 of 4 <br /> Organization Name/Phone Representative Name/Phone <br /> Installer <br /> Supplier ,` ' �� ;�'``� <br /> Service Organization <br /> Location of Record (As-Built) Drawings: <br /> �;�rt� �,!r <br /> Locatfon of Owner's Manuals: <br /> i f� ; ,., <br /> Location of Test Reports: <br /> ` /1. � Y <br /> A contract,dated ,for test and lnspectfon in accordance wfth NFPA Standard(s) <br /> No.(s) , dated , is in effect. <br /> 2. Certificate of System In Ilation. (Fili out aiter fnstallation is complete and wf�ing checked for opens, shorts, <br /> ground faults,and imp p�per branching, but prior to conducting operational acceptance tests.) <br /> This system has been installed in accordance with the NFPA Standards as Iisted below,was inspected bx <br /> �� , �' on � � ��; ; � , includes the devices listed <br /> below and s been in service since � �� �<. "�: <br /> � NFPA 72, Chapters �1" �3 ��� C5 r_'� ,� (cfrcle all that apply) <br /> , NFPA 70,Nerlone/Elecrrice/Code, Article 760 <br /> - Manufacturer's Instructions <br /> Other(specify): <br /> Signed: ��. �' Date: �� , ,� �� <br /> Organization: ' � ,,,-� /- � <br /> 3. CertiHcation of System Operation: <br /> All operational features and functions of this system were tested by � ,-�;� <br /> on f� �� � ' and found to be operating properly in accordance with the requirements of: <br /> NFPA 72, Chapters �3 �3 -'4� .-� b"� � (circle all that apply) <br /> - NFPA 70,Nationa/E/ectrice/Code, Article 760 <br /> Manufacturer's Instructions <br /> Other(specify): <br /> Signed: �� , ,� Date: � �, ,; <br /> � <br /> Organizatfon: ' � • <br /> C <br /> 4. Alarm Initiating Devices and Circufts(Use blanks to indicate quantity of devices.) <br /> MANUAL <br /> a) •° -��1 Manual Stations Noncoded Transmitters Coded <br /> b) - i ;ft Combination Manual Fire Alarm and Guard's Tour Coded Stations <br /> AUTOMATIC <br /> Coverage: Complete: Partial: <br /> a) �f�' Smoke Detectors lon Photo <br /> b) fc. r> Duct Detectors lon Photo <br /> c) ii-iet Heat Detectors Ff RR FT/RR RC <br /> d) il -i� SprinMer Water Flow Switches: Noncoded Transmitters Coded <br /> e) Other(list): <br />