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NFPA 72 Cert of Completion.pdfFIRE ALARM AND EMERGENCY COMMUNICATION SYSTEM RECORD OF COMPLETION To be completed by the system installation contractor at the time of system acceptance and approval. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Attach additional sheets, data, or calculations as necessary to provide a complete record. 1. PROPERTY INFORMATION Name of property: Address: a®l_e�IV (S %XA5'Er Description of property: 4 o h i * 7� aG7 Occupancy type: .21 � l4 f ,� Name of property representative: )W in / cle. / f Address: % 3 0 5' S a ✓nd lr I Phone: oCo 6 - i O ` f ~ Fax: E-mail: peLU I^ / a k It e_,ot4.j • ev" Authority having jurisdiction over this property: "�t Phone: 4alrI d!7 — t q6 r Fax: E-mail: J_f jt l� • +� / 4,1 !l - 1" 2. INSTALLATION, SERVICE, AND TESTING CONTRACTOR INFORMATION T Installation contractor for this equipment: pZ \Pttre Cc% =nC_ .1 Address: :5 0 & r . License or certification number: Phone: Fax: �7t E-mail: \ Service organization for this equipment: F �z i r� Y rp�e G� �r1 -If1C_ _ Address: r 1 ?-% License or certification number: &2'15W*6 Phone: Fax: E-mail: A contract for test and inspection in accordance with NFPA standards is in effect as of: \ Contracted testing company: r F t re 'rO�eGV\or\ 1r r • J Address: E,.ere4I Phone: Fax: E-mail: Contract expires: Contract number: Frequency of routine inspections: 3. DESCRIPTION OF SYSTEM OR SERVICE J�Oire alarm system (nonvoice) ❑ Fire alarm with in -building fire emergency voice alarm communication system (EVACS) ❑ Mass notification system (MNS) ❑ Combination system, with the following components: ❑ Fire alarm ❑ EVACS ❑ MNS ❑ Two-way, in -building, emergency communication system ❑ Other (specify): NFFIA 72, Fig, 10.18,2.1 1 (p. 1 of 12) Copyright © 2009 National Fire Protection Association This form may be copied for individual use other than for resale It may not be copied for commercial sale or distribution