Loading...
HomeMy WebLinkAboutLA172362 ' < <�L� � Z.. ; .� ,� � ��� � ������ ������ � � . , . , � . r � ,, , : : . � , s uz. ,� . . . „ _ _ ;, � � � � � � � �� � � � ��������� ������ ,�� � , : ���.. � � � � � � �r � � � � �' , � ��, 3 �- ���; f �:� � �,� � � _ � � �.,�. � � ,�:_ � � ,,.; .., � ;. � k x� � � .< ' �'� J <� ` d #Y > f � � AP � .. `v' �, . y's` . 4.. ` A — ` .h,I �` `� - � =t r � S = :" : � ��` � t ~ ' � �t _� _t.�.�- J : e d �-- M,,'� _ m, .- . , � a= � � r f :s �i �"vy. [ i y . �.xr���� � 4 ht.r M � �� ;m e - ��" �., "� F,�$.>�.# �`" � ���� ,. �4� t �� �!� �,� ' . § .. � � i hf � - x, , r.+'.-" �� ra x, �s ��.� ��� . F �; 't.,Ep Y ,�,� `,� � ' . . �'� Y S.�#� _- "�z.±S `} -� -V� �� '� � T,v.,.. � � W+��1LY. ♦ : , t i ��"y '. .'-�r 'v q- 3e'" Y"t : _ � � f - . _ ,1,_,,a. � y`x .M^t'�'�y�,�,� A. u ' a^,_ ,s t, .fi'. ,',`�r,x�T�,Y; �' „ � .x ,� .. €:�m � .;�' y .. �;:� �x �� ���'r' ��,� . t � , � _� ,�. � - e ,.�t= �.,yT,.+,��. �. �t x k - � �S �' ''� a" E -.�,f:.�� Y ` ,� . � �. �,. � �� . �"` � ``*�.�r..��� �,s.-�� - � � . �T - "- `�" � . 'y t" a,�`' >2 ,, x.ti�y � ,,� -_ - �� � � �i. } � � ��4��M��� 1� - - '�N:i u`�`^€ ,,�+ . ^. k" ,2� _ t"'+ '�. t � k+,_ - .�z J �� u � � x �• y r: , _ "" , <in.. .�c �> „- 7„1 . ,. . 3�, ,. ,e,.t� ,r, . �, . � . . . ' * �,: a ��. �s � ,,r �+$,�.,� r�`r.�� � ,;n� ,�d r �, s--`- :��w� ; v „r +: s m f t�_ . a ,: �, � k<z „���' �,'"'�", ` ,�� �� ��" �� �,� y�'. �" � - :£ kti`�.��� A' #§. �: � £ �k a %m +j. ' S .� ' ) } �r' ��� � ; }�� " . � � � �.� �'. .^Q. �+N 3- - �;- � t �� � $ �:� �£ S � f -t�° ..�, t�?. �s'f_. _ ' F . .V�. ..k " '.�� 2 . .. ,�. .: . . '� r ?� ,� -{' ,. . `f£ _ " ' � .� w�� R ', ,. r �€ „3Y �'� � : .,�<n , .< r u �iwy f� Rw���� ' . 4 �'� ,�. �� n? N4 -r- �#M��...��� � 3 t � '�a�����������������w�����# ,�f ����4�����i������, .� 4 �, � T .�'F' � ' �� r r. /�is � _ ::� 4 'l, F��`fi� ,.�� f..,,. . � �E. a„ .-.'. : . 1 _ . . . . . . .. . .. . � � �rt b � s S �� z ; .. � � s � ;, � � � . `. y }� 6 � � � , } , ��..- -; � � � ��,���"� � � _ < ., � , � � _ , � �, - �;� , — � �� ; � �i � . . �„ , . , � t �.. Y.. . ` � � � ��� .. ,> . . _ �. � , �_� <= zs�- � ' �nufacitur+�d Hom� Sv��ems 'fest A�davi� �is fom�must be cornplete�in its entirety and be su�rnitt�d at the Bui�ding Final inspecticfn far the insiallation of� nanufactured horne. AI3 tests must be campfete+d and signed off an this form. A cerE`rf'icate of occupancy vvi14 rtat� ssued �ntil#his completed fc�rrn is received. = a � ���(�. SYS'TE�A8 TEST VERJFICAT�{3N Qesc�p�tm Date Pas�sed S'rgnature af Tes#er �1'�Itt�.i�: F't�suartt ta GFR 328tI.612{t�} aate: ?ri�#Name t�#`I'�t at�ci Ctmrpany: I1l�t't81'Lil1+B: Pursuartt to CFFt 32�?.81 Z{aj C'�at�e: 'rint lVame of T+�ar�i G�any. '��'Q T@3� Pu�r�t ta CPR 328U.612{c} Dafe: �tint Plame of 7'ester ar�i�omp�rty: �T� Pursuarrt to CFR 3�#.?05 ar►d tFGC 4f16.4 C�ate: G� „� _ -.,�,,,,�,,,�..,.. [^kJ � 3�i1��C}��8'fi��e"�i1(��'tNTI�l811�f: �U�,-1 {f�'�j��i,.,e 1 �1Jl..�S"='l..► i"W�� +'�..�1 I AG-c��• �I�C�1'tGBI C��1�'1�Oi1i1: P'11fSl�i�t to CF�Z 32$5.�a2 QSIe: }titrt NBrr�e of T'ester and Cr�mR�Y :�19C#t'fC�1 P : Pu�suartt#o C�R 3285_702 Daie: '�nt N�rne of T a�d Contparry: c1�C#iYCCB[CC�11U1ty: Pursuan##o CFR 3285.7f�2 Date: h'�t Narne cs#'t�r ar�d trotr�ny: ►�ke A�ann Tes� �,��o eF�aaso.aos c�e: 7irtt of:T �C�cunpa�t: cer#ify� syster�s ' it�be�t t�tnp�et+�d� �und�i�e in c�rr� �ith tlte� ' ' iden�ti�t#i�ar�r Y��� � ���.. � �� � �