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HomeMy WebLinkAboutLA175438 � � ��'����j����� � � � o � � : 9a �� . �� � 4.��. .. ` �._... . IF 'S a�� a9 e ��� a t : A 's f� � a' �-a. a !� a "' # 0 .,.,'�5�„ 6'�' & f� .. � � } �R 0 � R A N'.:. ' Y 6�h Q' :R 9" ' t 0 i ' "3 f ' �c, ^ # �,. � �'�.:. S � �-� a. .� :.;n:� 8 �7 : 3`�' � tl �.:.i ,;,. � F� .A 91.i�. ,s •' i e s� :r Y:.:t �: �: .� S. �� ' e a�c . . .�'_.:......_.._ #��d :_ s :°i !1:3x_ � • e �a e, !��i P ��" i ' t+:+f 3-. : G -a_. �i�>:.. • -�at a w, � r , t � -i � w iY �. � .r. � m E � R �r �� i �i �,� I : be I` T } .A � �:.l:� .� � °� ��� f ,� ,r ._. � r � 'il I � a.�. . e a t': >r 9�xc ! ' � t , _ _ c r ♦ ♦ � i�- .,I� /Yt� � s. �xs;e r: e ��� _ tr �;::� �„ ;.� Y� 1 t "ro:0 _ 't:", .:-t' ' f�- tr4: �5�. y' ♦ f... rJi ":Z ' i: :♦ "�9� %gI�4�'i1..�.'... � �j"�5:: � � 1 ) ; + �. �anufac�ured Home Svste„ ms Test�f�tda, rrit f`�is forrn must be contpleted i►�its entireiy and be submitted at the 6uitding Eina!ins�ecticar�for the instatlatiar�af a �anufactured home. A11 tests rr�ust be complated and si�ner�off on this form. A cer�ifica#e of c�ccupancy wit!not be ssued un�il thi�compieted forrn is received. � � ���. SYSTEMS TEST YERlFICATIt?fi! t�saription Date Pa Sigr�atur��Tester dra�n Lin�: ��ua�t to c�t�.s�2�� a�te: srint lV�ne o#7�er and Cc�tpany: IA�Ste�`Li�: Pursuan#to C�R 328t?.�i12{a) Ek�t�: �rir�#N�o€Ta�ter amcJ C.om�rany: F�1'�T� Fttrsuart#to GFR 328t),612{c} Date: ?r�n#Name of T�and C�ny: C�T�Bt� P�,csttar�t tc CFR 3280.705�nr!1Ft�C�,4 �ate: � — �,� — , ......�,,,,� �rint�ar�of T�ster ar�c!Corr�p�ar�y: �.!f�.i'�(� ��;��Q� �(�,.�� �t}�3���(Y���• � E ca��►perat#ior�l. ��suant�a C�R 32s5,�o2 oate: 'rir�N�e t�Tester ar�d Gattp�any: �l+�ctric�! Pol��r�t�t: �u�se�r�ta C�R�;t85.�a2 aate. �rir►t Name of T��!C.orttpany: _ +CB�Ct7�R13itt�li',y; Pttrst�r�to C�R 32tf5.7fl2 i3a#e. 'rir�N�rte o€7este�'at�i Car�pany: �m�ol�er A�r T�G �ufsuarn to c�;�so.2o� o�t�: '�rt o�Te�eraadcor�nY= tset�ifj/t�te at�re syst�s ' h�s b�e�tt t�om ait�was foutx#to#�e fi�mp` t�t t#��novisic�' ` ed f�e'e�h � �-., ��.;�_ - �- � � � �� � -