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HomeMy WebLinkAboutLA175138 � �7�� � � � � � ���� ������� ������ � � � � �� "thL����u�t,b��p����►t#��ti��an�b�:��r����tf��������r�i!i�p��n:�r����tait�c�.a� �c�����+c�e. k1�� �i��t��r�r �r���n�d c�F�r�°����f �A�r� , c�c���r v,���t tr� �r+�-����t�pd�i`�a�m�r��u+�d: ���`����'��'�`�;�P��t��t � ���� � � ��� �� ��� � � ����!'���' �� �ir���r"�"+��.1���:'�.±���(b} �= 5-�R- Z� _ P�N,�ta�T . �r�i�r�� /�/l!�` L L C,. � . ��1:����+����t�:�.��;��� c�e. � •. . ��' :t� �� 5-- I 9- Z� ' � . � � � � . � � ��h�tt : t�`'C����__.' ��� ��"1�;.� �-L-�.._ � � � ,, , . �� ��t?�"�'�1�t��to�C�R�:�t����� � � ��;��S I�-- 2 U P����T�r�C�,�� M Nf�2: L.,. L c,. � � . �� � , , _ z _. t��ti'1`�'�!�r�lt�����1�5�c!t���,�t, C�: ' ���"t'��C�rr�iar�r: , ���i�ail����iA�'P�t��G��2�.�' �3�c��� �� ��I�t��'+�i�`a�td � ��'Q.�---- `1 ��_� !� �� ��r1+c�������a�t����:� �: :� �43�� � ' c�'�e+e���p�: i �i �, C- � �w4f�.�� � � . r �- .� ��'�tt���i�.�ur�a�u�t�t����R.�5;�t�2 �e; �j�r���1�!-� ' � Pr���'t'�`� ��� �`����v'a,�...... � , � � � :k. �"'` ►_ ���... �.G_'�� C' � � � ���r��111mt'1"�t: i�ut�tu�E�Ci���.'�8 E�: 5��.�1`��-- 2G � � l��f�t�r�'���d G�n�y: � H't2 L 1- C.— - �a�.�e�res a��s���+�r�+�r�d'i+���d�r��n�mp��r.a����ort���1�t'e� ��� 3 � • ~`�.�.���---�:- `� ���I � ��- � , �—��°�-- ,,:� ; � _l �-- 2� I�anuf�ctured �a�e Svs�ems 'Test A�d�vi� �is farm must be cotnpleted in it$er�#irety ar�d be submi�ted at the 8uilriing�inat irupection for the installation of a r�anufactuced hame. At�tests r�ust be com�ietecS a�c�si�r��off on�this fcrrm. A cerfificate of t�ccu�ancy will not t� �sued until this cc�mpfeted form is received. C�1 ��� �� ��`�` �� 3XSTE�IS TEST VEF�lF1CAT�flN �crip�on Date Passed Signature of Tester ��'8!!1 Llri�: Pursuarrt tt�C�R 3280.fi'12(b} Da#e: �titt#N�rte t�Tes�er atu!C;ompany: AfB�C L.ii1e: Pursu�rxt�C�R:�.612(a) Clafe: 'tir�Nante o#T and Coct�aarty: =ix1�3�'e T@�: Rursuarrt tar CFR 32so.s12{c) �: �rt tVame of Te.�er 8r�compa�,y: i+BS 7�t: Pursuant ta GFR 328t1.705 and iFG�4t}6.4 �a#ea i� »- - :�w�"�.,.,;,...� �;r�c r�rr�c�� ar�a c�,rn�y: �j t1�..Y1/� �f�.���.�" �l�.��.J'�}��`�,,.�t�-��. aect�cal C�pera#ion�rl: ��r��,t ta c��z s2$s.�c�2 oate: '�t Narr+e of Te�er and Co�npany: . '�Si P�r��t�'ty: Pursuant#o CFR 3285.7Q'L aat�; 'r�t of T anci r►y; :I�G�1 CORb�lUt�t: Pt�su�tt bo CFR�.7'il2 Da#�; hir�t Na�e t�`T�te�'�I C�ny: il'1€tok8►A18t'1#'!T@S� Put�uant to CFR�28Q�4 DBt�: 'ra�t Na�s t�f T+e�ter�rui CanRarry: t�y#t�e abc�sys� " has b+eett c�m ar�d�+ras fr�ttttr!to be in cxict�p w�t t�:��ns id�ed�r esc� ysterz�s te�t: ..� " �" �