Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
LA175139
� .�. ���s i .�� � � ��� � . � � ������ � � ������� _ � � � � � � � � � 7'���orr���.-t�t;�i�l�t��,e�N��+�d b�s����et t���u�f���r�al tns��ir�n-f�r����l�ai��� �t����'�c� �����t�c���a�s���a�n�F���►r�t !��r�������+�y vu��t b+� 3��u�i��t� ' , fvt����+�d; - ��"�'�"P�'���I�'��'�'� �`��� - �P� ���.�rFT� ���.�:���������.��. �: _ � � � � �— 2. f � � P����T�r�E��rtmr � �►� �.l� ' '��';�����t�C�.�.�k'1�;��) �; 5..,� � , , . __ . PI'1��t�`T��i1•���C NL}�'Vl- : E��,;C� • . �`I��'!�.'��F'xur�t�ttb�'��3:�����. t:�s:.,�' � �� �� ��������� �L(.� r ��_ � e � , � . _. ,, - ._ ... �_. . . ���``�.�. . Ct�;���E!'t . . .'�E��,i�'��4' L'�: PEii�t�s�T�'�tcl;��i�: ��i�C���1p��i�k'!!+�E�+�t�it tCu.�2:,�:1�2 E�: � �; ` ' , � �� � ����� � - ��t�r►���+�,�►�,"� � � �„ ���� � � � � � �� ►� � ���+�; ������` Krc� !�:�' t, 1�� ' �� � �r ����� � _� � _ "��� . � � � � � � � . . ,: � ��±������:����r��:��a� �: � � � � � ��y�'�"�~�—=�- + . ,. . �� � � ; " v; �s"�k# e - i�'�' , 8� . { �` �:- �c � . ��`�#'�'1�'�'�"��I�dti�tik#ti{��1�3�1?��� C��: S- � � �p ; , . _ , . P�t i�fi�`�1�ip�riy; �`!J �. `, L G C� . l s��#�e�re��n����b���r��f i��rd�b��c�o�np���kr��leu���rt��'i�t � ��0�- - . ������ /� , � , -. � "" _ .., � , , �, .S/ Z p ��- r�' �� I�anui��tured HQrn+� �vs�e__��__ms„Test A�(f'idav�t �is form must be eompleted in its entirety and be submitted at the Buiidirtg Fina[ins�ection for ihe installatiort ttf a nanufactured horne. Ai!tests must be compi�ted and sign�d off c�tF►is form. A cer�ifi�a#e of occupar�cy wi[�not be �ee�uritil this compieted form is receiveci. �� �.J�--�' �� ��..� f�� l SYSfiE�S TEST VERIF1CATtt}N C�scrip�on �ate Pas;�ed Sigraature of T�ter }rain Lin�: Pursuac�#o CFR 3280.612{b) Date: 'rint Name of T�ter artd Camparty: AISi,B�'l.i11e: Pu�nt tu G�R 3280.612(a} t3ate: 'hmt N�rne o€T et�i�ny: ��t�Tes#: Pursua�tto CFR 328U.612(c) C7ate: 'ri�t Name af T�t�r and CompanY: �T�: Purs�uarrt to CFR 32�.7t}�ar�!IFGC•406.4 Qc�te: � -�� �-�--, . (� c��.�.s.�--" �r�t t�i�rr�e of Te�ber and Ccmt�any: �J��' �(�jt�Q�' [�(��,',� ����,Q,�jf�.��. �1+�Git�CB�t��l"'d#'10[1�1: Pur�t�tt tt�CFR 32$a.�tY1 tJ�te: }rirrt Naime of T �t�d Ctu�tp�ty: :ItC�7GS1 PO�'�'Ity': F'�at�tfar�t't�CFFi 32$�.702 t7aie: 'tir�t Na�r►e arf T�ter�nd ComEaany: �lectt�icatl�at�nuit�: �>urs+�r�t ta CF�t 32�55.��2 oate: 'rirrt N�e c�€Teste�ar�d Campany: 31�QIfB A181'i'1'�TBS� Put�uarYt to CFR 328fl2t#8 E7�te: 'rntt t�T and ComP��Y c;et#i(y the a#ove s�terr�s�ir�t�as caorn �!�fc�uttc3�b�in t�rp' �tl� ' 'ons'td�err�f`►�f�' y�� � A'� .- � Qa�: /