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<body>
<div align="center">
<table width="750" border="0" cellspacing="0" cellpadding="0">
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<td height="42">
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<table width="280" border="0" cellspacing="0" cellpadding="0">
<tr>
<td width="278">
<img src="../../Temp/Default-Landscape.png" width="278" height="60"><br>
<h3><strong>Besiktningsprotokoll</strong></h3>
<h5 align="left">Funktionskontroll av yentilationssystem enlight
<strong>BFS 2011:16 OVK1 </strong></h5>
<p align="left"><strong>A1 - Byggnad</strong></p>
</td>
</tr>
</table>
</td>
<td width="462" height="195">
<table class="platsForStampel" width="467" border="0" cellspacing="0" cellpadding="0">
<tr>
<td height="38">
<table width="467" border="0" cellspacing="0" cellpadding="0">
<tr>
<td class="Referensnr" width="387" height="38" align = "left" valign="top">
<input type="text" name="ID_Text1" id="ID_Text1" align="left" size="72" placeholder="Referens nr">
</td>
<td class="a" width="71" height="38"><div align="center"><strong>A</strong></div></td>
</tr>
</table>
</td>
</tr>
<tr>
<td height="176" width="467" align = "left" valign="top">
<div align="left">Plats for stampel</div>
</td>
</tr>
</table></td>
</tr>
</table></td>
</tr>
<tr>
<td height="42">
<table class="Fastighetsbeteckning" width="750" height="42" border="0" cellspacing="0" cellpadding="0">
<tr>
<td width="281" align = "left" valign="top">
<input type="text" name="ID_Text2" id="ID_Text2" align="left" size="50" placeholder="Fastighetsbeteckning">
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<td class="Byggnadensadress" width="195" align = "left" valign="top">
<input type="text" size="35" name="ID_Text3" id="ID_Text3" align="left" placeholder="Byggnadens adress">
</td>
<td class="Postnr" width="93" align = "left" valign="top">
<input type="text" size="11" name="ID_Text4" id="ID_Text4" align="left" placeholder="Postnr">
</td>
<td class="Ort" width="166" align = "left" valign="top">
<input type="text" size="29" name="ID_Text5" id="ID_Text5" align="left" placeholder="Ort">
</td>
</tr>
</table></td>
</tr>
<tr>
<td height="42">
<table class="Byggnadsagaren" width="750" height="42" border="1" cellspacing="0" cellpadding="0">
<tr>
<td width="281" align = "left" valign="top">
<input type="text" size="50" name="ID_Text6" id="ID_Text6" align="left" placeholder="Byggnadsagaren">
</td>
<td width="195" align = "left" valign="top">
<input type="text" size="35" name="ID_Text7" id="ID_Text7" align="left" placeholder="Postadress">
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<td width="93" align = "left" valign="top">
<input type="text" size="11" name="ID_Text8" id="ID_Text8" align="left" placeholder="Postnr">
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<td width="166" align = "left" valign="top">
<input type="text" size="29" name="ID_Text9" id="ID_Text9" align="left" placeholder="Ort">
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</tr>
</table></td>
</tr>
<tr>
<td height="42">
<table class="Faktureringsadress" width="750" height="42" border="0" cellspacing="0" cellpadding="0">
<tr>
<td width="278" align = "left" valign="top"><input type="text" name="ID_Text10" id="ID_Text10" align="left" size="50" placeholder="Faktureringsadress"></td>
<td class="Postadress2" width="198" align = "left" valign="top"><input type="text" name="ID_Text11" id="ID_Text11" align="left" size="35" placeholder="Postadress"></td>
<td class="Postnr3" width="94" align = "left" valign="top">
<input type="text" name="ID_Text12" id="ID_Text12" align="left" size="11" placeholder="Postnr">
</td>
<td width="166" align = "left" valign="top">
<input type="text" name="ID_Text13" id="ID_Text13" align="left" size="29" placeholder="Ort">
</td>
</tr>
</table></td>
</tr>
<tr>
<td height="42">
<table class="Forvaltare" width="750" height="42" border="1" cellspacing="0" cellpadding="0">
<tr>
<td width="362" align = "left" valign="top"><input type="text" name="ID_Text14" id="ID_Text14" align="left" size="69" placeholder="Fastighetsansvarig/Forvaltare"></td>
<td width="106" align = "left" valign="top">
<input type="text" name="ID_Text15" id="ID_Text15" align="left" size="15" placeholder="Telefonnr">
</td>
<td width="260" align = "left" valign="top">
<input type="text" name="ID_Text16" id="ID_Text16" align="left" size="46" placeholder="Fax / e-post">
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</tr>
</table></td>
</tr>
<tr>
<td height="42">
<table class="Internet" width="750" height="42" border="0" cellspacing="0" cellpadding="0">
<tr>
<td width="135" height="40"align = "left" valign="top"><input name="ID_Text17" type="text" id="ID_Text17" placeholder="Internet byggnadsnamn" size="21" align="left"></td>
<td class="byggnadsnr" width="142" align = "left" valign="top">
<input name="ID_Text18" type="text" id="ID_Text18" placeholder="Internet byggnadsnr" size="22" align="left"></td>
<td width="198" align = "left" valign="top">
<input name="ID_Text19" type="text" id="ID_Text19" placeholder="Verksamhet" size="36" align="left">
</td>
<td class="bra" width="92" align = "left" valign="top">
<input name="ID_Text20" type="text" id="ID_Text20" placeholder="BRA. i m" size="11" align="left"></td>
<td class="Ant" width="85" align = "left" valign="top">
<input name="ID_Text21" type="text" id="ID_Text21" placeholder="Ant. Lgh" size="12" align="left">
</td>
<td width="79"align = "left" valign="top">
<input name="ID_Text22" type="text" id="ID_Text22" placeholder="Ant. Lokaler" size="11" align="left">
</td>
</tr>
</table></td>
</tr>
</table></td>
</tr>
</table>
<table width="750" height="330" border="1"cellpadding="0" cellspacing="0">
<caption>
<div align="left">A2 - Besiktning (+ sammanstallning av system inom byggnaden)</div>
</caption>
<tr>
<th width="81" scope="col"> </th>
<th width="78" scope="col">A</th>
<th width="41" scope="col">B</th>
<th width="61" scope="col">C</th>
<th width="45" scope="col">D</th>
<th width="62" scope="col">E</th>
<th width="79" scope="col">F</th>
<th width="81" scope="col">G</th>
<th width="110" scope="col">H</th>
<th width="90" scope="col"> </th>
</tr>
<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button16" id="ID Button16" value="Skaoa B1">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"><div align="center">2</div></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"><div align="center">B1</div></td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button1" id="ID Button1" value="Ta bort B1">
</form></td>
</tr>
<tr>
<td ><form name="form13" method="post" action="">
<input type="submit" name="ID Button17" id="ID Button17" value="Skaoa B2">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button2" id="ID Button2" value="Ta bort B2">
</form></td>
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<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button3" id="ID Button3" value="Skada B3">
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<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button3" id="ID Button3" value="Ta bort B3">
</form></td>
</tr>
<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button4" id="ID Button4" value="Skaoa B4">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button14" id="ID Button14" value="Ta bort B4">
</form></td>
</tr>
<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button5" id="ID Button5" value="Skaoa B5">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button5" id="ID Button5" value="Ta bort B5">
</form></td>
</tr>
<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button6" id="ID Button6" value="Skaoa B6">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button6" id="ID Button6" value="Ta bort B6">
</form></td>
</tr>
<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button7" id="ID Button7" value="Skaoa B7">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button7" id="ID Button7" value="Ta bort B7">
</form></td>
</tr>
<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button8" id="ID Button8" value="Skaoa B8">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button8" id="ID Button8" value="Ta bort B8">
</form></td>
</tr>
<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button9" id="ID Button9" value="Skaoa B9">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button9" id="ID Button9" value="Ta bort B9">
</form></td>
</tr>
<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button10" id="ID Button10" value="Skaoa B10">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button10" id="ID Button10" value="Ta bort B10">
</form></td>
</tr>
<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button11" id="ID Button11" value="Skaoa B11">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button11" id="ID Button11" value="Ta bort B11">
</form></td>
</tr>
<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button12" id="ID Button12" value="Skaoa B12">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button12" id="ID Button12" value="Ta bort B12">
</form></td>
</tr>
<tr>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button15" id="ID Button15" value="Skaoa B13">
</form></td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td bgcolor="#FFF911"> </td>
<td> </td>
<td><form name="form13" method="post" action="">
<input type="submit" name="ID Button13" id="ID Button13" value="Ta bort B13">
</form></td>
</tr>
<tr></tr>
<tr></tr>
<tr></tr>
<tr></tr>
<tr></tr>
<tr></tr>
</table>
<table width="750" border="0" cellspacing="0" cellpadding="0">
<tr>
<td>Ingar samtliga Ventilationsystem for byggnaden i denna besiktning
<input type="checkbox" name="JA" value="JA">
JA
<input type="checkbox" name="Nej" value="Nej">Nej</td>
</tr>
</table>
<table width="750" border="1" cellpadding="0" cellspacing="0">
<caption>
<div align="left">A3 - Allmant Allmant omdome, kommentarer, uppgifter om besiktningsman.</div>
</caption>
<tr>
<td height="226" colspan="5"> </td>
</tr>
<tr>
<td height="32" colspan="2"align = "left" valign="top">
<label for="ID_Text6">Besiktningsman</label><br>
<input name="ID_Text6" type="text" id="ID_Text5" size="60" align="left" value="Torbjorn Eld">
</td>
<td width="144" align = "left" valign="top">
<label for="ID_Text6">Telefon nr</label>
<input name="ID_Text6" type="text" id="ID_Text5" size="22" align="left" value="08-56485950">
</td>
<td colspan="2" align = "left" valign="top">
<label for="ID_Text6">Fax / e-post</label><br>
<input name="ID_Text6" type="text" id="ID_Text5" size="49" align="left" value="torbjorn.eld@pbt.se">
</td>
</tr>
<tr>
<td height="29" colspan="2"align = "left" valign="top">
<label for="ID_Text6">Foretag</label><br>
<input name="ID_Text23" type="text" id="ID_Text23" size="60" align="left" value="PB Teknik AB"></td>
<td align = "left" valign="top">
<label for="ID_Text6">Postaddress</label>
<input name="ID_Text6" type="text" id="ID_Text5" size="22" align="left" value="Vretenvagen 2">
</td>
<td width="151" align = "left" valign="top">
<label for="ID_Text6">Postnr</label>
<input name="ID_Text6" type="text" id="ID_Text5" size="14" align="left" value="171 54">
</td>
<td width="291" align = "left" valign="top">
<label for="ID_Text6">Ort</label><br>
<input name="ID_Text6" type="text" id="ID_Text5" size="29" align="left" value="SOLNA">
</td>
</tr>
<tr>
<td width="140" height="27" align = "left" valign="top">
<label for="ID_Text6">Certiferingsorgan</label>
<input name="ID_Text6" type="text" id="ID_Text5" size="23" align="left" value="Swedcert">
</td>
<td width="182" align = "left" valign="top">
<label for="ID_Text6">Cert nummer</label><br>
<input name="ID_Text6" type="text" id="ID_Text5" size="31" align="left" value="1987">
</td>
<td align = "left" valign="top">
<label for="ID_Text6">Giltighetstid</label>
<input name="ID_Text6" type="text" id="ID_Text5" size="22" align="left" value="2017-02-29">
</td>
<td colspan="2" align = "left" valign="top">
<label for="ID_Text6">Behorighetsniva</label><br>
<input name="ID_Text6" type="text" id="ID_Text5" size="49" align="left" value="Riks K">
</td>
</tr>
<tr>
<td height="44" colspan="5" align = "left" valign="top">
<table class="OrtDatum" width="750" height="42" border="0" cellspacing="0" cellpadding="0">
<tr>
<td width="330" height="40" class="SOLNA">
<label for="ID_Text6">Ort, Datum for underskrift</label><br>
<input name="ID_Text6" type="text" id="ID_Text5" size="60" align="left" value="SOLNA 2012-">
</td>
<td class="Namnteckning" width="420">
<label for="ID_Text6">Namnteckning</label><br>
<input name="ID_Text6" type="text" id="ID_Text5" size="77" align="top" value="">
</td>
</tr>
</table>
</td>
</tr>
</table>
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