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f i < <br /> Duct Seal Affidavit <br /> r -7'37�'�'� <br /> Company A�fR S /` f1-� ���--s �j �icense� ���� <br /> AddresriJDA1�/.� / • Permit# I 3 3�'� <br /> ��2 C� �..�-e,o�i eN s /''�-�, <br /> ��o%��r�ii/ls . ��. 3�S�L,� <br /> ��3 . a��- 8� 8� <br /> � <br /> � u�� � �H/e ,affiant,hereby affirm that I am the duly licensed contractor of record for the above <br /> referenced permit,that all of the forgoing information is true and accurate,and that the dud sealing at the above <br /> referenced address has been completed in accordance with all applicable codes and standards, <br /> � <br /> Cont�actors Name(printed) �ll�/� �/o�-r�f-,� Date � o"ZD /�.- <br /> Signature <br />