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10/05/2012 FRI 14:11 FA% <br /> �001/001 <br /> Fron: 09/27/2012 12:�0 �029 P.001l001 <br /> . <br /> .y����h r,:i <br /> ��. <br /> Duct Se�! Affidavit <br /> Company ��� lS �?lDur� /�/�j /�j ��/ <br /> _ � License# 4"'-'� ` ' � <br /> ,�d� U�S'/ �� ��� . ����� <br /> � � Per <br /> r <br /> � <br /> � '��� ����� afnan�hereby affirm that I am the du Iice <br /> hr nsed contractoc of reoord fcr the above <br /> referenced permit,that all of the forgoing Information Is true and aca,rate,and that the duct sealing at the above <br /> referenced address has been cornpleted i�accordana with aU applicable eodes and standards. <br /> Contractors Name �inted� ��/ �/o��/d���r'r" <br /> — Date � � <br /> Stgnature <br />