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♦ <br /> Duct Seal Affidavit <br /> Com an ( �.� ���' ��� Q� <br /> p Y- �� � � License#��Q � �s �S <br /> Address ��4i! (�Q �a � Permit# ��s� � <br /> �� ; -�r ���� <br /> � � � � �� <br /> � a�ant,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 duct sealing at the above <br /> referenced address has been completed in accordance with all applicable codes and standards. <br /> � <br /> Contractors Name(printed) Yi j �� <br /> Date_ �d � �f � <br /> , <br /> Signature G� <br />