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w <br /> 4 <br /> tf YJ <br /> Duct Seal Affidavit <br /> Compan�� �'L ���� L�('� License# C�e-p� '�J �J S <br /> Address���'� g C L1�LEr.iv T�'� Permit# � .3��� <br /> ��PN��H ��l��t F�- .335�� <br /> I SL/SH If 1�.:�i i��1�nS ,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 duct sealing at the above <br /> referenced address has been completed in accordance with all applicable codes and standards. <br /> Contractors Name(printed) � 1�5 f}/� l�: l L Z--1�m� Date �� 1�s 1� <br /> Signature / � w��->� <br />