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f" �t �� <br /> iy,�,� f i f,. ., <br /> .*I�� .i. <br /> Duct Seal Affidavit <br /> Company )�-� �����'��S License# C�4c��f 9 2�o <br /> Address ��c7� l� 7� c�� • Permit# � ���/ <br /> / ,Q PJ'f`/21.�I LL S �t- <br /> I 1 l t G� I'C I�D•��..s ,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 rinted� �—k �"���ZS Date � � 2�f <br /> �� ) � <br /> Signature � <br />