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i �(' <br /> 2� <br /> �:�,�����y��.��_.,. <br /> .��,.,_.,�,�_�;�:, <br /> _.;: ,, . <br /> � - ���.j�«: <br /> ? „'��,;.'�"�'`� ;�,T , <br /> °. ,v;i::a, 'w't ` i r. <br /> ;;v;��:.�';�... .aa:;. 'i�;�. I <br /> '+x, y��r��,'.� ri�f--: ,.. i. <br /> �,1 �r�,'Yd>'_,_:.p..t `�O'�`\�� <br /> ��t �• <br /> Duct Seal Affidavi� <br /> Company.�C..:. �� I_icense#�U"1�1 (1 � L' 1��� <br /> � <br /> ��5� 1 '(���c�� rtV� �" <br /> �cldress t �E��r�it# � ��`���� <br /> �2��I1� —�-�. ��3��� <br /> I a;:is;:t,hereby affirm thaY I am the duly licensed contractor of record for the above <br /> referenced permit, ha�all of the forgoing information is true and accurate,and that the duct sealing at the above <br /> re�'�r�nr.���ddress has been cornplQtrd in arcordance vvith all applicabie cotles and standar�is. <br /> Contractors Name(printeci) Date � <br /> .�.�-- <br /> a <br /> Signature <br />