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�r i m <br /> y .I_,i" } <br /> - ti <br /> Duct Seal Affidavit <br /> Company C License#__ C �C I S�f 7/0�' <br /> Address ����1 � �-��,,,, � Permit#�f.�lp � <br /> �� . <br /> �"38�D1 <br /> �'9�y : �� � <br /> �!'�'���./ affiant,hereby affirm that I am the duly licensed contractor of record for the a <br /> bove <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) /�/�4�5 (�1�✓IUS� Date f( �Z � ��� <br /> Si nature , ���-✓�1.� <br /> B <br />