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v f R t� <br /> f\ . . t . <br /> Duct Seal Affidavit <br /> Company / <br /> t t� license# ��Q <br /> Address � 0 ^ � `� C�i�t �L <br /> Permit# ��__ <br /> z L � ` / ` � ���-�� <br /> I �V i n �i'�7 affiant,hereby affirm that I am the duly licensed contractor of record for the above <br /> referenced permit,that all of the forgoi�g 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) L t/�-,� �-►��-7 Date�� ��/� <br /> Signature <br />