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>�! ��f <br /> . 4 .� 1 t' . <br /> �A <br /> Duct Seal Affidavit <br /> Company�i�'l�v'�i c�r.1�S��,n�,�-� �KV;� �� License# ��� f Z� � �v " <br /> � <br /> Address 3 3�b � S� �r- �� Permit# � 3 �� oZ <br /> � � �b � �� 7/� <br /> J;�2,���'e�s: 3 �'il.��C7 �t►9-c�a�c� l�c�� <br /> �p���,���s, �C3�5�Z <br /> 1 ��� wq v1��WYV� ,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 1 w� �"�����-� Date � `7' �� � <br /> � <br /> Signature <br />