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� <br /> P <br /> Duct Seal Affidavit <br /> Company /U! r ` �p� Q� License#�� �) ,���17,5 <br /> � � <br /> � � , �; <br /> Address �.Cif.f' ���iiin_,,,� Permit# ,��_L �� <br /> 3 8"/�3.5' ,5��.- �� <br /> ���, ���/J . �/� �3�3ST�/% <br /> I �'`/ �P a�ant,hereby affirm that I am the duly licensed contractor of record for the above <br /> referenced permit, hat 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 /> � <br /> Contractors Name(printed) <1���S ..e' s Date �� ' � ' � <br /> , <br /> l�"� �.-,Y,.� <br /> Signature � d � ; � <br />