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V l p <br /> Yi��l_.� •f':J� <br /> Duct Seal Affidavit <br /> Company �py A2� /�}�C <br /> �icense# C/��O/o y/,S <br /> Address 7� .34 pSTE"t'>v ��. <br /> Permit# � ��� 7� <br /> N PR �c. 3y6s3 <br /> �� ���" �` affiant,hereby affirm that I am the dul iicens <br /> referenced permit, t all of the forgoing information is true and ac urate,and that the duct seai ng at the abov <br /> referenced address has been completed in accordance with all applicable codes and standards. <br /> e <br /> Contractors Name(printed) l�AdC f/v7r(f�Ns / <br /> ��Q�y A!!� p/� oate �✓-�/-/ ,3 <br /> �gnature ` * <br /> l � <br /> • '— I�OSi oN �1/y <br />