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4 w; <br /> � , ,,�t�F; ��t� <br /> . S �J s <br /> Duct Seal Affidavit <br /> Company �" a ruf /J C License# C�GD,.S �6...�3 <br /> Address ��`�'�� ��Q ��j <br /> Permit#_ � <br /> _ ,�G� Cc GYD[�OG>� 4'jQ-� - <br /> ����Cyf��'�� <br /> �---�� /`� affiant,hereby affirm that I am the dul li <br /> y cense�c�ntractor of record for the above <br /> referenced p rmit,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) �G�r� TI� ! 1 Date "—��` �� <br /> Signature �c.c..�'� <br />