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I <br /> � <br /> � <br /> r� ��� <br /> Duct Seal Affidavit <br /> Company_��iY ��cl-; SE'rvi� a� �G�SCU License# � � `j� <br /> ���� <br /> Address� �X 1�"ab Permit#_ l y o�o�' <br /> Z.e�h'urh i I l , �1 . 33�3G <br /> �i.Q t'Z t�`�S�{" - <br /> �J� � <br /> _Z��urh� II. 5 . �� �3Sya- <br /> (�, c are- <br /> ����'S �✓• � �—��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) l _�'1C1Y''�S �j • �'�'L��(y)v(Z.e Date_ � a�j-o�G� <br /> Signature - - <br />