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Duct Seal Affidavit <br /> Company�i rTr� �n Sey�V�«Cc� �GcSLo���c. �icense# ��C 1 �Xl�J�9�j <br /> Address �U• �s k (��p Permit# / �J �� ° <br /> �z�PN-�J12F��U�S , �I - �3� 9 <br /> j��O� 3-Z��3 _�1 i SSc` `17t�, <br /> ��4+Y�[�i�S �� � ��5ya. <br /> I �Y1CtY��PS - �LC}'Il���affiant, hereby a�rm 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 /> Contradors Name(printed) ��c�Y���� �t rn� ..p �i/�-� Date �— l I"a6l <br /> � <br /> � <br /> Signatur <br />