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. <br /> 4 <br /> Duct Seal Affidavit <br /> Company /��2� T 1��77�v� �-CvaUN� �icense# �/� ) 36 674- 0� <br /> Address �j�(�2Z (9 �� S�YZi� ermit# � � �� � ° <br /> `i L 1 ��_ - <br /> Z rf �2�tc c.S � 3 � .sy�- - ------- <br /> , <br /> I �(E�] .SuS Tl C� ,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 /> Contractors Name(printed) /U� .1 �S�C� Date l � OGT ?p/� <br /> Signature <br />