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i"rf };; <br /> ' �•t � <br /> I <br /> Duct Seal Affidavit <br /> Company_ ��r��C,� �t�-ViC�� bf�(�QSCU License# �AL�,��`rjyCf� <br /> Address�-�• �j0� � ��-� Permit# � "l lP�� <br /> � "z-�tt�4 R l�(�-L.`> , j?, ���5 3? <br /> _�FS�o3 �r�c?�;��,,2 0 <br /> Z.E�'H�I�{ �u-S �1� ����yr� <br /> I��Ir��C,� �.0►�'UZ C� 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,V'1Gyl�P` U ' �C�(n10��E' Date ��' 23� Z'��3 <br /> : <br /> Signature <br />