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s Y,�,�'b�-. <br /> %{'�:[���3�' `' <br /> �./��` <br /> Duct Seal Affidavit <br /> Company �� 1' ,����, O� � License#(��� L V � �O� � <br /> Address ���J� � � �T . Permit# I� /Z�'�' <br /> ��, ��� r'11 S 33 ��-�z <br /> I ��(�-,�n��� 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)��a� ►�ar� M o� Date I I �� ' J <br /> Signature <br /> �___._�-- <br />