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� <br /> � <br /> Duct Seal Affidavit <br /> ��� � / / ��3 <br /> Company ��� License# ��� / �( � <br /> Address Permit# <br /> � <br /> I $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 /> �� <br /> Contractors Name(printed) � S5 �Jh�' Date C ( �� � � � <br /> Signature <br />