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'��f <br /> `;' <br /> Duct Seal Affidavit <br /> Company/�i11'�Q(� �V� r� p�ti <br /> License# � �'�`jyQ g <br /> Address �-d • �X ��aC� Permit# t 5 Q ( � <br /> �'�' ����3�1 <br /> �,� �_ 3R��t 3 I���c►� <br /> Z N � �-1 . 3��s�c�. <br /> I�I r �t� �y�-�/��ant, 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) 'by'�� � 4� .P��-.� Date �-p�G' r <br /> Signature e <br />