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M . <br /> • <br /> .� <br /> Duct Seal Affidavit <br /> Com an r <br /> p y �L7 [C✓1�-� License#� � 1��S 7�Cj <br /> Address J �v! l �� S� Permit# � � 1 oa <br /> ���`�,���s �C � S `%2 <br /> I �V�� L �e.7 ,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) �vG/j �/'�7 Date � ~l ��/ � <br /> Signature <br />