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� <br /> , . <br />� L����s�� <br /> ��'� _ _ ��'�'� <br /> ,``.t `'�:. <br /> u�J L�,1 <br /> ,;, <br /> r-�.: <br /> � - f. <br /> �' <br /> �-- <br /> �'``� -�° - <br /> �uct Se�l Affidavit <br /> �ompany�(Ir'�T-�.� 52�db c�e�� �icense# CO�C.. ������g � <br /> Address �(�� �X 1�a-U Permit# ��`� v � <br /> ���1\S J� - ����� <br /> ,��� �s�� �� �� � <br /> �h,� � � ��s�a. <br /> I� � <br /> �r�2C..in S-2v'�a�QZ?affiant, hereby affirm that I m the duly licensed contractor of record for the above <br /> referenced permit,that all of the forgoing information is t ue and accurate,and that the duct sealing at the above <br /> referenced address has been completed in accordance wit all applicable codes and standards. <br /> Contractors Name(printed) �rl-2_ �� � 1 ' �'Y�— Date <br /> Signature <br /> � <br />