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_ r, . <br /> Y t „ '- . � � <br /> , " ' �: <br /> ' �C(�M t (' �' <br /> b' (Sy$4 �-yfnr�� `7 - � � —I'`y <br /> � <br /> .{�. <br /> ,��- � ,�' ;,, <br /> �`�-��A : <br /> �.r�f� � ~���) <br /> ;�� <br /> 1 <br /> � I � <br /> �` ,� <br /> <''' <br /> ' Md.'<r <br /> Duct Sea Affidavit <br /> Company L7 -TC�- License# �-,� G 1 �����G <br /> Address � ��� n��� ��/� �''� Permit# � �s J �"� <br /> Z � �l �c � <br /> I affiant,hereby affirm tha I am the duly licensed contractor of record for the above <br /> referen permit,that all of the forgoing information s true and accurate,and that the duct sealing at the above <br /> referenced address has been completed in accordance ith all applicable codes and standards. <br /> Contractors Name(printed) �Gr� L �� Date �`� ��1 7 <br /> Signature <br />