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CITY OF EVERETT <br /> PIPING TEST AFFIDAVIT <br /> Owner ' � � L �P�C'il �/'✓(JL�S�1� �C'�Il l <br /> Job Address �- � 2 �1 �3 �� � � Permit No. ���� 1 3 �' �� -�� <br /> � I <br /> The refrigerant line / natural / LP / medical gas system (circle one) was tested at �psi for a <br /> totalof � � min s. S� �7 //3 <br /> WITNESSED BY �� -�• �.G�-t1� __ Date _ <br /> ignat o o c ant r questing gas service / <br /> INSTALLED BY � �� /� Date � � _ <br /> i ur ir�T�l i i i7-- <br /> C�f�S 1����%� <br /> Please arranye for someone to be present on the daie of requested inspection to provide access for <br /> the inspection. <br /> RFf-RIGEFANT CONTAINING PARTS OF THE SV5T6M THAT IS FIEL�ERFCTED SHALL BE TESTED FOR LEAK Al'TEST PRESSURES NOT <br /> LESS THAN Tr1E LOWER OF THE DESIGN PRESSURES OR THE SETTING OF THE PRESSURE RELIEF DEVICES. THE DESIGN PRESSURE <br /> FGH ifSTING SHALL 6E THOSE LISTED ON THE CONDENSING UNIT OR COMPRESSOR UNIT NAMEPLATE.(WAC 51-42-1108) <br /> Hard Copy–Job Site Pink Copy – Contractor White Copy– ',nspector <br /> — -z�--�– <br /> - --_ - _ _.__. _.y._ � eu�_�—� -_�:�r'�'cl1TC"�' ._ .. � . ,e,..a . <br />