Laserfiche WebLink
CITY OF EVERETT <br /> PIPING TEST AFFIDAVIT <br /> Owner <br /> Job Address (05"bZ EV,ithga:M vUA( Et/J.-fair vrf I5La3 Permit No. <br /> The refrigerant line / natural / LP / medical gas system (circle one) was tested at 20 psi for a <br /> total of 60 minutes. <br /> WITNESSED BY Date <br /> (Signature of occupant requesting gas service) <br /> INSTALLED BY f -- Sco-rr 6-4Ave.4 Eve-A.4446-1 Date 5--4. - i8 <br /> (Signature of installing gas fitter) NEFocrditiertor4 <br /> Please arrange for someone to be present on the date of requested inspection to provide access for <br /> the inspection. <br /> REFRIGERANT CONTAINING PARTS OF THE SYSTEM THAT IS FIELD ERECTED SHALL BE TESTED FOR LEAKS AT TEST PRESSURES NOT <br /> LESS THAN THE LOWER OF THE DESIGN PRESSURES OR THE SETTING OF THE PRESSURE RELIEF DEVICES.THE DESIGN PRESSURE <br /> FOR TESTING SHALL BE THOSE LISTED ON THE CONDENSING UNIT OR COMPRESSOR UNIT NAME PLATE.(WAC 51-42-1108) <br /> Hard Copy - Job Site Pink Copy - Contractor White Copy- Inspector <br /> PWPTA(5/17) <br />