Laserfiche WebLink
CITY OF EVERETT <br /> PIPING TEST AFFIDAVIT <br /> Owners �^ <br /> 7 ��: <br /> Job Address 54-1 Permit No. M -0,.�?-1 <br /> The refrigerant linenatura / LP / medical gas system (circle one) was tested at j, psi for a <br /> total of '� ,AO minutes. <br /> WITNESSED BY M_ Date 3 l 2 l l6 <br /> Ignature o occupant reffliesting gas service <br /> INSTALLED BY Date <br /> Installing I <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 LEAK 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 NAMEPLATE.(WAC 51-42-1108) <br /> Hard Copy—Job Site Pink Copy— Contractor White Copy— Inspector <br />