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a � <br /> �*:�y <br /> ,n.�x <br /> (�" H <br /> a�3 eo <br /> �r �� <br /> � r <br /> .e n <br /> yz <br /> oxo <br /> �a �, � <br /> c��� <br /> �i o� <br /> HC <br /> Q H � <br /> H/� M� <br /> y�Y � <br /> x y� �.__.._ . _._. .__ .. . ._ __ . ._ . _ . . _.�._ _.....—.�.----._.__.. .. . <br /> . . ..�_ _ _. � <br /> �" H a , <br /> N <br /> � �r SNOHOMISH C0�1NTY COMMUNITY I�EYE�OPMENT � >'�, <br /> � o� ��• � ��GAS PIPING TEST A�FIDAVIT �# <br /> Homeowner l�U.c/ r/f- �"i"F '��?� ' - � <br /> ,� ,. <br /> `ilddress `y���� ��l�/�i�E� L�i� Permit No.�JI.�'9 _ •, ? <br /> The gas piping system was teated at ��� paRor e total of -;� minutes�: <br /> 1-• �'j • '' , s. <br /> � � <br /> _.-" , A � <br /> ��' "'j �r WITNESSED BY ,=� .���✓ u , .� ��� ,� � ��- . <br /> "' '� � s pneturs of occupent request np yas serv ce) •.� ate � <br /> 1 � � �-� • � �� <br /> �. � INSTALLED BY —�" -/< .--, ;ti c _-..� J �� <br /> `' _ sip ture of,lnstall ny pas f tter) � � <br /> �. + <br /> 1` �� (� Please arranys for someone to be present on the date of roqueated insp�ctlon to�rovide�^'"`"" <br /> accesa for the inapector. The white copy must be mailed to Snohomish County Community <br /> Development, 4th Floor, Administratlon Bldq., Everett, WA 98201 upon compl�ibn. .� <br /> i , <br /> �— � Hard Copy - Job Site Pink Copy - Contractor White Copy- Meil � <br /> � co•�or <br /> I `�'� +►1F <br /> � .. <br />