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GAS PIPING TESTAFFIDAVIT <br /> Owner's Name —� I Iti1 yL°/�,ry <br /> t � f 1 c 13yti) <br /> JobAddress �Q �- �()l,l. ) ('� _ �U� C�VeYE�t Permit No. ��SE_�__ <br /> (206�670-1258 <br /> Installing Contractor R[LIABLE SHEET METAL, INC./DBA ARCO INSTALLATION, LTD. Phone 1-800•B69•7043 <br /> The gas piping system at the above address has been under pressure test for <br /> �� Minutes at �� pounds- without leaking. <br /> Signnture of Installing Gas Fitter �U�l�l.�(ps���_ Date . ./�_'./�„"p � __ ._ <br /> Signature of Homeowner � • � - Date__�d'�1—�,p <br /> � <br />