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Homeowner, <br />CITY OF EVERETT <br />GAS PIPING TEST AFFIDAVIT <br />� J �5��//CJ���/I/ <br />The gas piping system was tested at �S pai for a total of�minutes. <br />WITNESSED BY <br />INSTALLED BY <br />�(d te � <br />� a ee � <br />Please arrange for someone to be present on the date of requeated inspection to provide <br />acce3s for the inspector. <br />Hard Copy - Job Site Pink Copy - Contractor White Copy - Inspector <br />