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..-......n�.-_.�.-�-..-.�..�_ ....._.�.....y.�+—.-aa.-.P"?PaT>�n^_• <br />_.........._.�_ ...�-.� ....� .•--•• -�.. , ,.. <br />�� T.. .i.. _�'r�� _.. .. ' ' . ... � . .. . ... � <br />GAS PIPING TEST AFFIDAVIT <br />OwnersName —�II�� ����f�C\\�--- -- — <br />Job Address � � 1 �1��'�-�-U� �v � � - �v�((� <br />Inslalling Contractor RELIABLE SHEET METAL, INCJDBA ARCO INSTALLATION, LTD_ <br />Permit No. �����— <br />(206) 670-1256 <br />Phone _?'800-869-7043 _ <br />The g��s piping system at the above address has been under pressure tesl (or <br />I� Minutes at _. ��— Po nds - wilhoul leaking. <br />--- �\� v V v i ��, �. f/�_ �— . Gate I v_ � V-�l� <br />Signature of Inslalling Gas Fitter ` <br />-� ' ��lv�..-a,.. — Date I v _ 1 O _ � <br />SignatureofHomeowner_._ 51+.��-��- <br />