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CITY OF EVERETT <br /> � <br /> GAS PIPING TEST AFFIDAVIT <br /> Homeowner �".i�nn�N �ua�s�ea�,� �E[���a otiy <br /> Addreas_, (� �,vwst�... A�F Permit No. M���8-og2 <br /> The gas pipinq system was tested at �s osi for a totd of 'iD minutes. <br /> 'ITNESSED BY % � � �—I �— <br /> w stiey yas s�nr • ( �te <br /> (s e o oc nq <br /> INSTALLED BY' ��� <br /> (si ature o stall np p�s fitter) �t� <br /> Please arranpe for someone to be present on the dat� ot nqut�t�d insp�ctbn to provid� <br /> access for the inspector. <br /> Hard Copy - Job Site Pink Copy - Contractor Whlb Copy - �nsPscta <br />