Laserfiche WebLink
� ' <br /> CITY OF EVERETT �i . <br /> GAS PIPINC.TEST AFFIDAVIT <br /> � Homeowner �'�'n�� �:7" �"� <br /> Addreis_ �y 1�/ (�a.lce.� 5 T �'�<rt�� w�� permft No. <br /> The yas pipinp syst�m was tested at �S– psi for a totd of / S"— minutes. <br /> , <br /> I ' <br /> WITNESSED BY Q'ri/L�" � '�''"""-"-'" -✓ . --------.._...I <br /> s �natun o occupant roquest np �as wrv � at� <br /> INSTALLED BY _ �� �.�� � <br /> f (sipe�tun o nsta n s er ate � <br /> ' Please arranpe for somfone to be pros�nt on th�dat� of nqu�sbd insp�ctbn to provide <br /> acceas for the inspector. <br /> Hard Copy - Job Sits Pink Copy - Contractor WhR� Co <br /> py- Inepector <br /> � <br /> L.�.� , . . <br />