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Homeowner <br />Add <br />CITY OF EVERETT <br />GAS PIPING TEST AFFIDAVIT <br />� �o <br />� Ii,��� �� <br />The gas p�ping syatem was teated at l 5 psi for a total of t.s minutes. <br />WITNESSED B1 <br />INSTALLED BY <br />�date ��� <br />�- s zado <br />(date <br />Piease arrange for someone to be present on the date of requested inspectfon to provide <br />access for the inspector. <br />Hard Copy - Job Site Pink Copy - Contractor White Copy - Inspector <br />