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0 <br />CITY OF EVERETT <br />GAS PIPING TEST AFFIDAVIT <br />The gas pipinp system wea tested at � <br />WITNESSED BY <br />INSTALLED BY <br />Permit No. 02— °2 � <br />/ <br />for a total of �' � minutes. <br />re ot fnstainyrp pas <br />_� ! / � <br />( ate <br />�/v/o3 <br />(date <br />Please arrange fnr someone to be prese�it nn the date of requested inapection to provida <br />access for the ingpector. <br />Hard Copy - Job Site Pink Copy - Contnctor White Copy - Inspector <br />