Laserfiche WebLink
� CITY OF EVERETT <br /> PIPING TEST AFFIDAVIT <br /> Owner 4��r���'� n —� / <br /> JobAddress � �-��l �C�/�"����<`�T Permit ��o. (jl:`����C�;� Y ; <br /> � <br /> The refrigerant line / natural / I.P i medical gas system (circle one) was tested at �7 psi for a <br /> +.otal of � minutes. <br /> i� <br /> WITNESSEDBY r�C�iC_<,� Date '%����c� <br /> —Z��t�J e o occupant requesUng gas service ' <br /> I�1S i A!.LED BY /,,� ; ' , _ Date <br /> � � ,' %< < — <br /> �,i�STu�,?�?',4,r.7:���r:i�,"1 t;.:.=.-r1t7,1-- — , <br /> Ple3se arrange (or some�n�r to be present on the date of reyuested inspection to provide access for ; <br /> the inspection. i <br /> PL°Ff�IGERANi CONTAINING PARTS OF TFIE SYST[A1 THAT!S FI[LD ER[CTGD SHALL BE TESTED FOR LEAK AT TEST PRESSURES NOT i <br /> LESS THAN TH[LOWER OF THE DFSIGN PPESSURES ON THE SETTING OF TNE PRESSURE RELIEF DEVICES. THE DESIGN PRESSURE <br /> FOR TCSTING SHALL BE THOS:LISTFD ON TH[CONDENSING UNIT OR COh1PRESSOR UNIT NA�dEPLATE.(WAC 51-42-1108) � <br /> Hard Copy—Job Site Pink Copy— Contractor White Copy— Inspector �', <br /> . � ` <br />