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- _ _ _ _. - -- - <br /> J <br /> CITY OF EVER�TT . <br /> GAS PIPING TEST AFFIDAVIT � <br /> Hom�owner �,T'�Q� <br /> Address�219 IA/i4VE J1iP. Permit No.QZ(�Zp97 <br /> The p�s pipinp syat�m was t�sted �t /S osi for� totN of •��inMlN. ��- <br /> WITNESSED BY� �'l� •• � <br /> (s anatur occu ant roqu t np Q�s krv � � ate � <br /> INSTALLED BY . � <br /> (sipnature o insta np p�s tt�r �te � <br /> Please arranqe for someone to b� present on th� d�t� of nqu�sted inap�ction to provide <br /> accesa for the inspector. <br /> Hard Copy - Job Site Pink COpy - ContraCtor Whit� Copy - Inspector <br />