Laserfiche WebLink
CITY OF EVERETT <br /> PIPING TEST AFFIDAVIT � <br /> Owner �( �/i5� 2 y r`1 f�(�-E.' 'L(J <br /> Job Address K /u v � Permit No. �O��G � ' cJ 2 � <br /> � <br /> The refrigeran�ne / naturai / LP / medical gas system (circle one) was tested at % � psi for a <br /> total ot � minutes. � <br /> WITNESSED BY ,�i�,�,yi, � �1t� Date � l� �/('� <br /> �$ignat re o pccu ant requestin as service <br /> INSTALLED 3Y fjJ7ti �' �,�,� Date � � ��, ��1 � <br /> �aiQr�aT7rssrann�rjas � . <br /> Please arrange for someone to be present on the date of requested inspection to provide access for <br /> the inspection. <br /> REFRIGERANT CONTAINING PARTS OF THE SYSTEM THAT IS FIELD EFECTED SHALL BE TESTED FOR LEAK AT TEST PRESSURES NOT <br /> LESS THAN TIiE LOWER OF THE DESIGN PFESSURES OR THE SETTING OF THE PRESSURE RELIEF DEVICES. THE DESIGN PRESSURE <br />� FOR TESTING SHALL BE THOSE LISTED ON THE CONDENSING UNIT OR COMPRESSOR UNIT NAMEPLATE.(WAC 51-42•1108) <br /> � Hard Copy—Job Site Pink Copy— Contractor White Copy— Inspector <br />