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. ....__.. _ ._._...._��_.�........._.. <br /> ...-....�...e.., ._ ...:e�n'm+.':." : .n«-aYA�fM .l� <br /> Ireohsr.�,.,ny..,.n..,.........._. ,. ._____ . . .. . . _ <br /> CITY OF EVERETT <br /> GAS PIPING TEST AFFIDAVIT <br /> Ho�,�ow��� <br /> � <br /> Address 7.2n19 le'�' llUi L.� Permit No.('�L'�l/_DZs� <br /> i <br /> The gas pipiny system was tested at /� osi for a total of�_minutes. <br /> WITNESSED BY ���� <br /> y upa quest ny yas serv ce) (date <br /> INSTALLED BY � <br /> (s'gnat e o installiny yas itter) �dste <br /> � Please arrange for someone to be preaent on the date of requested inspectfon to provide <br /> accessfortheinspector. <br /> � Hard Copy - Job Site Pink Copy - Contractor White Copy - Inspector <br />