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4E-7T CITY OF EVERETT <br /> PIPING TEST AFFIDAVIT <br /> r <br /> Owner <br /> Job Address7z� 5-Tf � 17/ r �T Permit NoN,( <br /> The refrigerant line / `natural "LP / medical gas system (circle one) was tested at psi for a <br /> total of CA% minutes. 'an <br /> WITNESSED BY Q Date .J <br /> (Sign tufe f o upa711= <br /> esting gas service) <br /> INSTALLED BY Date Z3— <br /> 11-7 <br /> 7(161gnatu're of installi g gas fitter) <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 ERECTED SHALL BE TESTED FOR LEAKS AT TEST PRESSURES NOT <br /> LESS THAN THE LOWER OF THE DESIGN PRESSURES 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 NAME PLATE.(WAC 51-42-1108) <br /> Hard Copy - Job Site Pink Copy - Contractor White Copy - Inspector <br /> PWPTA(5/17) <br />