Laserfiche WebLink
CITY OF EVERETT <br /> PIPING TEST AFFIDAVIT <br /> Owner 'sVA a7 H <br /> Job Address 502-8 N A,1 , Q4L AVE Permit No. MI-)OH — 03 5 <br /> The refrigerant line / natural / LP / medical gas system (circle one) was tested at �,�psi for a <br /> total of 30 minutes. <br /> WITNESSED BY jprL p,4i-j C(iopt iz- Date <br /> — bignature ot occupant requesting gas service <br /> INSTALLED BY �U T� z ,^1 -- Date <br /> —(si r aInstallingga I <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 LEAK 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 NAMEPLATE. (WAC 51-42-1108) <br /> 1 <br /> Hard Copy—Job Site Pink Copy— Contractor White Copy— Inspector / Z <br /> i <br />