Laserfiche WebLink
_ ,. ,_ --�----�� <br /> CITY OF EVERETT <br /> PIPING TEST AFFIDAVIT <br /> Owner �/i��� (� �J� �'N� �'c{ L ��i� <br /> Job Address � � i.� ' (� '—�. F i�" �' Permit No. !�! � 7 d�' ���� � <br /> `��2.t�% <br /> The refrigerant line / natural / LP / medical gas system (circle one) was tested at _ �(> psi for a <br /> total of _�� minutes. <br /> WITNESSED BY � :�-�,��� . �� Date I C��.�����/ � <br /> ��L����%�'� (Signature of occupan equestin gas service) <br /> INSTALLED BY Date _1����,�� <br /> natu of installing 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 />