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/ <br /> ♦ j <br /> � �� 7"� � �` ,�`� .. . - -- - _ <br /> �f2'g` -LS�l` J <br /> CITY �F EVEi3ET7` <br /> GAS PIPING TEST AFFIDAVIT <br /> Homeowner �, _ �D ,b h EL <br /> Address� � � Permit No.`�l")j�p -a�7 <br /> The gas piping systeen was tested at�psi lor a cotal of � <br /> minutes. <br /> WITN[SSED BY �/ J <br /> ($�9 0 o y uesting q�s service) . ��J �� <br /> (d8te) <br /> INSTALL�D BY � <br /> (sig t re of nsta Q <br /> � g gas fitter) (date �— <br /> Piease arrange tor someone to be present on the date ot rgquested inspection to provide <br /> access fo� the inspector. <br /> Hard Copy -Job Site pink Copy - Contractor <br /> White Copy - Inspector <br /> l00/10�d WeZd'Ol OtOl id e�d ZEEO-EOE-SdV-I aej 113b3�3 ,S33lAA0a XIS <br />