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4877. CITY OF EVERETT <br /> GREASE DUCT TEST AFFIDAVIT <br /> Owner , S044.) '/''1 12/14 <br /> Job Address 27 - 6�- Ze 1-rc/ 1.444, 5' Permit No.iV2J, 'O7--0/' <br /> A light test or approved equivalent test method was performed to determine that all welded <br /> and brazed joints of the entire grease duct system are liquid tight. (IMC 506.3.31) <br /> WITNESSED BY.,.. J' 141 Date 114- <br /> INSTALLED <br /> 14-INSTALLED BY Alex LI-M1 v Date /1 --1e4-4 <br /> Please arrange for someone to be present on the date of the requested inspection to provide <br /> access for the inspection. <br /> Hard/Manila Copy-Job Site Yellow Copy-Contractor White Copy- Inspect r <br />