Laserfiche WebLink
#4,k7r-7‘ <br /> CITY I OF EVERETT <br /> PIPING TEST AFFIDAVIT <br /> Owner r i .54eptitti 5 <br /> Job Address i `I Zg J t /4 Ave- E tkr ` 987-1) 1 Permit No. M 171 I-' /c <br /> 10 <br /> The refrigerant line / natural / LP / medical gas system (circle one) was tested at I zi psi for a <br /> total of I) minutes. <br /> WITNESSED BY ."4/,-/; <br /> ..� Date //f361t7 <br /> IgnAture o occupant requesting gas service <br /> INSTALLED BY � Date xt..30 <br /> (Signatur instaiiing 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 LEAK AT TEST PRESSURES NOT <br /> LESS THAN THE LOWER OF THE DESIGN PRESSURES CR 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. (WAG 51-42-1108) <br /> Hard Copy—Job Site Pink Copy — Contractor White Copy—inspector <br />