Gas Piping Test AffidavitJ V
CM' OF EDNIONDS
Develolmi-ent Sc nice • lk paruncw
131 ach .\�Z
Pbxx: 4;!,---71Ae?0
Fmk dO.-<T% adma'-irdnx-QxLr rr
GAS PIPL\ G TEST AFFIDAN TT
Permit \o.: -c3?--3
T� gas P 7-a, f s. a:em v z tested at ' psi for a total of 10 minute;.
-Ncc for Sir& F�T']v ReddeDces the requirement is 3 p_ci for a total of io minute;.
ire capzei'.%- o' the gauze was 15 psi. not to exceed 5 times the test precure.
i
:tTilsa B
INMA i F>7 BY
(ofi
L 1, Zap
(date)
(date)
Completion and submittal of this afbdaNit is not intended to replace the need for
inspection by the City of Edmonds. The use of this affida-,it is being accepted as a
temporary- measure to allow connection of a gas appliance or mechanical unit
during the COS-ID-ig Emergency. Please be sure to request appropriate
inspection(s) once restrictions have been lifted.