Laserfiche WebLink
� � � PROPANE GAS <br /> � �,,, AND AIC irtc. <br /> ���e 1988 813-782-5013 <br /> 4441 Allen Road-Zephyrhills, FL 33541 <br /> DUCT SEAL AFFIDAVIT <br /> Job Name T���72.(�/ItJ License # CAC043948 <br /> Address J�9p� � /��2G1� � Permit# / 3�P�P'� <br /> ` � K Il/t"_`-✓ <br /> � � <br /> . 33��� <br /> Phone � �3- 7�g �' �D�Q - ���,��cz�� <br /> , <br /> I, �{�(l� ��}�,1-R, , affiant, herby affirm that I am the dully licensed <br /> contractor of record for the above referenced permit, that all of the forgoing information is true <br /> and accurate, and that the duct sealing at the above referenced address has been completed in <br /> accordance with all appliance codes and standards with: <br /> ❑ Mastic Tape ❑ Mastic <br /> Contractor's Name (printed) �� ✓-'ti �U�4 f�,/r�, Date f� l���-- <br /> Signature <br /> �� <br /> -_.._ <br />