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_` � . �_., <br /> � 4 � ' • � PROPANE GAS <br /> i A('dD A/C ttvc. <br /> ������ A��� s��-�s2-so i 3 <br /> -�Y-? 1 ��i"�;� Road .' ,��n��-1�i115, f'I., 335�1 <br /> DUCT SEAL AFFIDAVIT <br /> ._�-� . <br /> Job Name � ��'j t/� ? License # CAC043948 <br /> Address �p�/�� �G�GC/���,t�dq��, Permit # `�T� � p� <br /> � ��`ls �� <br /> 333��- <br /> Phone �05 - �aR- 14�0� <br /> I� ��--°V�� � ��H�2, , 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 �fMastic <br /> Contractor's Name (printed) ��.,1, �:✓ ,Qq�/� Date -� Z- /,3 <br /> Signature <br />