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��3� <br /> �<J � � I <br /> PROPANE GAS <br /> � AND A/C iNC. <br /> S%��� ,'`��8 813-782-5013 <br /> -�-1-tI 111�n Roa�1 - "l.c��h�i�hill�. I=L ;;5�1 <br /> DUCT SEAL AFFIDAVIT <br /> Job Name ��rzG � /���,�o,.-� License # CAC043948 <br /> —� <br /> Address ��l/� 'S L v-£n Q�g�s' ,Q� Permit # ��.��� <br /> Z�.i��,��/� � <br /> 3 3�y <br /> Phone g�.� -- 7 7�-r�-�� <br /> I, /`� z. �'� <� J��H2� , 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 /> �astic Tape �Iastic <br /> Contractor"s Name (printed) /`C �v,�,-v � ,�i�fj/Z Date � /U <br /> Signature `� <br />