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��� � � � PROPANE GAS <br /> � AND AIC iNC. <br /> ;";��_ "��88 813-782-50�3 <br /> -}-�-�! \il���� Rc�ac� — /.�E�ll�rhills. I�'1. ;;i-�l <br /> DUCT SEAL AFFIDAVIT <br /> Job Name �iE'/�1,� S��vL�� �� License # CAC043948 <br /> Address ��� yd �T��1�L Permit# ?�� J 'J IU <br /> � �,//S <br /> 33.�'Yz <br /> Phone ��„3 ��$^ �/ 77 <br /> I, ��Vi%✓ i� 1�Af�/Z , 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 /> �Iastic Tape L(,4-�Glastic <br /> Contractor's Name (printed) � � U< ��t/ � /��/�l/� Date �/��..3 <br /> Signature <br />