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- � ---�- . 7 <br /> '� PRQPANE GAS <br /> � AND A/C �rvc <br /> �%n�E' ��8� 813-782-5013 <br /> -�-�-�i Oii�t� K<,a�1 /�E�h�rhliE,. I i. �.��-}1 <br /> Dl1CT SEAL AFFIDAVIT <br /> Job Name �� � GiQ.f,L',;,v I.icense # C'AC"04;�)48 <br /> Address --�_�y� l� ----,Sf�..T/LG Permit # � ,�8 <br /> - --�� y. --� _ - - - <br /> -��-���-�� ��s - ,�� <br /> ----------- ---��s_y_z--- <br /> �/3 -��z---//�y <br /> Phone- -— <br /> I, __ /'�_� v'� �_�__,��f�i`L__ _ _, aftiant. Ilerby atiirm that 1 an� thc: dully licensed <br /> contractor of record (or the abo�c reterenced �ermit, that all of the tor�oin� intonnation is true <br /> and accurate, and that the duct sealing at the ahove r�fer�nced address has hccn cumE�ltted in <br /> accordance with all appliance codrs and standards with: <br /> �Mastic [ape [�-P'O�astic <br /> Contractor's Name (printed) /� L�- �/i N � ��Qf�� Uate � 22�� <br /> - ----- -- ---'--- <br /> -— ----- - - ---- � <br /> Signature <br />