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L1 -.. <br /> ���/ � �R{�f'ANE GAS ' <br /> � � <br /> � . ��.!`�� �✓� 3NC <br /> `�--urr�-�. <br /> ' �� `-?82-50 i � <br /> . . � ;;=« <br /> DUCT SEAL AFFIDAVIT <br /> Job Name /'��4T��� £n�� License # CAC043948 <br /> Address 66/� ,Os�£�v CT Permit# _�_�``� � __ <br /> .-- <br /> �� .'�J G✓oo�O C�•vp os' <br /> � � � , �.•� s 33sY� <br /> Phone g6 3" ,�� y � �3� / <br /> I, , affiant, herby affirm that 1 am the dully licensed <br /> contractor record for the a ove 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 "l,ape astic <br /> Contractor's Name (printed) �L �• `^' �'���� Date �� � 3 <br /> Signature <br />