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w <br /> t <br /> Duct Seal Affidavit <br /> � , <br /> Company ��G�/�� l� /�/�,�% ���'��� ���u,� �lJ , License# �� � � � � � � � <br /> �� �� 9 � I I � ,� � ,�� �;/ <br /> �i, , � �� <br /> � � �r� Y ' � � � l�L 3 j5 �( � � <br /> � , i��-�,,� Address Permit# <br /> � !1 �� �'1 � U i .�� �l c� � <br /> b�li � �5 SW v.n.c� � � �� I � <br /> zP � � � : ,// � L '�� � <br /> ,� <br /> I ' � ' U�nt, hereby affirm that I am the duly licensed contractor of record for the above <br /> refer nced permit,that all of the forgoing information is true and accurate,and that the duct sealing at the above <br /> referenced address has been completed in accordance with all applicable codes and standards. <br /> Contractors Name(printed) � � �"'��l / ,J Dn��V c�. Date � � � �� I�°' l <br /> -� os--1-�-------- ---- _____ <br /> , _�__ �:���_�-�� <br /> --- <br /> ;,_ __l� day of �To�, �n I _ <br /> Signature `.1=�,�Ere rr?e person Ily ap�eared � <br /> T� � �_6 1�nn o r�_ <br /> ;�,.°+°�;raown�o be t �:�ssan who exe�b�,ed�hs <br /> j .!:�o�e�g F�strumento a�r�a�icryowledge�t�rai Fat• <br /> � ,� t ..,:�sarne as his f�ee act d d. <br /> ,, ����"�a,,,, CYNTHIA C GUESF; �,. , 6 �' � <br /> �`1ra�p��' � '^ - �.--:r <br /> . ,- .,.,.c..� <br /> ._°+ .R�; Notary Public-State of Florida <br /> - - fkU°i'��¢'�P'di�L6� —- - <br /> - + . •c My Comm.Expires Apr 6,2014 <br /> :'9F oF`�P; Commission#DD 979617 <br /> �''������"� Bonded Through Natioral Notary Assn. <br />