RC-10-17-2422 GASState License # LPG 29903
3200 West 14 Avenue fl L C 3 C/ C/
Hialeah, FL 33012
Phone 786-200-3001 Fax 866-523-1699 r�
nest asantracto aol.cam C
Florida Building Code, Fuel Gas Section 4061 1 lnspettivn, Testing and Purging
406.1 General. Prlor to acceptance and initial operation, all piping installations
small he inspected and pressure tested to determine that the materla Is, design,
fabrication, and installaRion practices comply with the requirements of this cads.
Permit Number.
Owner Information:
Name: x w
Address, City, Sate it Zip _
Contractor Best Gas Contractors
License No: 28903
T"nr ? ` Installation: New ,_.Upgrade to Existi
i1jaun work: (Must include test details and Include pipLig
and appliances.)
System Pressure from Meter:
IF Hybridsystem, Branch pressure:
Water Column: C,' 6
Test Duratlo
Date of
Signature Date
Print Name
State of Florida County of Seal
Swor I and subs�bed before me this ' day of
hy= Yf Personally Kndwn () Indentification - Type of ID
to r--
Signature o Notary-pti Cray' �; ticta-y ]ua+,c Ssate of Fia-da
David Pinauft
MGG 303905
~y �� Expires G3:2al2023
This installation will m vision
rule 48-1.01, The South Florida Bldg. code NFPA 54, NFPA 58 and
regulations of the State Fire Marshall.
METER READIN BEFORE AND AFrER DELIVERY
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Serving Miami -Dade and Broward Counties
WE SELL & SERV
N u . 214126 GAS AP PLANET SE
BARBEQUES
POOUSPA HEATERS
Dolphin Gas System, Inc.
1614 N.E. 205th Terrace
tami, FL 33179
(305) 651 -U000 - Fax (305) 653-8645
www.dolphingas.net
DATE
r
SOLD TO t
ADDRESS _r r 5
`-'I'I y ---
S
rly
Type Del (ery
.
CASHROUTE
SPEC1
*ByCharge
Gallon - 4.23;IbsPoundsPriceAmount
DOLPHIN LP GAS
.c 7F f � �• • r: �:
F r� .
-
's
THIS INVOICE IS YOUR STATE-
UTILITY TAX
MENT AND IS DUE 10 DAYS
STATE SALES
FROM THIS DATE.
TAX
DELIVERY
Late charges, Bookkeeping charges and
legal fees may be included on or added to
CHARGE
,
all Delinquent Accounts.
TOTAL
ESTE RECIBO ES SU ESTADO DE CUENTA Y SE
SIGNATURE
PRODUCT TEMPERATURE COMPENSATED TO 60OF
PROPANE FLAMMABLE GAS - UN1075