APP-PDTVDFDEUinVBBlCHPLUMBING PERMIT APPLICATION(INCLUDES GAS AND FIRE SPRINKLER)100 NW1"' Avenue Delray Beach FL 33444(561) 243-7200 Fax: (561) 243-7221Website: www.delravbeachfl.aovPROPERTY CONTROL #: 12 n 43 - 46 - 21 - 26 -001 -1020PLEASE PRINT:JOBSITE ADDRESS1 Harbourside Dr #1102PROPERTY OWNER NAME Andrew KiaerHOME PHONE ( 917 ) 270-0192CELLC )PROPERTY OWNER ADDRESS 1 Harbourside Dr Apt 1102PLUMBING CONT'R (COMPANY) NAME Terrano Plumbing and RemodelingPLUMBING CONT'R (COMPANY) ADDRESS 11444 Clear Creek PlaceCITY Boca Raton st FL zip 33428BUS. PHONE ( 561 ) 497-3197CELL ( )E-MAIL info@terranopIumbing.coinFAX()FOR OFI-ICE USE ONLY:BLDG PERMIT _PLBG PERMITPERMIT FEE: _PLAN CHECK FEE:MCR #:APPROVALS:PLBG: DATEFIRE: DATEUTILITIES: DATENOTE: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN ISO-DAYS OR IF ACWITY LAPSES FOR 180 DAYS. PLANSMUST BE ON THE JOB SITE FOR ALL INSPECTIONS. FINAL INSPECTION IS REQUIRED ON ALL PERMITS.XRESIDENTIALDESCRIPTION OF WORK:TYPE OF INSTALLATION - CHECK ALL THAT APPLY:COMMERCIALGENERAL PLUMBING: NEWREPAIR/REPLACEMENTX GASXWATER HEATERS: ELECTRICWATER CONNECTION: BACKFLOW INSTALLATION: FIRESEWER CONNECTION:SOLAR PANEL INSTALLATION:IRRIGATIONOTHERSCOPE OF WORK (Describe WORK and LOCATION: Kitchen/Bedroom/Garage, etc):Replace 38 gallon water heater like for like located in closet inside unitPROJECT COST (LABOR AND MATERIAL): $ $1,985.00□FIRE SPRINKLER: (2 SETS OF PLANS REQUIRED)NUMBER OF HEADS NEW REPAIR/REPLACEMENT/RELOCATIONPROJECT COST (LABOR AND MATERIAL): $□GAS WORK: NEWTYPE OF GAS: NATURAL:SCOPE OF WORKREPAIR/REPLACEMENTL.P.GENERATORNUMBER OF OUTLETS:PROJECT COST (LABOR AND MATERIAL): $_CFC053956SIGNATURE OF QUALIFIERSTATE OF FloridaCONTR. REGIS ! RA TION H10662581-2022 ORWORKERS COMP ifEXEMPT (FID/FEIN)#COUNTY OF Palm BeachThe foregoing instrument was acknowledged before me by means of (^physical presence or [ ] online notarizationthis _4th day of September , 2024 by Rn^iario T. TerrannSignature of Notary Public - State of FloridaREV 5/2023(Printed Name of Above Signatory)Notary Public Iwe o'f Florida f ^KerrI Evans Iy Commission hh 494638 produced IdentificationXp 2/19/2028 IType of Identification Produced