APP-P-24-220937PfOPERTY CONTROL#
PL
JOf
PRi )PERTY OWNER NAME'
HO
PROPERTY OWNER ADDRESS ^ v^cvenx\
PH fMBING CONT'R (COMPANY) NAME fa \OrN.U'-r .
PLl FMBING CONTR (COMPANY) ADDRESS ^3 \ 3E S<-4-K
cn ^cc\r\(\ ST Pi zip .
BU
FA
NC TB\ PERMIT EXPfRES IF WORK IS NOT STARTED WITHIN 180-DAYS OR IF ACTIVITY LAPSES FOR 180 DAYS, PLANS
Ml ST BE ON THE JOB SITE FOR ALL INSPECTIONS. FINAL INSPECTION IS REQUIRED ON ALL PERMITS.
DE
T\
mVDFDEUniVBBIOi
lOdNW I®'Avenue Delray Beach FL 33444
(561)243-7200 Fax: (661)243-7221
Wi bsite: mvdelravbeach.com
PLUMBING PERMIT APPLICATION
(INCLUDES GAS AND FIRE SPRINKLER)
FOR OFFICE USE ONLY:
ASE PRINT:
SITE ADDRESS S Pe-.cVrrv\- Gac-W-x- e^\ V-C\\j
VIE PHONE (F)[n\ ) 21 K CELL.
i.PUONEilS-^) ' ■^Rf)S CELL
BLDG PERMIT#
PLBG PERMIT#
PERMIT FEE
PLAN CHECK FEE:
MCR#:
APPROVALS:
PLBG; DATE:
FIRE: DATE:
BSD:DATE
IA2 \ -5'^ ^HE~upjL^ia\\trpl{)rnWi(\j.^.^r(^i.LCyCY^
SCRIPTION OF WORK;RESIDENTIAL COMMERCIAL
TE OF INSTALLATION CXIECK ALL THAT APPLY:
L^^'^AIR/EIEPLACEMENT
GAS
[3^GENERAL PLUMBING:
WATER HEATERS: _
SEWER CONNECTION:
NEW
ELECTRIC
WATER CONNECTION;
SOLAR PANEL INSTALLATION: O -S Q\
SCOPE OF WORK (Describe WORK and LOCATION: Kitchen/Bedroom/Garage, etc): OC\C\6V\cX0l
V>:V.VV\ cx
I^OJECT^CGST (LABOR
[]FIRE SPRINKLER: (3 SETS OF PLANS REQUIRED)
NUMBER OF HEADS ^NEW
PROJECT GO^: I \1) S :
SEPAJR/REPLACEMENT/RBLOCATION
NEWGAS WORK:
TYPE OF GAS: NATURAL:
SCOPE OF WORK
ANR
REPAIR/REPLACEMENT ^GENERATOR
L.P. NUMBER OF OUTLETS:
I >4^3-
tfNATURirOF QUALIFIER CONTR. REGISTRATION #
\TE OF ^ \OV \ C\CX
UNTY QfIS^PiUXM" ck
Th^ foregoing instrument was acknowledged before me this H day
anbvV>.vxceA c-i,N\Vp.r.
ST,
CO
OR
WORKERS COMP #EXEMPT (FID /FEIN) #
Personally Known
OR
Produced Identification
SHEILA PASCAT?/MY OMISSION § HHI19837
5: April 26,2025
Rvsd. 3/10