HomeMy WebLinkAbout08-8022
CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780-0020
LP/NATURALGAS PERMIT
8022
Permit Number: 8022
Permit Type: LP/NA TURAL GAS
Class of Work: FIRE-LP/NATURAL GAS
Proposed Use: NOT APPLICABLE
Square Feet:
Est. Value:
Improv. Cost:
Date Issued:
Total Fees:
Amount Paid:
Date Paid:
Work Desc:
Address: 5026 ALL BLVD
ZEPHYRHILLS, FL.
Township: Range: Book:
Lot(s): Block: Section:
Subdivision: CITY OF ZEPHYRHILLS
Parcel Number: 11-26-21-0010-20700-00AO
Name: STANLEY, GORDON & JOANNE TRUST
Address: POBOX 2658
CROSSVILLE TN 38557
6/30/2008
200.00
200.00
6/30/2008
INSTALL 2 GAS TANKS
Phone:
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1/k
Chapter 633, Florida Statutes, authorizes the City to charge and collect user fees to pay for the costs of fire
prevention and protection related activities such as inspections, plan review, administrative fees, and other
costs related to the aforementioned.
Complete Plans, Specifications and Fee Must Accompany Application. Commencement of work without written approval of
the Fire Department's Fire Marshal or required permits or opening up for commercial activity without an approved final
inspection shall be charged double permit fee per day of operation or a minimum of $100.00, whichever is greater. All
work shall be performed in accordance with City Codes and Ordinances.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT".
~. ....
CONTRACTOR SIGNATURE I IC
PERMIT EXPIRES I MONTHS WITHOUT APPROVED INSPEcnON
CALL FOR INS ECTION - 8 HOURS NOTICE REQUIRED
ZEPHYRHILLS FIRE RESCUE DEPT - Fire Marshal Office - 813-780-0041
813-780-00~
City of Zephyrhills Permit Application
Building Department
, . Fax-813-780-0021
SDVV
Phone Cootactfol Penol.'ng ",.. h, ,I,.....,..... .l;;>,""'" "
Owner Phone Number :Js:J ~ 'Z.. () " .- 45$ I
Owner Phone Number 11' / 3 ~ 7 8' ~. :5 ,( 3 I
Owner Phone Number I I
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Owner.s Name 'J..( r ~ VA ;' "
Owner's Address I ~
Fee Simple Titleholder Namel
· Date Received
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Fee Simple Titleholder Address
5'OZ(..
JOB ADDRESS
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SUBDIVISION
(OBTAINED FROM PROPERTY TAX NOTICE)
SIGN CJ MOVE 0
DEMOLISH
WORK PROPOSED
B
PROPOSED USE 0
TYPE OF CONSTRUCTION 0
DESCRIPTION OF WORK 1.2 "5 rC / /
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NEW CONSTR
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STEEL D OTHER I
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HEIGHT [
BUILDING SIZE
D BUILDING 1$
D ELECTRICAL 1$
D PLUMBING 1$
D MECHANICAL 1$
D GAS 0
FINISHED FLOOR ELEVATIONS I
VALUATION OF TOTAL CONSTRUCTION
BUILDER
SIGNATURE
AMP SERVICE . ~ PROGRESS ENERGY 0 W.R.E.C
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VALUATIONOFMECHANICALINST;~~~.N~:~ #z4'"." ~~:
D SPECIALTY 0 OTHER . (.p~~.f."" ~t{7~. /'/.~ .
I FLOOD ZONE AREA DYES OJ'D ~ ~ '1 _"_
I~~I
ROOFING
COMPANY
REGISTERED
License #
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License # IN: &.::.: " f ~
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License # Il::L1300 It 4 I
MECHANICAL
SIGNATURE
COMPANY
REGISTERED
Y/ N
FEE CURRENT
Y/N
Address
License #
OTHER
SIGNATURE
COMPANY
REGISTERED
Y/N
FEE CURRENT
Y/N
Address
License #
111111111111111 1111111111111111111111111111111111111111111111111111111I1111111I1111111I111111111111111111II11I111111I1111111111111111111111111111
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wi Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
....PROPERTY SURVEY required for all NEW construction.
11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111I111111111111111111111111111111111111I
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a No~ce of Commencement is required. (AlC upgrades over $5000)
Agent (for the cql'tractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
Driveways-Not over Counter if on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restricUbns"
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in'accordance with state and: local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
~nder state law. If the own.er or intended contractor are uncertain as to what licensing requirements may apply for the
Intended work, they are advised to contact the Pasco County Building Inspection Division-Licensing Section at 727-847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco
County.
TRANSPORTATION IMPACT/UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and
90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to
receiving a "certificate 'of occupancy" or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law-Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone
other than the "owner", I certify that I have obtained a copy of the above described document and promise in good faith to
deliver it to the "owner" prior to commencement.
CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also
certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to:
Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, Water/Wastewater Treatment.
Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers-Seawalls, Docks, Navigable Waterways.
Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment,
Septic Tanks.
US Environmental Protection Agency-Asbestos abatement.
Federal Aviation Authority-Runways.
I understand that the following restrictions apply to the use of fill:
Use offill is not allowed in Flood Zone "V" unless expressly permitted.
If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a
"compensating volume" will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application, for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proce~d with the work a~d not as authori~y !o viol~t:, cancel, alter, or
set aside any provisions of the technical codes, nor shall Issuance of a permit prevent the BUilding OffiCial from thereafter
requiring a correction of errors in plans, c~n~truction or violat~o~s o~ any codes. Eve~ permit issued. shall become. invalid
unless the work authorized by.such permit IS commenced Within SIX months of permit Issuance, or If work authorrzed by
the permit is suspended or abandoned for a period of six (6) mo~ths after the time th~ work is commenced: An extension
may be requested, in writing, from the Building Officia~ for a perrod not t~ exceed nrn~ty ~90) da~s and Will demonstrate
justifiable cause for the extension. If work ceases for nrnety (90) consecuttve days, the\Job IS conSIdered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WiTH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU TICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 111.03) tj
CONTRACTOR
Subscribed and sw n
by
Who Is/are personall k wn to me or has/have produced
as identification.
<(___,__..9~.~RjiQ AGENT" . .
'SUbsci/bed and swom t or affirmed) before me thIS
by
Who is/are personally known to me or haslhave produced
as identification.
Notary Public
Notary Public
Commission No.
Commission No.
Name of Notary typed, printed or stamped
Name of Notary typed, printed or stamped
'",
Fire Chief Keith Williams
H...t"'b UWII"1
ZEPHYRHILLS FIRE DEPARTMENT
6907 Dairy Road, Zephyrhills, FL 33542
Bus (813)780-0041 Fax (813)780-0044
FIRE SERVICE USER FEES
Contractor.~ ~~ R~....(~
Billing Address: ~~:;' ;;{~~ "<<-
Billing Phone No.:
Billing Fax No.:
Contact:
Occupancy No.:
Plan No.: oB - o~ E
Business Name: A~
Business Address: --; - =.....~
Business Phone No.:
Business Fax No.:
Contact:
PLAN REVIEW FEES
B Site Plan N/C
MuHi-Family/Commercial .06 sf
(Minimum Charge $25.00
o Plan Revisions DBl
INSPECTION FEES
NlC
NlC
$100
$250
$500
SPRINKLER SYSTEMS
B 0 - 25 Heads $50
, 26 plus Heads $100
STANDPIPE SYSTEM
o Per Riser $50
FIRE PUMP
o Per Pump
FIRE ALARM SYSTEM
B 0 - 25 Devices $50
26 plus Devices $100
SUPPRESSION SYSTEMS
B:: ::
B Other $50
KITCHEN EXHAUST
o HoodIOucts
OTHER
o LPlnslallalion per lank
~FueITanklnsbd~on
(Per Tank)
o Natural Gas Installation
(Per System)
o Spray Booth
$100
Annual
1 st Re-inspection
2nd Re-inspection
3rd Re-inspection
4th Re-Inspection
(Business closed until
vio~ons corrected)
SPRINKLER SYSTEMS
~ Hydro Undergrounds $45
Hydrostatic Test $65
Acceptance Test $45
Hydrant Flow $75
$15 per_II
$25 pertank
$25 per system
$50 ~ Tent 1 0'x1 0' or gr!later
Fire Pump
$50 Fire Suppression
$5O>l2.... System Acceptance
$50 0 EXhaust HoodIOuct $30
$50 D Re-inspection DBl
(other than annual)
$50 0 Inspection scheduled DBl
and cancelled less than
24 hours
B Construction Insp. N/C
Emergency; Vehicle Ao $50
PLANS TOTALlJID] INSPECTION TOTALC]
Comments:
FIRE ALARM SYSTEM
B System Acceptance $50
Recall Acceptance $50
OTHER
~ Fire Wall/Smoke Wall
lP Gas
Natural Gas
GRAND TOTAL
$15
$45
$30
per system
per systBm
per tent
PERMIT FEE FALSE ALARM FEE
Sprinkler $50 1 st Alarm NlC
Standpipes $50 2nd Alarm N/C
Fire Pump $50 3rd Alarm N/C
Hoods $50 4th Alarm $100
Fire Alarm $50 5thA/arm $150
lP Gas $50 6th Alarm $200
Natural Gas $50 NONCOMPUANCE $150
F~Tanks- pertank~ Z-
Sparklers ~
Fire Works $500
CampFire $25
Controlled Bum $100
HoodIDuct $50
Place of Assembly $50 Annual
Fire Protection $25
Flammable Application $50 Annual
Waste Tire Storage $50 Annual
Generator < KW $100
Generator >30 KW 150
Bic-Hazard Waste $100 Annual
Fumigation Tenting $50
Torch Pot/Applied $50
Hsz. Materials $100 Annual
B
,..J;M., FALSE ALARM
PERMITTOTAL~ - TOTAL I
~ .:}DO-
MK
UT""
Date:~
'ns~ctor: ~ It rt'\l--t -- rfv1....-'
ACORQ.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
06/06/2008
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Doug Jones c/o AJG Risk Management Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
8800 E. Chaparral Rd, Suite 230 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Scottsdale, AZ 85250
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Zurich-American Insurance Company
Oasis Acquisition, Inc. etal All. Emp: TOTAL ELECTRIC SERVICE OF INSURER B:
TAMPA, INC. INSURER c:
2054 Vista Parkway Suite 300
West Palm Beach, FL 33411 INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~~: ~o,.~~ POLICY NUMBER POUCYEFFECTIVE POLICY EXPIRATION LIMITS
~NERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
=::::J CLAIMS MADE D OCCUR
-
RGARAGE LIABILITY
ANY AUTO
EXCESSIUMBRELLA LIABILITY
o OCCUR D CLAIMS MADE
R DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
A I>JolY PROPRIETORlPARTNERlEXECUTIVE
OFFICERlMEMBER EXCLUDED?
~~~~I~~P~O~I~~~NS below
OTHER
WC 29-38-687-06
EACH OCCURRENCE $
~~~~~H YE~~~~~~ncel $
MED EXP (Anyone person) $
PERSONAl & ADV INJURY $
GENERAL AGGREGATE $
PRODUCTS - COM PlOP AGG $
COMBINED SINGLE LIMIT $
(Ea accident)
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
(Per accident)
AUTO ONLY - EA ACCIDENT $
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EACH OCCURRENCE $
AGGREGATE $
$
$
$
X I TV;;~~nJI~;' I IOTH-
ER
06/01/2008 06/01/2009 E.L. EACH ACCIDENT $ 1,000,000
E.L. DISEASE - EA EMPLOYEE $ 1,000,000
E.L. DISEASE - POLICY LIMIT $ 1,000,000
GEN'L AGGRE~E LIMIT APPLIES PER:
~. POLICY I I P,bW;: n LOC
~TOMOBILE LIABILITY
I-- ANY AUTO
I--
ALL OWNED AUTOS
f-- SCHEDULED AUTOS
HIRED AUTOS
I--
f-- NON-OWNED AUTOS
f--
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
pyLlCENSE HOLDER: JOHN MADISON - EC 0001439 AND ROY W BAKER
EC
.-.certl.fl~te#: 08FL075769447
lf~nrF:fi-; !;;, - r5'--'
1 3 O;O~.'. ~1~ ~ J'----.:.--~J l.Jb. ~ Ull
: u U JUN 1 D 2008 II
I' . --- '- ..:;..,J ~
. -...-.----...,..--.
. . ,City of ZephyrhiU~
'---~-"'-'
Location Coverage Period: 06/01/2008
06/01/2009
Coverage is provided for only
those employees leased to
but not subcontractors of:
TOTAL ELECTRIC SERVICE OF TAMPA, INC.
8929 MAISLlN DRIVE
TAMPA, FL 33637
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
CITY OF ZEPHYRHILLS BLDG DEPT NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
5335 EIGHTH STREET IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ZEPHYRHILLS, FL 33542
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE &~Z~
ACORD 25 (2001/08)
@ACORDCORPORATION1988
Pasco County Parcel: 11-26-21-001O-20700-00AO 001
Page 1 of2
Search Again Show Map Generalized Building Schematic Estimate Taxes Frequently Asked Questions
Other Parcel Cards: 1 I l I .3. I .4
Other Agency Data: Tax Collector School Board Supervisor of Elections
Data Current as Of: Weekly Archive - Saturday, May 31, 2008
Parcel ID 11-26-21-0010-20700-00AO (Card: 001 of 004)
Classification 11 - Retail Stores, One Story, All Types
Mailing Address Assessment (totals)
STANLEY GORDON R & JOANNE LIV Ag Land $0
TRUST Land $95,102
STANLEY GORDON R & JOANNE TTEE Building $245,595
PO BOX 2658
CROSSVILLE, TN 385572658 Extra Features $3,048
P1:'l-y,1~~LAd.dr~$.$_,:,_See All _~_~qd.J"_~~$~$ (First Shown) Total Assessment $343,745
5018 GALL BLVD Save Our Homes $0
ZEPHYRHILLS, FL 33542-4959
Leaal Description (First 4 Lines) Taxable Value $343,745
THAT PORTION VACATED SCL RR
RjW & THAT PORTION OF A PARCEL
LYING EAST OF BLOCK 208 CITY
OF ZEPHYRHILLS PB 1 PG 54 DESC
Land Detail (Card: 001 of 004)
I Line II Use I Descriptio Zoning Units II Type II Price I conditIon'.
I 1 I 1100 STORE lFU 00C2 I 7,000.00 II SF II $6.24 II 1.25 I $5
I 2 I 1100 STORE lFLI 00C2 121,601.00 II SF II $1.50 II 1.25 I $4
Additional Land Information
I Acres II 0.66 II Tax Area II 30ZH I FEMA codelCU1commeric
Building Information - Use 11 - Retail Stores (One Story) (Card: 001 of 004)
Year Built 1988 Stories 1.0
Exterior Wall 1 Concrete Block Stucco Exterior Wall 2 Average
Roof Structure Gable or Hip Roof Cover Asphalt or Composition Shingle
Interior Wall 1 Drywall Interior Wall 2 None
Flooring 1 Ca rpet Flooring 2 None
Fuel Electric Heat Forced Air - Ducted
A/C Central Baths 2.0
Line Description Sq. Feet Repl. Cost
1 .!.l.SI 720 $29,491
2 AOF 1,280 $131,072
3 CAN 200 $6,144
Extra Features (Card: 001 of 004)
Line Description Year Units Value
1 PAV ASP 1988 15,050 $3,048
Sales History
Previous Owner FUTUREWARE ENTERPRISES INC
Year Month Book/Page Type II Amount
2004 06 5902 / 0632 WD II $300,000
2002 01 4833 / 1210 WD II $107,100
1993 12 3235 / 0399 WD II $160,000
http://appraiser.pascogov.comlsearchlparce1.aspx?sec= 11 &twn=26&mg=21 &sbb=OO 1 O&bl... 6/6/2008
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