Permit SFAT 52 Simmons 2011 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
C E R T I F I C A T E O F O C C U P A N C Y
P E R M A N E N T
Issue Date 4/09/12
Parcel Number . . . . 172174 -0001- -
Property Address . . 52 SIMMONS RD
ATLANTIC BEACH FL 32233
Subdivision Name . . .
Legal Description . . .
Property Zoning . . . TO BE UPDATED
Owner BEACHES HABITAT
Contractor BEACHES HABITAT
904 241 -1222
Application number . . 11- 00002400 000 000
Description of Work . . SINGLE FAMILY ATTACHED DWELLING
Construction type . . . TYPE 5 -A
Occupancy type . . . RESIDENTIAL
Flood Zone ZONE X
Special conditions .
2007 FLORIDA BUILDING CODE WITH 2009 REVISIONS
,
Approved
Build �' g Of ficia'
VOID UNLESS SIGNED BY BUILDING OFFICIAL
CITY OF ATLANTIC BEACH
CERTIFICATE OF OCCUPANCY WORKSHEET
Date Requested:
Contractor Name: -M —$ r �
Permit #: //- 244:y0
Property Address: .a c5;922 '� ens _
Legal Description:
Improvements to the above - described property have been completed in
accordance with the terms of the permit and are certified to be ready for
occupancy as:
Single - Family Residence
❑ Commercial
❑ Other:
Lowest Floor Elevation:
Required As Built FFE
The following must be completed before issuing Certificate of Occupancy:
Department Date Notified Date Approved Approved By
Fire Dept. _-
Public Works 1�_s' L( 0/J
Public Utilities s'' Lf _ Ak.Gt ea.)
Building ¢ r 6 _
Planning
44- r.
Tree Mitigation /�
Satisfied `T
Final Survey with FFE VYes No
All Re- Inspect Fees Paid (/ es No
Termite Treatment Yes No
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White, Debbie
From: Hall, Erika
Sent: Monday, April 09, 2012 9:16 AM
To: White, Debbie
Subject: RE: CERTIFICATE OF OCCUPANCY REQUESTS
Tree Permit is closed / no mitigation due; No other known P/Z issues.
Thanks,
Erika
From: White, Debbie
Sent: Thursday, April 05, 2012 2:49 PM
To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika
Cc: Graham Shirley; Jones, Mike
Subject: CERTIFICATE OF OCCUPANCY REQUESTS
TO ALL:
Beaches Habitat has requested their Certificate of Occupancy inspections
on:
12 -2400 52 Simmons Road
12 -2401 54 Simmons Road
Please email me your results.. Thanks, Debbie
Debbie White
City of Atlantic Beach
Building Department
(904) 247 -5826
(904) 247 -5845 FAX
White, Debbie
From: White, Debbie
Sent: Thursday, April 05, 2012 2:49 PM
To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika
Cc: Graham Shirley; Jones, Mike
Subject: CERTIFICATE OF OCCUPANCY REQUESTS
TO ALL:
Beaches Habitat has requested their Certificate of Occupancy inspections
on:
12 -2400 52 Simmons Road
12 -2401 54 Simmons Road
Please email me your results.. Thanks, Debbie
Debbie White
City of Atlantic Beach
Building Department
(904) 247 -5826
(904) 247 -5845 FAX
i
J •
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INTERIOR
NIBAN .5% EXTERIOR
DELTA DUST .05% PERIMETER __
SUSPEND SC .06% EAVES X - --
OTHER . GARAGE I hereby acknowledge the satisfactory completion of all services
OTHER �� rendered and agree to pay the cost of services as specified
OTHER above
71 = • /ICE' r. - o ESORIPT4ON '.....UNT1NFORMA11ON
PRECONSTRUCTION PRECONSTRUCTION /2nd $0.00
TREATMENT Bill -To: [103560]
BEACHES HABITAT
Subtotal $0.00 PAUL FINDLEY
We are grateful for your business. Tax $0.00
52 SIMMONS ROAD
Total $0.00 ATLANTIC BEACH, FL 32233
Thank you, _ _ _ —_.__ -
DAVID HONRATH, OWNER Amount Due $0.00 904- 334 -2278 /
•
Order: 40083 Tech: 1`
Date: 03/19/12 Q
Day: Monday Time In: l ; ° 6
Time: 09:00
Tech: 2 Time Out: "
Target Pest: Map:
Location: [103560] 904 -334 -2278
2nd TREATMENT BEACHES HABITAT
PAUL FINDLEY
52 SIMMONS ROAD
ATLANTIC BEACH, FL 32233
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BEACHES HABITAT
We are grateful for your business. Tax $0.00 PAUL FINDLEY
Thank you, Total $0.00 54 SIMMONS ROAD
_. _.......... __-_-.:.. .____.._._._._..__........._._.
DAVID HONRATH, O ATLANTIC BEACH, FL 32233
WNER v._. 00
Amount Due $
904- 334 -2278
•
Order: 40084 Tech: Ni
Date: 03/19/12 '9:00
Day: Monday Time In:
Time: 09:30 a 1
Tech: 2 Time Out:
Target Pest: Map: j
Location: [103561] 904 -334 -2278
2nd TREATMENT BEACHES HABITAT
PAUL FINDLEY
54 SIMMONS ROAD
ATLANTIC BEACH, FL 32233
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White, Debbie
From: Nodine, Phil
Sent: Friday, April 06, 2012 12:59 PM
To: White, Debbie; Carper, Rick; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika
Cc: Graham Shirley; Jones, Mike
Subject: RE: CERTIFICATE OF OCCUPANCY REQUESTS
Good to go for PW
From: White, Debbie
Sent: Thursday, April 05, 2012 2:49 PM
To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika
Cc: Graham Shirley; Jones, Mike
Subject: CERTIFICATE OF OCCUPANCY REQUESTS
TO ALL:
Beaches Habitat has requested their Certificate of Occupancy inspections
on:
12 -2400 52 Simmons Road
12 -2401 54 Simmons Road
Please email me your results.. Thanks, Debbie
Debbie White
City of Atlantic Beach
Building Department
(904) 247 -5826
(904) 247 -5845 FAX
White, Debbie
From: Clemons, Malcolm
Sent: Friday, April 06, 2012 1:45 PM
To: White, Debbie
Subject: RE: CERTIFICATE OF OCCUPANCY REQUESTS
Backflow inspection ok. Malcolm
From: White, Debbie
Sent: Thursday, April 05, 2012 2:49 PM
To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika
Cc: Graham Shirley; Jones, Mike
Subject: CERTIFICATE OF OCCUPANCY REQUESTS
TO ALL:
Beaches Habitat has requested their Certificate of Occupancy inspections
on:
12 -2400 52 Simmons Road
12 -2401 54 Simmons Road
Please email me your results.. Thanks, Debbie
Debbie White
City of Atlantic Beach
Building Department
(904) 247 -5826
(904) 247 -5845 FAX
1
White, Debbie
From: Walker, Chris
Sent: Friday, April 06, 2012 9:05 AM
To: White, Debbie
Subject: 52/54 Simmons
All good here.
1
White, Debbie
From: Walker, Chris
Sent: Friday, April 06, 2012 9:05 AM
To: White, Debbie
Subject: 52/54 Simmons
All good here.
J
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Li CASH - -- — — - --
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ATERIAT:I'PRODUCT 1JOM lt. " is ii '," U CREDIT CARD — --
TERMIDOR SC .06% ATIIC
DEMAND CS
03% CRAWL ;CUSTOMER SIGNATURE ; ,
_ — - - --
MAXFORCE GEL .01% INTERIOR ,�_ 4/
NIBAN 5% EXTERIOR `
DELTA DUST .05% PERIMETER ._— CA_
SUSPEND SC .06% EAVES - - -.. - - - -- X _ .
OTHER GARAGE I hereby acknov+ledod the satisfactory completion of all services
OTHER rendered and agree to pay the cost of services as specified
C7
OTHER (1 abov
- 1IICE.t s` rgo , •r. a ESCRIPTION ?':=PR10E. ,g :'? UNT1NFORMAi1ON
PRECONSTRUCTION PRECONSTRUCTION /2nd $0.00 Bill-To: [103560]
TREATMENT BEACHES HABITAT
Subtotal $0.00 PAUL FINDLEY
We are grateful for your business. Tax $0.00 52 SIMMONS ROAD
Total $0.00 ATLANTIC BEACH, FL 32233
Thank you,
904-334-2278
DAVID HONRATH, OWNER Amount Due $0.00 904 334 2278
Order: 40083 Tech: 17
Date: 03/19/12
Day: Monday Time In: ���
Time: 09:00
Tech: 2 Time Out: LJ Q
Target Pest: Map:
Location: [103560] 904 -334 -2278
BEACHES HABITAT
2nd TREATMENT PAUL FINDLEY
52 SIMMONS ROAD
ATLANTIC BEACH, FL 32233
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03/12/2012 15:13 904 - 2490703 BROOKS AND LIMBUAGH PAGE 01/02
v ' „ 1 ' EARLY POWER AGREEMENT & RELEASE
l
y'" CITY OF ATLANTIC BEACH
T,
Electric power is requested now under the conditions and terms of this fully executed Agreement & Release
Job Address:
rn rn en _S f C c
Permit No. I 000 0 zI
`` l O f Service Type (Circle One): Overhead Underground
�
We, the undersigned General Contractor and Electrician, understand and agree:
1. "Early Power" is purely for our construction convenience, it is Reg required by Codes and does not
substitute for Final Inspections or the C/O (Certificate of Occupancy at must be issued before occupancy,
and as such is at the discretion of the Building Official.
2. The City of Atlantic Beach will make a special inspection prior to the early power energizing. All rough
inspections must have prior Approval, including meter base connections.
3. Occupancy or use of the new construction before a formal C/O constitutes fraudulent use of the early
electric service. Such action is expressly prohibited and penalized by The City of Atlantic Beach
Ordinances. A violation of this Agreement shall result in a request for prompt removal of electric service
after a twenty -four hour notice.
4. "Early Power" release authority is the Electrician and /or the Contractor and must not occur before:
a. Equipment, devices and fixtures are installed (or blanked off) ,safely.
b. Panel is complete with breakers and cover, and (labeling required at final inspection).
c. Service connection and grounding is complete.
d. The electric system bas safely passed through electrical check.
e. Meter can is permanently marked with address.
f Temporary address numbers displayed (Permanent numbers are required for C /O).
5. This fully completed form is to be submitted to the Building Department by hand, mail or fax.
6. Future such Agreements will not be accepted from those who violate any one of the above items.
.
CONTRACTOR - 3 1 z 12
DATE
PRINT NAME ' G�. 1 7
-,---
ELECTRICIAN f- 1 1 m • s ` DATE S ) 12, _ 1
PRINT NAME Pl t ery, Li m ittuul, 6 I C
800 Seminole Road, Atlantic Beach FL 32233
Phone: (904)247-5826 Fax: (904)247 -5845 http : / /www_coab,us revised 01 30 09
�' r f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
'� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
A
fa) 111
Application Number 11- 00002400 Date 9/01/11
Property Address 52 SIMMONS RD
Application type description SINGLE FAMILY ATTACHED DWELLING
Property Zoning TO BE UPDATED
Application valuation . . . 75000
Application desc
NEW SINGLE FAMILY ATTACHED
Owner Contractor
BEACHES HABITAT
1671 FRANCIS AVENUE
ATLANTIC BEACH FL 32233
(904) 241 -1222
Structure Information 000 000
Construction Type TYPE 5 -A
Occupancy Type RESIDENTIAL
Flood Zone ZONE X
Permit PLUMBING PERMIT
Additional desc .
Sub Contractor . ADVANTAGE PLUMBING
Permit Fee . . . 125.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 2/28/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 ELECTRIC CODE
*SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST
CONTROL COMPANY PRIOR TO C.O.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Avoid damage to underground water /sewer utilities. Verify
vertical and horizontal location of utilities. Hand dig if
necessary. If field coordination is needed, call 247 -5834.
Ensure all meter boxes, sewer cleanouts and valve covers
are set to grade and visible.
A sewer cleanout must be installed at the property line.
PERMIT IS cfleitgiNVAVNLIV49 Affiimitotiltart4 4illfiDilialliCEWW3 THE FLORIDA
BUILDING CODES.
. 1 , ; . j ,,
0 `` C ITY OF ATLANTIC BEACH
s-) 800 SEMINOLE ROAD
0 �:`' "` = ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Page 2
Application Number 11- 00002400 Date 9/01/11
Special Notes and Comments
metal lid. Cleanout to be set to grade and visible.
Call Public Works (247 -5834) for Erosion and Sediment
Control Inspection before beginning any site work.
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 125.00 125.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 129.00 129.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: c ,'�� -� '-e:=0
NEW -.�� PERMIT # //
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub i2, Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet o.
Hose Bibs Urinal
Kitchen Sink / Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater /
Other Fixtures Water Treating System j73
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Lawn Sprinkler System - Number of Heads ❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
❑ Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate the provisions of any other state or Local law regulation construction or the performance of construction.
Property Owners Name -13 c - tCit \ r - j4 Cc* Phone Number 2L\ 1 _ \ r ) 9 2
Plumbing Company C.. .. \v.1 ∎ SsYb Office Phone2 - L} Fax (2-L ) -O 9
Co. Address: f::>9 (7 a ` , Q.0- Ci
tY `��- � State F I Zip 'm2SO
License Holder (Print): -n `Ce . 0 s - State Certi tion/Registration # C cC .142
Notarized Signature of License Holder . /� ■ E 0-4-1.4 2
:ke401;;.. � , , MICHELLE L CREWS Sworn and subscribed before me this ( 2.---P day o Pull 20 \ \
': . MY COMMISSION # EE037670 ((�� n , ,� ,�," : EXPIRES October 26, 2014 S of Notary Public` e 0 )...,. -DS
(407) 398 -0153 FlorldallotaryServka.com
F
.'�f CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
44 :: Oil
Application Number 11- 00002400 Date 12/14/11
Property Address 52 SIMMONS RD
Application type description SINGLE FAMILY ATTACHED DWELLING
Property Zoning TO BE UPDATED
Application valuation . . . 75000
Application desc
NEW SINGLE FAMILY ATTACHED
Owner Contractor
BEACHES HABITAT
1671 FRANCIS AVENUE
ATLANTIC BEACH FL 32233
(904) 241 -1222
- -- Structure Information 000 000 SINGLE FAMILY ATTACHED
Construction Type TYPE 5 -A
Occupancy Type RESIDENTIAL
Flood Zone ZONE X
Permit MECHANICAL HVAC PERMIT
Additional desc . INSTALL NEW SYSTEM 2.5 TON
Sub Contractor . FLORIDA AIR SERVICE & ENG.LLC
Permit Fee . . . 99.00 Plan Check Fee .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 6/11/12
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 ELECTRIC CODE
*SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST
CONTROL COMPANY PRIOR TO C.O.
WINDOW AND DOOR INSPECTION:
*INSTALLATION INSTUCTIONS REQUIRED
*ALL STICKERS ARE TO REMAIN ON THE WINDOWS
*PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
NATIONA1 ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Avoid damage to underground water /sewer utilities. Verify
vertical and horizontal location of utilities. Hand dig if
necessary. If field coordination is needed, call 247 -5834.
Ensure all meter boxes, sewer cleanouts and valve covers
are set to grade and visible.
A sewer cleanout must be installed at the property line.
PERMIT IS�1f ' 6NL� t ACP@RER9e r eP III A�l 'I`IY`� A7 AN'RI& FA RIAR*CL l A'N3 THE FLORIDA
BUILDING CODES.
$ CITY OF ATLANTIC BEACH
1 � 800 SEMINOLE ROAD
J , -°' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
N
Page 2
Application Number 11- 00002400 Date 12/14/11
Special Notes and Comments
metal lid. Cleanout to be set to grade and visible.
Call Public Works (247 -5834) for Erosion and Sediment
Control Inspection before beginning any site work.
Roll off container company must be on City approved list
and container cannot be placed on City right -of -way.
Other Fees STATE MECH DCA SURCHARGE 2.00
STATE MECH DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 99.00 99.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 103.00 103.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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MECHANICAL PERMIT APPLICATION ,/,,
CITY OF ATLANTIC BEACH (( - . 2)P
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845 /
JOB ADDRESS: S L ' s s S IM oN ((Z-l� PERMIT # - ( 1 -( 0D
PROJECT VALUE $ 4,, 0 O
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
---
Air Conditioning: Unit Quantity 2— Tons Per Unit 2 . S
Heat: Unit Quantity - BTU's Per Unit Seer Rating 1'1
Duct Systems: Total CFM /NO REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
AR1# 340gi3
Air Conditioning: Unit Quantity Tons Per Unit REQUIRED
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity (Requires 3 sets of plans)
Commercial Hoods Quantity (Requires 3 sets of plans)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets Boilers BTU's
Elevators /Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
# Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name Phone Number
Mechanical Company - FutAti ,4- ,ctomi' Office Phone `"ilk -C44 ax 60 Y- eli.4 -
Co. Address: KO I4L N itib 4/ vcJ,t5 f City IP ot��a State `Z- Zip ;2oFl
eN� v� �IL� Ci p
License Holder (Print P ' :,.,' o k) -- State Certification/Registration # CAc tr)3G
�•'MMI88! t
Notarized SignatureAf Ll z r' 1
*i 4 ..∎ . ` •ay of / 20 �/
1 "'S'vY� and subscr .ed before m: , is
fit: NEE 121278 Z 'Alf
W. ,
,A asvr ,S Lure of Notar , 'ublic -, r
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