945 Plaza PLRS23-0118 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
KUSHNIR MIKHALL 13536 CHAUNY RD JACKSONVILLE FL 32246
COMPANY:ADDRESS:CITY:STATE:ZIP:
PRESTO PLUMBING LLC 3383 W Beaver St JACKSONVILLE FL 32254
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171262 0000 ROYAL PALMS UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
945 PLAZA PLUMBING RESIDENTIAL 7 Fixtures $2400.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 7 $49.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $108.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 6/29/2023
PERMIT NUMBER
PLRS23-0118
ISSUED: 6/29/2023
EXPIRES: 12/26/2023
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 6/29/2023
PERMIT NUMBER
PLRS23-0118
ISSUED: 6/29/2023
EXPIRES: 12/26/2023
PLUMBING RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
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Plumbing Permit Application
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Deot(@coab.us
**ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
PERMIT#: PLRS z3 -o r Is
JOB ADDRESS: 945 Plaza ----------------PROJECT VALUE $._2,;._.4_00_;_·..;_oo:,__ ____ _
�EW OR REPLACEMENT INSTALLATION and/or □RE-PIPE
TYPE OF FIXTURE Bathtub Clothes Washer Dishwasher Drinking Fountain Floor Drain Floor Sink Hose Bibs Kitchen Sink Laundry Tray Lavatory Other Fixtures
LMISCELLANEOUS
Osewer Replacement □Back Flow Preventer
QTY
1
2
TYPE OF FIXTURE Septic Tank & Pit Shower Shower Pan Slop Sink Three Compartment Sink Toilet Urinal Vacuum Breakers
QTY
Water Connected Appliances __ _ Water Heater Water Treating System
D Lawn Sprinkler System (number of sprinkler heads) __ _�rease Interceptor (Trap) ___ gallons (Requires 3 sets of plans)D Well ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**Oother
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.
Owner Name: Kushnir Mikhail Phone Number: (904) 597-5668
Plumbi ng Company: Presto Plumbing LLC
Co. Address: 3383 W Beaver St
Office Phone: (904) 647-1820 Fax. _______ _
City: Jacksonville State:� Zip: _32�2_5�4-. __
License Holder: Paul Eric Forster L"7 State Certification/Registration# CFC1429261 77 L---
Notarized Signature of License Holderr-::.-..,,,c--�--------------------------
The foregoing instrument was ackno County of�-.ro .• .\
""" Notary Public State of Florida
a. Cammi Joann Sampelcmt.:bzw My Co�mlsalon HH 377946
Expires 3/2312027
ged before me thisd7 day of :f 'l\e.20J3 in the State of Florida,I _I
Signature of Notary Public
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'fJ Personally Known OR [ ] Produced ldentifica� ...___ {y� of Identification: ____________________ _
Updated 10/17/18