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337 Plaza RESA17-0007 laundry room addition CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 RESIDENTIAL ADDITION - SINGLE OR TWO FAMILY RESIDENTIAL ADDITION MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: RESA17-0007 Description: laundry room addition Estimated value: 20000 Issue Date: Expiration Date: PROPERTY ADDRESS: Address: 337 PLAZA RE Number: 170001 0000 PROPERTY OW NER: Name: MALZAHN PAUL NELS JR Address: 337 PLAZA Atlantic Beach, FL 32233-5441 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: Address: Phone: PERMIT INFORMATION: Please see attached conditions of approval. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU 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. * A notice of Commencement is only required for work exceeding an estimated value of $2,500. For HVAC work, a Notice of Commencement is only required when HVAC work exceeds and estimated value of$7,500. §„ City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) 800 Seminole Road — ' Atlantic Beach, Florida 32233-55 ,LSA 11 f 44 J) Phone(904)247-5826aFax b.us 4)247-5845 11I q E-mail: builtling4ept@c0ab.us Date routed: 14(Ali T - City web-site: http)tw w.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: 33� P�Q"��( De artment review required Yes o Buildin Applicant: SWR-�'( amm�g &Zom 1 p 1111 1\.,,, Tree Admmrsr r Project: VLLL(\AN o)L)n Ll(.l[�t 1w) Wor ' u rc Utilities Public Safety jJ Fire Services L tit .�.� Req C/f�C� - -'+B.G Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: P4,proved. ❑Denied. . ❑Not applicable (Circle one.) Comments: BUILDING PLANN ING Reviewed by: Date: TREE ADMIN. Second Review: ❑Approved as revised. ❑D ied. . ❑Not applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. [-]Denied. . ❑Not applicable Comments: Reviewed by: Date: Revised 05/19/2017 jiffilhL CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD IF ATLANTIC BEACH,FL 32233 (904)247-5800 BUILDING DEPARTMENT REVIEW COMMENTS Date: 5.30.2017 Permit#: RESA17-0007 AppIicant: Paul N.Malzahn Jr. Site Address: 337 Plaza All Site Address: 337 Plaza,All Review: 1 Phone: 248.760.3108 RE#: 170001-0000 Email: nelsandchristina ail.com Homeowner: same CORRECTION COMMENTS: These comments are from 1 of 4 departments that are reviewing this application. f bmit legal survey. The survey submitted has information cut off at the tom. Mike Jones L/71 R Building Inspector/Plan Reviewer City Of Atlantic Beach a 800 Seminole Road S' Atlantic Beach, Fl, 32233-5445 Ofc (904) 247-5844 Fax(904) 2447-55845 L erna"J.-0e PWC oM ty, 0/t- T/v/17 Ma 1 yts:>r r City of Atlantic Beach APPLICATION NUMBER m Building Department (To be assigned by the Building Deparhnenq r 600 Seminole Road s Atlantic Beach,Florida 32233-5445 Phone(904)247-5826 - Fax(904)247-5845 E-mail: building-dept@coab.us Data routed: d� IC 'l�I T City web-site: IMP I/uww.coab.us APPLICATIONREVIEWAND TRACKING FORM Property Address: LaEfT 33 " artment review required Yes No in Applicant: Q arming&Zorn 11 Admmis rProject: \QLl(\ is Utilitiesic SafetyServices f?eview fee $ Dept Signature Other Agency Review or PermEEeceiptDate ified BFlorida Dept.of Environmental ProteFlorida Dept.of TransportationSt.Johns River Water ManagementArmy Corps of EngineersDivision of Hotels and RestaurantsDivision of Alcoholic Beverages and Other: APPLICATION STATUS rPLANNING wing Department First Review: ❑Approved. Denied. . ❑Not applicable Circle one.) Comments: BUILDING l�'L°fCP T Pe&ZONING i /3/Reviewed by: Date: //EE ADMIN. second Review: Approved as revised. ❑Denied. . []Not applicable PUBLIC WORKS Comments:S PUBLIC UTILITIES Vb/r+ 7 }'2cj ��eL ��M oVwt f1"F��da�it PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. . ❑Not applicable Comments: Reviewed by: Date: Revlead 06h W201] ZONING REVIEW COMMENTS C� ' City of Atlantic Beach s) Community Development Department r 800 Seminole Road Atlantic Beach,Florida 32233-5445 Date: 6/13/2017 Permit: RESA17-0007 Applicant: Review: ZONING Address: , Site Address: 337 PLAZA Phone: REM: 1700010000 Email: Correction Comments Tree Removal: Section 23-21 requires a Permit for Tree Removal on all major development on all existing developed sites having any structure or vehicle use areas where additions, renovations, upgrades or site changes are intended or anticipated within a two-year period of time when any such activity is valued at ten thousand dollars ($10,000.00) or more. If no trees will be removed, then please fill out an Affidavit of No Tree Removal. Both forms are available on the city website under "Planning and Zoning" and at City Hall. Informational Comments Zoning Planner , CITY OF ATLANTIC BEACH J� td 800 Seminole Read J Atlantic Beach,Florida 32233 V„) Telephone(904)247-5800 FAX(904)247-5845 Jiil)' REVISION REQUEST SHEET OR CORRECTIONS TO REVIEW COMMENT Date: 13,�ON2017 Received by: Resubmitted: Permit Number: R FS/A 7 7 — 0007 Original Plans Examiner: Project Name: Project Address: 33-7 'PLh'ZA ATLANTIC IaZA&.H 3223-5 Contractor: Contact Name: Contact Phone : 2yS-160-3108 Contacte-mail: neLsand chr's+i na P4M.+�1• COM Revision/Plan Check/Permit Fee(s)Due: $ Description of Proposed Revision to Ex' tin Permit: AS l2Eque5TE.A RI 'D 9-1 RQoEDEt ' ) REE + VE4ei ATioN AIF(DAVT Additional Increase in Building Value: $ Additional S.F. Site Plan Revised: Public W/U Approval: By signing below.I(Print nerve)- A L N • M Al2A14N )R, affnm that the above revision is inclusive proposedC�znges. l3,luN 2017 Signature of Contractor/ em(conaacw must sign ifincrease in valuation) Dam Office Use Only Date: Approved: Rejected: Notified by: Plan Review Comments: Department review re uired Yes No Building ning Tree Administ ni or Plans Examiner Public Works Public Utilities Public Safety Fire Services Date amma,v,s ar.a c uv, City of Atlantic Beach :: APPLICATION NUMBER Building Department (To be assgned by the Building DeparMent.) _ 800 Seminole Road MAY 2 5 2017 Atlantic Beach, Florida 32233-5445 Phone(904)2475826 Fax(904)2 845 ' 46;�:vsJ E-mail: building-depi@coab.us — Date routed: ��I�'l 11 r City web-site. IMP//www.coab.us APPLICATIONREVIEWAND TRACKING FORM Property Address: 33 1 �a�� De rt It review re wired Yes No Buildin Applicant: D W R" anning &Zom I Tr eeA minis r Project: `Qll(\/�./y NDrn L�:iVM u is Utilities Public Safety Fire Services Review fee $ Dept Signature W gency Review or Permit Required Review or Receipt Date of Permit Ver Pied Bept.of Environmental Protectionept.of Transportation River Water Management Districtrps of Engineersof Hotels and Restaurantsof Alcoholic Beverages and Tobacco APPLICATION STATUS Reviewing Department First Review: Approved. ❑Denied. . ❑Not applicable (Circle one.) Comments: ///6�yj/�,��//yy//ma�yy///� ///��, BUILDING Ae, ""'`'-W `(/#f4f4* PLANNING&ZONING r Reviewed by: Date: TREE ADMIN. Second Review: ❑Approved as revised. ❑Denied. . ❑No[applicable PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. ❑Denied. . ❑Not applicable Comments: Reviewed by: Date: Revised 05119/2017 ?cam City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Department.) n 800 Seminole Road 0 `— �"'Ei BE E� ? _- �1 7 s Atlantic Beach,Florida 32233-5445 q Phone(904)247-5826 Fax(904)247-5845 q)1 2 52017 , 1f q E-mail: building-dept@coab.us Date routed: -QS 414 ll r Cityweb-site: hhp://www.coab.us APPLICATION REVIEW AND TRACKING FORM PProperty Address: 33 1 (6191:;Z�i De ent review re uired Yes No Buildin Applicant: D W R 4 anning &Zonl 11 ,�� JJ TreeA minis Project: O-LLRAA N coon C(M-( LVI ,Fublic Utilities Public Safety Fire Services Review fee $ ;(/J Dept Signature Other Agency Review or Permit Required Review or Receipt Date of Permit Verified B Florida Dept.of Environmental Protection Florida Dept.of Transportation St.Johns River Water Management District Anny Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ❑Approved. [ Denied. , of applicable (Circle one.) Comments: BUILDING PLANNING&ZONING iqg , C Reviewed by: vier– Date. 7 TREE ADMIN. Second Review: ❑Approved as revised. [ Denied. . ❑Not applicable IC WOKS Comments: PUBLIC UTILITIES 13 ZS/ PUBLIC SAFE Reviewed by: Date: FIRE SERVICES Third Review: ❑Approved as revised. []Denied. . ❑Not applicable Comments: Reviewed by: Date: Revised 05/1912017 Building Permit Application Updet d5/5/17 City of Atlantic Beach OFFICE COPY 800 Seminole Road,Atlantic Beach, FL 32233 Phone: (904)247-5826 Fax: (904)247-5845 t� I� WE) K-f. 5 )� — Job Address: 33'! PLAZA ATIANTtG Rr�tu1 y FL 22 3 Permit Number: , Legal Description RE# 1-7 000 1 —0 Valuation of work(Replacement Cost)$20 O�Heated/Cooled SF (etl SP Non-Heated/Cooled • Class of Work(Circle one): New ddition Alteration Repair Move Demo Pool Window/Door • Use of existing/proposed structure(s)(Circle one): Commercial esldential • If an existing structure,is a fire sprinkler system installed?(Circle one): Yes No /A • Submit a Tree Removal Permit Application if any trees are to be removed or Affidavit of No Tree Removal Describe In detail the ty a ofyy�Jork to be performed:f'1tAMg M I?dpP It TIG /N F✓•rM E-P l sjfi RxF. 9 o C,YH/INS WALL AN98y1LtJ gPrWA611c WALL To 9,g pL uSR W, M1131OE e�00P.W /K c13✓SINS aMI JorTN W1cI. PoRrwcYFR/DRYER RNV VEIW4Y SINK Pe✓R APM-M�- L��y' �oR� M�04 ✓' Np krm w1TN �Xr =C' fD N u r�11 4 D rAI- R9rgPFKtfs, INfnKL A/C I FNT r 1MAIra A/ct✓�„Yi� 1Ns71Lu rwa N Florida Product Approval# for multiple products use product approval form Property Owner Information Name: PAVJ. N. MAL-ZAARN ,JR Address: 337 PL 7,A City Ai 50fll State FL, _Zip $2.253 Phone 2H8-760-3109, E-Mail Owner or Agent(if Agent,,Power of Atf6imey or Agency Letter Required) Contractor Informal n Name of Company: Qualifying Agent:_-_� Address City_State Office Phone Job Site/Contact Number State Certification/Registration# E-Mall Architect Name&Phone# Engineer's Name&Phone# Workers Compensation Exempt/Insu r/Lease Employees/Expiration pace Application is hereby made to obtain a permit to do the work and installations as indicated.I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulationg construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS, WELLS,POOLS,FURNACES,BOILERS,HEATERS,TANKS,and AIR CONDITIONERS,etc. OWNER'S AFFIDAVIT:1 certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. 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 RECORD YOUR NOTICE OF COMMENCEMENT. (Sigradure&Owner or Agent) nature of Contractor) (Includtracto ed and sworn to or affi ed befo a this_ ay of Signed and sworn to(or affirm before me this_day of Z01 I by by (Signature of Notary) TORI GINUESPERGER (Signature of Not MyoWMISSl0N#FF924.951 '-> EXPIRES'.Ccto)er6,2019 c�to-�e`& acneeeiAx W'ary PuefcUr9xmibrs e' [ I Personally Known OR ll Personally Known OR [ ]Produced IdentificationIJ� [ ]Produced Identification Type of Identification: r/ Gov . Type of Identification: CITY OF ATLANTIC BEACH OFFICE COPY OWNER / BUILDER AFFIDAVIT `I U81 I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 "CONSTRUCTION CONTRACTING"REQUIRES OWNER I BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF YOU MAY BUILD OR IMPROVE A ONE—OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF$25,000.00 OR LESS. THE BUILDING MUSTBE FOR YOUR USE AND OCCUPANCY. ITMAYNOTBEBUILTFORSALEORLEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN IMCENSED PERSON AS YOUR C_nprr QML YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. IL INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO $5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN-OCCUPATIONAL LICENSE'IS NOT ADEQUATE THE OWNER SHOULD PHYSICALLY SEE THE COUNTY "CERTIFICATE OF COMPETENCY" OR THE FLORIDA "CONTRACTORS CERTIFICATE° TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. - 337 PLAU *TLgNrjLFIFACg FLpnV33 248-�bo-31o8 ADDRESS PHONENUMBER R+vI. nr. MAL,74}w J2 P�� 22""zorl B MTU�1 RE nthe wunrym DATE Balmrem = eofyz St.W0Flmda4 he.pmwally app tlherm W M1lmselil NeraePaM affim,sthat allsletememanaaeciamuonsamtmaanaate. �\ Naery Paam aue�pe,sate a��,ceunb et 1�..1�-YAC ❑❑=l, lwre n S O Z Z 'R ai0M Ca1N01EBRE5 8' MY SIRES oICNnr u6.209 -•+•,•••, EXPIPErun Notary Sgnature: j B.tlla�R tl.v= F:IBIA6Nvme-BdIhe ARNvi,;REVISPL:V�Na009 Permy) # OFFICE COPY NOTICE OF COMMENCEMENT State of FL Countyof PL)VAL- Tax Folio No. 17000( —oacc To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF COMMENCEMENT. Legal Description of property being improved: me q1 (, —Z's E Address ofproperty being improved:_ 337 'PLAZA ATLA';'+rle GeAGR. GL 827-33 General description ofimprovements: LAUNVRy Root,,l Anp too n/ Owner: IPAOL N MA1.ZA.11N ,IR Address: 337 ?LAZA ArLANYIc BEAM, a 327s3 IOwner's interest in site of the improvement: Fee Simple Titleholder(if other than owner): N/A Name:WQ Contractor.SME 6 owpie-IL Address: Telephone No.: Fax No: Surety(if any) - Address: Amount of Bond$ Telephone No: Fax No: Name and address of mypemon malting a loan for the construction ofthe improvements Name: Address: Phone No: Fax No: Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be served: Name: Address: Telephone No: Fax No: . . In addition to himself owner designates the following person to receive a copy of the.Limon's Notice as provided in Section 713.06(2)(b),Florida Statues. (Fill in at Owner's option) Nome: Address: Telephone No: Fax No: Expiration date of Notice of Commencement(the expiration date is one(1)year from the date ofrecordmg unless a different data is O specified): THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: Date: 22Mpy2ol7 $efore meihis day of in the County of Duval,State hes 0c 2017119437.0R BK 17991 Page 384, DFFlanda, person yappsared 'emonally Known: a Number PM221 ?roduced Identification: Recorded 0ser!CLERK IRC PM, Ronnie Fussell CLERK CIRCUIT COURT DUVAL 4omry Pnblic: COUNTY dy carrm15510R RECORDING$10.00 Y'yyi�:^jy TONWICLESP51 T' MY CAMMISSICN C FF 929961 EXPIRMOcrober6,2019 MW,sT.Nitay P01sum rxfnia MAP SHOWING BOUNDARY SURVEY OF LOT 18, BLOCK 11, AS SHOWN ON MAP OF PLAT NO. 1 SUBDIVISION "A" ATLANTIC BEACH AS RECORDED IN PWT BOOK 6, PAGE 60, OF THE CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLA, CERTIFIED TO: BRENT NARKEERIC2; BRYAN C. GOODE EL P..L.; OLD REPUBLIC NATIONAL TME INSURANCE COL@ANY; KOYERENT KOMAGE, LLC SCALE: 1'-20' DATE: 12/23/15 I I OFFICE COPY LO1 I T tT LOT 15 I LOT 19 I 5U(P) NB4'55'53"E 49.77'(ACT) ver LOT 18 • I 10.8' nY I umw,p tlaa' T N Z l0 n dvR N RB nrupl �a m,wLus f � H M�� N �• c a R m P I OV wO 4 0!4 O O O P �,Gm P_ • .. �� I 7.1' - 1w y� TREE & VEGETATION AFFIDAVIT City of Atlantic Beach r Department of Community Development Planning&Zoning Division 800 Seminole Road Atlantic Beach,FL 32233 ualy> (P)904247-5800 (F)904247-5845 PERMIT# SECTIONI-APPLICANT INFORMATION svner(s) F- Legal Authorized Agent- NAME OF APPLICANT FAVL N. I`AAL2AbN JV NAMEOFCOMPANY ADDRES50FCOMPAW 331 POI ATLwnc BM" F f 3ZZ3 3 PHONE CELL Zqg-760-3lot EMAIL y�elsandchris{Ina@Qrvell•c T CONTRACTOR CERTIFICATION NUMBER ATLBCH BUSINESS TAX RECEIPT NUMBER SECTION 11-SITE INFORMATION STREET ADDRESS OF PROPERTY 2�7 PL AZa aanaddrm hmaorr'' qas igmdrodJtWvP".O,Olon l "Ba4din9Cargmb�tat fg )2475826 W'eq"e an address LEGAL DESCRIPTION Sv -l0 1 / l/0 - Z S — L4d7- /]e Q / LOT l V BLOCK1,9- 11 SUBDIVISION I d J P 4C> REAL ESTATE NUMBER (700())-0000 LOTOR PARCEL SIZE SO FT AC RESIDENTIAL COMMERCIAL OTHER(SPECIFY) 1 affirm that I have reviewed the provisions of Chapter 13, 'Protection of Trees and Native Vegetation'of the Municipal Code of Ordinances for the City ofAdandc Beach,FL and/or I have participated in a pre-application meeting with the Adminisnaror of those regulations. Subsequently,I affirm that no regulated trees and no regulated vegetation will be damaged,destroyed and/or removed from theabo a ri or djace operties in conjunction with this la SIG:r7 SIGNATURE OF OWNER Signed and sworn before meonthis J3 dayof JVIrlE 7017 ,by state of Countyof � Identification verified: M4 (9 - - 2�45 Oath sworn: r fo TONIC@llNESPEPaEN pp°.?'s EXPIRES 10N YF62019 C/ !l"^1yRE, E%PIPES'.Octebor 6,2019 NaWty Signature SanPo;ery Publk UnEew�+sis °ft• My commission expires: v'21Z