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1073 ATLANTIC BLVD CIV24-0002 - Revision Request-3-11-24 Revision Request/Correction to Comments **ALL INFORMATION HIGHLIGHTED IN GRAY IS REQUIRED. City of Atlantic Beach Building Department 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT #: _____________________ Revision to Issued Permit OR Corrections to Comments Date: ________________ Project Address: ____________________________________________________________________________________ Contractor/Contact Name: ____________________________________________________________________________ Contact Phone: ______________________________ Email: _________________________________________________ Description of Proposed Revision / Corrections: __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ _______________________________ affirm the revision/correction to comments is inclusive of the proposed changes. (Printed name) • Will proposed revision/corrections add additional square footage to original submittal? No Yes (additional s.f. to be added: _____________________________) • Will proposed revision/corrections add additional increase in building value to original submittal? No *Yes (additional increase in building value: $____________________) (Contractor must sign if increase in valuation) *Signature of Contractor/Agent: _______________________________________________________ __________________________________________________________________________________________________ (Office Use Only) Approved Denied Not Applicable to Department Permit Fee Due $_______________ Revision/Plan Review Comments_______________________________________________________________________ __________________________________________________________________________________________________ Department Review Required: Building _____________________________________________ Planning & Zoning Reviewed By Tree Administrator Public Works Public Utilities _____________________________________________ Public Safety Date Fire Services Updated 10/17/18