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:
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_______________________________ 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: _______________________________________________________
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(Office Use Only)
Approved Denied Not Applicable to Department Permit Fee Due $_______________
Revision/Plan Review Comments_______________________________________________________________________
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Department Review Required:
Building _____________________________________________
Planning & Zoning Reviewed By
Tree Administrator
Public Works
Public Utilities _____________________________________________
Public Safety Date
Fire Services Updated 10/17/18