1021 ATLANTIC BLVD 1011 COMM24-0029 REVISION 7-23-24l s
1f TIp Revision Request/Correction to Comments ALL INFORMATION
HIGHLIGHTED IN
111 City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
7 "';"r
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: COMM24-0029
Revision to Issued Permit OR Corrections to Comments Date: 7/23/2024
Project Address: 1021 Atlantic Blvd. Unit 1011 , Atlantic Beach, FL 32233
Contractor/Contact Name: Samantha & John Miller
Contact Phone: 973-479-8534 Email: mrssammiller@gmail.com
Description of Proposed Revision/Corrections:
No food is being prepared or offered.
Disregard any demo or other work formerly submitted from Brewz (we only completed costmetic Improvements:flooring and paint).
Samantha Miller 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 C. Yes(additional s.f. to be added:
Will proposed revision/corrections add additional increase in building value to original submittal?
Of No I*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
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PROJECT NO.:15003
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