1661 Atlantic Beach Dr. POOL24-0043 Revision Form 12_11_24Revision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT
"ALL REVISION SUBMITTALS MUST BE EMAILED AS A PDF ATTACHMENT ONLY"
Revision to Issued Permit OR 'a-' Corrections to Comments Date:-
Project Address: /&V/Z r7C 41i1 --x ���L ht"alll c �� Y2 -
Contra ctor/Conta ct
2
Contractor/Contact Name: 011147wW�� 41wllz 5
Contact Phone: 7a -7 - Email:
Description of Proposed Revision / Corrections:
urn Ao,6- i- AIZaffirm the revision/correction to comments is inclusive of the proposed changes.
(Printed name)
Will proposed revision/corrections add additional square footage to original submittal?
Flo ❑ Yes (additional s.f. to be added: )
Will proposed revision/corrections add additional increase in building value to original submittal?
li�o []*Yes (additional increase in building value: $ ) (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
(Office Use Only)
❑ Approved ❑ Denied 1 Not Applicable to Department Permit Fee Due $
Revision/Plan Review Commen
Department Review Required:
Building
Planning & Zoning
Tree Administrator
Public Works
Public Utilities
Public Safety
Fire Services
Reviewed By
Date