469 ATLANTIC BLVD ELPP24-0057 REV 1-7-25 Revision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
f�� 800 Seminole Rd, Atlantic Beach, FL 32233 l
D Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: LLQ . Z4-oo57
r **ALL REVISION SUBMITTALS MUST BE EMAILED AS A PDF ATTACHMENT ONLY**
Revision to Issued Permit OR Corrections to Comments Date:- 1177732--5-
Project
17773ZSProject Address: ii:'661 [ 1:)' tail
Contractor/Contact Name: a`t
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Contact Phone: cloy_ 70 7- Z� Email: '{G�� ( o V /e� T �; ,
Description of Proposed Revision/Corrections:
( (AS k1( ?u(t ► I 11 4u.ciAlS -��--
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?
P'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