1089 Atlantic Blvd revision for PW A ClpP/ES
fa Q CITY OF ATLANTIC BEACH
I� 860 Seminole Road
antiL lTele Beach,Florida 32233
-5800
�//t4 JAC /_ �O Telephone(904)247-5866
{/1, /�/ FAX(904)247-5645
REVISION REQUEST SHEET OR
CORRECTIONS TO REVIEW COMMENT
Date: ! / Received by: Resubmitted:
Permit f ber: / — Al a`W —
Original Plans Examiner: ( 0,, Project Name: /10fc Neb
Project Address: - ii
Contractor: icor Contact Name: %O)p
Contact Phone: 4 y '3 1 — /7d Contact e-mail: Ad r3✓1&P F its Cf Com
Revision/Plan Cl,,—k/Permit Fee(s)Due: $
Desmi tion of Pronosed Revision to Existing Permit:
.4F V/sepq A17 0. O / MAO / M/, Dot M / , a
vi /e -
Addition crease m m mg aloe: $ 0 Additional S.F. e9
Site Plan Revised: Public W/U Approval:
By signing below.I(prim name) /OD /�F-s C F� affirm that the above revision
is inclusive of a propo hanger.
Signature of Contractor/ ent(Cmm w mon sip,irinawu in nimnion) Dat
ntlaJ Appmvcd: Re sled: NMiri by:
Plan Review Comments:
Department review re wired Yes No
Building
Planning g Zoning Plans Fvcaminer
Tree Administrator
Public Works
Public Utilities
Public Safety Date o.muiana aa.o
Fire Services
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