886 OCEAN BLVD IRR21-0023 revision 11-16-21 �,j�11/' Revision Request/Correction to Comments **ALL INFORMATION
,.j HIGHLIGHTED IN
4 City of Atlantic Beach Building Department GRAY IS REQUIRED.
Vir Seminole Rd, Atlantic Beach, FL 32233
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"), Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT I ZI -00✓ 3
❑ Revision to Issued Permit OR VI/Corrections to Comments Date: //,/5/ZI
Project Address: gpi EC VP
Contractor/Contact Name: 1LZ.7/Jf / /FYls
Contact Phone: 9C)/- 92,3 — 1S-if p if Email: X LJ 'szw 411 i&7
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?
2/No ❑ Yes (additional s.f.to be added:
• W,ill proposed revision/corrections add additional increase in building value to original submittal?
E iio ❑*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