992 Ocean Blvd RESA17-0025 LVL Kitchen RECEIVED ,:
R
MAY 2 1 CITY OF ATLANTIC BEACH
800 Seminole Road
Atlantic Beach,Florida 32233
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IL
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REVISION REQUEST/CORRECTIONS TO PLAN REVIEW COMMENTS
Date-2 I `" 1 Revision to Issued Permit Corrections to Comments_ Permit# P,,c—S A i -b�aS
Project Address/"2 QC,6AW iS I UD . 6- �4rv7-1 L �LlkA , F1 , ?�-2-
Contractor/Contact Name
Phone q64 '619 �L1 19 Email V lei���i P�10Vol�(r�Q�S Ica' mrr' lyc� -
Description of Proposed Revision/Corrections: Permit Fee Du
L 1!< l7`G�OW
Additional Increase in Building Value $ ` 11 Additional S.F.
By signing below,I C ��i V I- , PJ affirm the Revision is inclusive of the proposed changes.
(printed name)
,) v
Signature o ontractor/Agent toAnust sign if increase in valuation) Date
(Office Use Only)
Approved Denied Not Applicable to Department
Revision/Plan Review Comments(� v o 10 Co pyr
Department Review Required:
Planning & Zoning Rev ed By
Tree Administrator
Public Works
Public Utilities
Public Safety Date
Fire Services