1325 Beach Ave PLRS21-0010 Revision, Add Sewer -S��%Lyr.
Revision Request/Correction to Comments **ALL INFORMATION
,'s~ i`' HIGHLIGHTED IN
''' City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 �i 1
'"''' G
r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT ( -0O)D
❑ Revision to Issued Permit OR ❑ Corrections to Comments Date's 1 2
Project Address: , d . �6- '
ic* -
Contractor/Contact Name: k- )1\1)21110W //I/14'4\1441 IC
Contact Phone: (°11 Zip"— 63 Email: A'l"k)N I ‘Vkii) \\cc, v,iV0i'
Description of Proposed Revision/Corrections: 1 o '�Y"6K..
1
I affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• proposed revision/corrections add additional square footage to original submittal?
W.
❑ Yes (additional s.f.to be added: )
• I proposed revision/corrections add additional increase in building value to original submittal?
iNo ❑*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