962 OCEAN BLVD DWAY22-0005 revision 2-25-22 .
Revision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 z -tJcos
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
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25
0 Revision to Issued Permit OR um Corrections to Comments Date: Z •Z• Vi.
Project Address: gb 2 QC5PrN P 1 'JD. A-SLA-n(�G � µ / PC,
Contractor/Contact Name: /24 V C-/1 1i pf1'1 '4J INC
Contact Phone: %ri7 - 710 . 0717 Email: L a._-/ •kms Al'. V A Ali,,
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Description of Proposed Revision/Corrections:
/Gr' P4l/y /7---e-714 0080 Etc Ls-r PA S
4 Ccc' crr ii
eytSE S le-iv sioN To NE UV P? AE,— orz-I VE DEN LI KJ
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 0 Yadditional s.f.to be added:
• ill proposed revision/corrections add additio :I incre..e in bu. ding value to original submittal?
INNo Q*Yadditional increase in buildi •'value: )(Contractor must sign if increase in valuation)
*Signature of Contractor/A:- s : _,
V
(Office Use Only)
E Approved E 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
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