392 4th St RES22-0203 revision 7-28-22 rt,--Ch ri.;
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 �7
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V Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: R es 2.2_- 0C. . .
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❑ Revision to Issued Permit OR Corrections to Comments Date: Z 7 J .1L i -2.\
Project Address: 2 95- . .t-c- (39 a 'VI`
Contractor/Contact Name: g.,Cc-tJ' d Q 6 v 12-vS_R j /�) c , /c _
Contact Phone( 1 Or-0 _93 . 13 I Email: Ccs+ f mss°&) /A73 cz.GT Fl 641----C--c»61,
Description of Proposed Revision/Corrections:
i C t.' . .,(l/-vso,J affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• _Wil�l proposed revision/corrections add additional square footage to original submittal?
L No ❑ Yes(additional s.f.to be added: )
• Will proposed revision/corrections add additional increase in building value to original submittal?
❑No Q*Yes (additional increase in building value: $ 1/0 OD ,d a ) (Contractor must sign if increase in valuation)
*Signature of Contractor/Agent: eli be,)
(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