605 PLAZA RFNC22-0096 revision 10-12-22 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
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: RI)C. 2-oO9 7
❑ Revision to Issued Permit OR Corrections to Comments Date: 10 r (a.. /Lc z Z
Project Address: (00'6" f (‘-1` 13r ( 1VA- rC FL 3 ZL 3
Contractor/Contact Name:
Contact Phone: 9O1 - CPI-2R 7 Email: -FicAc -S IeS �evs0.e3La
Description of Proposed Revision/Corrections:
m cP u_)/ to rizt �� d Csa1 LcAsciDrau� /
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 ❑ Yes (additional s.f.to be added:
• Will proposed revision/corrections add additional increase in building value to original submittal?
❑No ❑*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
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j MAP SHOWING BOUNDARY SURVEY OF
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AS RECOROLG IN KAT ROOK 3C.PAGE GD ACCORDING TO THE MAP RECORDED-UV THE CURREN'PUULIC RTCO�i S or DtrVAL COUP?.(LCRlR6.
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