2400 SEMINOLE RD RESO22-0040 revision 10-12-22 A rf�ylllr r+r
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
`9; 'r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: RES02 - 00LI0
❑ Revision to Issued Permit OR L"J Corrections to Comments Date: to /2 Z--
Project
Project Address: +2$ 2`10O Sc•-;.w I t f1-44
Contractor/Contact Name: Sym Lwh ck3c.r sj l lK. ( belk- J Fl•r k. Etre... L4"0ltc•.r,,.1 J
Contact Phone: quLi 11 0 S z2_ Email: Mk sy .
Description of Proposed Revision/Corrections:
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1.-44414.i.4,, Sct affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• Wioposed revision/corrections add additional square footage to original submittal?
EI No ❑ Yes (additional s.f.to be added:
• Wjll 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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