541 BEACH AVE RES22-0134 REVISION 11-9-22 Revision Request/Correction to Comments **ALL INFORMATION
rf"-Lir, HIGHLIGHTED IN
i'o City of Atlantic Beach Building Department GRAY IS REQUIRED.
gl 800 Seminole Rd, Atlantic Beach, FL 32233 �7 1
v;3 w''' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: RSZZ- oL 4
14 Revision to Issued Permit OR ❑ Corrections to Comments Date: ///9p04-
-
Project Address: 5 if-1 8P - illi .
Contractor/Contact Name: S r,git,fl✓ �o�es v1/4,..j li I VC.kb A�,n� Rex INI ( ettiv.f
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Contact Phone: 904-J7E 67 9- y 8Email: rex ® S i • L11oYheS"c(. c D
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Description of Proposed Revision/Corrections:
Ca-St l'A p(ice. oet,An 1 Zes
I Nek (),)i' Ui ca%vS affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
• W. I proposed revision/corrections add additional square footage to original submittal?rLI
No ❑ Yes (additional s.f.to be added: )
• W. I proposed revision/corrections add additional increase in buil' g value to original submittal?
❑
No *Yes (additional increase in building valu • $ // ) (Contractor must sign if increase in valuation)
ii
*Signature of Contractor/Agent: gi / f
(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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PROTECT 541 BEACH AVENUE
Lou Pontigo and
Associates, Inc , CLIENT SIGNATURE HOMES
4745 Sutton Park Ct..Suite 204
• Jacksonville.Florida 32224 jOe NOSIGN-21-00617 SHT.NO.
Ph.(904)242-0908 K-2-2
FL:CA#8344 SC:CA#3579 DATE 11.0$.22 J
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