1726 BEACH AVE RESO22-0069 REVISION 11-18-22 ALL
Revision Request/Correction to Comments **HIGHLI HIGHLIGHTED
ON
4%'t �f`��� HIGHLIGHTED IN
'� "' City of Atlantic Beach Building Department GRAY IS REQUIRED.
LI ' 800 Seminole Rd, Atlantic Beach, FL 32233 �p/J, Coo;3!)- ( K� Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: J a)- O0I
❑ Revision to Issued Permit OR ❑ Corrections to Comments Date: 1/1/7/7/92
Project Address: 112(0 ( 6i4 G I4U 6 N c 6
Contractor/Contact Name: (ru'`I k C41(.64-) S 0 th U 1 ,0/L( 9 4- u'C-'
Contact Phone: q°4 - $"1 — 96 f Email: (,I0t9i 0 c(,) G Gfl—AX, ct
Description of Proposed Revision/Corrections:
/6)k.f U 6E /P i r410EO G� /eY1 .if'6&
I 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?
CI No CI*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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