5 10th St RESO22-0058 revision 12-7-22 1r%Llj-.
Revision Request/Correction to Comments **ALL INFORMATION
sHIGHLIGHTED IN
*iit City of Atlantic Beach Building Department GRAY IS REQUIRED.
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800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: RES J 22 —0058
❑ Revision to Issued Permit OR LJ Corrections to Comments Date: /2.07 202 2.
Project Address: 5 /0 111
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Contractor/Contact Name: cCOhct/d CTrQ._(p tic.
Contact Phone:( o )zoo- / --/s. Email: dream $K9 c€U11437yi'(H,a,/. cow
Description of Proposed Revision/Corrections:
Oddrt 011 of SQirQ/ Sig irS Iv /iie /A s'b'e 07e /Ate,
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?
MrNo ❑ 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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