685 AMBERJACK LN DWAY22-0061 REVISION 3-22-23 : Revision Request/Correction to Comments **ALL INFORMATION
(<:.0S * HIGHLIGHTED IN
°410' City of Atlantic Beach Building Department GRAY IS REQUIRED.
\'- 800 Seminole Rd, Atlantic Beach, FL 32233
�a;° v Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
❑ Revision to Issued Permit OR ❑ Corrections to Comments Date:
Project Address: Co B S km b e r ( c x < ❑.i'\
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Contractor/Contact Name: 5 Z d " l 8 7 7 v (l, I)( ( 1.----( c, ( (
Contact Phone: Email: )\7 0 V7
Description of Proposed Revision/Corrections:
N) &(/U LRL OOT
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?
❑No ❑*yes (additional increase in building value: $ )(Contractor must sign if increase in valuation)
*Signature of Contractor/Agent:
(Office Use Only)
❑ Approved Cl 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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