1291 BEACH AVE RESO21-0048 REVISION 4-26-23_1Revision Request/Correction to Comments
tlCity of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: ig-Dept@coab.us
Revision to Issued Permit OR /Correctio s to Comments
Project Address: t y A\/E-
Contra cto r/Contac
Name:
Contact Phone:
Description of Proposed Revision / Corrections:
**ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.
PERMIT#: is O`+ S
Date: q/184-5
s in `tom Af ciffTt
f T0211574DEL affirm the revision/correction to comments is inclusive of the proposed changes.
(printed name)
VW' proposed revision/corrections add additional square footage to original submittal?
No Yes (additional s.f. to be added: )
proposed revision/corrections add additional increase ' building value to original submittal?
No *Yes (additional increase in building value: ) (contractor must sign if increase in valuation)
*Signature of Contractor/Agent: T
(Office Use Only)
Approved ❑ Denied ❑ Not Applicable to Department Permit Fee Due $
Revision/Plan Review Comme
Department Review Required:
Building
Planning & Zoning
Tree Administrator
Public Works
Public Utilities
Public Safety
Fire Services
Reviewed By
Date
Updated 10/17/18