362 SARGO RD RESO24-0006 revision 2-26-24 1/j Revision Request/Correction to Comments **ALL INFORMATION
HIGHLIGHTED IN
rJ ii City of Atlantic Beach Building Department GRAY IS REQUIRED.
"� 800 Seminole Rd, Atlantic Beach, FL 32233
f3'� Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: (?ES c '4 ' 000(%
❑ Revision to Issued Permit OR ❑ Corrections to Comments Date: `2 1,c2(:, ),;?4Project Address: 36 a .54,0(70 K^
Contractor/Contact Name: 4,94/e e 2f4PAI fly
Contact Phone: 9C2/ 70 7—.5-6'9 Email: N/,4
Description of Proposed Revision/Corrections:
R6iloi1/491 old &f e c/e, J`/d wC 1 1e1e�4CG ;/PT ,A -e.e
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: /6 6 .S, )
• Will proposed revision/corrections add additional increase in building value to original submittal?
VirNo ❑*Yes(additional increase in building value: $ )(Contractor must sign if increase in valuation)
*Signature of Contractor/Agent: "5 G
(Office Use Only)
L Approved ❑ Denied H 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 Updated10/17/18
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TRI-STATE LAND SURVEYORS, INC.
84:1 BAYMEADOWS WAY SUITE #Z JACKSONLE, FLORIDA 32256 (904) 731-7235
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I HEREBY CERTIFY THAT THE ABOVE LANDS WERE SURVEYED UNDER AMY
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