310 - 312 4TH ST - REV 1 .,,,. ,;::,,,4‘. ..:1_,0 CE C 0 T 1 i i ITY OF ATLANTIC BEACH
J f' "" $7 J 800 SEMINOLE ROAD
JUL 1 4
') ' ; ,. J ATLANTIC BEACH,FL 32233
,�J13J� lid (904)247-5800
By _
'evision Request Sheet
Date: 7 �� �S Received by: Resubmitted:
Permit mber: Clearance Sheet Number: r '
Original Plans Examiner: %1(' 3 ØC) • Project Name: 1�.rG 1Q+J
Project Address: 3(e. 7 J Z 4" Z
Contractor: 'C33(a 1:34 LcD MJc (GO NA'ntact Name: - RI) )Q„641a CO .
Contact Phone Number: 64.—23 3_aqo y Contact Fax Number: lay Z y( - C3 2
Revision/Plan Check/Permit Fee(s)Due:$
Description of Proposed Revision to Existing Permit:
Pending Hold: _
Structural: /Y &1 C r tiet. siocr r
Plumbing:
Mechanical:
Electrical:
Misc.:
Additional Increase in Building Value:$ Additional Square Footage:
Clearance Sheet/Site Plan Revised: Environmental Health Approval:
By signing below,I(printname) X00 Ay. do,e a) affirm that the above revision is inclusive of the
proposed changes.
Sig e of Contractor/Agent(Contractor must sign if increase in valuation) Date /
Office Use Only
Date: 7./ S' / c Approved: X Rejected: Notified by:
Plan Review Comments:
1k*'s- C c r rl Ic Pe rm; l- • 1 -fl/4On - / S-/ ei
Plans E ' er Date
Created osrosiosiio I
I
1