1696 ATLANTIC BEACH DR - REV. AC PAD J, r-S 41�frir,\ CITY OF ATLANTIC BEACH
800 Seminole Road
\9 Atlantic Beach,Florida 32233
`-
15 /-- ) Telephone(904)247-5800
FAX(904)247-5845
f REVISION REQUEST SHEET
Date: //111 / Received by: Resubmitted:
Permit Number: )5--,5��- 1901
Original Plans Examiner: T1i� �)c- c S Project Name: 'kvtli ✓�4L� 06„∎� ,� elk )
Project Address: 1 o 9(` /1+4...}r` y �cL, 4.t,e_
Contractor:j x,j j 6,, (.,*,s — Sk ii k,,1 Contact Name: Ja,,,,,{ s C a toc„d- -
Contact Phone : 'J o-/•- y —Yol.-3 Contact e-mail: )e_c,,-.4 c_ti- -to f(b ,e,-; ;,1L.,cep
Revision/Plan Check/Permit Fee(s)Due: $
Description of Proposed R vision to Existingermit:
i - I o .c.�-L A-c. A: a a-u r..5Lt 1.'S;49 c o 4-110,„se_____
Additional Increase in Building Value: $ .. Additional S.F. `
Site Plan Revised: — ---- Public W/U Approval:
By signing below. I(print name) u c g C o,�it L affirm that the above revision
is inclusive of the proposed changes.
_ Aillf 4 /it// S
Signa . " of Contractor/ gent(Contractor nmst sign if increase in valuation) Date
Office Use Only
Date: 9,/6- /s •
Approved: X Rejected: Notified by:
Plan Review Comments:
e'€QSe Ca 11 toll iliac kg. It, ___p,c Jc - p • v l e c f /,
De•artment review required Yes No
dingy
fild-
g &Zonin•
ee Aagiagrator Plans Examiner
Public Works
Public Utilities ?• /6 '/.5.
Public Safety _
Fire Services Date Created a/20115 Rev.2
•
j ` �1-f�' CITY OF ATLANTIC BEACH
(-----' Sig
800 Seminole Road
s f Atlantic Beach,Florida 32233
ti
r Telephone(904)247-5800
FAX(904)247-5845
\0,i1
REVISION REQUEST SHEET
Date: 9//1) / 5 Received by: Resubmitted:
Permit Number: )5 Sf%■ - )90 I ( , ��(� /�
Original Plans Examiner: T1 � 3o•ie S Project Name: A'HanTt b6r4L� (6„kN4 z1 CI14.6
Project Address: 1i-q(i A+14r,Ai c_ .,(1.L 4A LL
Contractor:I o)110 „r/S — S4wL Mc, Contact Name: Ja wtc S C o wt c-t"
Contact Phone : /o4-1—ci 8'?—4/04-3 Contact e-mail: i t_o.rt c,tl- t_-h 11 bA tie/s 'r 4 c_■cowl
Revision/Plan Check/Permit Fee(s)Due: $
Description of Proposed R vision to ExistingPermit:
Re l oc-e AC A Rs vision✓�:5L.a- c .4-1,0,,,c___
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below. I(print name) a c s C oral L14- affirm that the above revision
is inclusive of the proposed changes.
/<<1
Sigma of Contractor/ gent(Contractor must sign if increase in valuation) Date
Office Use Only
Date: Approved: Rejected: Notified by:
Plan Review Comments:
artment review required Yes No ,
uildi -- . 6,444./ C
annin ZoninI
ree Administrator Plans Examiner
Public Works
Public Utilities //��S
Public Safety f
Fire Services Date Created 8/20/15 Rev 2