178 BEACH AVE - REVISION FENCE S \.l\l:r ' CITY OF ATLANT BEACH
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800 Seminole IC Road
na ._ Atlantic Beach,Florida 32233
. :c.r Telephone(904)247-5800
to
FAX(904)247-5845
�J,31 r REVISION REQUEST SHEET
Date: i - Z 2 - /,j Received by: Resubmitted:
Permit Number: /5" F,O C.E 2.42 7(
Original Plans Examiner: l�. Rtttt Rek'roject Name: /7$ e Fric-tf
Project Address: /7g Rewc.0
Contractor: CAtt RECL C 1.)50..vCT1$S Contact Name: At y4-�� Q rieS‘4_,
Contact Phone : Contact e-mail:
Revision/Plan Check/Permit Fee(s)Due: $
Description of Proposed Revision to Existing Permit:
/51AD ,9 el:■A /T/Cec)q-/- 9 - e' 5 ,JCS .
Additional Increase in Building Value: $ &O0 Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below.I(print name) m t" C&OZkEr-L affirm that the above revision
is inclusive of the a roposed ch: ges.
Signature of r ontractor/A:-nt(Contractor must sign if increase in valuation) Date
Office Use Only
Date: Approved: Rejected: _ Notified by:
Plan Review Comments:
Department review required Yes No
Building
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Planning &Zoning
Tree Administrator Plans Examiner
Public Works _
Public Utilities
Public Safety
Fire Services Date created 8/20/15 Rev.2
NEW Fence and Gate
BEACH AVENUE
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