582 COASTAL OAKS DR - REV SHEET ���' CITY OF ATLANTIC BEACH
Sri 800 Seminole Road
' —. J O Atlantic Beach,Florida 32233
J r OFFICE G
COPY Telephone(904)247-5800
FAX(904)247-5845
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REVISION REQUEST SHEET
Date: / O 7 /,c Received by: 40F6 7ryve", Resubmitted:
Permit N er: /5_ S,1 — ?6,/
Original Plans Examiner: /ry JQ44,1 Project Name: VEZC
Project Address: 5712 bitY r G4,CC a
Contractor: L (rS C o Contact Name: 7 OO co
Contact Phone : 7Q 7r-23 j p�g _/ 1 C oaf
Revision/Plan Check/Permit Fee(s)Due: Contact e-mail: L�o/d od CcG6c • «w
Description of Proposed Revision to Existing Permit:
6—
Additional Increase in Building Value: $ Additional S.F.
Site Plan Revised: Public W/U Approval:
By signing below.I(print name) affirm that the above revision
is inclusive of the pro•• -: t. ! -s.
/I
/0Ar
Si re of Contractor/Agent(Contractor must sign if increase in valuation) Date
Office Use Only
Date: /0—S-7 5- Approved: x Rejected: Notified by:
Plan Review Comments:
Scan .1,)e ccs& 40 f.pYmvJ #` Cv /I Ca/! 1avcJc, .
p ink.--f :pc) b cap/.
Department review required Yes No
Building ,�yt /�
Planning &Zoning „ ('X
Tree Administrator Plans Examiner
Public Works
•
Public Utilities `0_ Q _,/ 5
Public Safety O
Fire Services Date
Created 8/20/15 Rev.2