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130 CLUB DR - REVISION REQUEST
-.mow \ (� )F ATLANTIC BEACH 800 Seminole Road � : j Atlantic Beach,Florida 32233 }:!., OCT 3 0 2015 Telephone(904)247-5800 FAX(904)247-5845 \Jj;l-/ r.1 r" Pk t•••■REV ' • 1k. 1! + I SHEE r` i I ....ii `�./ ../ u jj Date: /D- 30- 1 5— Received by: Resubmitted: Permit Number: (i--.SJ=/' -. .23 2) /24# - -- Original Plans Examiner: 4Ai Jae- Sbri Project Name: e.,5c8cK c- Project Address: • /3v C/v 6 Or. x.i.)' Contractor: 'Tick rn ab .( - �' 1 �i Contact Name: 6 Q0.- Contact Phone : 909 6-4/V` Contact e-mail: aKtot46.4-cuc,4rt,A6 4.10) 1 /iontGov„L Revision/Plan Check/Permit Fee (s) Due: $ Description of Proposed Revision to Existing Permit: /0114 am' r 6 Lam, ytVem-t4"4-.N / 75c F� ✓ ree'( P Sic J el t.�.kr_ 4 off- Elev�. 4' . ,..5 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 c •e proposed changes. S.• •-ire of Contractor/Agent(Contracto. gsigif increase in valuation) Date Office Use Only Date: /0• (30'/ Cr. Approved: x Rejected: by: Plan Review Comments: eeW Sib^ later b rt pieitcer 'AA, Trio c•t/ a -Ate sSS 1 Pr C R+cdrrive ox Tab S)/4 p4v., a F/.t. 'Tv°grap#4rco/ rife vey. Toms !' Lan .IArS 4dc# pt ear se lo p•r on` . Department review required Yes No uildina / tanning &Zoning /777"...44, Tree Administrator Plans Examiner Public Works Public Utilities 10•, .!S"— Public Safety Fire Services Date Created 8/20/15 Rev 2