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303 10th St - Revision Request ' 4 .' CITY OF ATLANTIC BEACH � FILE COPY 800 Seminole Road ...0 Atlantic Beach, Florida 32233 ±J; . Telephone (904) 247 -5800 4 �`` FAX (904) 247 -5845 71 - Dili FP REVISION REQUEST SHEET Date: 2 i / 247 6 Received by: Resubmitted: Permit �Nfumber: /6'.. 4F 2 — 24 rL, Original Plans Examiner: Project Name: BO F Project Address: 3 g /or-n' Sly -,c `� ? Q s A•��c.;s Contractor: 4 A vO,Q ,Lorrrc.s, L.4 . Contact Name: Contact Phone : 7e, • 6V = 9-f a 3 Contact e - mail: 8 � y �� ~� Revision / Plan Check / Permit Fee (s) Due: $ I � ry ��� / ��'��yharl�s •cows Description of Proposed Revision to Existing Permit: 24 u i.r 4.4o 67,v Cif r- 44,AiG - lei. .roc fn 7yv,er o fr ! t/ dt Gv„s"if 7 r/ _s_ " t t— - e Additional Increase in Building Value: $ (> Additional S.F. () Site Plan Revised: 4/ D Public W / U Approval: By signing below. I (print name) 90 Ay 4 /a I, ,6- j, affirm that the above revision is inclusive of the proposed changes. AWL _ _..e.-.■".. ... 2/1/4 /2CJ/6 Si, . ure of ontractor / Age • ' (Contractor must sign if increase in valuation) Date Office Use Only Date: a2// 9, /c Approved: x Rejected: Notifi 7) E ©E V E Plan Review Comments: l ? ^16 Revl S ec� as s(., b mu cI a 11 { read �, ,b Ca // Bryan L99nOJ - y - /o pi-ck -c-p J p b Co� Department review required Yes o Building �^ ' Planning & Zoning , Tree Administrator Plans Examiner Public Works Public Utilities 2J/ 9 Public Safety / Fire Services Date Created 8/20/15 Rev. 2